Search results for: Alice S. Chang

Authors: Alice Carter, Lucy Dumbell, Lorna Cameron, Victoria Lewis

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The Olympic discipline of eventing is the triathlon of equestrian sport, consisting of dressage, cross-country and show jumping. Falls on the cross-country are common and can be serious even causing death to rider. Research identifies an increased risk of a fall with an increasing number of obstacles and for jumping efforts later in the course suggesting fatigue maybe a contributing factor. Advice based on anecdotal evidence suggests riders undertake strength and conditioning programs to improve their ‘core’, thus improving their ability to maintain and control their riding position. There is little empirical evidence to support this advice. Therefore, the aim of this study is to investigate truck muscle fatigue and cognitive function during a simulated jumping test. Eight adult riders participated in a riding test on a Racewood Event simulator for 10 minutes, over a continuous jumping programme. The SEMG activity of six trunk muscles were bilaterally measured at every minute, and normalised root mean squares (RMS) and median frequencies (MDF) were computed from the EMG power spectra. Visual analogue scales (VAS) measuring Fatigue and Pain levels and Cognitive Function ‘tapping’ tests were performed before and after the riding test. Average MDF values for all muscles differed significantly between each sampled minute (p = 0.017), however a consistent decrease from Minute 1 and Minute 9 was not found, suggesting the trunk muscles fatigued and then recovered as other muscle groups important in maintaining the riding position during dynamic movement compensated. Differences between the MDF and RMS of different muscles were highly significant (H=213.01, DF=5, p < 0.001), supporting previous anecdotal evidence that different trunk muscles carry out different roles of posture maintenance during riding. RMS values were not significantly different between the sampled minutes or between riders, suggesting the riding test produced a consistent and repeatable effect on the trunk muscles. MDF values differed significantly between riders (H=50.8, DF = 5, p < 0.001), suggesting individuals may experience localised muscular fatigue of the same test differently, and that other parameters of physical fitness should be investigated to provide conclusions. Lumbar muscles were shown to be important in maintaining the position, therefore physical training program should focus on these areas. No significant differences were found between pre- and post-riding test VAS Pain and Fatigue scores or cognitive function test scores, suggesting the riding test was not significantly fatiguing for participants. However, a near significant correlation was found between time of riding test and VAS Pain score (p = 0.06), suggesting somatic pain may be a limiting factor to performance. No other correlations were found between the factors of participant riding test time, VAS Pain and Fatigue, however a larger sample needs to be tested to improve statistical analysis. The findings suggest the simulator riding test was not sufficient to provoke fatigue in the riders, however foundations for future studies have been laid to enable methodologies in realistic eventing settings.

Keywords: eventing, fatigue, horse-rider, surface EMG, trunk muscles

Procedia PDF Downloads 191

Authors: Chih-Ping Chang

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Different from traditional objective evidence, social media evidence has its own characteristics with easily tampering, recoverability, and cannot be read without using other devices (such as a computer). Simply taking a screenshot from social network sites must be questioned its original identity. When the police search and seizure digital information, a common way they use is to directly print out digital data obtained and ask the signature of the parties at the presence, without taking original digital data back. In addition to the issue on its original identity, this conduct to obtain evidence may have another two results. First, it will easily allege that is tampering evidence because the police wanted to frame the suspect and falsified evidence. Second, it is not easy to discovery hidden information. The core evidence associated with crime may not appear in the contents of files. Through discovery the original file, data related to the file, such as the original producer, creation time, modification date, and even GPS location display can be revealed from hidden information. Therefore, how to show this kind of evidence in the courtroom will be arguably the most important task for ruling social media evidence. This article, first, will introduce forensic software, like EnCase, TCT, FTK, and analyze their function to prove the identity with another digital data. Then turning back to the court, the second part of this article will discuss legal standard for authentication of social media evidence and application of that forensic software in the courtroom. As the conclusion, this article will provide a rethinking, that is, what kind of authenticity is this rule of evidence chase for. Does legal system automatically operate the transcription of scientific knowledge? Or furthermore, it wants to better render justice, not only under scientific fact, but through multivariate debating.

Keywords: federal rule of evidence, internet forensic, printouts as evidence, social media evidence, United States v. Vayner

Procedia PDF Downloads 291

Authors: Chang Qin, Daham Mustafa, Abderrahmane Khiat, Pierre Bienert, Paulo Zanini

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Nowadays, companies are facing lots of challenges in the process of digital transformation, which can be a complex and costly undertaking. Digital transformation involves the collection and analysis of large amounts of data, which can create challenges around data management and governance. Furthermore, it is also challenged to integrate data from multiple systems and technologies. Although with these pains, companies are still pursuing digitalization because by embracing advanced technologies, companies can improve efficiency, quality, decision-making, and customer experience while also creating different business models and revenue streams. In this paper, the issue that data is stored in data silos with different schema and structures is focused. The conventional approaches to addressing this issue involve utilizing data warehousing, data integration tools, data standardization, and business intelligence tools. However, these approaches primarily focus on the grammar and structure of the data and neglect the importance of semantic modeling and semantic standardization, which are essential for achieving data interoperability. In this session, the challenge of data silos in Industry 4.0 is addressed by developing a semantic modeling approach compliant with Asset Administration Shell (AAS) models as an efficient standard for communication in Industry 4.0. The paper highlights how our approach can facilitate the data mapping process and semantic lifting according to existing industry standards such as ECLASS and other industrial dictionaries. It also incorporates the Asset Administration Shell technology to model and map the company’s data and utilize a knowledge graph for data storage and exploration.

Keywords: data interoperability in industry 4.0, digital integration, industrial dictionary, semantic modeling

Procedia PDF Downloads 94

Authors: P. Chang, C. Lopez, C. Burbano

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Flood protection zones are riparian buffers that are formed to manage and mitigate the impact of flooding, and in turn, protect local populations. The purpose of this study was to evaluate the Guía Técnica de Criterios para el Acotamiento de las Rondas Hídricas in Colombia against international regulations in Canada and Spain, in order to determine its limitations and contribute to its improvement. The need to establish a specific corridor that allows for the dynamic development of a river is clear; however, limitations present in the Colombian Technical Guide are identified. The study shows that international regulations provide similar concepts as used in Colombia, but additionally integrate aspects such as regionalization that allows for a better characterization of the channel way, and incorporate the frequency of flooding and its probability of occurrence in the concept of risk when determining the protection zone. The case study analyzed in Dosquebradas - Risaralda aimed at comparing the application of the different standards through hydraulic modeling. It highlights that the current Colombian standard does not offer sufficient details in its implementation phase, which leads to a false sense of security related to inaccuracy and lack of data. Furthermore, the study demonstrates how the Colombian norm is ill-adapted to the conditions of Dosquebradas typical of the Andes region, both in the social and hydraulic aspects, and does not reduce the risk, nor does it improve the protection of the population. Our study considers it pertinent to include risk estimation as an integral part of the methodology when establishing protect flood zone, considering the particularity of water systems, as they are characterized by an heterogeneous natural dynamic behavior.

Keywords: environmental corridor, flood zone determination, hydraulic domain, legislation flood protection zone

Procedia PDF Downloads 113

Authors: Mei-Chun. Chang

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STEAM (Science, Technology, Engineering, Art, and Mathematics) represents a cross-disciplinary and learner-centered teaching model that cultivates students to link theory with the presentation of real situations, thereby improving their various abilities. This study explores students' learning performance after using the 6E model in STEAM teaching for a professional course in the digital media design department of technical colleges, as well as the difficulties and countermeasures faced by STEAM curriculum design and its implementation. In this study, through industry experts’ work experience, activity exchanges, course teaching, and experience, learners can think about the design and development value of virtual idol products that meet the needs of users and to employ AR/VR technology to innovate their product applications. Applying action research, the investigation has 35 junior students from the department of digital media design of the school where the researcher teaches as the research subjects. The teaching research was conducted over two stages spanning ten weeks and 30 sessions. This research collected the data and conducted quantitative and qualitative data sorting analyses through ‘design draft sheet’, ‘student interview record’, ‘STEAM Product Semantic Scale’, and ‘Creative Product Semantic Scale (CPSS)’. Research conclusions are presented, and relevant suggestions are proposed as a reference for teachers or follow-up researchers. The contribution of this study is to teach college students to develop original virtual idols and product designs, improve learning effectiveness through STEAM teaching activities, and effectively cultivate innovative and practical cross-disciplinary design talents.

Keywords: STEAM, 6E model, virtual idol, learning effectiveness, practical courses

Procedia PDF Downloads 127

Authors: Chang-Jen Lan

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Current Level of Service (LOS) index adopted in Highway Capacity Manual (HCM) for signalized intersections on surface streets is based on the intersection average delay. The delay thresholds for defining LOS grades are subjective and is unrelated to critical traffic condition. For example, an intersection delay of 80 sec per vehicle for failing LOS grade F does not necessarily correspond to the intersection capacity. Also, a specific measure of average delay may result from delay minimization, delay equality, or other meaningful optimization criteria. To that end, a reliability version of the intersection critical degree of saturation (v/c) as the LOS index is introduced. Traditionally, the level of saturation at a signalized intersection is defined as the ratio of critical volume sum (per lane) to the average saturation flow (per lane) during all available effective green time within a cycle. The critical sum is the sum of the maximal conflicting movement-pair volumes in northbound-southbound and eastbound/westbound right of ways. In this study, both movement volume and saturation flow are assumed log-normal distributions. Because, when the conditions of central limit theorem obtain, multiplication of the independent, positive random variables tends to result in a log-normal distributed outcome in the limit, the critical degree of saturation is expected to be a log-normal distribution as well. Derivation of the risk index predictive limits is complex due to the maximum and absolute value operators, as well as the ratio of random variables. A fairly accurate functional form for the predictive limit at a user-specified significant level is yielded. The predictive limit is then compared with the designated LOS thresholds for the intersection critical degree of saturation (denoted as X

Keywords: reliability analysis, level of service, intersection critical degree of saturation, risk based index

Procedia PDF Downloads 131

Authors: Jesmin Akter, Chang Hyuk Ahn, Ilho Kim, Jaiyeop Lee

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Global pandemic coronavirus disease (COVID-19) caused by Severe acute respiratory syndrome SARS-CoV-2, to control the spread of the COVID-19 pandemic, wastewater surveillance has been used to monitor SARS-CoV2 prevalence in the community. The challenging part is establishing wastewater surveillance; there is a need for a well-equipped laboratory for wastewater sample analysis. According to many previous studies, reverse transcription-polymerase chain reaction (RT-PCR) based molecular tests are the most widely used and popular detection method worldwide. However, the RT-qPCR based approaches for the detection or quantification of SARS-CoV-2 genetic fragments ribonucleic acid (RNA) from wastewater require a specialized laboratory, skilled personnel, expensive instruments, and a workflow that typically requires 6 to 8 hours to provide results for just minimum samples. Rapid and reliable alternative detection methods are needed to enable less-well-qualified practitioners to set up and provide sensitive detection of SARS-CoV-2 within wastewater at less-specialized regional laboratories. Therefore, scientists and researchers are conducting experiments for rapid detection methods of COVID-19; in some cases, the structural and molecular characteristics of SARS-CoV-2 are unknown, and various strategies for the correct diagnosis of COVID-19 have been proposed by research laboratories, which are presented in the present study. The ongoing research and development of these highly sensitive and rapid technologies, namely RT-LAMP, ELISA, Biosensors, GeneXpert, allows a wide range of potential options not only for SARS-CoV-2 detection but also for other viruses as well. The effort of this study is to discuss the above effective and regional rapid detection and quantification methods in community wastewater as an essential step in advancing scientific goals.

Keywords: rapid detection, SARS-CoV-2, sensitive detection, wastewater surveillance

Procedia PDF Downloads 86

Authors: Hyoun Joong Kim, Jin Woo Jun, Sib Sankar Giri, Cheng Chi, Saekil Yun, Sang Guen Kim, Sang Wha Kim, Jeong Woo Kang, Se Jin Han, Se Chang Park

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Vibrio corallilyticus is a well-known pathogen of coral. It is also infectious to a variety of shellfish species, including Pacific oyster (Crassostrea gigas) larvae. V. corallilyticus is remained to be a major constraint in marine bivalve aquaculture practice, especially in artificial seed production facility. Owing to the high mortality and contagious nature of the pathogen, large amount of antibiotics has been used for disease prevention and control. However, indiscriminate use of antibiotics may result in food and environmental pollution, and development of antibiotic resistant strains. Therefore, eco-friendly disease preventative measures are imperative for sustainable bivalve culture. The present investigation proposes the application of bacteriophage (phage) as an effective alternative method for controlling V. corallilyticus infection in marine bivalve hatcheries. Isolation of phages from sea water sample was carried out using drop or double layer agar methods. The host range, stability and morphology of the phage isolates were studied. In vivo phage efficacy to prevent V. corallilyticus infection in oyster larvae was also performed. The isolated phages, named pVco-5 and pVco-7 was classified as a podoviridae and pVco-14, was classified as a siphoviridae. Each phages were infective to four strains of seven V. corallilyticus strains tested. When oyster larvae were pre-treated with the phage before bacterial challenge, mortality of the treated oyster larvae was lower than that in the untreated control. This result suggests that each phages have the potential to be used as therapeutic agent for controlling V. corallilyticus infection in marine bivalve hatchery.

Keywords: bacteriophage, Vibrio coralliilyticus, Oyster larvae, mortality

Procedia PDF Downloads 224

Authors: Claude Nsobya, Alice Moncaster, Karen Potter, Jed Ramsay

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The shift in Flood Risk Governance (FRG) has moved away from traditional approaches that solely relied on centralized decision-making and structural flood defenses. Instead, there is now the adoption of integrated flood risk management measures that involve various actors and stakeholders. This new approach emphasizes people-centered approaches, including adaptation and learning. This shift to a diversity of FRG approaches has been identified as a significant factor in enhancing resilience. Resilience here refers to a community's ability to withstand, absorb, recover, adapt, and potentially transform in the face of flood events. It is argued that if the FRG merely focused on the conventional 'fighting the water' - flood defense - communities would not be resilient. The move to these people-centered approaches also implies that communities will be more involved in FRG. It is suggested that effective flood risk governance influences resilience through meaningful community involvement, and effective community engagement is vital in shaping community resilience to floods. Successful community participation not only uses context-specific indigenous knowledge but also develops a sense of ownership and responsibility. Through capacity development initiatives, it can also raise awareness and all these help in building resilience. Recent Flood Risk Management (FRM) projects have thus had increasing community involvement, with varied conceptualizations of such community engagement in the academic literature on FRM. In the context of overland floods, there has been a substantial body of literature on Flood Risk Governance and Management. Yet, groundwater flooding has gotten little attention despite its unique qualities, such as its persistence for weeks or months, slow onset, and near-invisibility. There has been a little study in this area on how successful community involvement in Flood Risk Governance may improve community resilience to groundwater flooding in particular. This paper focuses on a case study of a flood risk management project in the United Kingdom. Buckinghamshire Council is leading Project Groundwater, which is one of 25 significant initiatives sponsored by England's Department for Environment, Food and Rural Affairs (DEFRA) Flood and Coastal Resilience Innovation Programme. DEFRA awarded Buckinghamshire Council and other councils 150 million to collaborate with communities and implement innovative methods to increase resilience to groundwater flooding. Based on a literature review, this paper proposes a new paradigm for effective community engagement in Flood Risk Governance (FRG). This study contends that effective community participation can have an impact on various resilience capacities identified in the literature, including social capital, institutional capital, physical capital, natural capital, human capital, and economic capital. In the case of social capital, for example, successful community engagement can influence social capital through the process of social learning as well as through developing social networks and trust values, which are vital in influencing communities' capacity to resist, absorb, recover, and adapt. The study examines community engagement in Project Groundwater using surveys with local communities and documentary analysis to test this notion. The outcomes of the study will inform community involvement activities in Project Groundwater and may shape DEFRA policies and guidelines for community engagement in FRM.

Keywords: flood risk governance, community, resilience, groundwater flooding

Procedia PDF Downloads 71

Authors: Meng-Na Dai, Bao-Fang Wen, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Chang-Hai Tang, Zhi-Qiang Feng, Wen-Qiang Yin

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Based on the analysis of literature in the health emergency management in China with recent 10 years, this paper discusses the Chinese current research hotspots, development trends and shortcomings in this field, and provides references for scholars to conduct follow-up research. CNKI(China National Knowledge Infrastructure), Weipu, and Wanfang were the databases of this literature. The key words during the database search were health, emergency, and management with the time from 2009 to 2018. The duplicate, non-academic, and unrelated documents were excluded. 901 articles were included in the literature review database. The main indicators of abstraction were, the number of articles published every year, authors, institutions, periodicals, etc. There are some research findings through the analysis of the literature. Overall, the number of literature in the health emergency management in China has shown a fluctuating downward trend in recent 10 years. Specifically, there is a lack of close cooperation between authors, which has not constituted the core team among them yet. Meanwhile, in this field, the number of high-level periodicals and quality literature is scarce. In addition, there are a lot of research hotspots, such as emergency management system, mechanism research, capacity evaluation index system research, plans and capacity-building research, etc. In the future, we should increase the scientific research funding of the health emergency management, encourage collaborative innovation among authors in multi-disciplinary fields, and create high-quality and high-impact journals in this field. The states should encourage scholars in this field to carry out more academic cooperation and communication with the whole world and improve the research in breadth and depth. Generally speaking, the research in health emergency management in China is still insufficient and needs to be improved.

Keywords: health emergency management, research situation, bibliometrics, literature

Procedia PDF Downloads 138

Authors: Chee Fei Chang, May Yee Ng

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As a result of its geographical location, flood is a natural disaster that happens regularly in Malaysia. Every year, heavy rainfall is brought by the cyclical monsoon to the East coast of Peninsular Malaysia. In recent years, the occurrence of unexpected heavy downpour somehow connected to climate-change phenomena is also on the increasing trend. Ironically, despite that Malaysians have suffered significant monetary losses as a result of the recurring floods in past many decades, little has been done by the government from the perspective of taxation. Perhaps due to political reason or as a populist measure, the federal and local government are more inclined to offer small cash handout then rolling out long-term tax policy or measure in relieving the financial and tax burden of the victims and affected business entities. Except for the one-off tax break granted to affected businesses in 2007, the authors have not found any income tax exemption or deduction order gazetted with regard to flood disaster. Hence, it is imperative for this study to explore the need and challenges of implementing flood inflicted disaster tax relief or credit in Malaysia. This research consists of two major parts. First, the assessment of relevant tax policies/ measures with regard to non-government organisations and other affected parties. Content and thematic analyses will be applied on current tax legislations and orders issued for this part. Second, a comparative analysis will be conducted benchmarking various disaster tax reliefs and credits implemented in developed countries. Resulting from the increasing climate change-related disasters in Malaysia, the findings of this study will shed light on the importance of introducing disaster tax relief measures to assist individual victims as well as the affected businesses.

Keywords: climate-changed related disaster, disaster tax credits, tax relief for victims, tax measures for disaster recovery

Procedia PDF Downloads 122

Authors: Jingcheng Ma, Patricia B. Weisensee, Young H. Shin, Yujin Chang, Junjiao Tian, William P. King, Nenad Miljkovic

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Water droplet impact on surfaces is a ubiquitous phenomenon in both nature and industry. The transfer of mass, momentum and energy can be influenced by the time of contact between droplet and surface. In order to reduce the contact time, we study the influence of substrate motion prior to impact on the dynamics of droplet recoil. Using optical high speed imaging, we investigated the impact dynamics of macroscopic water droplets (~ 2mm) on rigid nanostructured superhydrophobic surfaces vibrating at 60 – 300 Hz and amplitudes of 0 – 3 mm. In addition, we studied the influence of the phase of the substrate at the moment of impact on total contact time. We demonstrate that substrate vibration can alter droplet dynamics, and decrease total contact time by as much as 50% compared to impact on stationary rigid superhydrophobic surfaces. Impact analysis revealed that the vibration frequency mainly affected the maximum contact time, while the amplitude of vibration had little direct effect on the contact time. Through mathematical modeling, we show that the oscillation amplitude influences the possibility density function of droplet impact at a given phase, and thus indirectly influences the average contact time. We also observed more vigorous droplet splashing and breakup during impact at larger amplitudes. Through semi-empirical mathematical modeling, we describe the relationship between contact time and vibration frequency, phase, and amplitude of the substrate. We also show that the maximum acceleration during the impact process is better suited as a threshold parameter for the onset of splashing than a Weber-number criterion. This study not only provides new insights into droplet impact physics on vibrating surfaces, but develops guidelines for the rational design of surfaces to achieve controllable droplet wetting in applications utilizing vibration.

Keywords: contact time, impact dynamics, oscillation, pear-shape droplet

Procedia PDF Downloads 454

Authors: Yu-Che Cheng, Min-Lih Chang, Ke-Hao Cheng, Chuan-Cheng Wang

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Taiwan is an island located along the southeastern coast of the Asian continent, located between Japan and the Philippines. It is surrounded by the sea on all sides. However, due to the presence of the Central Mountain Range, the rivers on the east and west coasts of Taiwan are relatively short. This geographical feature results in a phenomenon where, despite having rainfall that is 2.6 times the world average, 58.5% of the rainwater flows into the ocean. Moreover, approximately 80% of the annual rainfall occurs between May and October, leading to distinct wet and dry periods. To address these challenges, Taiwan relies on large reservoirs, storage ponds, and groundwater extraction for water resource allocation. It is necessary to construct water treatment facilities at suitable locations to provide the population with a stable and reliable water supply. In general, the construction of a new water treatment plant requires careful planning and evaluation. The process involves acquiring land and issuing contracts for construction in a sequential manner. With the increasing severity of global warming and climate change, there is a heightened risk of extreme hydrological events and severe water situations in the future. In cases of urgent water supply needs in a region, relying on traditional lengthy processes for constructing water treatment plants might not be sufficient to meet the urgent demand. Therefore, this study aims to explore the use of simplified water treatment procedures and the construction of rapid "temporary water treatment plants" to tackle the challenges posed by extreme climate conditions (such as a century-long drought) and situations where water treatment plant construction cannot keep up with the pace of water source development.

Keywords: temporary water treatment plant, emergency water supply, construction site groundwater, drought

Procedia PDF Downloads 91

Authors: Jae-Ho Jang, Jung-Soo Kim, Byung-Jun Kim, Dae-Geun Nam, Uoo-Chang Jung, Yoon-Suk Choi

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Low alloy steels are widely used for pressure vessels, spent fuel storage, and steam generators required to withstand the internal pressure and prevent unexpected failure in nuclear power plants, which these may suffer embrittlement by high levels of radiation and heat for a long period. Therefore, it is important to improve mechanical properties of low alloy steels for the integrity of structure materials at an early stage of fabrication. Recently, it showed that a double austenitizing and tempering (DTA) process resulted in a significant improvement of strength and toughness by refinement of prior austenite grains. In this study, it was investigated that the mechanism of improving mechanical properties according to the change of microstructure by the second fully austenitizing temperature of the DAT process for low alloy steel required the structural integrity. Compared to conventional single austenitizing and tempering (SAT) process, the tensile elongation properties have improved about 5%, DBTTs have obtained result in reduction of about -65℃, and grain size has decreased by about 50% in the DAT process conditions. Grain refinement has crack propagation interference effect due to an increase of the grain boundaries and amount of energy absorption at low temperatures. The higher first austenitizing temperature in the DAT process, the more increase the spheroidized carbides and strengthening the effect of fine precipitates in the ferrite grain. The area ratio of the dimple in the transition area has increased by proportion to the effect of spheroidized carbides. This may the primary mechanisms that can improve low-temperature toughness and elongation while maintaining a similar hardness and strength.

Keywords: double austenitizing, Ductile Brittle transition temperature, grain refinement, heat treatment, low alloy steel, low-temperature toughness

Procedia PDF Downloads 511

Authors: Chang-Fa Liu, Yi-Ting Wang, Yuan Liu, Hai-Feng Wei, Lei Fang, Jin Li

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Heavy metals in sediments can cause adverse ecological effects while it exceeds a given criteria. The present study investigated sediment environmental quality, pollutant enrichment, ecological risk, and source identification for copper, cadmium, lead, zinc, mercury, and arsenic in the sediments collected from tidal flat marsh of Shuangtai estuary, China. The arithmetic mean integrated pollution index, geometric mean integrated pollution index, fuzzy integrated pollution index, and principal component score were used to characterize sediment environmental quality; fuzzy similarity and geo-accumulation Index were used to evaluate pollutant enrichment; correlation matrix, principal component analysis, and cluster analysis were used to identify source of pollution; environmental risk index and potential ecological risk index were used to assess ecological risk. The environmental qualities of sediment are classified to very low degree of contamination or low contamination. The similar order to element background of soil in the Liaohe plain is region of Sanjiaozhou, Honghaitan, Sandaogou, Xiaohe by pollutant enrichment analysis. The source identification indicates that correlations are significantly among metals except between copper and cadmium. Cadmium, lead, zinc, mercury, and arsenic will be clustered in the same clustering as the first principal component. Copper will be clustered as second principal component. The environmental risk assessment level will be scaled to no risk in the studied area. The order of potential ecological risk is As > Cd > Hg > Cu > Pb > Zn.

Keywords: ecological risk assessment, heavy metals, sediment, marsh, Shuangtai estuary

Procedia PDF Downloads 350

Authors: Bing–Jing Zhao, Chang-Kui Liu, Hong Wang, Min Hu

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Electron beam rapid manufacturing (EBRM) or Selective laser melting is an additive manufacturing process that uses 3D CAD data as a digital information source and energy in the form of a high-power laser beam or electron beam to create three-dimensional metal parts by fusing fine metallic powders together.Object:The present study was conducted to evaluate the mechanical properties ,the phase transformation,the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM,SLM and forging technique.Method: Ti-6Al-4V alloy standard test pieces were manufactured by EBRM, SLM and forging technique according to AMS4999,GB/T228 and ISO 10993.The mechanical properties were analyzed by universal test machine. The phase transformation was analyzed by X-ray diffraction and scanning electron microscopy. The corrosivity was analyzed by electrochemical method. The biocompatibility was analyzed by co-culturing with mesenchymal stem cell and analyzed by scanning electron microscopy (SEM) and alkaline phosphatase assay (ALP) to evaluate cell adhesion and differentiation, respectively. Results: The mechanical properties, the phase transformation, the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM、SLM were similar to forging and meet the mechanical property requirements of AMS4999 standard. a­phase microstructure for the EBM production contrast to the a’­phase microstructure of the SLM product. Mesenchymal stem cell adhesion and differentiation were well. Conclusion: The property of the Ti-6Al-4V alloy manufactured by EBRM and SLM technique can meet the medical standard from this study. But some further study should be proceeded in order to applying well in clinical practice.

Keywords: 3D printing, Electron Beam Rapid Manufacturing (EBRM), Selective Laser Melting (SLM), Computer Aided Design (CAD)

Procedia PDF Downloads 455

Authors: Ponchang Apollos Wuyep, Alice Njolke Mafe, Longchi Satkat Zacheaus, Dogun Ojochogu, Dabot Ayuba Yakubu

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Fungi causes huge losses when infections occur both in plants and animals. Synthetic Antifungal drugs are mostly very expensive and highly cytotoxic when taken. This study was aimed at determining the in vitro and in vivo antifungal activities of the leaves and stem extracts of Terminalia mantaly (Umbrella tree)H. Perrier on Aspergillus species in a bid to identify potential sources of cheap starting materials for the synthesis of new drugs to address the growing antimicrobial resistance. T. mantaly leave and stem powdered plant was extracted by fractionation using the method of solvent partition co-efficient in their graded form in the order n-hexane, Ethyl acetate, methanol and distilled water and phytochemical screening of each fraction revealed the presence of alkaloids, saponins, Tannins, flavonoids, carbohydrates, steroids, anthraquinones, cardiac glycosides and terpenoids in varying degrees. The Agar well diffusion technique was used to screen for antifungal activity of the fractions on clinical isolates of Aspergillus species (Aspergillus flavus and Aspergillus fumigatus). Minimum inhibitory concentration (MIC50) of the most active extracts was determined by the broth dilution method. The fractions test indicated a high antifungal activity with zones of inhibition ranging from 6 to 26 mm and 8 to 30mm (leave fractions) and 10mm to 34mm and 14mm to36mm (stem fractions) on A. flavus and A. fumigatus respectively. All the fractions indicated antifungal activity in a dose response relationship at concentrations of 62.5mg/ml, 125mg/ml, 250mg/ml and 500mg/ml. Better antifungal efficacy was shown by the Ethyl acetate, Hexane and Methanol fractions in the in vitro as the most potent fraction with MIC ranging from 62.5 to 125mg/ml. There was no statistically significant difference (P>0.05) in the potency of the Eight fractions from leave and stem (Hexane, Ethyl acetate, methanol and distilled water, antifungal (fluconazole), which served as positive control and 10% DMSO(Dimethyl Sulfoxide)which served as negative control. In the in vivo investigations, the ingestion technique was used for the infectious studies Female Drosophilla melanogaster(UAS-Diptericin)normal flies(positive control),infected and not treated flies (negative control) and infected flies with A. fumigatus and placed on normal diet, diet containing fractions(MSM and HSM each at concentrations of 10mg/ml 20mg/ml, 30mg/ml, 40mg/ml, 50mg/ml, 60mg/ml, 70mg/ml, 80mg/ml, 90mg/ml and 100mg/ml), diet containing control drugs(fluconazole as positive control)and infected flies on normal diet(negative control), the flies were observed for fifteen(15) days. Then the total mortality of flies was recorded each day. The results of the study reveals that the flies were susceptible to infection with A. fumigatus and responded to treatment with more effectiveness at 50mg/ml, 60mg/ml and 70mg/ml for both the Methanol and Hexane stem fractions. Therefore, the Methanol and Hexane stem fractions of T. mantaly contain therapeutically useful compounds, justifying the traditional use of this plant for the treatment of fungal infections.

Keywords: Terminalia mantaly, Aspergillus fumigatus, cytotoxic, Drosophila melanogaster, antifungal

Procedia PDF Downloads 87

Authors: Yu-Hsuan Chang, Jian-Hao Su, Chen-Yu Chen, Wei-Mon Yan

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In this work, the experimental measurement was applied to examine the membrane type and flow field design on the performance of a planar membrane humidifier. The performance indexes were used to evaluate the planar membrane humidifier. The performance indexes of the membrane humidifier include the dew point approach temperature (DPAT), water recovery ratio (WRR), water flux (J) and pressure loss (P). The experiments contain mainly three parts. In the first part, a single membrane humidifier was tested using different flow field under different dry-inlet temperatures. The measured results show that the dew point approach temperature decreases with increasing the depth of flow channel at the same width of flow channel. However, the WRR and J reduce with an increase in the dry air-inlet temperature. The pressure loss tests indicate that pressure loss decreases with increasing the hydraulic diameter of flow channel, resulting from an increase in Darcy friction. Owing to the comparison of humidifier performances and pressure losses, the flow channel of width W=1 and height H=1.5 was selected as the channel design of the multi-membrane humidifier in the second part of experiment. In the second part, the multi-membrane humidifier was used to evaluate the humidification performance under different relative humidity and flow rates. The measurement results indicate that the humidifier at both lower temperature and relative humidity of inlet dry air have higher DPAT but lower J and WRR. In addition, the counter flow approach has better mass and heat transfer performance than the parallel flow approach. Moreover, the effects of dry air temperature, relative humidity and humidification approach are not significant to the pressure loss in the planar membrane humidifier. For the third part, different membranes were tested in this work in order to find out which kind membrane is appropriate for humidifier.

Keywords: water management, planar membrane humidifier, heat and mass transfer, pressure loss, PEM fuel cell

Procedia PDF Downloads 206

Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

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Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

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Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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Authors: Chi-Jung Chung, Chao-Hsiang Chang, Chiu-Shong Liu, Sheng-Wei Li, Mu-Chi Chung, Ting-Jie Wen, Hui-Ling Lee

Abstract:

Cigarette smoke contains volatile organic compounds (VOCs), such as acrylamide, 1,3-butadiene, and benzene. This study aimed to explore the associations between the urinary levels of cotinine and VOC metabolites and the risk of urothelial carcinoma (UC). A hospital-based case–control study involving two groups matched on the basis of age ( ± 3 years) and gender was designed. UC was clinically diagnosed through urological examinations and pathologically verified. Smoking-related information was collected through questionnaires and face-to-face interviews with all study participants. Urine samples were collected for the analysis of the urinary levels of VOC metabolites, cotinine, and 8-hydroxydeoxygua- nosine (8-OHdG), which was selected as a proxy of oxidative stress. Multiple logistic regressions were applied to estimate the risk of UC. The urinary cotinine and 8-OHdG levels of the UC group were higher than those of the control group. The urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA), N- acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S- (4- hydroxy-2-buten-1-yl)-Lcysteine-3, trans, trans-muconic acid (t,t- MA), and S-phenylmercapturic acid (SPMA) increased as the urinary levels of cotinine increased. Relevant dose-response relationships between the risk of UC risk and the urinary levels of AAMA , t,t-MA, SPMA, and 8-OHdG were found after adjusting for potential risk factors. The UC risk of participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG were 3.5–6-fold higher than those of other participants. Increased urinary levels of VOC metabolites were associated with smoking-related UC risk. The development of UC should be explored in large-scale in vitro or in vivo studies with the repeated measurement of VOC metabolites.

Keywords: volatile organic compound, urothelial carcinoma, cotinine, 8-hydroxydeoxyguanosine

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Authors: Rong-Yang Lai, Jia-Yu Wu, Chih-Han Chang, Yung-Chung Chen

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The dental bridge is one of the clinical methods of the treatment for missing teeth. The dental bridge is generally designed for two layers, containing the inner layer of the framework(zirconia) and the outer layer of the porcelain-fused to framework restorations. The design of a conventional bridge is generally based on the antagonist tooth profile so that the framework evenly indented by an equal thickness from outer contour. All-ceramic dental bridge made of zirconia have well demonstrated remarkable potential to withstand a higher physiological occlusal load in posterior region, but it was found that there is still the risk of all-ceramic bridge failure in five years. Thus, how to reduce the incidence of failure is still a problem to be solved. Therefore, the objective of this study is to develop mechanical designs for all-ceramic dental bridges framework by reducing the stress and enhancing fracture resistance under given loading conditions by finite element method. In this study, dental design software is used to design dental bridge based on tooth CT images. After building model, Bi-directional Evolutionary Structural Optimization (BESO) Method algorithm implemented in finite element software was employed to analyze results of finite element software and determine the distribution of the materials in dental bridge; BESO searches the optimum distribution of two different materials, namely porcelain and zirconia. According to the previous calculation of the stress value of each element, when the element stress value is higher than the threshold value, the element would be replaced by the framework material; besides, the difference of maximum stress peak value is less than 0.1%, calculation is complete. After completing the design of dental bridge, the stress distribution of the whole structure is changed. BESO reduces the peak values of principle stress of 10% in outer-layer porcelain and avoids producing tensile stress failure.

Keywords: dental bridge, finite element analysis, framework, automatic program

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Authors: Chia-Wen Yeh, Ting-Sheng Lin, Chih-Han Chang

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Pressure garment has been used to prevent and treat the hypertrophic scars following serious burns since 1970s. The use of pressure garment is believed to hasten the maturation process and decrease the highness of scars. Pressure garment is custom made by reducing circumferential measurement of the patient by 10%~20%, called Reduction Factor. However the exact reducing value used depends on the subjective judgment of the therapist and the feeling of patients throughout the try and error process. The Laplace Law can be applied to calculate the pressure from the dimension of the pressure garment by the circumferential measurements of the patients and the tension profile of the fabrics. The tension profile currently obtained neglects the stress relaxation and hysteresis effect within most elastic fabrics. The purpose of this study was to investigate the influence of the tension attenuation, from stress relaxation and hysteresis effect of the fabrics. Samples of pressure garment were obtained from Sunshine Foundation Organization, a nonprofit organization for burn patients in Taiwan. The wall tension profile of pressure garments were measured on a material testing system. Specimens were extended to 10% of the original length, held for 1 hour for the influence of the stress relaxation effect to take place. Then, specimens were extended to 15% of the original length for 10 seconds, then reduced to 10% to simulate donning movement for the influence of the hysteresis effect to take place. The load history was recorded. The stress relaxation effect is obvious from the load curves. The wall tension is decreased by 8.5%~10% after 60mins of holding. The hysteresis effect is obvious from the load curves. The wall tension is increased slightly, then decreased by 1.5%~2.5% and lower than stress relaxation results after 60mins of holding. The wall tension attenuation of the fabric exists due to stress relaxation and hysteresis effect. The influence of hysteresis is more than stress relaxation. These effect should be considered in order to design and evaluate the pressure of pressure garment more accurately.

Keywords: hypertrophic scars, hysteresis, pressure garment, stress relaxation

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Authors: Mark Kaahwa, Chang Zhu, Moses Muhumuza

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This study investigates the satisfaction of distance education university students (DEUS) with the use of audio media as a medium of instruction. Studying students’ satisfaction is vital because it shows whether learners are comfortable with a certain instructional strategy or not. Although previous studies have investigated the use of audio media, the satisfaction of students with an instructional strategy that combines radio teaching and podcasts as an independent teaching strategy has not been fully investigated. In this study, all lectures were delivered through the radio and students had no direct contact with their instructors. No modules or any other material in form of text were given to the students. They instead, revised the taught content by listening to podcasts saved on their mobile electronic gadgets. Prior to data collection, DEUS received orientation through workshops on how to use audio media in distance education. To achieve objectives of the study, a survey, naturalistic observations and face-to-face interviews were used to collect data from a sample of 211 undergraduate and graduate students. Findings indicate that there was no statistically significant difference in the levels of satisfaction between male and female students. The results from post hoc analysis show that there is a statistically significant difference in the levels of satisfaction regarding the use of audio media between diploma and graduate students. Diploma students are more satisfied compared to their graduate counterparts. T-test results reveal that there was no statistically significant difference in the general satisfaction with audio media between rural and urban-based students. And ANOVA results indicate that there is no statistically significant difference in the levels of satisfaction with the use of audio media across age groups. Furthermore, results from observations and interviews reveal that DEUS found learning using audio media a pleasurable medium of instruction. This is an indication that audio media can be considered as an instructional strategy on its own merit.

Keywords: audio media, distance education, distance education university students, medium of instruction, satisfaction

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Authors: Chang Li Yu

Abstract:

Resistances commonly happened during sexual offenders treatment program (SOTP), and removing resistances was one of the treatment goals on it. Studies concerning treatment effectiveness relied on pre- and post-treatment evaluations, however, no significant difference on resistance revealed after treatment, and the above consequences generally contributed to the low motivation for change instead. Therefore, the aim of this study was to investigate the resistance across each stage of change among sexual offenders (SO). The present study recruited prisoned SO in Taiwan, excluding those with literacy difficulties; finally, 272 participants were included. Of all participants completed revised version of URICA (University of Rhode Island Change Assessment) and resistance scale specifically for SO. The former included four stages of change: pre-contemplation (PC), contemplation (C), action (A), and maintain (M); the later composed eight types of resistance: system blaming, victims blaming, problems with treatment alliance, social justification, hopelessness, isolation, psychological reactance, and passive reactance. Both of the instruments were with well reliability and validity. Descriptive statistics and ANOVA were performed. All of 272 participants, age under 25 were 18(6.6%), 25-39 were 133(48.9%), 40-54 were 102(37.5%), and age over 55 were 19(7.0%); college level and above were 53(19.5%), high school level were 110(40.4%), and under high school level were 109(40.1%); first offended were 117(43.0%), and recidivist were 23(8.5%). Further deleting data with missing values and invalid questionnaires, SO with stage of change on PC were 43(18.9%), C were 109(47.8%), A were 70(30.7%), and on M were 6(2.6%). One-way ANOVA showed significant differences on every kind of resistances, excepting isolation and passive reactance. Post-hoc analysis showed that SO with different stages had their main resistance. There are two contributions to the present study. First, this study provided a clinical and theoretical measurement of evaluation that was never used in the past. Second, this study used an evidence-based methodology to prove a clinical perspective differed from the past, suggesting that resistances to treatment on SO appear the whole therapeutic process, when SO progress into the next stage of change, clinicians have to deal with their main resistance for working through the therapy.

Keywords: resistance, sexual offenders treatment program (SOTP), motivation for change, prisoned sexual offender

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Kuo-Chun Chien, Chia-Hui Chang, Ren-Der Sun

Abstract:

Legal Judgment Prediction (LJP) is a subtask for legal AI. Its main purpose is to use the facts of a case to predict the judgment result. In Taiwan's criminal procedure, when prosecutors complete the investigation of the case, they will decide whether to prosecute the suspect and which article of criminal law should be used based on the facts and evidence of the case. In this study, we collected 305,240 indictments from the public inquiry system of the procuratorate of the Ministry of Justice, which included 169 charges and 317 articles from 21 laws. We take the crime facts in the indictments as the main input to jointly learn the prediction model for law source, article, and charge simultaneously based on the pre-trained Bert model. For single article cases where the frequency of the charge and article are greater than 50, the prediction performance of law sources, articles, and charges reach 97.66, 92.22, and 60.52 macro-f1, respectively. To understand the big performance gap between articles and charges, we used a bipartite graph to visualize the relationship between the articles and charges, and found that the reason for the poor prediction performance was actually due to the wording precision. Some charges use the simplest words, while others may include the perpetrator or the result to make the charges more specific. For example, Article 284 of the Criminal Law may be indicted as “negligent injury”, "negligent death”, "business injury", "driving business injury", or "non-driving business injury". As another example, Article 10 of the Drug Hazard Control Regulations can be charged as “Drug Control Regulations” or “Drug Hazard Control Regulations”. In order to solve the above problems and more accurately predict the article and charge, we plan to include the article content or charge names in the input, and use the sentence-pair classification method for question-answer problems in the BERT model to improve the performance. We will also consider a sequence-to-sequence approach to charge prediction.

Keywords: legal judgment prediction, deep learning, natural language processing, BERT, data visualization

Procedia PDF Downloads 122

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Jenn-Woei Hsieh, Ching-Yu Tseng

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This study aimed to determine the effects of whole-body vibration (WBV) training on lower-extremity muscle strength and balance control performance among community-dwelling middle-aged and older adults in the United States. Twenty-nine participants without any contraindication of performing WBV exercise completed all the study procedures. Participants were randomly assigned to do body weight exercise with either an individualized vibration frequency and amplitude, a fixed vibration frequency and amplitude, or no vibration. Isokinetic knee extensor power, limits of stability, and sit-to-stand tests were performed at the baseline and after 8 weeks of training. Neither the individualized frequency-amplitude WBV training protocol nor the fixed frequency-amplitude WBV training protocol improved isokinetic knee extensor power. The limits of stability endpoint excursion score for the individualized frequency-amplitude group increased by 8.8 (12.9%; p = 0.025) after training. No significant differences were observed in fixed and control group. The maximum excursion score for the individualized frequency-amplitude group at baseline increased by 9.2 (11.5%; p = 0.006) after training. The average weight transfer time score significantly decreased by 0.21 s in the fixed group. The participants in the individualized group showed a significant increase (3.2%) in weight rising index score after 8 weeks of WBV training. These results suggest that 8 weeks of WBV training improved limit of stability and sit-to-stand performance. Future studies need to determine whether WBV training improves other factors that can influence posture control.

Keywords: whole-body vibration training, muscle strength, balance control, middle-aged and older adults

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Authors: Yi-Shuan ShaoShao, Yen-An Tsai, Chia-Huang Chang, Kai-Wei Liao, Ming-Song Tsai, Mei-Lien Chen

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Organophosphate pesticides (OPs) is an environmental hormone with proven endocrine-disrupting effects that may affect the growth and development in human. A large amount of organophosphate pesticides (OPs) is used throughout Taiwan, and human may be exposed through dietary intake or residential use. During pregnancy, OPs can be transferred to the blood stream reaching the fetus through the placenta. The aim of this study was to explore the association between maternal OPs exposure levels and fetal developments and birth outcomes. A birth cohort was follow-up. Maternal urine sample were collected at the first, second, and third gestational trimester. Fetal growth characteristics were measured by ultrasonic scan and birth outcomes were assessed by pediatrician. Urinary metabolite of organophosphate pesticides were assessed using gas chromatography-mass spectrometry. The analytes included dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphates (DMDTP), diethylphosphate (DEP), diethylthiophosphate (DETP), and diethyldithiophosphate (DEDTP). We found that all of urine samples in each trimester were detected at least one metabolite for dialkyl phosphate (DAP). The detection rate range of OP urinary metabolites were from the lowest 22% DEDTP to the highest 100% DMP and DMTP. And to compared geometric means (GM) of urinary metabolites with three trimesters, that third trimester had the highest concentration for DMPs, DEPs, and DAPs in pregnant women were 368.01, 169.85 and 543.75 nmol/g creatinine, respectively. We observed that DAPs concentration in first and second trimester were significantly negative association with head circumference. DMPs in first trimester was significantly negative association with thoracic circumference (p=0.05) by spearman correlation. Our results support associations with prenatal OPs exposure with fetal head circumference and thoracic circumference. It provided that maternal OPs exposure might affect birth outcomes. Thus, prenatal exposure to OPs and health risk worthy of attention and concern.

Keywords: DAPs, birth outcomes, organophosphate pesticides, prenatal

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