Search results for: Natural Frequency Analysis of a Porous Functionally Graded Shaft System

Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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Authors: Jorge Martínez-Rodríguez, Esther Pérez-Carrillo, Diana Laura Anchondo Álvarez, Julia Lucía Leal Villarreal, Mariana Juárez Dominguez, Luisa Fernanda Torres Hernández, Daniela Salinas Morales, Erick Heredia-Olea

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Maize tortillas are a staple food in Mexico which are mostly made by nixtamalization, which includes the cooking and steeping of maize kernels in alkaline conditions. The cooking step in nixtamalization demands a lot of energy and also generates nejayote, a water pollutant, at the end of the process. The aim of this study was to reduce the cooking time by adding a maize soaking step before nixtamalization while maintaining the quality properties of masa and tortillas. Maize kernels were soaked for 36 h to increase moisture up to 36%. Then, the effect of different cooking times (0, 5, 10, 15, 20, 20, 25, 30, 35, 45-control and 50 minutes) was evaluated on viscosity profile (RVA) of masa to select the treatments with a profile similar or equal to control. All treatments were left steeping overnight and had the same milling conditions. Treatments selected were 20- and 25-min cooking times which had similar values for pasting temperature (79.23°C and 80.23°C), Maximum Viscosity (105.88 Cp and 96.25 Cp) and Final Viscosity (188.5 Cp and 174 Cp) to those of 45 min-control (77.65 °C, 110.08 Cp, and 186.70 Cp, respectively). Afterward, tortillas were produced with the chosen treatments (20 and 25 min) and for control, then were analyzed for texture, damage starch, colorimetry, thickness, and average diameter. Colorimetric analysis of tortillas only showed significant differences for yellow/blue coordinates (b* parameter) at 20 min (0.885), unlike the 25-minute treatment (1.122). Luminosity (L*) and red/green coordinates (a*) showed no significant differences from treatments with respect control (69.912 and 1.072, respectively); however, 25 minutes was closer in both parameters (73.390 and 1.122) than 20 minutes (74.08 and 0.884). For the color difference, (E), the 25 min value (3.84) was the most similar to the control. However, for tortilla thickness and diameter, the 20-minute with 1.57 mm and 13.12 cm respectively was closer to those of the control (1.69 mm and 13.86 cm) although smaller to it. On the other hand, the 25 min treatment tortilla was smaller than both 20 min and control with 1.51 mm thickness and 13.590 cm diameter. According to texture analyses, there was no difference in terms of stretchability (8.803-10.308 gf) and distance for the break (95.70-126.46 mm) among all treatments. However, for the breaking point, all treatments (317.1 gf and 276.5 gf for 25 and 20- min treatment, respectively) were significantly different from the control tortilla (392.2 gf). Results suggest that by adding a soaking step and reducing cooking time by 25 minutes, masa and tortillas obtained had similar functional and textural properties to the traditional nixtamalization process.

Keywords: tortilla, nixtamalization, corn, lime cooking, RVA, colorimetry, texture, masa rheology

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Authors: Reiko Yamamoto

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This paper reports on a joint research project in which a researcher in applied linguistics and elementary school teachers in Japan explored new ways to realize emotional synchrony in a classroom in childhood education. The primary purpose of this project was to develop a cross-curriculum of the first language (L1) and second language (L2) based on the concept of plurilingualism. This concept is common in Europe, and can-do statements are used in forming the standard of linguistic proficiency in any language; these are attributed to the action-oriented approach in the Common European Framework of Reference for Languages (CEFR). CEFR has a basic tenet of language education: improving communicative competence. Can-do statements are classified into five categories based on the tenet: reading, writing, listening, speaking/ interaction, and speaking/ speech. The first approach of this research was to specify the linguistic proficiency of the children, who are still developing their L1. Elementary school teachers brainstormed and specified the linguistic proficiency of the children as the competency needed to synchronize with others – teachers or peers – physically and mentally. The teachers formed original can-do statements in language proficiency on the basis of the idea that emotional synchrony leads to understanding others in communication. The research objectives are to determine the effect of language education based on the newly developed curriculum and can-do statements. The participants of the experiment were 72 third-graders in Uji Elementary School, Japan. For the experiment, 17 items were developed from the can-do statements formed by the teachers and divided into the same five categories as those of CEFR. A can-do checklist consisting of the items was created. The experiment consisted of three steps: first, the students evaluated themselves using the can-do checklist at the beginning of the school year. Second, one year of instruction was given to the students in Japanese and English classes (six periods a week). Third, the students evaluated themselves using the same can-do checklist at the end of the school year. The results of statistical analysis showed an enhancement of linguistic proficiency of the students. The average results of the post-check exceeded that of the pre-check in 12 out of the 17 items. Moreover, significant differences were shown in four items, three of which belonged to the same category: speaking/ interaction. It is concluded that children can get to understand others’ minds through physical and emotional synchrony. In particular, emotional synchrony is what teachers should aim at in childhood education.

Keywords: elementary school education, emotional synchrony, language proficiency, sympathy with others

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Authors: Rose Mini Agoes Salim, Shahnaz Safitri

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The aim of this study is to test the effectiveness of teaching kindness in preschool children by using several techniques. Kindness is a physical act or emotional support aimed to build or maintain relationships with others. Kindness is known to be essential in the development of moral reasoning to distinguish between the good and bad things. In this study, kindness is operationalized as several acts including helping friends, comforting sad friends, inviting friends to play, protecting others, sharing, saying hello, saying thank you, encouraging others, and apologizing. It is mentioned that kindness is crucial to be developed in preschool children because this is the time the children begin to interact with their social environment through play. Furthermore, preschool children's cognitive development makes them begin to represent the world with words, which then allows them to interact with others. On the other hand, preschool children egocentric thinking makes them still need to learn to consider another person's perspective. In relation to social interaction, preschool children need to be stimulated and assisted by adult to be able to pay attention to other and act with kindness toward them. On teaching kindness to children, the quality of interaction between children and their significant others is the key factor. It is known that preschool children learn about kindness by imitating adults on their two way interaction. Specifically, this study examines two types of teaching techniques that can be done by parents as a way to teach kindness, namely the picture-storybook reading and hand-puppet storytelling. These techniques were examined because both activities are easy to do and both also provide a model of behavior for the child based on the character in the story. To specifically examine those techniques effectiveness in teaching kindness, two studies were conducted. Study I involves 31 children aged 5-6 years old with picture-storybook reading technique, where the intervention is done by reading 8 picture books for 8 days. In study II, hand-puppet storytelling technique is examined to 32 children aged 3-5 years old. The treatments effectiveness are measured using an instrument in the form of nine colored cards that describe the behavior of kindness. Data analysis using Wilcoxon Signed-rank test shows a significant difference on the average score of kindness (p < 0.05) before and after the intervention has been held. For daily observation, a ‘kindness tree’ and observation sheets are used which are filled out by the teacher. Two weeks after interventions, an improvement on all kindness behaviors measured is intact. The same result is also gained from both ‘kindness tree’ and observational sheets.

Keywords: kindness, moral teaching, storytelling, hand puppet

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Authors: Beloulou Mohamed Lamine, Bouhouf Attef, Meliani Walid, Sellami Dalila, Lamara Abdelhak

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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with post-surgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariate analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature or component, particularly in surgeries that are more prone to chronicization.

Keywords: chronic postsurgical pain, postsurgical chronic neuropathic pain, regional anesthesia and analgesia techniques (RAAT), neuropathic pain score dn2, preventive impact

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Authors: B. Nair, S. Singh

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Oral health behaviors such as dietary preferences and tooth brushing are acquired during a child’s primary socialization period yet many oral health promotion interventions are implemented without taking into account the role and impact of parental influence in supporting healthy oral health behaviors. The aim and objective of this study was to determine the relationship between parental income and level of education with knowledge, attitudes and perceptions of oral health care practices. Methods: The study design was cross-sectional and exploratory, and data collection occurred in two phases. Phase 1 comprised of a self-administered questionnaire. The sample consisted of parents of 313 Grade 1 learners aged between 5-6 years old attending one of twelve selected public primary schools in the Chatsworth Circuit, Durban, South Africa. Phase 2 comprised of focus group discussions held at 5 purposively selected schools. Data collection comprised of a semi-structured face-to-face group interview with the objective of obtaining a deeper understanding of parental knowledge, attitudes and perceptions of dental caries. Results and Discussion: Almost 56% of participants earned a monthly income of less than R6000 (600 US dollars). Nearly three quarters (77.5%) of participants indicated that they did not have medical aid/insurance scheme. More than three-quarters of the participants (76.6%) identified diet as being the primary cause of decayed teeth. More than half of the study sample (56.1%) indicated that milk teeth were important and that rotten teeth (74.6%) could affect the child’s health. Almost half (49.8%) of participants reported that “bad teeth” were inherited. With more than two-thirds of the participants (77.7%), having at most a high school education, there was a correlation between the level of the caregiver’s education and the oral health care of the child. The analysis of the correlation between a child having decayed teeth and income (p=.007); and the manner in which the income is received (p=.003) was statistically significant. The results indicate that more effort needs to be placed in understanding parental knowledge, perceptions and attitudes towards dental caries. Parental level of education, income and oral health literacy is shown to be related to attitudes, and perceptions towards dental caries and its subsequent preventive measures. These findings have important implications for oral health planning at community and facility-based levels.

Keywords: oral health prevention, parental education, dental caries, attitudes and perceptions

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Authors: A. Yousuf, M. Iqbal, A. Mir, S. Aziz

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This study deals with the women’s right to land for gender equality. Economic Transformation Initiative, Gilgit-Baltistan (ETI-GB), an ambitious program supported by International Fund for Agricultural Development United Nation (IFAD, UN), aims to strengthen land reforms process in disputed area of Gilgit-Baltistan (GB) Pakistan, that is taking place first time in the history. This project is a brick to build the foundation of land reforms and land policies in GB. The ETI-GB provides substantive support to government of GB in developing policy measures and initiatives to promote women’s right to have and to own land is kind of unconventional step in a very traditional society. It would be interesting to have discussion and document the people’s response regarding this project. The study has used mixed method for data collection. For qualitative data, content analysis is used to have a thorough understanding of different types of land reforms across the globe particularly in South Asia. Theoretical understanding of the literature is essential which provides the basis why land reforms are important and how far it plays an important role when it comes to eliminating inequality. Focused group discussion was carried out for verification and triangulation of data. For quantitative, survey was conducted to take responses from the people of the region and analyzed. The program is implemented in Ghizer district of GB. 2340 households were identified as beneficiaries of newly developed land. Among them, 2285 were men households, and 55 were women households. There is a significant difference between men and women households. In spite of great difference, it is a great achievement of the donor that in history of GB, first time women are going to be entitled to land ownership. GB is a patriarchal society, many social factors like cultural, religious play role for gender inequality. In developing countries, such as Pakistan, the awareness of land property rights has not been given proper attention to gender equality development frameworks. It is argued that land property rights of women have not been taken into mainstream policymaking in the development of nation building process. Consequently, this has generated deprivation of women’s property rights, low income level, lack of education and poor health. This paper emphasises that there should have proper land property right of women in Gilgit-Baltistan Pakistan, provided that the gender empowerment could be increased in terms of women’s property rights.

Keywords: gender equality, women right to land ownership, property rights, women empowerment

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Authors: Betsy H. Edwards

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Background: Public Health England recognises unprotected sex and consequent transmission of sexually transmitted infections (STIs) as significant problems within student populations. Government surveys show that 50% of sexually-active young adults engage in unprotected sex with new partners, with 10% never using condoms. The recent Channel Four mini-series ‘It’s a Sin’ dramatises the 1980s AIDS epidemic and has been praised for its educational value and for promoting safe sexual practices to its viewers. This mixed-methods questionnaire study aims to investigate whether the series can change attitudes towards safe sex in student populations, can promote the use of condoms in student populations, and whether television, in general, is a useful tool for promoting health education. Methods: A questionnaire, created on Microsoft Forms, was distributed to students at the University of Birmingham via Facebook groups between September 2021 and May 2022. To consent, participants had to be aged 18 or over, a student at the university, have seen the entire series of ‘It’s a Sin’, and read the study information. Data was confidentially stored within the University’s secured OneDrive in accordance with the study’s approved ethics application. Quantitative questions measured participants’ attitudes and behaviours using Likert scales. Qualitative data was analysed using thematic analysis. Quantitative Results: 78 students completed the questionnaire. 43 participants (55%) felt that the series ‘It’s a Sin’ promoted safe sex. 74 participants (96%) and 31 participants (39%) said they were ‘very likely’ or ‘likely’ to use condoms with a casual partner during penetrative sex and oral sex respectively. 27 participants (35%) felt that watching ‘It’s a Sin’ made them more likely to use condoms; of these 27 participants, all were ‘very likely’ or ‘likely’ to use condoms during penetrative sex, and 9 were ‘very likely’ or ‘likely’ to during oral sex. 49 participants (63%) and 53 participants (68%) felt that television is a good way to provide health education and to promote healthy behaviours respectively. Qualitative Results: 56 participants (72%) gave reasons why the series had been associated with an increased uptake in HIV testing. Three themes emerged: increased education and attention, decreased stigmatisation, and relatability of characters on screen. Conclusions: This study suggests that the series ‘It’s a Sin’ can influence attitudes towards and the uptake of safe sexual practices. It would be useful for further research - using larger, randomised samples - to explore impacts upon populations lesser-educated about sexual health, who potentially have more to gain from watching series such as ‘It’s a Sin’.

Keywords: GUM, It's a sin, media, sexual health, students, television, tv

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Chrysoula Karathanasi, Senad Karavdic, Angela Odero, Michèle Baumann

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It is not only the economic determinants that impact on life conditions, but maintaining a good level of life satisfaction (LS) may also be an important challenge currently. In Luxembourg, university students receive financial aid from the government. They are then registered at the Centre for Documentation and Information on Higher Education (CEDIES). Luxembourg is built on migration with almost half its population consisting of foreigners. It is upon this basis that our research aims to analyze the associations with mental health factors (health satisfaction, psychological quality of life, worry), perceived financial situation, career attitudes (adaptability, optimism, knowledge, planning) and LS, for non-Luxembourgish and native postgraduate students. Between 2012 and 2013, postgraduates registered at CEDIES were contacted by post and asked to participate in an online survey with either the option of English or French. The study population comprised of 644 respondents. Our statistical analysis excluded: those born abroad who had Luxembourgish citizenship, or those born in Luxembourg who did not have citizenship. Two groups were formed one consisting 147 non-Luxembourgish and the other 284 natives. A single item measured LS (1=not at all satisfied to 10=very satisfied). Bivariate tests, correlations and multiple linear regression models were used in which only significant relationships (p<0.05) were integrated. Among the two groups no differences were found between LS indicators (7.8/10 non-Luxembourgish; 8.0/10 natives) as both were higher than the European indicator of 7.2/10 (for 25-34 years). In the case of non-Luxembourgish students, they were older than natives (29.3 years vs. 26.3 years) perceived their financial situation as more difficult, and a higher percentage of their parents had an education level higher than a Bachelor's degree (father 59.2% vs 44.6% for natives; mother 51.4% vs 33.7% for natives). In addition, the father’s education was related to the LS of postgraduates and the higher was the score, the greater was the contribution to LS. Whereas for native students, when their scores of health satisfaction and career optimism were higher, their LS’ score was higher. For both groups their LS was linked to mental health-related factors, perception of their financial situation, career optimism, adaptability and planning. The higher the psychological quality of life score was, the greater the LS of postgraduates’ was. Good health and positive attitudes related to the job market enhanced their LS indicator.

Keywords: career attributes, father's education level, life satisfaction, mental health

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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Authors: Valentina Marutyan

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Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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Authors: Keneilwe Matlhaku

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Crosslinguistic studies (theoretical and clinical) have shown delays and significant misarticulation in the acquisition of the rhotics. This article provides a detailed analysis of the early development of the rhotic phoneme, an apical trill /r/, by monolingual Setswana (Tswana S30) children of age ranges between 1 and 4 years. The data display the following trends: (1) late acquisition of /r/; (2) a wide range of substitution patterns involving this phoneme (i.e., gliding, coronal stopping, affrication, deletion, lateralization, as well as, substitution to a dental and uvular fricative). The primary focus of the article is on the potential origins of these variations of /r/, even within the same language. Our data comprises naturalistic longitudinal audio recordings of 6 children (2 males and 4 females) whose speech was recorded in their homes over a period of 4 months with no or only minimal disruptions in their daily environments. Phon software (Rose et al. 2013; Rose & MacWhinney 2014) was used to carry out the orthographic and phonetic transcriptions of the children’s data. Phon also enabled the generation of the children’s phonological inventories for comparison with adult target IPA forms. We explain the children’s patterns through current models of phonological emergence (MacWhinney 2015) as well as McAllister Byun, Inkelas & Rose (2016); Rose et al., (2022), which highlight the perceptual and articulatory factors influencing the development of sounds and sound classes. We highlight how the substitution patterns observed in the data can be captured through a consideration of the auditory properties of the target speech sounds, combined with an understanding of the types of articulatory gestures involved in the production of these sounds. These considerations, in turn, highlight some of the most central aspects of the challenges faced by the child toward learning these auditory-articulatory mappings. We provide a cross-linguistic survey of the acquisition of rhotic consonants in a sample of related and unrelated languages in which we show that the variability and volatility in the substitution patterns of /r/ is also brought about by the properties of the children’s ambient languages. Beyond theoretical issues, this article sets an initial foundation for developing speech-language pathology materials and services for Setswana learning children, an emerging area of public service in Botswana.

Keywords: rhotic, apical trill, Phon, phonological emergence, auditory, articulatory, mapping

Procedia PDF Downloads 38

Authors: Amritee Bora, B. S. Mipun

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Land degradation is often used to describe the land environmental phenomena that reduce land’s original productivity both qualitatively and quantitatively. The study of land degradation vulnerability primarily deals with “Environmentally Sensitive Areas” (ESA) and the amount of topsoil loss due to erosion. In many studies, it is observed that the assessment of the existing status of land degradation is used to represent the vulnerability. Moreover, it is also noticed that in most studies, the primary emphasis of land degradation vulnerability is to assess its sensitivity to soil erosion only. However, the concept of land degradation vulnerability can have different objectives depending upon the perspective of the study. It shows the extent to which changes in land use land cover can imprint their effect on the land. In other words, it represents the susceptibility of a piece of land to degrade its productive quality permanently or in the long run. It is also important to mention that the vulnerability of land degradation is not a single factor outcome. It is a probability assessment to evaluate the status of land degradation and needs to consider both biophysical and human induce parameters. To avoid the complexity of the previous models in this regard, the present study has emphasized on to generate a simplified model to assess the land degradation vulnerability in terms of its current human population pressure, land use practices, and existing biophysical conditions. It is a “Mixed-Method” termed as the land degradation vulnerability index (LDVi). It was originally inspired by the MEDALUS model (Mediterranean Desertification and Land Use), 1999, and Farazadeh’s 2007 revised version of it. It has followed the guidelines of Space Application Center, Ahmedabad / Indian Space Research Organization for land degradation vulnerability. The model integrates the climatic index (Ci), vegetation index (Vi), erosion index (Ei), land utilization index (Li), population pressure index (Pi), and cover management index (CMi) by giving equal weightage to each parameter. The final result shows that the very high vulnerable zone primarily indicates three (3) prominent circumstances; land under continuous population pressure, high concentration of human settlement, and high amount of topsoil loss due to surface runoff within the study sites. As all the parameters of the model are amalgamated with equal weightage further with the help of regression analysis, the LDVi model also provides a strong grasp of each parameter and how far they are competent to trigger the land degradation process.

Keywords: population pressure, land utilization, soil erosion, land degradation vulnerability

Procedia PDF Downloads 166

Authors: Saddam Husain Dhobi, Bikrant Karki

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The main objective of this paper is save money, balance ecosystem of the terrestrial organism, control global warming, and enhancing the storage capacity of the battery with requiring weight and thinness by using Cyanobacteria in the battery. To fulfill this purpose of paper we can use different methods: Analysis, Biological, Chemistry, theoretical and Physics with some engineering design. Using this different method, we can produce the special type of battery that has the long life, high storage capacity, and clean environment, save money so on and by using the byproduct of Cyanobacteria i.e. glucose. Cyanobacteria are a special type of bacteria that produces different types of extracellular glucoses and oxygen with the help of little sunlight, water, and carbon dioxide and can survive in freshwater, marine and in the land as well. In this process, O₂ is more in the comparison to plant due to rapid growth rate of Cyanobacteria. The required materials are easily available in this process to produce glucose with the help of Cyanobacteria. Since CO₂, is greenhouse gas that causes the global warming? We can utilize this gas and save our ecological balance and the byproduct (glucose) C₆H₁₂O₆ can be utilized for raw material for the battery where as O₂ escape is utilized by living organism. The glucose produce by Cyanobateria goes on Krebs's Cycle or Citric Acid Cycle, in which glucose is complete, oxidizes and all the available energy from glucose molecule has been release in the form of electron and proton as energy. If we use a suitable anodes and cathodes, we can capture these electrons and protons to produce require electricity current with the help of byproduct of Cyanobacteria. According to "Virginia Tech Bio-battery" and "Sony" 13 enzymes and the air is used to produce nearly 24 electrons from a single glucose unit. In this output power of 0.8 mW/cm, current density of 6 mA/cm, and energy storage density of 596 Ah/kg. This last figure is impressive, at roughly 10 times the energy density of the lithium-ion batteries in your mobile devices. When we use Cyanobacteria in battery, we are able to reduce Carbon dioxide, Stop global warming, and enhancing the storage capacity of battery more than 10 times that of lithium battery, saving money, balancing ecology. In this way, we can produce energy from the Cyanobacteria and use it in battery for different benefits. In addition, due to the mass, size and easy cultivation, they are better to maintain the size of battery. Hence, we can use Cyanobacteria for the battery having suitable size, enhancing the storing capacity of battery, helping the environment, portability and so on.

Keywords: anode, byproduct, cathode, cyanobacteri, glucose, storage capacity

Procedia PDF Downloads 348

Authors: Lindsay Foreman

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Introduction: Goals have become synonymous with the quest for the good life and the pursuit of happiness, with coaching and positive psychology gaining popularity as an approach in recent decades. And yet mental health is on the rise and the leading cause of disability, wellbeing is on the decline, stress is leading to 50-60% of workday absences and the need for action is indisputable and urgent. Purpose: The purpose of this study is to better understand two things we cannot see, but that play the most significant role in these outcomes - what we think and how we feel. With many working on the assumption that positive thinking and an optimistic outlook are necessary or valuable components of goal pursuit, this study uncovers the reality of the ‘inner-game’ from the coachee's perspective. Method: With a mixed methods design using a Q Method study of subjectivity to ‘make the unseen seen’. First, a wide-ranging universe of subjective thoughts and feelings experienced during goal pursuit are explored. These are generated from literature and a Qualtrics survey to create a Q-Set of 40 statements. Then 19 participants in professional and organisational settings offer their perspectives on these 40 Q-Set statements. Each rank them in a semi-forced distribution from ‘most like me’ to ‘least like me’ using Q-Sort software. From these individual perspectives, clusters of perspectives are identified using factor analysis and four distinct viewpoints have emerged. Findings: These Goal Pursuit Viewpoints offer insight into the states and self-talk experienced by coachees and may not reflect the assumption of positive thinking associated with achieving goals. The four Viewpoints are 1) the Optimistic View, 2) the Realistic View 3) The Dreamer View and 4) The Conflicted View. With only a quarter of the Dreamer View, and a third of the Optimistic view going on to achieve their goals, these assumptions need review. And with all the Realistic Views going on to achieve their goals, the role of self-doubt, overwhelm and anxiousness in goal achievement cannot be overlooked. Contribution: This study offers greater insight and understanding of people's inner experiences as they pursue goals and highlights the necessary and normal negative states associated with goal achievement. It also offers a practical tool of the Q-set statements to help coaches and coachees explore the current state and help navigate the journey towards goal achievement. It calls into question whether goals should always be part of coaching and if values, identity, and purpose may play a greater role than goals.

Keywords: coaching, goals, positive psychology, mindset, leadership, mental health, beliefs, cognition, emotional intelligence

Procedia PDF Downloads 113

Authors: Eeva Wallenius-Nareneva, Tuula Toivanen-Labiad

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Background: Oral health promotion event was organised for forty Afghanistan, Iraqi and Bangladeshi underage asylum seekers in Finland. The invitation to arrange this coaching occasion was accepted in the Degree Programme in Oral Hygiene in Metropolia. The personnel in the reception center found the need to improve oral health among the youngsters. The purpose was to strengthen the health literacy of the boys in their oral self-care and to reduce dental fears. The Finnish studies, especially the terminology of oral health was integrated to coaching with the help of interpreters. Cooperative learning was applied. Methods: Oral health was interactively discussed in four study group sessions: 1. The importance of healthy eating habits; - Good and bad diets, - Regular meals, - Acid attack o Xylitol. 2. Oral diseases − connection to general health; - Aetiology of gingivitis, periodontitis and caries, - Harmfulness of smoking 3. Tools and techniques for oral self-care; - Brushing and inter dental cleaning. 4. Sharing earlier dental care experiences; - Cultural differences, - Dental fear, - Regular check-ups. Results: During coaching deficiencies appeared in brushing and inter dental cleaning techniques. Some boys were used to wash their mouth with salt justifying it by salt’s antiseptic properties. Many brushed their teeth by vertical movements. The boys took feedback positively when a demonstration with model jaws revealed the inefficiency of the technique. The advantages of fluoride tooth paste were advised. Dental care procedures were new and frightening for many boys. Finnish dental care system was clarified. The safety and indolence of the treatments and informed consent were highlighted. Video presentations and the dialog lowered substantially the threshold to visit dental clinic. The occasion gave the students means for meeting patients from different cultural and language backgrounds. The information hidden behind the oral health problems of the asylum seekers was valuable. Conclusions: Learning dental care practices used in different cultures is essential for dental professionals. The project was a good start towards multicultural oral health care. More experiences are needed before graduation. Health education themes should be held simple regardless of the target group. The heterogeneity of the group does not pose a problem. Open discussion with questions leading to the theme works well in clarifying the target group’s knowledge level. Sharing own experiences strengthens the sense of equality among the participants and encourages them to express own opinions. Motivational interview method turned out to be successful. In the future coaching occasions must confirm active participation of everyone. This could be realized by dividing the participants to even smaller groups. The different languages impose challenges but they can be solved by using more interpreters. Their presence ensures that everyone understands the issues properly although the use of plain and sign languages are helpful. In further development, it would be crucial to arrange a rehearsal occasion to the same participants in two/three months’ time. This would strengthen the adaption of self-care practices and give the youngsters opportunity to pose more open questions. The students would gain valuable feedback regarding the effectiveness of their work.

Keywords: cooperative learning, interactive methods, motivational interviewing, oral health promotion, underage asylum seekers

Procedia PDF Downloads 290

Authors: Connor Dunlop, Bassim Abbassi, Richard G. Zytner

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Life cycle assessment (LCA) is a powerful tool established by the International Organization for Standardization (ISO) that can be used to assess the environmental impacts of a product or process from cradle to grave. Many studies utilize the LCA methodology within the site remediation field to compare various decontamination methods, including bioremediation, soil vapor extraction or excavation, and off-site disposal. However, with the authors' best knowledge, limited information is available in the literature on a sustainability tool that could be used to help with the selection of the optimal remediation technology. This tool, based on the LCA methodology, would consider site conditions like environmental, economic, and social impacts. Accordingly, this project was undertaken to develop a tool to assist with the selection of optimal sustainable technology. Developing a proper tool requires a large amount of data. As such, data was collected from previous LCA studies looking at site remediation technologies. This step identified knowledge gaps or limitations within project data. Next, utilizing the data obtained from the literature review and other organizations, an extensive LCA study is being completed following the ISO 14040 requirements. Initial technologies being compared include bioremediation, excavation with off-site disposal, and a no-remediation option for a generic gasoline-contaminated site. To complete the LCA study, the modelling software SimaPro is being utilized. A sensitivity analysis of the LCA results will also be incorporated to evaluate the impact on the overall results. Finally, the economic and social impacts associated with each option will then be reviewed to understand how they fluctuate at different sites. All the results will then be summarized, and an interactive tool using Excel will be developed to help select the best sustainable site remediation technology. Preliminary LCA results show improved sustainability for the decontamination of a gasoline-contaminated site for each technology compared to the no-remediation option. Sensitivity analyses are now being completed on on-site parameters to determine how the environmental impacts fluctuate at other contaminated gasoline locations as the parameters vary, including soil type and transportation distances. Additionally, the social improvements and overall economic costs associated with each technology are being reviewed. Utilizing these results, the sustainability tool created to assist in the selection of the overall best option will be refined.

Keywords: life cycle assessment, site remediation, sustainability tool, contaminated sites

Procedia PDF Downloads 58

Authors: Mohamad Ammar Ayass, Natalya Griko, Victor Pashkov, Wanying Cao, Kevin Zhu, Jin Zhang, Lina Abi Mosleh

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Respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Early evidence pointed at the angiotensin-converting enzyme 2 (ACE-2) expressed on the epithelial cells of the lung as the main entry point of SARS-CoV-2 into the cells. The viral entry is mediated by the binding of the Receptor Binding Domain (RBD) of the spike protein that is expressed on the surface of the virus to the ACE-2 receptor. As the number of SARS-CoV-2 variants continues to increase, mutations arising in the RBD of SARS-CoV-2 may lead to the ineffectiveness of RBD targeted neutralizing antibodies. To address this limitation, the objective of this study is to develop a combination of aptamers that target different regions of the RBD, preventing the binding of the spike protein to ACE-2 receptor and subsequent viral entry and replication. A safe and innovative biomedical tool was developed to inhibit viral infection and reduce the harms of COVID-19. In the present study, DNA aptamers were developed against a recombinant trimer S protein using the Systematic Evolution of Ligands by Exponential enrichment (SELEX). Negative selection was introduced at round number 7 to select for aptamers that bind specifically to the RBD domain. A series of 9 aptamers (ADI2010, ADI2011, ADI201L, ADI203L, ADI205L, ADIR68, ADIR74, ADIR80, ADIR83) were selected and characterized with high binding affinity and specificity to the RBD of the spike protein. Aptamers (ADI25, ADI2009, ADI203L) were able to bind and pull down endogenous spike protein expressed on the surface of SARS-CoV-2 virus in COVID-19 positive patient samples and determined by liquid chromatography- tandem mass spectrometry analysis (LC-MS/MS). LC-MS/MS data confirmed that aptamers can bind to the RBD of the spike protein. Furthermore, results indicated that the combination of the 9 best aptamers inhibited the binding of the purified trimer spike protein to the ACE-2 receptor found on the surface of Vero E6 cells. In the same experiment, the combined aptamers displayed a better neutralizing effect than antibodies. The data suggests that the selected aptamers could be used in therapy to neutralize the effect of the SARS-CoV-2 virus by inhibiting the interaction between the RBD and ACE-2 receptor, preventing viral entry into target cells and therefore blocking viral replication.

Keywords: aptamer, ACE-2 receptor, binding inhibitor, COVID-19, spike protein, SARS-CoV-2, treatment

Procedia PDF Downloads 185

Authors: M. A. Hafiz, P. T. Matevenga

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Micro-level machining of metals is a developing field which has shown to be a prospective approach to produce features on the parts in the range of a few to a few hundred microns with acceptable machining quality. It is known that the mechanics (i.e. the material removal mechanism) of micro-machining and conventional machining have significant differences due to the scaling effects associated with tool-geometry, tool material and work piece material characteristics. Shape memory alloys (SMAs) are those metal alloys which display two exceptional properties, pseudoelasticity and the shape memory effect (SME). Nickel-titanium (NiTi) alloys are one of those unique metal alloys. NiTi alloys are known to be difficult-to-cut materials specifically by using conventional machining techniques due to their explicit properties. Their high ductility, high amount of strain hardening, and unusual stress–strain behaviour are the main properties accountable for their poor machinability in terms of tool wear and work piece quality. The motivation of this research work was to address the challenges and issues of micro-machining combining with those of machining of NiTi alloy which can affect the desired performance level of machining outputs. To explore the significance of range of cutting conditions on surface roughness and tool wear, machining tests were conducted on NiTi. Influence of different cutting conditions and cutting tools on surface and sub-surface deformation in work piece was investigated. Design of experiments strategy (L9 Array) was applied to determine the key process variables. The dominant cutting parameters were determined by analysis of variance. These findings showed that feed rate was the dominant factor on surface roughness whereas depth of cut found to be dominant factor as far as tool wear was concerned. The lowest surface roughness was achieved at the feed rate of equal to the cutting edge radius where as the lowest flank wear was observed at lowest depth of cut. Repeated machining trials have yet to be carried out in order to observe the tool life, sub-surface deformation and strain induced hardening which are also expecting to be amongst the critical issues in micro machining of NiTi. The machining performance using different cutting fluids and strategies have yet to be studied.

Keywords: nickel titanium, micro-machining, surface roughness, machinability

Procedia PDF Downloads 340

Authors: Claes Gunnarsson, Karin Fröding, Nina Hasche

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Innovation is a necessity for the evolution of societies and it is also a driving force in human life that leverages value creation among cross-sector participants in various network arrangements. Social innovations can be characterized as the creation and implementation of a new solution to a social problem, which is more effective and sustainable than existing solutions in terms of improvement of society’s conditions and in particular social inclusion processes. However, barriers exist which may restrict the potential of social innovations to live up to its promise as a societal welfare promoting driving force. The literature points at difficulties in tackling social problems primarily related to problem complexity, access to networks, and lack of financial muscles. Further research is warranted at detailed at detail clarification of these barriers, also connected to recognition of the interplay between institutional logics on the development of cross-sector collaborations in networks and the organizing processes to achieve innovation barrier break-through. There is also a need to further elaborate how obstacles that spur a difference between the actual and desired state of innovative value creating service systems can be overcome. The purpose of this paper is to illustrate barriers to social innovations, based on qualitative content analysis of 36 dialogue-based seminars (i.e. research circles) with nine Swedish focus groups including more than 90 individuals representing civil society organizations, private business, municipal offices, and politicians; and analyze patterns that reveal constituents of barriers to social innovations. The paper draws on central aspects of innovation barriers as discussed in the literature and analyze barriers basically related to internal/external and tangible/intangible characteristics. The findings of this study are that existing institutional structures highly influence the transformative potential of social innovations, as well as networking conditions in terms of building a competence-propelled strategy, which serves as an offspring for overcoming barriers of competence extension. Both theoretical and practical knowledge will contribute to how policy-makers and SI-practitioners can facilitate and support social innovation processes to be contextually adapted and implemented across areas and sectors.

Keywords: barriers, research circles, social innovation, service systems

Procedia PDF Downloads 257

Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

Procedia PDF Downloads 212

Authors: Ozcan Yavas, Berrak Erol Nalbur, Sermin Gunarslan

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A materiality matrix is a tool that organizations use to prioritize their activities and adapt to the increasing sustainability requirements in recent years. For the materiality index to move from business models to the sustainability business model stage, it must be done with all partners in the raw material, supply, production, product, and end-of-life product stages. Within the scope of this study, the Materiality Matrix was used to transform the business model into a sustainability business model and to create a sustainability roadmap in a factory producing electric buses. This matrix determines the necessary roadmap for all stakeholders to participate in the process, especially in sectors that produce sustainable products, such as the electric vehicle sector, and to act together with the cradle-to-cradle approach of sustainability roadmaps. Global Reporting Initiative analysis was used in the study conducted with 1150 stakeholders within the scope of the study, and 43 questions were asked to the stakeholders under the main headings of 'Legal Compliance Level,' 'Environmental Strategies,' 'Risk Management Activities,' 'Impact of Sustainability Activities on Products and Services,' 'Corporate Culture,' 'Responsible and Profitable Business Model Practices' and 'Achievements in Leading the Sector' and Economic, Governance, Environment, Social and Other. The results of the study aimed to include five 1st priority issues and four 2nd priority issues in the sustainability strategies of the organization in the short and medium term. When the studies carried out in the short term are evaluated in terms of Sustainability and Environmental Risk Management, it is seen that the studies are still limited to the level of legal legislation (60%) and individual studies in line with the strategies (20%). At the same time, the stakeholders expect the company to integrate sustainability activities into its business model within five years (35%) and to carry out projects to become the first company that comes to mind with its success leading the sector (20%). Another result obtained within the study's scope is identifying barriers to implementation. It is seen that the most critical obstacles identified by stakeholders with climate change and environmental impacts are financial deficiency and lack of infrastructure in the dissemination of sustainable products. These studies are critical for transitioning to sustainable business models for the electric vehicle sector to achieve the EU Green Deal and CBAM targets.

Keywords: sustainability business model, materiality matrix, electricity bus, carbon neutrality, sustainability management

Procedia PDF Downloads 61

Authors: Gileade P. Freitas, Helena B. Lopes, Alann T. P. Souza, Paula G. F. P. Oliveira, Adriana L. G. Almeida, Paulo G. Coelho, Marcio M. Beloti, Adalberto L. Rosa

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Bone tissue presents great capacity to regenerate when injured by trauma, infectious processes, or neoplasia. However, the extent of injury may exceed the inherent tissue regeneration capability demanding some kind of additional intervention. In this scenario, cell therapy has emerged as a promising alternative to treat challenging bone defects. This study aimed at evaluating the effect of local injection of bone marrow-derived mesenchymal stem cells (BM-MSCs) and adipose tissue-derived mesenchymal stem cells (AT-MSCs) on bone regeneration of rat calvaria defects. BM-MSCs and AT-MSCs were isolated and characterized by expression of surface markers; cell viability was evaluated after injection through a 21G needle. Defects of 5 mm in diameter were created in calvaria and after two weeks a single injection of BM-MSCs, AT-MSCs or vehicle-PBS without cells (Control) was carried out. Cells were tracked by bioluminescence and at 4 weeks post-injection bone formation was evaluated by micro-computed tomography (μCT) and histology, nanoindentation, and through gene expression of bone remodeling markers. The data were evaluated by one-way analysis of variance (p≤0.05). BM-MSCs and AT-MSCs presented characteristics of mesenchymal stem cells, kept viability after passing through a 21G needle and remained in the defects until day 14. In general, injection of both BM-MSCs and AT-MSCs resulted in higher bone formation compared to Control. Additionally, this bone tissue displayed elastic modulus and hardness similar to the pristine calvaria bone. The expression of all evaluated genes involved in bone formation was upregulated in bone tissue formed by BM-MSCs compared to AT-MSCs while genes involved in bone resorption were upregulated in AT-MSCs-formed bone. We show that cell therapy based on the local injection of BM-MSCs or AT-MSCs is effective in delivering viable cells that displayed local engraftment and induced a significant improvement in bone healing. Despite differences in the molecular cues observed between BM-MSCs and AT-MSCs, both cells were capable of forming bone tissue at comparable amounts and properties. These findings may drive cell therapy approaches toward the complete bone regeneration of challenging sites.

Keywords: cell therapy, mesenchymal stem cells, bone repair, cell culture

Procedia PDF Downloads 184

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

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Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

Procedia PDF Downloads 150

Authors: C. Romero, R. Ortega, P. Sánchez-Camacho, P. Aguilar, V. Segur, J. Ruiz, G. Gutiérrez

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Introduction: Breast cancer is a leading cause of death in CLM. (2.8% of all deaths in women and 13,8% of deaths from tumors in womens). It is the most tumor incidence in CLM region with 26.1% from all tumours, except nonmelanoma skin (Cancer Incidence in Five Continents, Volume X, IARC). Cancer registries are a good information source to estimate cancer incidence, however the data are usually available with a lag which makes difficult their use for health managers. By contrast, mortality and survival statistics have less delay. In order to serve for resource planning and responding to this problem, a method is presented to estimate the incidence of mortality and survival data. Objectives: To estimate the incidence of breast cancer by age group in CLM in the period 1991-2013. Comparing the data obtained from the model with current incidence data. Sources: Annual number of women by single ages (National Statistics Institute). Annual number of deaths by all causes and breast cancer. (Mortality Registry CLM). The Breast cancer relative survival probability. (EUROCARE, Spanish registries data). Methods: A Weibull Parametric survival model from EUROCARE data is obtained. From the model of survival, the population and population data, Mortality and Incidence Analysis MODel (MIAMOD) regression model is obtained to estimate the incidence of cancer by age (1991-2013). Results: The resulting model is: Ix,t = Logit [const + age1*x + age2*x2 + coh1*(t – x) + coh2*(t-x)2] Where: Ix,t is the incidence at age x in the period (year) t; the value of the parameter estimates is: const (constant term in the model) = -7.03; age1 = 3.31; age2 = -1.10; coh1 = 0.61 and coh2 = -0.12. It is estimated that in 1991 were diagnosed in CLM 662 cases of breast cancer (81.51 per 100,000 women). An estimated 1,152 cases (112.41 per 100,000 women) were diagnosed in 2013, representing an increase of 40.7% in gross incidence rate (1.9% per year). The annual average increases in incidence by age were: 2.07% in women aged 25-44 years, 1.01% (45-54 years), 1.11% (55-64 years) and 1.24% (65-74 years). Cancer registries in Spain that send data to IARC declared 2003-2007 the average annual incidence rate of 98.6 cases per 100,000 women. Our model can obtain an incidence of 100.7 cases per 100,000 women. Conclusions: A sharp and steady increase in the incidence of breast cancer in the period 1991-2013 is observed. The increase was seen in all age groups considered, although it seems more pronounced in young women (25-44 years). With this method you can get a good estimation of the incidence.

Keywords: breast cancer, incidence, cancer registries, castilla-la mancha

Procedia PDF Downloads 311

Authors: Gabriel Michel

Abstract:

The aim of our research is to find solutions for adapting university teaching to today's students and companies. To achieve this, we have tried to change the posture and behavior of those involved in the learning situation by promoting other skills. There is a gap between the expectations and functioning of students and university teaching. At the same time, the business world needs employees who are obviously competent and proficient in technology, but who are also imaginative, flexible, able to communicate, learn on their own and work in groups. These skills are rarely developed as a goal at university. The flipped classroom has been one solution. Thanks to digital tools such as Moodle, for example, but the model behind them is still centered on teachers and classic learning scenarios: it makes course materials available without really involving them and encouraging them to cooperate. It's against this backdrop that we've conducted action research to explore the possibility of changing the way we learn (rather than teach) by changing the posture of both the classic student and the teacher. We hypothesized that a tool we developed would encourage autonomy, the possibility of progressing at one's own pace, collaboration and learning using all available resources(other students, course materials, those on the web and the teacher/facilitator). Experimentation with this tool was carried out with around thirty German and French first-year students at the Université de Lorraine in Metz (France). The projected changesin the groups' learning situations were as follows: - use the flipped classroom approach but with a few traditional presentations by the teacher (materials having been put on a server) and lots of collective case solving, - engage students in their learning by inviting them to set themselves a primary objective from the outset, e.g. “Assimilating 90% of the course”, and secondary objectives (like a to-do list) such as “create a new case study for Tuesday”, - encourage students to take control of their learning (knowing at all times where they stand and how far they still have to go), - develop cooperation: the tool should encourage group work, the search for common solutions and the exchange of the best solutions with other groups. Those who have advanced much faster than the others, or who already have expertise in a subject, can become tutors for the others. A student can also present a case study he or she has developed, for example, or share materials found on the web or produced by the group, as well as evaluating the productions of others, - etc… A questionnaire and analysis of assessment results showed that the test group made considerable progress compared with a similar control group. These results confirmed our hypotheses. Obviously, this tool is only effective if the organization of teaching is adapted and if teachers are willing to change the way they work.

Keywords: pedagogy, cooperation, university, learning environment

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Nurul Hidayat

Abstract:

Based on the data from the Indonesian Tax Authority, the contribution of self-employed taxpayers in Indonesia is just approximately 1-2 percent of total tax revenues during 2013 - 2015. This phenomenon requires greater attention to understand what factors that may affect it. The fact that Indonesia has the most prominent Muslim population in the world makes it important to analyze whether there potentially exists a correlation between Islamic religiosity and low tax contribution. The low level of tax contribution may provide an initial indication of low tax morale and tax compliance. This study will extend the existing literature by investigating the influence of Islamic religiosity as a moderating effect on the relationship between the perceptions of government legitimacy and tax morale among self-employed taxpayers. There are some factors to consider when taking into account the issue of Islamic religiosity and its relationship with tax morale in this study. Firstly, in Islam, there is a debate surrounding the lawfulness of tax. Some argue that Muslims should not have to pay tax; while others argue that the imposition of the tax is legitimate in circumstances. These views may have an impact on government legitimacy and tax morale. Secondly, according to Islamic sharia, Islam recognizes another compulsory payment, i.e. zakat, which to some extent has similar characteristics to tax. According to Indonesian Income Tax Law, zakat payment has just been accommodated as a deduction from taxable income. As a comparison, Malaysia treats zakat as a tax rebate. The treatment of zakat only as a taxable income deduction may also lead to a conflicting issue regarding the perception of tax fairness that possibly erode the perception of government legitimacy and tax morale. Based on the considerations above, perceptions of government legitimacy become important to influence the willingness of people to pay tax while the level of Islamic religiosity has a potential moderator effect on that correlation. In terms of measuring the relationship among the variables, this study utilizes mixed-quantitative and qualitative methods. The quantitative methods use surveys to approximately 400 targeted taxpayers while the qualitative methods employ in-depth interviews with 12 people, consist of experts, Islamic leaders and selected taxpayers. In particular, the research is being conducted in Indonesia, the country with the largest Muslim population in the world which has not fully implemented Islamic law as state law. The result indicates that Islamic religiosity becomes a moderating effect on the way taxpayers perceived government legitimacy that finally influences on tax morale. The findings of this study are supportive for the improvement of tax regulations by specifically considering tax deductions for zakat.

Keywords: Islamic religiosity, tax morale, government legitimacy, zakat

Procedia PDF Downloads 240