Search results for: intelligent late

Authors: Michael A. Genovese

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The struggle for LGBTQ rights in the United States began in Greenwich Village, New York, in 1967, when police tried to break up a gathering of mostly gay men who were partying at the Stonewall Bar in NYC. As unlikely as it may sound, this “riot” proved to be consequential in raising the political consciousness of gay men in America. From that point on, gays engaged in a political battle to achieve the rights to which they were entitled. This essay examines changes in popular opinion regarding LGBTQ rights from the late 1960s through the Trump administration, and examines the role public pressure played on presidential politics. For most of this period, presidents “followed” public opinion. This was true even during the administration of Barack Obama when gay Americans finally achieved some clearly spelled out rights (e.g. same-sex marriage). The findings of this paper call into question certain assumptions about presidential leadership, and underline the power of public opinion in shaping policy.

Keywords: presidential leadership, gay rights, LGBTQ, popular opinion

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Authors: Kasra Ghaemi, Syeda Tasnim, Shohel Mahmud

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One of the main issues affecting the quality and shelf life of food products is temperature fluctuation during transportation and storage. Packaging plays an important role in protecting food from environmental conditions, especially thermal variations. In this study, the performance of using microencapsulated Phase Change Material (PCM) as a promising thermal buffer layer in smart food packaging is investigated. The considered insulation layer is evaluated for different thicknesses and the absorbed heat from the environment. The results are presented in terms of the melting time of PCM or provided thermal protection period.

Keywords: food packaging, phase change material, thermal buffer, protection time

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Authors: V. Vishu, R. Manimegalai

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A combination of Intelligence and Radio frequency identification to bring an enhanced authentication method for the improvement of visually challenged people. The main goal is to provide an improved authentication by combining Advanced Encryption Standard algorithm and Intelligence. Here the encryption key will be generated as a combination of intelligent information from sensors and tag values. The main challenges are security, privacy and cost. Besides, the method was created to evaluate the amount of interaction between sensors and significant influence on the level of visually challenged people’s mental and physical states. The proposal is to apply various ideas on independent living or to assist them for a good life.

Keywords: AES, encryption, intelligence, smart key

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Authors: Hermann Dornhackl, Konstantin Kadletz, Robert Luh, Paul Tavolato

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In this paper we describe the use of formal methods to model malware behaviour. The modelling of harmful behaviour rests upon syntactic structures that represent malicious procedures inside malware. The malicious activities are modelled by a formal grammar, where API calls’ components are the terminals and the set of API calls used in combination to achieve a goal are designated non-terminals. The combination of different non-terminals in various ways and tiers make up the attack vectors that are used by harmful software. Based on these syntactic structures a parser can be generated which takes execution traces as input for pattern recognition.

Keywords: malware behaviour, modelling, parsing, search, pattern matching

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Authors: Bidzina Matsaberidze, Anna Sikharulidze, Gia Sirbiladze, Bezhan Ghvaberidze

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In the modern world emergency management decision support systems are actively used by state organizations, which are interested in extreme and abnormal processes and provide optimal and safe management of supply needed for the civil and military facilities in geographical areas, affected by disasters, earthquakes, fires and other accidents, weapons of mass destruction, terrorist attacks, etc. Obviously, these kinds of extreme events cause significant losses and damages to the infrastructure. In such cases, usage of intelligent support technologies is very important for quick and optimal location-transportation of emergency service in order to avoid new losses caused by these events. Timely servicing from emergency service centers to the affected disaster regions (response phase) is a key task of the emergency management system. Scientific research of this field takes the important place in decision-making problems. Our goal was to create an expert knowledge-based intelligent support system, which will serve as an assistant tool to provide optimal solutions for the above-mentioned problem. The inputs to the mathematical model of the system are objective data, as well as expert evaluations. The outputs of the system are solutions for Fuzzy Multi-Objective Emergency Location-Transportation Problem (FMOELTP) for disasters’ regions. The development and testing of the Intelligent Support System were done on the example of an experimental disaster region (for some geographical zone of Georgia) which was generated using a simulation modeling. Four objectives are considered in our model. The first objective is to minimize an expectation of total transportation duration of needed products. The second objective is to minimize the total selection unreliability index of opened humanitarian aid distribution centers (HADCs). The third objective minimizes the number of agents needed to operate the opened HADCs. The fourth objective minimizes the non-covered demand for all demand points. Possibility chance constraints and objective constraints were constructed based on objective-subjective data. The FMOELTP was constructed in a static and fuzzy environment since the decisions to be made are taken immediately after the disaster (during few hours) with the information available at that moment. It is assumed that the requests for products are estimated by homeland security organizations, or their experts, based upon their experience and their evaluation of the disaster’s seriousness. Estimated transportation times are considered to take into account routing access difficulty of the region and the infrastructure conditions. We propose an epsilon-constraint method for finding the exact solutions for the problem. It is proved that this approach generates the exact Pareto front of the multi-objective location-transportation problem addressed. Sometimes for large dimensions of the problem, the exact method requires long computing times. Thus, we propose an approximate method that imposes a number of stopping criteria on the exact method. For large dimensions of the FMOELTP the Estimation of Distribution Algorithm’s (EDA) approach is developed.

Keywords: epsilon-constraint method, estimation of distribution algorithm, fuzzy multi-objective combinatorial programming problem, fuzzy multi-objective emergency location/transportation problem

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Authors: Hiranmoyee Das

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Aim. Due to late presentation and delayed diagnosis mortality rate of retinoblastoma is more than 50% in developing counties. So to facilitate the diagnosis, to decrease the disease and treatment burden and to increase the disease survival rate, an attempt was made for early diagnosis of Retinoblastoma by including fundus examination in routine immunization programs. Methods- A unique immunization card is followed in a tertiary health care center where examination of pupillary reflex is made mandatory in each visit of the child for routine immunization. In case of any abnormality, the child is referred to the ophthalmology department. Conclusion- Early detection is the key in the management of retinoblastoma. Every child is brought to the health care system at least five times before the age of 2 years for routine immunization. We should not miss this golden opportunity for early detection of retinoblastoma.

Keywords: retinoblastoma, immunization, unique, early

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Authors: Tatipamula Samiksha Goud, .A.Naveena, M.sresta

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Traffic congestion is a major issue in many cities throughout the world, particularly in urban areas, and it is past time to switch from a fixed timer mode to an automated system. The current traffic signalling system is a fixed-time system that is inefficient if one lane is more functional than the others. A structure for an intelligent traffic control system is being designed to address this issue. When traffic density is higher on one side of a junction, the signal's green time is extended in comparison to the regular time. This study suggests a technique in which the signal's time duration is assigned based on the amount of traffic present at the time. Infrared sensors can be used to do this.

Keywords: infrared sensors, micro-controllers, LEDs, oscillators

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Authors: Aftab Ahmed, Ghulam Mehboob

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The object of presentation is to highlight the importance of condition which is a very rare genetic disorder although Paget’s disease is common but its juvenile type is very rare and a late presentation due to very slow onset and lack of earlier standard management. We present a case of 25 years old male with a chronic history of bone pain and a slow onset of mild swelling, later on diagnosed as juvenile Paget disease of bone. Rarity of this condition with inaccessibility for standard health treatment can lead to a significant delay in presentation and its management. There have been 50 reported cases worldwide according to Genetic Home Reference. There is increased osteoclastic activity along with osteoblastic activity related to gene alteration and osteoprotegrin deficiency. Morbidity of disease is very significant which lead children to become immobilize.

Keywords: juvenile, Paget’s disease, bone, Northern Area of Pakistan

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Authors: Ahmed F. Ghanem, Marwa I. Wahba, Asmaa N. El-Dein, Mohamed A. EL-Raey, Ghada E.A. Awad

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Numerous attempts are being performed in order to formulate suitable packaging materials for meat products. However, to the best of our knowledge, the incorporation of free hibiscus extract or its microcapsules in the pure polyvinyl alcohol (PVA) matrix as packaging materials for meats is seldom reported. Therefore, this study aims at protection of the aqueous crude extract of hibiscus flowers utilizing spry drying encapsulation technique. Fourier transform infrared (FTIR), scanning electron microscope (SEM), and zetasizer results confirmed the successful formation of assembled capsules via strong interactions, spherical rough microparticles, and ~ 235 nm of particle size, respectively. Also, the obtained microcapsules enjoy high thermal stability, unlike the free extract. Then, the obtained spray-dried particles were incorporated into the casting solution of the pure PVA film with a concentration 10 wt. %. The segregated free-standing composite films were investigated, compared to the neat matrix, with several characterization techniques such as FTIR, SEM, thermal gravimetric analysis (TGA), mechanical tester, contact angle, water vapor permeability, and oxygen transmission. The results demonstrated variations in the physicochemical properties of the PVA film after the inclusion of the free and the extract microcapsules. Moreover, biological studies emphasized the biocidal potential of the hybrid films against microorganisms contaminating the meat. Specifically, the microcapsules imparted not only antimicrobial but also antioxidant activities to PVA. Application of the prepared films on the real meat samples displayed low bacterial growth with a slight increase in the pH over the storage time up to 10 days at 4 oC which further proved the meat safety. Moreover, the colors of the films did not significantly changed except after 21 days indicating the spoilage of the meat samples. No doubt, the dual-functional of prepared composite films pave the way towards combined active/smart food packaging applications. This would play a vital role in the food hygiene, including also quality control and assurance.

Keywords: PVA, hibiscus, extraction, encapsulation, active packaging, smart and intelligent packaging, meat spoilage

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Authors: Arun Prasad

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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

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Authors: Hania Pasandi

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Since its publication in 1856, Madame Bovary has established itself as one of the most adapted texts of French literature. Some eighteen film adaptations and twenty-seven rewritings of Madame Bovary in fiction to date shows a great enthusiasm for recreating Flaubert’s masterpiece in a variety of mediums. Posy Simmonds’ 1999 graphic novel, Gemma Bovery stands out among these adaptations as the graphic novel with its visual and narrative structure offers a new reading experience of Madame Bovary, while combining Emma Bovary’s elements with contemporary social, cultural, and artistic discourses. This paper studies the transposition of Flaubert’s Madame Bovary (1857) to late twentieth-century Britain in Posy Simmonds’ 1999 graphic novel, Gemma Bovery by exploring how it borrows the essential flaubertian themes, from its source text to incorporate it with contemporary cultural trends.

Keywords: graphic novel, Gemma Bovery, Madame Bovary, transposition

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Countries (MECs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern that place a huge burden to individuals, families, communities, and health care systems. The high rates of consanguineous marriages, along with the unacceptable termination of at-risk pregnancy in MECs, reduce the possible solutions to control the high prevalence of GBDs. Since the early 1970s, most of MECs have started introducing premarital screening services (PSS) as a preventive measure to identify the asymptomatic carriers of GBDs and to provide genetic counseling to help couples plan for healthy families; yet, the success rate of PSS is very low. Purpose: This paper aims to highlight the factors that affect the success of PSS in MECs. Methods: An integrative review of articles located in CINAHL, PubMed, SCOPUS, and MedLine was carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders”. Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MECs and published after 2010 were included. Studies that were not published in English were excluded. Results: Eighteen articles were included in the review. The results showed that PSS in most of the MECs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meet its ultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, lack of prenatal diagnosis services and therapeutic abortion, emotional factors, religious beliefs, and lack of genetic counseling services. However, poor public awareness, late timing of the screening, religious misbeliefs, and the lack of adequate counseling services were the most common barriers identified. Conclusion and Implications: The review help in providing a framework for an effective preventive measure to reduce the prevalence of GBDs in MECS. This framework focuses primarily in overcoming the identified barriers by providing effective health education programs in collaboration with religious leaders, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling to consider people’s values, beliefs, and preferences.

Keywords: premarital screening, middle east, genetic blood disorders, factors

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Authors: Dhananjay Singh, M. Abdullah-Al-Wadud

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The Internet of Things is a concept of a large scale ecosystem of wireless actuators. The actuators are defined as things in the IoT, those which contribute or produces some data to the ecosystem. However, ubiquitous data collection, data security, privacy preserving, large volume data processing, and intelligent analytics are some of the key challenges into the IoT technologies. In order to solve the security requirements, challenges and threats in the IoT, we have discussed a message authentication mechanism for IoT applications. Finally, we have discussed data encryption mechanism for messages authentication before propagating into IoT networks.

Keywords: Internet of Things (IoT), message authentication, privacy, security

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Authors: G. Robles, A. Stifi, José L. Ponz-Tienda, S. Gentes

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This research paper aims to identify, analyze and rank factors affecting labor productivity in Spain with respect to their relative importance. Using a selected set of 35 factors, a structured questionnaire survey was utilized as the method to collect data from companies. Target population is comprised by a random representative sample of practitioners related with the Spanish construction industry. Findings reveal the top five ranked factors are as follows: (1) shortage or late supply of materials; (2) clarity of the drawings and project documents; (3) clear and daily task assignment; (4) tools or equipment shortages; (5) level of skill and experience of laborers. Additionally, this research also pretends to provide simple and comprehensive recommendations so that they could be implemented by construction managers for an effective management of construction labor forces.

Keywords: construction management, factors, improvement, labor productivity, lean construction

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Authors: Richard Joseph, Nerey Mvungi

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An electric power system includes a generating, a transmission, a distribution and consumers subsystems. An electrical power network in Tanzania keeps growing larger by the day and become more complex so that, most utilities have long wished for real-time monitoring and remote control of electrical power system elements such as substations, intelligent devices, power lines, capacitor banks, feeder switches, fault analyzers and other physical facilities. In this paper, the concept of automation of management of power systems from generation level to end user levels was determined by using Power System Simulator for Engineering (PSS/E) version 30.3.2.

Keywords: automation, distribution subsystem, generating subsystem, PSS/E, TANESCO, transmission subsystem

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Authors: Pingping Lin, Xudong Luo

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Natural language often conveys emotions of speakers. Therefore, sentiment analysis on what people say is prevalent in the field of natural language process and has great application value in many practical problems. Thus, to help people understand its application value, in this paper, we survey various applications of sentiment analysis, including the ones in online business and offline business as well as other types of its applications. In particular, we give some application examples in intelligent customer service systems in China. Besides, we compare the applications of sentiment analysis on Twitter, Weibo, Taobao and Facebook, and discuss some challenges. Finally, we point out the challenges faced in the applications of sentiment analysis and the work that is worth being studied in the future.

Keywords: application, natural language processing, online comments, sentiment analysis

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Authors: Gaurav Upadhyay, Nand Kishore, Prashant Ranjan, V. S. Tripathi, Shivesh Tripathi

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A frequency reconfigurable multiband antenna for intelligent transportation system (ITS) applications is proposed in this paper. A PIN-diode is used for reconfigurability. Centre frequencies are 1.38, 1.98, 2.89, 3.86, and 4.34 GHz in “ON” state of Diode and 1.56, 2.16, 2.88, 3.91 and 4.45 GHz in “OFF” state. Achieved maximum bandwidth is 18%. The maximum gain of the proposed antenna is 2.7 dBi in “ON” state and 3.95 dBi in “OFF” state of the diode. The antenna is simulated, fabricated, and tested in the lab. Measured and simulated results are in good confirmation.

Keywords: ITS, multiband antenna, PIN-diode, reconfigurable

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Authors: James E. Mahon

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This paper addresses the important question in the philosophy of lies and deception of whether all lying requires an intention to deceive. It does by examining a recent attempt by two philosophers to argue that Immanuel Kant abandoned the view that all lying requires an intention to deceive, in order to be able to claim that lying to God was possible. Ian Proops and Roy Sorensen have recently argued that although Kant always held that it was impossible for anyone to intend to deceive God, late in his life he came to believe that it was possible to lie to God. Kant came to believe that this was possible, they argue, because Kant came to believe that lying is not always deceptive, and that it was possible to tell non-deceptive lies, including non-deceptive lies to God. In this paper their arguments will be broken down and analyzed. Based on a close textual reading of the published works and the Kant’s lectures on ethics, it will be argued that Proops and Sorensen are wrong about what Kant believed about lying in general and lying to God in particular. This paper concludes that Kant never did abandon the Deceptionist position that all lying requires an intention to deceive.

Keywords: Kant, lie, deception, intention, God, ethics, belief, assertion

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Authors: Boudjelthia Radhwane

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Self-compacting concrete (SCC) developed in Japan in the late 80s has enabled the construction industry to reduce demand on the resources, improve the work condition and also reduce the impact of environment by elimination of the need for compaction. The shrinkage of concrete is the main cause of cracking in bridge decks. Bridge decks tend to be restrained from shrinkage, and this restraint along with other factors causes the bridge to crack. The characteristics of SCC under restrained shrinkage are important to understand in order to predict the cracking behavior in actual structures. Restrained shrinkage testing is done in accordance to AASHTO testing protocol. The free shrinkage performance and cracking behavior were reported and compared when changing the sand to aggregate ratio and the water to cement ratio. The results of free shrinkage show that when a mix design has higher free shrinkage, it will crack in restrained shrinkage earlier than a mix with lower free shrinkage.

Keywords: concrete mix, cracking behavior, restrained shrinkage, self compacting concrete

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Authors: Maxwel F. Silva, José Geraldo Pedrosa

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The issue revolves around the discourse on development that was current in Brazil in the late nineteenth and early twentieth century and its relation to industrialization as idea of civility, modernity and progress. The main objective of this paper is to analyze the workmanship of the visionary entrepreneur and organic intellectual Roberto Cochrane Simonsen (1889-1948). In the set of speeches, lectures and conferences pronounced by Simonsen, the USA constantly appears like model of civilization. The hypothesis is that, as base of the proposals of industrialization defended by him there was an idea of Americanism that would serve of foundation to a way of thinking and acting. For Simonsen, the construction of a nation is directly related to its industrialization. In his thought, develop the Brazil means to structure the country with rational economic mechanisms. This paper investigates the American influences on the discourse of Simonsen about the development of Brazil.

Keywords: Americanism, development of Brazil, Simonsen, social discourse

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Authors: J. D. García Espinel, Paula Pérez Sánchez, Carlos Egea Ruiz, Carlos Lardín Mifsut, Andrés López-Aranguren Oliver

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This paper shortly describes three main actuations over a Waste Water Treatment Plant (WWTP) for reducing its energy consumption: Optimization of the biological reactor in the aeration stage by including new control algorithms and introducing new efficient equipment, the installation of an innovative hybrid system with zero Grid injection (formed by 100kW of PV energy and 5 kW of mini-wind energy generation) and an intelligent management system for load consumption and energy generation control in the most optimum way. This project called RENEWAT, involved in the European Commission call LIFE 2013, has the main objective of reducing the energy consumptions through different actions on the processes which take place in a WWTP and introducing renewable energies on these treatment plants, with the purpose of promoting the usage of treated waste water for irrigation and decreasing the C02 gas emissions. WWTP is always required before waste water can be reused for irrigation or discharged in water bodies. However, the energetic demand of the treatment process is high enough for making the price of treated water to exceed the one for drinkable water. This makes any policy very difficult to encourage the re-use of treated water, with a great impact on the water cycle, particularly in those areas suffering hydric stress or deficiency. The cost of treating waste water involves another climate-change related burden: the energy necessary for the process is obtained mainly from the electric network, which is, in most of the cases in Europe, energy obtained from the burning of fossil fuels. The innovative part of this project is based on the implementation, adaptation and integration of solutions for this problem, together with a new concept of the integration of energy input and operative energy demand. Moreover, there is an important qualitative jump between the technologies used and the alleged technologies to use in the project which give it an innovative character, due to the fact that there are no similar previous experiences of a WWTP including an intelligent discrimination of energy sources, integrating renewable ones (PV and Wind) and the grid.

Keywords: aeration system, biological reactor, CO2 emissions, energy efficiency, hybrid systems, LIFE 2013 call, process optimization, renewable energy sources, wasted water treatment plants

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Authors: Mohamed Abd Elfattah Ibraheem Elghrbawy

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Icons are a significant group of cultural heritage objects that deserve to be maintained and conserved, as these ions are performed according to religious standards and norms. The ideal structure of icons is five strata, the lower layer is a wood plate, and the upper layer is the varnish layer that is exposed to photo-oxidation, that is turned into a fragile yellow layer. In addition, the components of the icons are important in dating these ions, so X-Ray Fluorescence (XRF), X-Ray Diffraction (XRD), and Scanning Electron Microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) patterns were used. SEM-EDX pattern revealed that the red pigment was vermillion (HgS), that was used in the late period, with a slight difference from the synthesized pigment. Pigments were subjected to chromatic alteration due to different agents, such as microbial agents and pollutants, in particular SO₂, whereas the pigment-based pigments are more sensitive. Moreover, cleaning, varnish removal, and retouching are important processes in the conservation of icons.

Keywords: conservation, cultural heritage, Egyptian icon, pigments

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Authors: Samra Naz, Aneeqa Ahmed, Qurat-ul-ain Mubarak, Irum Nausheen

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Driver safety systems protect driver from accidents by sensing signs of drowsiness. The paper proposes a technique which can detect the signs of drowsiness and make corresponding decisions to make the driver alert. This paper presents a technique in which the driver will be continuously monitored by a camera and his eyes, head and mouth movements will be observed. If the drowsiness signs are detected on the basis of these three movements under the predefined criteria, driver will be declared as sleepy and he will get alert with the help of alarms. Three robust techniques of drowsiness detection are combined together to make a robust system that can prevent form accident.

Keywords: drowsiness, eye closure, fatigue detection, yawn detection

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Authors: Saiping An

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The spells in Chinese Buddhism are often regarded by current scholarship as syllables with mystical power, as a ritual and practice of oral chanting, or as texts engraved on cultural relics. This study hopes to point out that the spell as a kind of behavior and material also provokes the believers to interpret its soteriology with various Buddhist doctrines and philosophies. It will analyze Mahāvairocana Tantra which is the main classic of the tradition regarded by the academic circles as 'Esoteric Buddhism', two annotations of these scriptures composed in the Tang and Liao Dynasty respectively, as well as some works of monks and lay Buddhists in the late Ming and early Qing dynasties. It aims to illustrate that spells in Chinese Buddhism are not simply magical voices and the words engraved on the cultural relics; they have also enriched the doctrines and thoughts of Chinese Buddhism. Their nature and soteriological methods are far more abundant than current academic circles have revealed.

Keywords: spell, Chinese Buddhism, philosophy, Buddhist doctrines

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Authors: Amin Nazerzadeh, Afsaneh Nouri Houshyar , Azadeh Noori Hoshyar

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With the rapid growing of information technology, the industry and manufacturing systems are becoming more automated. Therefore, achieving the highly accurate automatic systems with reliable security is becoming more critical. Biometrics that refers to identifying individual based on physiological or behavioral traits are unique identifiers provide high reliability and security in different industrial systems. As biometric cannot easily be transferred between individuals or copied, it has been receiving extensive attention. Due to the importance of security applications, this paper provides an overview on biometrics and discuss about background, types and applications of biometric as an effective tool for the industrial applications.

Keywords: Industial and manufacturing applications, intelligence and security, information technology, recognition; security technology; biometrics

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Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: Wai Yan Shih, Sau Man Wong, Wing Chung Chang, Wai Chi Chan

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Background: Late-life depression is associated with significant consequences. Although symptomatic reduction is achievable through pharmacological interventions, older adults are more vulnerable to the side effects than their younger counterparts. In addition, drugs do not address underlying cognitive dysfunctions such as rumination and reduced autobiographical memory specificity (AMS), both shown to be maladaptive coping styles that are associated with a poorer prognosis in depression. Considering how aging is accompanied by cognitive, psychological and physical changes, the interplay of these age-related factors may potentially aggravate and interfere with these depressive cognitive dysfunctions in late-life depression. Special care should, therefore, be drawn to ensure these cognitive dysfunctions are adequately addressed. Aim: This randomized controlled trial aims to examine the effect of mindfulness-based cognitive therapy (MBCT) on depressed older adults, and whether the potential benefits of MBCT are mediated by improvements in rumination and AMS. Method: Fifty-seven participants with an average age of 70 years old were recruited from multiple elderly centers and online mailing lists. Participants were assessed with: (1) Hamilton depression scale, (2) ruminative response scale, (3) autobiographical memory test, (4) mindful attention awareness scale, and (5) Montreal cognitive assessment. Eligible participants with mild to moderate depressive symptoms and normal cognitive functioning were randomly allocated to an 8-week MBCT group or active control group consisting of a low-intensity exercise program and health education. Post-intervention assessments were conducted after the 8-week program. Ethics approval was given by the Institutional Review Board of the University of Hong Kong/Hospital Authority. Results: Mixed-factorials ANOVAs demonstrated significant time x group interaction effects for depressive symptoms, AMS, and dispositional mindfulness. A marginally significant interaction effect was found for rumination. Simple effect analyses revealed a significant reduction in depressive symptoms for the both the MBCT group (mean difference = 7.1, p = .000), and control group (mean difference = 2.7, p = .023). However, only participants in the MBCT group demonstrated improvements in rumination, AMS, and dispositional mindfulness. Bootstrapping-based mediation analyses showed that the effect of MBCT in alleviating depressive symptoms was only mediated by the reduction in rumination. Conclusions: The findings support the use of MBCT as an effective intervention for depressed older adults, considering the improvements in depressive symptoms, rumination, AMS and dispositional mindfulness despite their age. Reduction in ruminative tendencies plays a major role in the cognitive mechanism of MBCT.

Keywords: mindfulness-based cognitive therapy, depression, older adults, rumination, autobiographical memory specificity

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Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

Abstract:

Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

Procedia PDF Downloads 199

Authors: Masoud Hassanzade Novin, Bahloul Salmani

Abstract:

Translation cannot be considered as a simple linguistic act. Through the rise of descriptive approach in the late 1970s and 1980s, translation process managed to meet the requirements of social aspects as well as linguistic approaches. To have the translation considered as the cross-cultural communication through which various cultures communicate in ideological and cultural constraints, the contrastive analysis was conducted in this paper to reveal the distortions imposed in the translated texts. The corpus of the study involved the novel 1984 written by George Orwell and its Persian translated texts which were analyzed through the qualitative type of the research based on critical discourse analysis (CDA) and Toury's norms as well as Lefever's concepts of ideology. Results of the study revealed the point that ideology and the cultural constraints were considered as an important stimulus which can control the process of the translation.

Keywords: critical discourse analysis, ideology, norms, translated texts

Procedia PDF Downloads 314

Authors: Jacques Wels

Abstract:

Japan has one of the highest average retirement ages within the OCDE and is paving the way to raise the retirement age to 70. However, the Japanese labour market is facing two main issues that can have detrimental effects on health: non-standard employment forms are widespread among the ageing workforce, and poor working conditions can contribute to explain poor health in late career. To assess such a relationship, the study uses data from JSTAR. Using mediation analysis, it particularly looks at the association between job dissatisfaction, employment status, self-perceived health (SPH), and use of health care services. Results show that work quality and employment status are associated with SPH. Contract work has a particularly negative impact and therefore contributes to explain the use of health care services but is not significantly associated with lower job satisfaction levels. SPH is a good predictor of the use of health care services.

Keywords: self-reported health, occupational health, employment, older workers, mediation

Procedia PDF Downloads 87