Search results for: voltage improvement

Authors: Mona Rashidirad, Hamid Salimian

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Dynamic capabilities, as the most considerable capabilities of firms in the current fast-moving economy may not be sufficient for performance improvement, but their contribution to performance is undeniable. While much of the extant literature investigates the impact of dynamic capabilities on organisational performance, little attention has been devoted to understand whether and how dynamic capabilities create value. Dynamic capabilities as the mirror of competitive strategies should enable firms to search and seize new ideas, integrate and coordinate the firm’s resources and capabilities in order to create value. A careful investigation to the existing knowledge base remains us puzzled regarding the relationship among competitive strategies, dynamic capabilities and value creation. This study thus attempts to fill in this gap by empirically investigating the impact of dynamic capabilities on value creation and the mediating impact of competitive strategy on this relationship. We aim to contribute to dynamic capability view (DCV), in both theoretical and empirical senses, by exploring the impact of dynamic capabilities on firms’ value creation and whether competitive strategy can play any role in strengthening/weakening this relationship. Using a sample of 491 firms in the UK telecommunications market, the results demonstrate that dynamic sensing, learning, integrating and coordinating capabilities play a significant role in firm’s value creation, and competitive strategy mediates the impact of dynamic capabilities on value creation. Adopting DCV, this study investigates whether the value generating from dynamic capabilities depends on firms’ competitive strategy. This study argues a firm’s competitive strategy can mediate its ability to derive value from its dynamic capabilities and it explains the extent a firm’s competitive strategy may influence its value generation. The results of the dynamic capabilities-value relationships support our expectations and justify the non-financial value added of the four dynamic capability processes in a highly turbulent market, such as UK telecommunications. Our analytical findings of the relationship among dynamic capabilities, competitive strategy and value creation provide further evidence of the undeniable role of competitive strategy in deriving value from dynamic capabilities. The results reinforce the argument for the need to consider the mediating impact of organisational contextual factors, such as firm’s competitive strategy to examine how they interact with dynamic capabilities to deliver value. The findings of this study provide significant contributions to theory. Unlike some previous studies which conceptualise dynamic capabilities as a unidimensional construct, this study demonstrates the benefits of understanding the details of the link among the four types of dynamic capabilities, competitive strategy and value creation. In terms of contributions to managerial practices, this research draws attention to the importance of competitive strategy in conjunction with development and deployment of dynamic capabilities to create value. Managers are now equipped with solid empirical evidence which explains why DCV has become essential to firms in today’s business world.

Keywords: dynamic capabilities, resource based theory, value creation, competitive strategy

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Authors: Glykeria A. Visvini, George N. Mathioudakis, Amaia Soto Beobide, Aris E. Giannakas, George A. Voyiatzis

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Polymeric nanocomposites have generated considerable interest in both academic research and industry because their properties can be tailored by adjusting the type & concentration of nano-inclusions, resulting in complementary and adaptable characteristics. The exceptional and/or unique properties of the nanocomposites, including the high mechanical strength and stiffness, the ease of processing, and their lightweight nature, are attributed to the high surface area, the electrical and/or thermal conductivity of the nano-fillers, which make them appealing materials for a wide range of engineering applications. Polymeric «breathable» membranes enabling water vapor permeability (WVP) can be designed either by using micro/nano-fillers with the ability to interrupt the continuity of the polymer phase generating micro/nano-porous structures or/and by creating micro/nano-pores into the composite material by uniaxial/biaxial stretching. Among the nanofillers, carbon nanotubes (CNTs) exhibit particular high WVP and for this reason, they have already been proposed for gas separation membranes. In a similar context, they could prove to be promising alternative/complementary filler nano-materials, for the development of "breathable" products. Polypropylene (PP) is a commonly utilized thermoplastic polymer matrix in the development of composite films, due to its easy processability and low price, combined with its good chemical & physical properties. PP is known to present several crystalline phases (α, β and γ), depending on the applied treatment process, which have a significant impact on its final properties, particularly in terms of WVP. Specifically, the development of the β-phase in PP in combination with stretching is anticipated to modify the crystalline behavior and extend the microporosity of the polymer matrix exhibiting enhanced WVP. The primary objective of this study is to develop breathable nano-carbon based (functionalized MWCNTs) PP composite membranes, potentially also avoiding the stretching process. This proposed alternative is expected to have a better performance/cost ratio over current stretched PP/CaCO3 composite benchmark membranes. The focus is to investigate the impact of both β-nucleator(s) and nano-carbon fillers on water vapor transmission rate properties of relevant PP nanocomposites.

Keywords: carbon nanotubes, nanocomposites, nucleating agents, polypropylene, water vapor permeability

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Authors: Barbara Eschen Danielsen, Morten Niels Baxter, Per Sieverts Nielsen

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Europe is currently in an energy and climate crisis, which requires more sustainable solutions than what has been used to before. Europe uses 40% of its energy in buildings so there has come a significant focus on trying to find and commit to new initiatives to reduce energy consumption in buildings. The European Union has introduced a building standard in 2021 to be upheld by 2030. This new building standard requires a significant reduction of CO2 emissions from both privately and publicly owned buildings. The overall aim is to achieve a zero-emission building stock by 2050. EU is revising the Energy Performance of Buildings Directive (EPBD) as part of the “Fit for 55” package. It was adopted on March 14, 2023. The new directive’s main goal is to renovate the least energy-efficient homes in Europe. There will be a cost for the home owner with a renovation project, but there will also be an improvement in energy efficiency and, therefore, a cost reduction. After the implementation of the EU directive, many homeowners will have to focus their attention on how to make the most effective energy renovations of their homes. The new EU directive will affect almost one million Danish homes (30%), as they do not meet the newly implemented requirements for energy efficiency. The problem for this one mio homeowners is that it is not easy to decide which renovation project they should consider. The houses are build differently and there are many possible solutions. The main focus of this paper is to identify the most impactful solutions and evaluate their impact and evaluating them with a criteria based sustainability indicator framework. The result of the analysis give each homeowner an insight in the various renovation options, including both advantages and disadvantages with the aim of avoiding unnecessary costs and errors while minimizing their CO2 footprint. Given that the new EU directive impacts a significant number of home owners and their homes both in Denmark and the rest of the European Union it is crucial to clarify which renovations have the most environmental impact and most cost effective. We have evaluated the 10 most impactful solutions and evaluated their impact in an indicator framework which includes 9 indicators and covers economic, environmental as well as social factors. We have packaged the result of the analysis in three packages, the most cost effective (short term), the most cost effective (long-term) and the most sustainable. The results of the study secure transparency and thereby provides homeowners with a tool to help their decision-making. The analysis is based on mostly qualitative indicators, but it will be possible to evaluate most of the indicators quantitively in a future study.

Keywords: energy efficiency, building renovation, renovation solutions, building energy performance criteria

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Authors: Tassia Batista Pessato, Francielli Pires Ribeiro Morais, Fernanda Guimaraes Drummond Silva, Flavia Maria Netto

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Proteins and phenolic compounds can interact mainly by hydrophobic interactions. Those interactions may lead to structural changes in both molecules, which in turn could affect positively or negatively their functional and nutritional properties. Here, the structural changes of whey proteins (WPI) due to interaction with caffeic acid (CA) were investigated by intrinsic and extrinsic fluorescence. The effects of protein-phenolic compounds interactions on the total phenolic content and antioxidant activity were also assessed. The WPI-CA complexes were obtained by mixture of WPI and CA stock solutions in deionized water. The complexation was carried out at room temperature during 60 min, using 0.1 M NaOH to adjust pH at 7.0. The WPI concentration was fixed at 5 mg/mL, whereas the CA concentration varied in order to obtain four different WPI:CA molar relations (1:1; 2:1; 5:1; 10:1). WPI and phenolic solutions were used as controls. Intrinsic fluorescence spectra of the complexes (mainly due to Trp fluorescence emission) were obtained at λex = 280 nm and the emission intensities were measured from 290 to 500 nm. Extrinsic fluorescence was obtained as the measure of protein surface hydrophobicity (S0) using ANS as a fluorescence probe. Total phenolic content was determined by Folin-Ciocalteau and the antioxidant activity by FRAP and ORAC methods. Increasing concentrations of CA resulted in decreasing of WPI intrinsic fluorescence. The emission band of WPI red shifted from 332 to 354 nm as the phenolic concentration increased, which is related to the exposure of Trp residue to the more hydrophilic environment and unfolding of protein structure. In general, the complexes presented lower S0 values than WPI, suggesting that CA hindered ANS binding to hydrophobic sites of WPI. The total phenolic content in the complexes was lower than the sum of two compounds isolated. WPI showed negligible AA measured by FRAP. However, as the relative concentration of CA increased in the complexes, the FRAP values enhanced, indicating that AA measure by this technique comes mainly from CA. In contrast, the WPI ORAC value (82.3 ± 1.5 µM TE/g) suggest that its AA is related to the capacity of H+ transfer. The complexes exhibited no important improvement of AA measured by ORAC in relation to the isolated components, suggesting complexation partially suppressed AA of the compounds. The results hereby presented indicate that interaction of WPI and CA occurred, and this interaction caused a structural change in the proteins. The complexation can either hide or expose antioxidant sites of both components. In conclusion, although the CA can undergo an AA suppression due to the interaction with proteins, the AA of WPI could be enhanced due to protein unfolding and exposure of antioxidant sites.

Keywords: bioactive properties, milk proteins, phenolic acids, protein-phenolic compounds complexation

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Authors: Diaa Ahmed Mohamed Ahmedien

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Nowadays, it cannot be denied that the most important interactive arts trends have appeared as a result of significant scientific mutations in the modern sciences, and holographic art is not an exception, where it is considered as a one of the most important major contemporary interactive arts trends in visual arts. Holographic technique had been evoked through the modern physics application in late 1940s, for the improvement of the quality of electron microscope images by Denis Gabor, until it had arrived to Margaret Benyon’s art exhibitions, and then it passed through a lot of procedures to enhance its quality and artistic applications technically and visually more over 70 years in visual arts. As a modest extension to these great efforts, this research aimed to invoke extraordinary attempt to enroll sample of normal people in Egyptian community in holographic recording program to record their appreciated objects or antiques, therefore examine their abilities to interact with modern techniques in visual communication arts. So this research tried to answer to main three questions: 'can we use the analog holographic techniques to unleash new theoretical and practical knowledge in interactive arts for public in Egyptian community?', 'to what extent holographic art can be familiar with public and make them able to produce interactive artistic samples?', 'are there possibilities to build holographic interactive program for normal people which lead them to enhance their understanding to visual communication in public and, be aware of interactive arts trends?' This research was depending in its first part on experimental methods, where it conducted in Laser lab at Cairo University, using Nd: Yag Laser 532 nm, and holographic optical layout, with selected samples of Egyptian people that they have been asked to record their appreciated object, after they had already learned recording methods, and in its second part on a lot of discussion panel had conducted to discuss the result and how participants felt towards their holographic artistic products through survey, questionnaires, take notes and critiquing holographic artworks. Our practical experiments and final discussions have already lead us to say that this experimental research was able to make most of participants pass through paradigm shift in their visual and conceptual experiences towards more interaction with contemporary visual arts trends, as an attempt to emphasize to the role of mature relationship between the art, science and technology, to spread interactive arts out in our community through the latest scientific and artistic mutations around the world and the role of this relationship in our societies particularly with those who have never been enrolled in practical arts programs before.

Keywords: Egyptian community, holographic art, laser art, visual art

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Authors: M. Acin-Albiac, P. Filannino, R. Coda, Carlo G. Rizzello, M. Gobbetti, R. Di Cagno

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Demand for smart management of large amounts of agro-food by-products has become an area of major environmental and economic importance worldwide. Brewers' spent grain (BSG), the most abundant by-product generated in the beer-brewing process, represents an example of valuable raw material and source of health-promoting compounds. To the date, the valorization of BSG as a food ingredient has been limited due to poor technological and sensory properties. Tailored bioprocessing through lactic acid bacteria (LAB) fermentation is a versatile and sustainable means for the exploitation of food industry by-products. Indigestible carbohydrates (e.g., hemicelluloses and celluloses), high phenolic content, and mostly lignin make of BSG a hostile environment for microbial survival. Hence, the selection of tailored starters is required for successful fermentation. Our study investigated the metabolic strategies of Leuconostoc pseudomesenteroides and Lactobacillus plantarum strains to exploit BSG as a food ingredient. Two distinctive BSG samples from different breweries (Italian IT- and Finish FL-BSG) were microbially and chemically characterized. Growth kinetics, organic acid profiles, and the evolution of phenolic profiles during the fermentation in two BSG model media were determined. The results were further complemented with gene expression targeting genes involved in the degradation cellulose, hemicelluloses building blocks, and the metabolism of anti-nutritional factors. Overall, the results were LAB genus dependent showing distinctive metabolic capabilities. Leuc. pseudomesenteroides DSM 20193 may degrade BSG xylans while sucrose metabolism could be furtherly exploited for extracellular polymeric substances (EPS) production to enhance BSG pro-technological properties. Although L. plantarum strains may follow the same metabolic strategies during BSG fermentation, the mode of action to pursue such strategies was strain-dependent. L. plantarum PU1 showed a great preference for β-galactans compared to strain WCFS1, while the preference for arabinose occurred at different metabolic phases. Phenolic compounds profiling highlighted a novel metabolic route for lignin metabolism. These findings will allow an improvement of understanding of how lactic acid bacteria transform BSG into economically valuable food ingredients.

Keywords: brewery by-product valorization, metabolism of plant phenolics, metabolism of lactic acid bacteria, gene expression

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Authors: Shirly Bar-Lev, Michal Morag

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Cults are usually thought of as suppressive organizations, where creativity is systematically stifled. Except for few scholars, creativity in cults remains an uncharted terrain (Boeri and Pressley, 2010). This paperfocuses on how cult members sought real and imaginary spaces to express themselves and even used their bodies as canvases on which to assert their individuality, resistance, devotion, pain, and anguish. We contend that cult members’ creativity paves their way out of the cult. This paper is part of a larger study into the experiences of former members of cults and cult-like NewReligiousMmovements (NRM). The research is based on in-depth interviews conducted with thirtyIsraeli men and women, aged 24 to 50, who either joined an NRM or were born into one. Their stories reveal that creativity is both emplaced and embedded in power relations. That is why Foucault’s idea of Heterotopia and Winnicott’s idea of the battle between True and False self canbenefit our understanding of how cult members creatively assert their autonomy over their bodies and thoughts while in the cult. Cults’ operate on a complex tension between submission and autonomy. On the one hand, they act as heterotopias byallowing for a ‘simultaneousmythic and real contestation of the space in which we live. Ascounter-hegemonic sites, they serve as‘the greatest reserve of theimagination’, to use Foucault’s words. Cults definitely possesselements of mystery, danger, and transgression where an alternative social ordering can emerge. On the other hand, cults are set up to format alternative identities. Often, the individuals who inhibit these spaces look for spiritual growth, self-reflection, and self-actualization. They might willingly relinquish autonomy over vast aspects of their lives in pursuit of self-improvement. In any case, cultsclaim the totality of their members’ identities and absolute commitment and compliance with the cult’s regimes. It, therefore, begs the question how the paradox between autonomy and submissioncan spur instances of creativity. How can cult members escape processes of performative regulation to assert their creative self? Both Foucault and Winnicott recognize the possibility of an authentic self – one that is spontaneous and creative. Both recognize that only the true self can feel real andmust never comply. Both note the disciplinary regimes that push the true self into hiding, as well as the social and psychological mechanisms that individuals develop to protect their true self. But while Foucault spoke of the power of critic as a way of salvaging the true self, Winnicott spoke of recognition and empathy - feeling known by others. Invitinga dialogue between the two theorists can yield a productive discussion on how cult members assert their ‘true self’ to cultivate a creative self within the confines of the cult.

Keywords: cults, creativity, heterotopia, true and false self

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Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Mina Malak Hanna Saad

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New strategies for supplying banking services to the customer have been brought, which include online banking. Banks have begun to recall electronic banking (e-banking) as a manner to replace some conventional department features by means of the usage of the internet as a brand-new distribution channel. A few clients have at least one account at multiple banks and get admission to those debts through online banking. To test their present-day internet worth, customers need to log into each of their debts, get particular statistics, and paint closer to consolidation. Not only is it time-ingesting; however, but it is also a repeatable activity with a certain frequency. To solve this problem, the idea of account aggregation was delivered as a solution. Account consolidation in e-banking as a form of digital banking appears to build stronger dating with clients. An account linking service is usually known as a service that permits customers to manipulate their bank accounts held at exceptional institutions through a common online banking platform that places a high priority on safety and statistics protection. The object affords an outline of the account aggregation approach in e-banking as a distinct carrier in the area of e-banking. The advanced facts generation is becoming a vital thing in the improvement of financial services enterprise, specifically the banking enterprise. It has brought different ways of delivering banking to the purchaser, which includes net Banking. Banks began to study electronic banking (e-banking) as a means to update some of their traditional branch functions and the use of the net as a distribution channel. Some clients have at least multiple accounts throughout banks and get the right of entry to that money owed through the usage of e-banking offerings. To examine the contemporary internet's well-worth position, customers have to log in to each of their money owed, get the information and work on consolidation. This no longer takes sufficient time; however, it is a repetitive interest at a specified frequency. To address this point, an account aggregation idea is brought as an answer. E-banking account aggregation, as one of the e-banking kinds, appeared to construct a more potent dating with clients. Account Aggregation carrier usually refers to a service that allows clients to control their bank bills maintained in one-of-a-kind institutions via a common Internet banking working platform, with an excessive subject to protection and privateness. This paper offers an overview of an e-banking account aggregation technique as a new provider in the e-banking field.

Keywords: compatibility, complexity, mobile banking, observation, risk banking technology, Internet banks, modernization of banks, banks, account aggregation, security, enterprise developmente-banking, enterprise development

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Authors: A. Gramza-Michałowska, J. Skręty, M. Antczak, J. Kobus-Cisowska, D. Kmiecik, J. Korczak, Kulczyński Bartosz

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Background: Modern consumer highly appreciates the correlation between eating habits and health. Intensified research showed many proofs confirming that food besides its basic nutritional function, possess also significant prophylactic and therapeutic potential. Preventive potential of selected food is commonly used as improvement factor of patients life standard. World Health Organization indicates that diabetes (Diabetes mellitus) and obesity are two of the most common and dangerous diseases. Diet therapy is an element of diabetes education program and a part of healing process, allowing maintaining and remaining the optimal metabolic state of the system. It must be remembered that diabetes treatment should be individualized to each patient. One of highly recommended vegetable for diabetes is asparagus (Asparagus officinalis L.), low calories common plant, growing in European countries. Objective: To propose the technology of unsweetened muesli production with addition of new components, we investigated the effects of selected vegetable addition on antioxidative capacity and consumer’s acceptance of muesli as representative of breakfast product. Methods: Muesli was formulated from a composition of oat flakes, flaxseed, bran, carrots, broccoli and asparagus. Basic composition of muesli was evaluated as content of protein, lipids, fatty acid composition, ash, selected minerals and caloricity. Antioxidant capacity of muesli was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and PCL - photochemiluminescence antiradical potential. Proposed muesli as new product was also characterized with sensory analysis, which included color, scent, taste, consistency and overall acceptance of a product. Results: Results showed that addition of freeze-dried asparagus into muesli allowed to lower the fat content and caloricity of a product according to the base product. No significant loss in antioxidant potential was evaluated, also the sensory value of a product was not negative. Conclusion: Designed muesli would be an answer for obese people looking for healthy snack during the daytime. Results showed that product with asparagus addition would be accepted by the consumers and because of its antidiabetic potential could be a n important factor in prevention of diabetes or obesity. Financial support by the UE Project no PO IG 01.01.00.00-061/09

Keywords: muesli, vegetables, asparagus, antioxidant potential, lipids

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Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: T. Hamaishi, Y. Morinaga, H. Morita

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Introduction: Rice consumption in Japan has decreased, and Japanese government has recommended use of rice flour in order to expand the consumption of rice. There are two major protein components present in flour, called gliadin and glutenin. Gluten forms when water is added to flour and is mixed. As mixing continues, glutenin interacts with gliadin to form viscoelastic matrix of gluten. Rice flour bread does not expand as much as wheat flour bread. Because rice flour is not included gluten, it cannot construct gluten network in the dough. In recent years, some food additives have been used for dough-improving agent in bread making, especially surfactants has effect in order to improve dough extensibility. Therefore, we focused to fatty acid salt which is one of anionic surfactants. Fatty acid salt is a salt consist of fatty acid and alkali, it is main components of soap. According to JECFA(FAO/WHO Joint Expert Committee on Food Additives), salts of Myristic(C14), Palmitic(C16) and Stearic(C18) could be used as food additive. They have been evaluated ADI was not specified. In this study, we investigated to improving bread-making properties of rice flour dough adding fatty acid salt. Materials and methods: The sample of fatty acid salt is myristic (C14) dissolved in KOH solution to a concentration of 350 mM and pH 10.5. Rice dough was consisted of 100 g of flour using rice flour and wheat gluten, 5 g of sugar, 1.7 g of salt, 1.7g of dry yeast, 80 mL of water and fatty acid salt. Mixing was performed for 500 times by using hand. The concentration of C14K in the dough was 10 % relative to flour weight. Amount of gluten in the dough was 20 %, 30 % relative to flour weight. Dough expansion ability test was performed to measure physical property of bread dough according to the methods of Baker’s Yeast by Japan Yeast Industry Association. In this test, 150 g of dough was filled from bottom of the cylinder and fermented at 30 °C，85 % humidity for 120 min on an incubator. The height of the expansion in the dough was measured and determined its expansion ability. Results and Conclusion: Expansion ability of rice dough with gluten content of 20 %, 30% showed 316 mL, 341 mL for 120 min. When C14K adding to the rice dough, dough expansion abilities were 314 mL, 368 mL for 120 min, there was no significant difference. Conventionally it has been known that the rice flour dough contain gluten of 20 %. The considerable improvement of dough expansion ability was achieved when added C14K to wheat flour. The experimental result shows that c14k adding to the rice dough with gluten content more than 20 % was not improving bread-making properties. In conclusion, rice bread made with gluten content more than 20 % without C14K has been suggested to contribute to the formation of the sufficient gluten network.

Keywords: expansion ability, fatty acid salt, gluten, rice flour dough

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Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

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Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

Procedia PDF Downloads 225

Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

Procedia PDF Downloads 115

Authors: Weldeabrha Kiros Kidanemaryam

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The investigation is to examine intra-organizational supply chain relationships of firms, which will help to look at and give an emphasis on internal processes and operations strength and achievements to make an influence even for external relationship management and outstanding performances of organizations. The purpose of the study is to scrutinize the internal supply chain relationships within manufacturing companies located in Tigray. The qualitative and quantitative data analysis methods were employed during the study by applying the primary data sources (questionnaires & interviews) and secondary data sources (organizational reports and documents) with the purposive sampling method. Thus, a descriptive research design was also applied in the research project in line with the cross-sectional research design which portrays simply the magnitude of the issues and problems by collecting the required and necessary data once from the sample respondents. This is because the study variables don’t have any cause-and-effect relationship in the research project that requires other types of research design than a descriptive research design; it already needs to be assessed and analyzed with a detailed description of the results after quantifying the outcomes and degree of the issues and problems based on the data gathered from respondents. The collected data was also analyzed by using the statistical package for social sciences (SPSS Version 20). The intra-organizational relationships of the companies are moderately accomplished, which requires an improvement for enhancing the performances of each unit or department within the firms so as to upgrade and ensure the progress of the companies’ effectiveness and efficiency. Moreover, the manufacturing companies have low industrial discipline and working culture, weak supervision of manpower, delayed delivery in the process within the companies, unsatisfactory quality of products, underutilization of capacity, and low productivity and profitability, which in turn results in minimizing the performance of intra-organizational supply chain relationships and to reduce the companies’ organizational efficiency, effectiveness and sustainability. Hence, the companies should have to give emphasize building and managing the intra-organizational supply chain relationships effectively because nothing can be done without creating successful and progressive relationships with internal units or functional areas and individuals for the production and provision of the required and qualified products that permits to meet the intended customers’ desires. The study contributes to improving the practical applications and gives an emphasis on the policy measurements and implications of the manufacturing companies with regard to intra-organizational supply chain relationships.

Keywords: supply chain, supply chain relationships, intra-organizational relationships, manufacturing companies

Procedia PDF Downloads 34

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

Procedia PDF Downloads 192

Authors: Samantha Meyerholz

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MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

Procedia PDF Downloads 223

Authors: R. O. Babatunde, O. M. Igbalajobi, F. Matambalya

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Moderate economic growth in developing and emerging countries has led to improvement in the food consumption and nutrition situation in the last two decades. Nevertheless, about 870 million people, with a quarter of them from Sub-Saharan Africa, are still suffering from hunger worldwide. As part of measures to reduce the widespread poverty and hunger, cash transfer programmes are now being implemented in many countries of the world. While nationwide cash transfer schemes are few in Sub-Saharan Africa generally, the available ones are more concentrated in East and Southern Africa. Much of the available literature on social protection had focused on the poverty impact of cash transfer schemes at the household level, with the larger proportion originating from Latin America. On the contrary, much less empirical studies have been conducted on the poverty impact of cash transfer in Sub-Saharan Africa, let alone on the food security and nutrition impact. To fill this gap in knowledge, this paper examines the impact of cash transfer on food security in Nigeria. As a case study, the paper analysed the Ekiti State Cash Transfer Scheme (ECTS). ECTS is an unconditional transfer scheme which was established in 2011 to directly provide cash transfer to elderly persons aged 65 years and above in Ekiti State of Nigeria. Using survey data collected in 2013, we analysed the impact of the scheme on food availability and dietary diversity of the beneficiary households. Descriptive and Propensity Score Matching (PSM) techniques were used to estimate the Average Treatment Effect (ATE) and Average Treatment Effect on the Treated (ATT) among the beneficiary and control groups. Thereafter, a model to test for the impact of participation in the cash transfer scheme on calorie availability and dietary diversity was estimated. The results indicate that while households in the sample are clearly vulnerable, there were statistically significant differences between the beneficiary and control groups. For instance, monthly expenditure, calorie availability and dietary diversity were significantly larger among the beneficiary and consequently, the prevalence and depth of hunger were lower in the group. Econometric results indicate that the cash transfer has a positive and significant effect on food availability and dietary diversity in the households. Expanding the coverage of the present scheme to cover all eligible households in the country and incorporating cash transfer into a comprehensive hunger reduction policy will make it to have a greater impact at improving food security among the most vulnerable households in the country.

Keywords: calorie availability, cash transfers, dietary diversity, propensity score matching

Procedia PDF Downloads 384

Authors: Xue Ma, Yang Fu, Dangyuan Lei

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Passive daytime radiative cooling is an emerging technology which has attracted worldwide attention in recent years due to its huge potential in cooling buildings without the use of electricity. Various coating materials with different optical properties have been developed to improve the daytime radiative cooling performance. However, commercial cooling coatings comprising functional fillers with optical bandgaps within the solar spectral range suffers from severe intrinsic absorption, limiting their cooling performance. Fortunately, it has recently been demonstrated that introducing fluorescent materials into polymeric coatings can covert the absorbed sunlight to fluorescent emissions and hence increase the effective solar reflectance and cooling performance. In this paper, we experimentally investigate the key factors for fluorescence-assisted radiative cooling with TiO2-based white coatings. The surrounding TiO2 nanoparticles, which enable spatial and temporal light confinement through multiple Mie scattering, lead to Purcell enhancement of phosphors in the coating. Photoluminescence lifetimes of two phosphors (BaMgAl10O17:Eu2+ and (Sr, Ba)SiO4:Eu2+) exhibit significant reduction of ~61% and ~23%, indicating Purcell factors of 2.6 and 1.3, respectively. Moreover, smaller Stokes shifts of the phosphors are preferred to further diminish solar absorption. Field test of fluorescent cooling coatings demonstrate an improvement of ~4% solar reflectance for the BaMgAl10O17:Eu2+-based fluorescent cooling coating. However, to maximize solar reflectance, a white appearance is introduced based on multiple Mie scattering by the broad size distribution of fillers, which is visually pressurized and aesthetically bored. Besides, most colored pigments absorb visible light significantly and convert it to non-radiative thermal energy, offsetting the cooling effect. Therefore, current colored cooling coatings are facing the compromise between color saturation and cooling effect. To solve this problem, we introduced colored fluorescent materials into white coating based on SiO2 microspheres as a top layer, covering a white cooling coating based on TiO2. Compared with the colored pigments, fluorescent materials could re-emit the absorbed light, reducing the solar absorption introduced by coloration. Our work investigated the scattering properties of SiO2 dielectric spheres with different diameters and detailly discussed their impact on the PL properties of phosphors, paving the way for colored fluorescent-assisted cooling coting to application and industrialization.

Keywords: solar reflection, infrared emissivity, mie scattering, photoluminescent emission, radiative cooling

Procedia PDF Downloads 86

Authors: Carolin Schulze

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Characterized by a positive interdependence of learners, cooperative learning (CL) is one possibility of successfully dealing with the increasing heterogeneity of students. Various positive effects of CL on the mental, physical and social health of students have already been documented. However, this structure is still rarely used in physical education (PE). Moreover, there is a lack of information about factors that determine the successful implementation of CL in PE. Therefore, the objective of the current study was to find out factors that determine the successful implementation of CL in PE using a digital questionnaire that was conducted from November to December 2022. In addition to socio-demographic data (age, gender, teaching experience, and education level), frequency of using CL, implementation strategies (theory-led, student-centred), and positive and negative effects of CL were measured. Furthermore, teachers were asked to rate the success of implementation on a 6-point rating scale (1-very successful to 6-not successful at all). For statistical analysis, multiple linear regression was performed, setting the success of implementation as the dependent variable. A total of 224 teachers (mean age=44.81±10.60 years; 58% male) took part in the current study. Overall, 39% of participants stated that they never use CL in their PE classes. Main reasons against the implementations of CL in PE were no time for preparation (74%) or for implementation (61%) and high heterogeneity of students (55%). When using CL, most of the reported difficulties are related to uncertainties about the correct procedure (54%) and the heterogeneous performance of students (54%). The most frequently mentioned positive effect was increased motivation of students (42%) followed by an improvement of psychological abilities (e.g. self-esteem, self-concept; 36%) and improved class cohesion (31%). Reported negative effects were unpredictability (29%), restlessness (24%), confusion (24%), and conflicts between students (17%). The successful use of CL is related to a theory-based preparation (e.g., heterogeneous formation of groups, use of rules and rituals) and a flexible implementation tailored to the needs and conditions of students (e.g., the possibility of individual work, omission of CL phases). Compared to teachers who solely implemented CL theory-led or student-adapted, teachers who switched from theory-led preparation to student-centred implementation of CL reported more successful implementation (t=5.312; p<.001). Neither frequency of using CL in PE nor the gender, age, the teaching experience, or the education level of the teacher showed a significant connection with the successful use of CL. Corresponding to the results of the current study, it is advisable that teachers gather enough knowledge about CL during their education and to point out the need to adapt the learning structure according to the diversity of their students. In order to analyse implementation strategies of teachers more deeply, qualitative methods and guided interviews with teachers are needed.

Keywords: diversity, educational technology, physical education, teaching styles

Procedia PDF Downloads 81

Authors: Akanksha Dicholkar, Celin Jacob, Omkar More

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Work force instability, as demonstrated by high rates of staff turnover and lingering vacancy rates, continues to be a major challenge faced by health care organizations. The impact is manifested in workflow inefficiencies, delays in delivering patient care, and dissatisfaction among patients and staff, all of which can have significant negative effects on quality of care and patient safety. In addition, the staggering administrative costs created by a transient work force threaten health care organizations financial viability. One nurse retention strategy is to have newly hired nurses partake in Preceptorship. Precepting is a way to enculturate new employees into their role. Also good professional, collegial relationship between an experienced nurse and a newly hired nurse relations was evidenced. This study demonstrates impact of preceptor program on absconding rate, employee satisfaction & Patient satisfaction. Purpose of study: To decrease absconding rate. Objective: 1. To reduce the high absconding rate among nurses in Aster Medcity (AMC). 2. To facilitate the acclimatization of the newly hired nurse into their role, focusing on professional growth, inter-professional relationships and clinical skills required for the job. Methodology: Descriptive study by Convenience sampling method and collect data by direct observation, questionnaire, interviews. Sample size as per Sample size statistical table at 95 % CI. We conducted a pre and post intervention analysis to assess the impact of Preceptorship at AMC, with a daily occupancy of approx. 300 patients. Result: Preceptor program has had a significant improvement positive impact on all measured parameters. Absconding rate came down from 20% to 0% (P= 0.001). Patient satisfaction scores rose from 85% to 95%. Employee satisfaction rose form 65% to 85%. Conclusion: The project proved that Preceptor Development Programme and the steps taken in hand holding of the new joinees were effective in reducing the absconding rate among nurses and improved the overall satisfaction of new nurses. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptor commitment to the role is reinforced.

Keywords: absconding rate, preceptor, employee satisfaction index, satisfaction index

Procedia PDF Downloads 307

Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

Procedia PDF Downloads 78

Authors: Lacheheb Dhia Eddine Zakaria, Ballout Amor

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Today, it is necessary to be thrifty for its planet, on one hand the space being a rare, nonrenewable resource, and on the other hand the ecological, economic and social cost of the urban sprawl. It is commonly asserted that the promotion of a more compact and dense city has a positive effect in terms of public costs of investment, functioning and costs for the citizens and the users of the city. It is clear that the modes urban development management have to evolve profoundly, in particular towards a densification favourable to the raising of the urban quality through an ideal urban density on the scale of the individual housing estate. The lot as an individual housing estate was adopted as an alternative development model to the collective housing, thought in an anthropocentric perspective to emerge as a quality model where the density plays an important role, by being included in operations of a global coherence, in an optimal organization without forgetting the main importance of the deadlines of construction and the finalization of the works. The image of eternal construction site inflicted to our cities explains the renewed interest for the application of the regulatory framework and the completion of these limited operations without global coherence, which are summed up in our case to a ground cut in plots of land, sold then built independently without being finished, and support the relevance of the essential question of the improvement of the outside aspect bound to the appearance which can be revealed as a so important factor for a better use and a better acceptance of its housing environment, that the ratio of a number of houses on a plot of land or the number of square meters by house. To demonstrate the impact of the completion degree of the subdivision dwellings, roads system and urban public utilities on the density or the densification and therefore on the urban quality, we studied two residential subdivisions, the private subdivision Sellam and the subdivision El Imane with a common situation, and a different land surface, density and cutting, being occupied by various social classes, with different needs and different household average size. The approach of this work is based on the typo morphological analysis to reveal the differences in the degrees of completions of the subdivision’s built environment and on the investigation, by a household’s survey, to demonstrate importance of the degree of completion and to reveal the conditions of qualitative densification favourable and convenient to a better subdivision’s appropriation.

Keywords: subdivision, degree of completion, densification, urban quality

Procedia PDF Downloads 372

Authors: Mernoosh Abouzari, Shahrokh Sahraei

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Electronic government is a way for governments to use new technology that provides people with the necessary facilities for proper access to government information and services, improving the quality of services and providing broad opportunities to participate in democratic processes and institutions. That leads to providing the possibility of easy use of information technology in order to distribute government services to the customer without holidays, which increases people's satisfaction and participation in political and economic activities. The expansion of e-government services and its movement towards intelligentization has the ability to re-establish the relationship between the government and citizens and the elements and components of the government. Electronic government is the result of the use of information and communication technology (ICT), which by implementing it at the government level, in terms of the efficiency and effectiveness of government systems and the way of providing services, tremendous commercial changes are created, which brings people's satisfaction at the wide level will follow. The main level of electronic government services has become objectified today with the presence of artificial intelligence systems, which recent advances in artificial intelligence represent a revolution in the use of machines to support predictive decision-making and Classification of data. With the use of deep learning tools, artificial intelligence can mean a significant improvement in the delivery of services to citizens and uplift the work of public service professionals while also inspiring a new generation of technocrats to enter government. This smart revolution may put aside some functions of the government, change its components, and concepts such as governance, policymaking or democracy will change in front of artificial intelligence technology, and the top-down position in governance may face serious changes, and If governments delay in using artificial intelligence, the balance of power will change and private companies will monopolize everything with their pioneering in this field, and the world order will also depend on rich multinational companies and in fact, Algorithmic systems will become the ruling systems of the world. It can be said that currently, the revolution in information technology and biotechnology has been started by engineers, large economic companies, and scientists who are rarely aware of the political complexities of their decisions and certainly do not represent anyone. Therefore, it seems that if liberalism, nationalism, or any other religion wants to organize the world of 2050, it should not only rationalize the concept of artificial intelligence and complex data algorithm but also mix them in a new and meaningful narrative. Therefore, the changes caused by artificial intelligence in the political and economic order will lead to a major change in the way all countries deal with the phenomenon of digital globalization. In this paper, while debating the role and performance of e-government, we will discuss the efficiency and application of artificial intelligence in e-government, and we will consider the developments resulting from it in the new world and the concepts of governance.

Keywords: electronic government, artificial intelligence, information and communication technology., system

Procedia PDF Downloads 94

Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

Procedia PDF Downloads 132

Authors: Alexander Heckman, Rohan Goswami, Zachi Attia, Paul Friedman, Peter Noseworthy, Demilade Adedinsewo, Pablo Moreno-Franco, Rickey Carter, Tathagat Narula

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Background: Postoperative atrial fibrillation (POAF) is associated with adverse health consequences, higher costs, and longer hospital stays. Utilizing existing predictive models that rely on clinical variables and circulating biomarkers, multiple societies have published recommendations on the treatment and prevention of POAF. Although reasonably practical, there is room for improvement and automation to help individualize treatment strategies and reduce associated complications. Methods and Results: In this retrospective cohort study of solid organ transplant recipients, we evaluated the diagnostic utility of a previously developed AI-based ECG prediction for silent AF on the development of POAF within 30 days of transplant. A total of 2261 non-cardiac transplant patients without a preexisting diagnosis of AF were found to have a 5.8% (133/2261) incidence of POAF. While there were no apparent sex differences in POAF incidence (5.8% males vs. 6.0% females, p=.80), there were differences by race and ethnicity (p<0.001 and 0.035, respectively). The incidence in white transplanted patients was 7.2% (117/1628), whereas the incidence in black patients was 1.4% (6/430). Lung transplant recipients had the highest incidence of postoperative AF (17.4%, 37/213), followed by liver (5.6%, 56/1002) and kidney (3.6%, 32/895) recipients. The AUROC in the sample was 0.62 (95% CI: 0.58-0.67). The relatively low discrimination may result from undiagnosed AF in the sample. In particular, 1,177 patients had at least 1 AI-ECG screen for AF pre-transplant above .10, a value slightly higher than the published threshold of 0.08. The incidence of POAF in the 1104 patients without an elevated prediction pre-transplant was lower (3.7% vs. 8.0%; p<0.001). While this supported the hypothesis that potentially undiagnosed AF may have contributed to the diagnosis of POAF, the utility of the existing AI-ECG screening algorithm remained modest. When the prediction for POAF was made using the first postoperative ECG in the sample without an elevated screen pre-transplant (n=1084 on account of n=20 missing postoperative ECG), the AUROC was 0.66 (95% CI: 0.57-0.75). While this discrimination is relatively low, at a threshold of 0.08, the AI-ECG algorithm had a 98% (95% CI: 97 – 99%) negative predictive value at a sensitivity of 66% (95% CI: 49-80%). Conclusions: This study's principal finding is that the incidence of POAF is rare, and a considerable fraction of the POAF cases may be latent and undiagnosed. The high negative predictive value of AI-ECG screening suggests utility for prioritizing monitoring and evaluation on transplant patients with a positive AI-ECG screening. Further development and refinement of a post-transplant-specific algorithm may be warranted further to enhance the diagnostic yield of the ECG-based screening.

Keywords: artificial intelligence, atrial fibrillation, cardiology, transplant, medicine, ECG, machine learning

Procedia PDF Downloads 135

Authors: Deepak Kumar, Ravi Rajwanshi, Mohd. Aslam Yusuf, Nisha Kant Pandey, Preeti Singh, Mukesh Saxena, Neera Bhalla Sarin

Abstract:

Global issues are leading to concerns over food security. These include climate change, urbanization, increase in population subsequently leading to greater energy and water demand. Futuristic approach for crop improvement involves gene pyramiding for agronomic traits that empower the plants to withstand multiple stresses. In an earlier study from the laboratory, the efficacy of overexpressing γ-tocopherol methyl transferase (γ-TMT) gene from the vitamin E biosynthetic pathway has been shown to result in six-fold increase of the most biologically active form, the α-tocopherol in Brassica juncea which resulted in alleviation of salt, heavy metal and osmoticum induced stress by the transgenic plants. The glyoxalase I (gly I) gene from the glyoxalase pathway has also been earlier shown by us to impart tolerance against multiple abioitc stresses by detoxification of the cytotoxic compound methylglyoxal in Brassica juncea. Recently, both the transgenes were pyramided in Brassica juncea lines through sexual crosses involving two stable Brassica juncea lines overexpressing γ-TMT and gly I genes respectively. The transgene integration was confirmed by PCR analysis and their mRNA expression was evident by RT-PCR analysis. Preliminary physiological investigations showed ~55% increased seed germination under 200 mM NaCl stress in the pyramided line and 81% higher seed germination under 200 mM mannitol stress as compared to the WT control plants. The pyramided lines also retained more chlorophyll content when the leaf discs were floated on NaCl (200, 400 and 600 mM) or mannitol (200, 400 and 600 mM) compared to the WT control plants. These plants had higher Relative Water Content and greater solute accumulation under stress compared to the parental plants having γ-TMT or the glyI gene respectively. The studies revealed the synergy of two components from different metabolic pathways in enhancing stress hardiness of the transgenic B. juncea plants. It was concluded that pyramiding of genes (γ-TMT and glyI) from diverse pathways can lead to enhanced tolerance to salt and mannitol stress (simulating drought conditions). This strategy can prove useful in enhancing the crop yields under various abiotic stresses.

Keywords: abiotic stress, brassica juncea, glyoxalase I, α-tocopherol

Procedia PDF Downloads 550

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

Procedia PDF Downloads 65