Search results for: eccentric load introduction

Authors: S. Cichosz, A. Masek

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A new cellulose hybrid modification approach, which is undoubtedly a scientific novelty, is introduced. The study reports the properties of cellulose (Arbocel UFC100 – Ultra Fine Cellulose) and characterizes cellulose filled polymer composites based on an ethylene-norbornene copolymer (TOPAS Elastomer E-140). Moreover, the approach of physicochemical two-stage cellulose treatment is introduced: solvent exchange (to ethanol or hexane) and further chemical modification with maleic anhydride (MA). Furthermore, the impact of the drying process on cellulose properties was investigated. Suitable measurements were carried out to characterize cellulose fibers: spectroscopic investigation (Fourier Transform Infrared Spektrofotometer-FTIR, Near InfraRed spectroscopy-NIR), thermal analysis (Differential scanning calorimetry, Thermal gravimetric analysis ) and Karl Fischer titration. It should be emphasized that for all UFC100 treatments carried out, a decrease in moisture content was evidenced. FT-IR reveals a drop in absorption band intensity at 3334 cm-1, the peak is associated with both –OH moieties and water. Similar results were obtained with Karl Fischer titration. Based on the results obtained, it may be claimed that the employment of ethanol contributes greatly to the lowering of cellulose water absorption ability (decrease of moisture content to approximately 1.65%). Additionally, regarding polymer composite properties, crucial data has been obtained from the mechanical and thermal analysis. The highest material performance was noted in the case of the composite sample that contained cellulose modified with MA after a solvent exchange with ethanol. This specimen exhibited sufficient tensile strength, which is almost the same as that of the neat polymer matrix – in the region of 40 MPa. Moreover, both the Payne effect and filler efficiency factor, calculated based on dynamic mechanical analysis (DMA), reveal the possibility of the filler having a reinforcing nature. What is also interesting is that, according to the Payne effect results, fibers dried before the further chemical modification are assumed to allow more regular filler structure development in the polymer matrix (Payne effect maximum at 1.60 MPa), compared with those not dried (Payne effect in the range 0.84-1.26 MPa). Furthermore, taking into consideration the data gathered from DSC and TGA, higher thermal stability is obtained in case of the materials filled with fibers that were dried before the carried out treatments (degradation activation energy in the region of 195 kJ/mol) in comparison with the polymer composite samples filled with unmodified cellulose (degradation activation energy of approximately 180 kJ/mol). To author’s best knowledge this work results in the introduction of a novel, new filler hybrid treatment approach. Moreover, valuable data regarding the properties of composites filled with cellulose fibers of various moisture contents have been provided. It should be emphasized that plant fiber-based polymer bio-materials described in this research might contribute significantly to polymer waste minimization because they are more readily degraded.

Keywords: cellulose fibers, solvent exchange, moisture content, ethylene-norbornene copolymer

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Authors: Maryam Shahbazi, Amy B. Cerato

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The importance of a systems’ natural frequency (fn) emerges when the vibration force frequency is equivalent to foundation's fn which causes response amplitude (resonance) that may cause irreversible damage to the structure. Several factors such as pile geometry (e.g., length and diameter), soil density, load magnitude, pile condition, and physical structure affect the fn of a soil-pile system; some of these parameters are evaluated in this study. Although experimental and analytical studies have assessed the fn of a soil-pile system, few have included individual and grouped helical piles. Thus, the current study aims to provide quantitative data on dynamic characteristics of helical pile-soil systems from full-scale shake table tests that will allow engineers to predict more realistic dynamic response under motions with variable frequency ranges. To evaluate the fn of single and grouped helical piles in dry dense sand, full-scale shake table tests were conducted in a laminar box (6.7 m x 3.0 m with 4.6 m high). Two different diameters (8.8 cm and 14 cm) helical piles were embedded in the soil box with corresponding lengths of 3.66m (excluding one pile with length of 3.96) and 4.27m. Different configurations were implemented to evaluate conditions such as fixed and pinned connections. In the group configuration, all four piles with similar geometry were tied together. Simulated real earthquake motions, in addition to white noise, were applied to evaluate the wide range of soil-pile system behavior. The Fast Fourier Transform (FFT) of measured time history responses using installed strain gages and accelerometers were used to evaluate fn. Both time-history records using accelerometer or strain gages were found to be acceptable for calculating fn. In this study, the existence of a pile reduced the fn of the soil slightly. Greater fn occurred on single piles with larger l/d ratios (higher slenderness ratio). Also, regardless of the connection type, the more slender pile group which is obviously surrounded by more soil, yielded higher natural frequencies under white noise, which may be due to exhibiting more passive soil resistance around it. Relatively speaking, within both pile groups, a pinned connection led to a lower fn than a fixed connection (e.g., for the same pile group the fn’s are 5.23Hz and 4.65Hz for fixed and pinned connections, respectively). Generally speaking, a stronger motion causes nonlinear behavior and degrades stiffness which reduces a pile’s fn; even more, reduction occurs in soil with a lower density. Moreover, fn of dense sand under white noise signal was obtained 5.03 which is reduced by 44% when an earthquake with the acceleration of 0.5g was applied. By knowing the factors affecting fn, the designer can effectively match the properties of the soil to a type of pile and structure to attempt to avoid resonance. The quantitative results in this study assist engineers in predicting a probable range of fn for helical pile foundations under potential future earthquake, and machine loading applied forces.

Keywords: helical pile, natural frequency, pile group, shake table, stiffness

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Authors: Naniek Widayati Priyomarsono

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Introduction: In beginning of Karaton formation, namely, era of Javanese kingdom town had the power region outside castle town (called as Mancanegara), settlement of karaton can function as “the space-between” and “space-defense”, besides it was one of components from governmental structure and karaton power at that time (internal servant/abdi dalem and sentana dalem). Upon the Independence of Indonesia in 1945 “Kingdom-City” converted its political status into part of democratic town managed by statutes based on the classification. The latter affects local culture hierarchy alteration due to the physical development and events. Dynamics of social economy activities in Kampung Karaton surrounded by buildings of Complex of Karaton Kasunanan ini, have impact on the urban system disturbed into the región. Also cultural region image fades away with the weak visual access from existant cultural artefacts. That development lacks of giving appreciation to the established region image providing identity of Karaton Kasunanan particularly and identity of Surakarta city in general. Method used is strategy of grounded theory research (research providing strong base of a theory). Research is focused on actors active and passive relevantly getting involved in change process of Karaton settlement. Data accumulated is “Investigation Focus” oriented on actors affecting that change either internal or external. Investigation results are coupled with field observation data, documentation, literature study, thus it takes accurate findings. Findings: Karaton village has potential products as attraction, possessing human resource support, strong motivation from society still living in that settlement, possessing facilities and means supports, tourism event-supporting facilities, cultural art institution, available fields or development area. Data analyzed: To get the expected result it takes restoration in social cultural development direction, and economy, with ways of: Doing social cultural development strategy, economy, and politics. To-do steps are program socialization of Karaton village as Tourism Village, economical development of local society, regeneration pattern, filtering, and selection of tourism development, integrated planning system development, development with persuasive approach, regulation, market mechanism, social cultural event sector development, political development for region activity sector. Summary: In case the restoration is done by getting society involved as subject of that settlement (active participation in the field), managed and packed interestingly and naturally with tourism-supporting facilities development, village of Karaton Kasunanan Surakarta is ready to receive visit of domestic and foreign tourists.

Keywords: karaton village, finding, restoration, economy, Indonesia

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Authors: Shyamani Hettiarachchi, Thilini Lokubalasuriya, Shakeela Saleem, Dinusha Nonis, Isuru Dharmaratne, Lakshika Udugama

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Introduction: Late identification of language difficulties in children could result in long-term negative consequences for communication, literacy and self-esteem. This highlights the need for early identification and intervention for speech, language and communication difficulties. Speech and language therapy is a relatively new profession in Sri Lanka and at present, there are no formal standardized screening tools to assess language skills in Sinhala-speaking children. The development and validation of a short, accurate screening tool to enable the identification of children with syntactic difficulties in Sinhala is a current need. Aims: 1) To develop test items for a Sinhala Syntactic Structures (S3 Short Form) test on children aged between 3;0 to 5;0 years 2) To validate the test of Sinhala Syntactic Structures (S3 Short Form) on children aged between 3; 0 to 5; 0 years Methods: The Sinhala Syntactic Structures (S3 Short Form) was devised based on the Renfrew Action Picture Test. As Sinhala contains post-positions in contrast to English, the principles of the Renfrew Action Picture Test were followed to gain an information score and a grammar score but the test devised reflected the linguistic-specificity and complexity of Sinhala and the pictures were in keeping with the culture of the country. This included the dative case marker ‘to give something to her’ (/ejɑ:ʈə/ meaning ‘to her’), the instrumental case marker ‘to get something from’ (/ejɑ:gən/ meaning ‘from him’ or /gɑhən/ meaning ‘from the tree’), possessive noun (/ɑmmɑge:/ meaning ‘mother’s’ or /gɑhe:/ meaning ‘of the tree’ or /male:/ meaning ‘of the flower’) and plural markers (/bɑllɑ:/ bɑllo:/ meaning ‘dog/dogs’, /mɑlə/mɑl/ meaning ‘flower/flowers’, /gɑsə/gɑs/ meaning ‘tree/trees’ and /wɑlɑ:kulə/wɑlɑ:kulu/ meaning ‘cloud/clouds’). The picture targets included socio-culturally appropriate scenes of the Sri Lankan New Year celebration, elephant procession and the Buddhist ‘Wesak’ ceremony. The test was piloted with a group of 60 participants and necessary changes made. In phase 1, the test was administered to 100 Sinhala-speaking children aged between 3; 0 and 5; 0 years in one district. In this presentation on phase 2, the test was administered to another 100 Sinhala-speaking children aged between 3; 0 to 5; 0 in three districts. In phase 2, the selection of the test items was assessed via measures of content validity, test-retest reliability and inter-rater reliability. The age of acquisition of each syntactic structure was determined using content and grammar scores which were statistically analysed using t-tests and one-way ANOVAs. Results: High percentage agreement was found on test-retest reliability on content validity and Pearson correlation measures and on inter-rater reliability. As predicted, there was a statistically significant influence of age on the production of syntactic structures at p<0.05. Conclusions: As the target test items included generated the information and the syntactic structures expected, the test could be used as a quick syntactic screening tool with preschool children.

Keywords: Sinhala, screening, syntax, language

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Authors: Theresa Bacon-Baguley, Martina Reinhold

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Introduction: The purpose of this paper is to discuss the importance of both formative and summative evaluation of a Physician Assistant (PA) program with a distant campus delivered through Interactive Television (ITV) to assure equity of educational experiences. Methodology: A needs assessment utilizing a case-control design determined the need and interest in expanding the existing PA program to northern Michigan. A federal grant was written and funded, which supported the hiring of two full-time faculty members and support staff at the distant site. The strengths and weaknesses of delivering a program through ITV were evaluated using weekly formative evaluation, and bi-semester summative evaluation. Formative evaluation involved discussion of lecture content to be delivered, special ITV needs, orientation of new lecturers to the system, student concerns, support staff updates, and scheduling of student/faculty traveling between the two campuses. The summative evaluation, designed from a literature review of barriers to ITV, included 19 statements designed to evaluate the following items: quality of technology (audio, video, etc.), confidence in the ITV system, quality of instruction and instructor interaction between the two locations, and availability of resources at each location. In addition, students were given the opportunity to write qualitative remarks for each course delivered between the two locations. This summative evaluation was given to all students at mid-semester and at the end of the semester. The goal of the summative evaluation was to have 80% or greater of the students respond favorably (‘Very Good’ or ‘Good’) to each of the 19 statements. Results: Prior to the start of the first cohort at the distant campus, the technology was tested. During this time period, the formative evaluations identified key components needing modification, which were rapidly addressed: ability to record lectures, lighting, sound, and content delivery. When the mid-semester summative survey was given to the first cohort of students, 18 of the 19 statements in the summative evaluation met the goal of 80% or greater in the favorable category. When the summative evaluation statements were stratified by the two cohorts, the summative evaluation identified that students at the home location responded that they did not have adequate access to printers, and students at the expansion location responded that they did not have adequate access to library resources. These results allowed the program to address the deficiencies through contacting informational technology for additional printers, and to provide students with knowledge on how to access library resources. Conclusion: Successful expansion of programs to a distant site utilizing ITV technology requires extensive monitoring using both formative and summative evaluation. The formative evaluation allowed for quick identification of issues that could immediately be addressed, both at the planning and developing stage, as well as during implementation. Through use of the summative evaluation the program is able to monitor the success/ effectiveness of the expansion and identify specific needs of students at each location.

Keywords: assessment, distance learning, formative feedback, interactive television (ITV), student experience, summative feedback, support

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Authors: Shatakshi Garg

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As the world continues to grapple with the COVID-19 pandemic, India, one of the most populous democratic federal developing nation, continues to report the highest active cases and deaths, as well as struggle to let its health infrastructure not succumb to the exponentially growing requirements of hospital beds, ventilators, oxygen to save thousands of lives daily at risk. In this context, the paper outlines the handling of the COVID-19 pandemic since it first hit India in January 2020 – the policy decisions taken by the Union and the State governments from the larger perspective of its federal structure. The Constitution of India adopted in 1950 enshrined the federal relations between the Union and the State governments by way of the constitutional division of revenue-raising and expenditure responsibilities. By way of the 72nd and 73rd Amendments in the Constitution, powers and functions were devolved further to the third tier, namely the local governments, with the intention of further strengthening the federal structure of the country. However, with time, several constitutional amendments have shifted the scales in favour of the union government. The paper briefly traces some of these major amendments as well as some policy decisions which made the federal relations asymmetrical. As a result, data on key fiscal parameters helps establish how the union government gained upper hand at the expense of weak state governments, reducing the local governments to mere constitutional bodies without adequate funds and fiscal autonomy to carry out the assigned functions. This quasi-federal structure of India with the union government amassing the majority of power in terms of ‘funds, functions and functionaries’ exposed the perils of weakening sub-national governments post COVID-19 pandemic. With a complex quasi-federal structure and a heterogeneous population of over 1.3 billion, the announcement of a sudden nationwide lockdown by the union government was followed by a plight of migrants struggling to reach homes safely in the absence of adequate arrangements for travel and safety-net made by the union government. With limited autonomy enjoyed by the states, they were mostly dictated by the union government on most aspects of handling the pandemic, including protocols for lockdown, re-opening post lockdown, and vaccination drive. The paper suggests that certain policy decisions like demonetization, the introduction of GST, etc., taken by the incumbent government since 2014 when they first came to power, have further weakened the states and local governments, which have amounted to catastrophic losses, both economic and human. The role of the executive, legislature and judiciary are explored to establish how all these three arms of the government have worked simultaneously to further weaken and expose the fault-lines of the federal structure of India, which has lent the nation incapacitated to handle this pandemic. The paper then suggests the urgency of re-looking at the federal structure of the country and undertaking measures that strengthen the sub-national governments and restore the federal spirit as was enshrined in the constitution to avoid mammoth human and economic losses from a pandemic of this sort.

Keywords: COVID-19 pandemic, India, federal structure, economic losses

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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Authors: Aleksandra Rajewska-Rager, Maria Skibinska, Monika Dmitrzak-Weglarz, Natalia Lepczynska, Pawel Kapelski, Joanna Pawlak, Joanna Hauser

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Introduction: Inflammation and cytokines have emerged as a promising target in mood disorders research; however there are still very limited numbers of study regarding inflammatory alterations among adolescents and young adults with mood disorders. The Macrophage Migration Inhibitory Factor (MIF) and Stem Cell Factor (SCF) are the pleiotropic cytokines which may play an important role in mood disorders pathophysiology. The aim of this study was to investigate levels of these factors in serum of adolescent and young adults with mood disorders compared to healthy controls. Subjects: We involved 79 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorders: bipolar disorder (BP) and unipolar disorder with BP spectrum. Study group includes 23 males (mean age 19.08, SD 3.3) and 56 females (18.39, SD 3.28). Control group consisted 35 persons: 7 males (20.43, SD 4.23) and 28 females (21.25, SD 2.11). Clinical diagnoses according to DSM-IV-TR criteria were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID) in young adults respectively. Clinical assessment includes evaluation of clinical factors and symptoms severity (rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale). Clinical and biological evaluations were made at control visits respectively at baseline (week 0), euthymia (at month 3 or 6) and after 12 and 24 months. Methods: Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human MIF and SCF DuoSet ELISA kits were used. In the analyses non-parametric tests were used: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation. We defined statistical significance as p < 0.05. Results: Comparing MIF and SCF levels between acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6) we did not find any statistical differences. At baseline patients with age above 18 years old had decreased MIF level compared to patients younger than 18 years. MIF level at baseline positively correlated with age (p=0.004). Positive correlations of SCF level at month 3 and 6 with depression or mania occurrence at month 24 (p=0.03 and p=0.04, respectively) was detected. Strong correlations between MIF and SCF levels at baseline (p=0.0005) and month 3 (p=0.03) were observed. Discussion: Our results did not show any differences in MIF and SCF levels between acute episode of depression/hypo/mania and euthymia in young patients. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: cytokines, MIF, mood disorders, SCF

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Authors: Swati Mishra

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In recent years, there has been an explosion in Gold NanoParticle (GNP) research, with a rapid increase in publications in diverse fields, including imaging, bioengineering, and molecular biology. GNPs exhibit unique physicochemical properties, including surface plasmon resonance (SPR) and bind amine and thiol groups, allowing surface modification and use in biomedical applications. Nanoparticle functionalization is the subject of intense research at present, with rapid progress being made towards developing biocompatible, multi-functional particles. In the present study, the photochemical method has been done to functionalize various-shaped GNPs like nanostars by the molecules like ninhydrin. Ninhydrin is bactericidal, virucidal, fungicidal, antigen-antibody reactive, and used in fingerprint technology in forensics. The GNPs functionalized with ninhydrin efficiently will bind to the amino acids on the target protein, which is of eminent importance during the pandemic, especially where long-term treatments of COVID- 19 bring many side effects of the drugs. The photochemical method is adopted as it provides low thermal load, selective reactivity, selective activation, and controlled radiation in time, space, and energy. The GNPs exhibit their characteristic spectrum, but a distinctly blue or redshift in the peak will be observed after UV irradiation, ensuring efficient ninhydrin binding. Now, the bound ninhydrin in the GNP carrier, upon chemically reacting with any amino acid, will lead to the formation of Rhumann purple. A common method of GNP production includes citrate reduction of Au [III] derivatives such as aurochloric acid (HAuCl4) in water to Au [0] through a one-step synthesis of size-tunable GNPs. The following reagents are prepared to validate the approach. Reagent A solution 1 is0.0175 grams ninhydrin in 5 ml Millipore water Reagent B 30 µl of HAuCl₄.3H₂O in 3 ml of solution 1 Reagent C 1 µl of gold nanostars in 3 ml of solution 1 Reagent D 6 µl of cetrimonium bromide (CTAB) in 3 ml of solution1 ReagentE 1 µl of gold nanostars in 3 ml of ethanol ReagentF 30 µl of HAuCl₄.₃H₂O in 3 ml of ethanol ReagentG 30 µl of HAuCl₄.₃H₂O in 3 ml of solution 2 ReagentH solution 2 is0.0087 grams ninhydrin in 5 ml Millipore water ReagentI 30 µl of HAuCl₄.₃H₂O in 3 ml of water The reagents were irradiated at 254 nm for 15 minutes, followed by their UV Visible spectroscopy. The wavelength was selected based on the one reported for excitation of a similar molecule Pthalimide. It was observed that the solution B and G deviate around 600 nm, while C peaks distinctively at 567.25 nm and 983.9 nm. Though it is tough to say about the chemical reaction happening, butATR-FTIR of reagents will ensure that ninhydrin is not forming Rhumann purple in the absence of amino acids. Therefore, these experiments, we achieved the functionalization of gold nanostars with ninhydrin corroborated by the deviation in the spectrum obtained in a mixture of GNPs and ninhydrin irradiated with UV light. It prepares them as a carrier molecule totake up amino acids for targeted delivery or germicidal action.

Keywords: gold nanostars, ninhydrin, photochemical method, UV visible specgtroscopy

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Authors: Tomola Obamuyi

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The banking system in Nigeria adopted innovative banking, with the aim of enhancing financial inclusion, and making financial services readily and cheaply available to majority of the people, and to contribute to the efficiency of the financial system. Some of the innovative services include: Automatic Teller Machines (ATMs), National Electronic Fund Transfer (NEFT), Point of Sale (PoS), internet (Web) banking, Mobile Money payment (MMO), Real-Time Gross Settlement (RTGS), agent banking, among others. The introduction of these payment systems is expected to increase bank efficiency and customers' satisfaction, culminating in better performance for the commercial banks. However, opinions differ on the possible effects of the various innovative payment systems on the performance of commercial banks in the country. Thus, this study empirically determines how commercial banks use innovation to gain competitive advantage in the specific context of Nigeria's finance and business. The study also analyses the effects of financial innovation on the performance of commercial banks, when different periods of analysis are considered. The study employed secondary data from 2009 to 2018, the period that witnessed aggressive innovation in the financial sector of the country. The Vector Autoregression (VAR) estimation technique forecasts the relative variance of each random innovation to the variables in the VAR, examine the effect of standard deviation shock to one of the innovations on current and future values of the impulse response and determine the causal relationship between the variables (VAR granger causality test). The study also employed the Multi-Criteria Decision Making (MCDM) to rank the innovations and the performance criteria of Return on Assets (ROA) and Return on Equity (ROE). The entropy method of MCDM was used to determine which of the performance criteria better reflect the contributions of the various innovations in the banking sector. On the other hand, the Range of Values (ROV) method was used to rank the contributions of the seven innovations to performance. The analysis was done based on medium term (five years) and long run (ten years) of innovations in the sector. The impulse response function derived from the VAR system indicated that the response of ROA to the values of cheques transaction, values of NEFT transactions, values of POS transactions was positive and significant in the periods of analysis. The paper also confirmed with entropy and range of value that, in the long run, both the CHEQUE and MMO performed best while NEFT was next in performance. The paper concluded that commercial banks would enhance their performance by continuously improving on the services provided through Cheques, National Electronic Fund Transfer and Point of Sale since these instruments have long run effects on their performance. This will increase the confidence of the populace and encourage more usage/patronage of these services. The banking sector will in turn experience better performance which will improve the economy of the country. Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression,

Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression

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Authors: Mohd Suhaizan Shamsuddin

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Urbanization exacerbates the environment quality and pressures of matured urban trees' growth and development in changing environment. The growth of struggled matured urban tree-roots by spreading within the existences of infrastructures, resulting in large damage to the structured and declined growth. Many physiological growths declined or damages by the present and installations of infrastructures within and nearby root zone. Afford to remain both matured urban tree and infrastructures as a service provider causes damage and death, respectively. Inasmuch, spending more expenditure on fixing both or removing matured urban trees as risky to the future environment as the mitigation methods to reduce the problems are unconcerned. This paper aims to explain mitigation method practices of reducing the encountered problems of matured urban tree-roots settling and infrastructures while modified urban soil to sustain at an optimum level. Three categories capturing encountered conflicts growth of matured urban tree-roots growth within and nearby infrastructures by mitigating the problems of limited soil spaces, poor soil structures and soil space barrier installations and maintenance. The limited soil space encountered many conflicts and identified six methods that mitigate the survival tree-roots, such as soil volume/mounding, soil replacement/amendment for the radial trench, soil spacing-root bridge, root tunneling, walkway/pavement rising/diverted, and suspended pavement. The limited soil spaces are mitigation affords of inadequate soil-roots and spreading root settling and modification of construction soil media since the barrier existed and installed in root trails or zones. This is the reason for enabling tree-roots spreading and finds adequate sources (nutrients, water uptake and oxygen), spaces and functioning to stability stand of root anchorage since the matured tree grows larger. The poor soil structures were identified as three methods to mitigate soil materials' problems, and fewer soil voids comprise skeletal soil, structural soil, and soil cell. Mitigation of poor soil structure is altering the existing and introducing new structures by modifying the quantities and materials ratio allowing more voids beneath for roots spreading by considering the above structure of foot and vehicle traffics functioning or load-bearing. The soil space barrier installations and maintenance recognized to sustain both infrastructures and tree-roots grown in limited spaces and its benefits, the root barrier installations and root pruning are recommended. In conclusion, these recommended methods attempt to mitigate the present problems encountered at a particular place and problems among tree-roots and infrastructures exist. The combined method is the best way to alleviates the conflicts since the recognized conflicts are between tree-roots and man-made while the urban soil is modified. These presenting methods are most considered to sustain the matured urban trees' lifespan growth in the urban environment.

Keywords: urban tree-roots, limited soil spaces, poor soil structures, soil space barrier and maintenance

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Authors: Vangmayee. V. Subban, Somashekara H. S, Shwetha Prabhu, Jayashree S. Bhat

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Introduction and Need: Phonological processing is critical in learning to read alphabetical and non-alphabetical languages. However, its role in learning to read Kannada an alphasyllabary is equivocal. The literature has focused on the developmental role of phonological awareness on reading. To the best of authors knowledge, the role of phonological memory and phonological naming has not been addressed in alphasyllabary Kannada language. Therefore, there is a need to evaluate the comprehensive role of the phonological processing skills in Kannada on word decoding skills during the early years of schooling. Aim and Objectives: The present study aimed to explore the phonological processing abilities and their role in learning to decode pseudowords in children learning to read the Kannada language during initial years of formal schooling between 5.6 to 8.6 years. Method: In this cross sectional study, 60 typically developing Kannada speaking children, 20 each from Grade I, Grade II, and Grade III between the age range of 5.6 to 6.6 years, 6.7 to 7.6 years and 7.7 to 8.6 years respectively were selected from Kannada medium schools. Phonological processing abilities were assessed using an assessment tool specifically developed to address the objectives of the present research. The assessment tool was content validated by subject experts and had good inter and intra-subject reliability. Phonological awareness was assessed at syllable level using syllable segmentation, blending, and syllable stripping at initial, medial and final position. Phonological memory was assessed using pseudoword repetition task and phonological naming was assessed using rapid automatized naming of objects. Both phonological awareneness and phonological memory measures were scored for the accuracy of the response, whereas Rapid Automatized Naming (RAN) was scored for total naming speed. Results: The mean scores comparison using one-way ANOVA revealed a significant difference (p ≤ 0.05) between the groups on all the measures of phonological awareness, pseudoword repetition, rapid automatized naming, and pseudoword reading. Subsequent post-hoc grade wise comparison using Bonferroni test revealed significant differences (p ≤ 0.05) between each of the grades for all the tasks except (p ≥ 0.05) for syllable blending, syllable stripping, and pseudoword repetition between Grade II and Grade III. The Pearson correlations revealed a highly significant positive correlation (p=0.000) between all the variables except phonological naming which had significant negative correlations. However, the correlation co-efficient was higher for phonological awareness measures compared to others. Hence, phonological awareness was chosen a first independent variable to enter in the hierarchical regression equation followed by rapid automatized naming and finally, pseudoword repetition. The regression analysis revealed syllable awareness as a single most significant predictor of pseudoword reading by explaining the unique variance of 74% and there was no significant change in R² when RAN and pseudoword repetition were added subsequently to the regression equation. Conclusion: Present study concluded that syllable awareness matures completely by Grade II, whereas the phonological memory and phonological naming continue to develop beyond Grade III. Amongst phonological processing skills, phonological awareness, especially syllable awareness is crucial for word decoding than phonological memory and naming during initial years of schooling.

Keywords: phonological awareness, phonological memory, phonological naming, phonological processing, pseudo-word decoding

Procedia PDF Downloads 148

Authors: Ifeyinwa Victor-Uadiale, Georgina Pearson, Sophie Witter, D. Reidpath

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Introduction: Smoking, alcohol misuse, unhealthy diet, and physical inactivity are the primary drivers of noncommunicable diseases (NCD), including cardiovascular diseases, cancers, respiratory diseases, and diabetes, worldwide. Collectively, these diseases are the leading cause of all global deaths, most of which are premature, affecting people between 30 and 70 years. Empirical evidence suggests that these risk behaviors can be modified by community-based interventions (CBI). However, there is little insight into the mechanisms and contextual factors of successful community interventions that impact risk behaviours for chronic diseases. This study examined “Under what circumstances, for whom, and how, do community-based interventions modify smoking, alcohol use, unhealthy diet, and physical inactivity among adults”. Adopting the Capability (C), Opportunity (O), Motivation (M), Behavior (B) (COM-B) framework for behaviour change, it sought to: (1) identify the mechanisms through which CBIs could reduce tobacco use and alcohol consumption and increase physical activity and the consumption of healthy diets and (2) examine the contextual factors that trigger the impact of these mechanisms on these risk behaviours among adults. Methods: Pawson’s realist review method was used to examine the literature. Empirical evidence and theoretical understanding were combined to develop a realist program theory that explains how CBIs influence NCD risk behaviours. Documents published between 2002 and 2020 were systematically searched in five electronic databases (CINAHL, Cochrane Library, Medline, ProQuest Central, and PsycINFO). They were included if they reported on community-based interventions aimed at cardiovascular diseases, cancers, respiratory diseases, and diabetes in a global context; and had an outcome targeted at smoking, alcohol, physical activity, and diet. Findings: Twenty-nine scientific documents were retrieved and included in the review. Over half of them (n = 18; 62%) focused on three of the four risk behaviours investigated in this review. The review identified four mechanisms: capability, opportunity, motivation, and social support that are likely to change the dietary and physical activity behaviours in adults given certain contexts. There were weak explanations of how the identified mechanisms could likely change smoking and alcohol consumption habits. In addition, eight contextual factors that may affect how these mechanisms impact physical activity and dietary behaviours were identified: suitability to work and family obligations, risk status awareness, socioeconomic status, literacy level, perceived need, availability and access to resources, culture, and group format. Conclusion: The findings suggest that CBIs are likely to improve the physical activity and dietary habits of adults if the intervention function seeks to educate, incentivize, change the environment, and model the right behaviours. The review applies and advances theory, realist research, and the design and implementation of community-based interventions for NCD prevention.

Keywords: community-based interventions, noncommunicable disease, realist program theory, risk behaviors

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Authors: Zeina Nasr, Bashar Merheb

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The honey bee is a social insect that had driven the human interest much more than any other organism. Beekeeping practices dated the appearance of Man on earth and now it provides a hobby or a secondary work that contributes to the family revenue and requires a little time engagement and money investment. Honey production is not the only contribution of honey bees to the economy, since honey bees play an important role in the pollination. Bee keeping in Lebanon is an important part of the agricultural economy. However, a growing concern about bees is spreading globally, due to an accelerated decline of bees colonies. This raises the alert to preserve and protect local bee strains against uncontrolled introduction of foreign strains and invasive parasitic species. Mitochondrial DNA (mtDNA) markers are commonly used in studying genetic variation in the Apis mellifera species. The DraI-COI-COII test is based on the analysis of the intergenic region between the two genes COI and COII. The different honey bee strains differ in the presence or absence of the p sequence and the number of Q sequences present. A. m. syriaca belonging to the lineage Z, is the native honey bee subspecies in Lebanon, Syria, Jordan, and Palestine. A. m. syriaca is known for its high defensiveness, even though it has many important advantages. However, commercial breeder strains, such as the Italian (A. m. ligustica), and Carniolan (A. m. carnica) strains, have been introduced by beekeepers and regularly used for honey production. This raises worries about the disappearance of the local subspecies. It is obvious that identifying A. m. syriaca colonies and protecting them against uncontrolled mating with other bee strains is a crucial step to protect and improve the original local strain. This study aims to reveal the existing sub-species of honey bee in Akkar – Lebanon and to assess the influence of introgression on the hybridization of the local strain. This will help to identify areas of pure A.m. syriaca population over this district to be considered in choosing syriaca reserves. We collected samples of bees from different regions of Akkar district in order to perform mtDNA analysis. We determined the restriction fragments length of the intergenic region COI-COII, using the restriction enzyme DraI. The results showed both the C and the Z lineages. Four restriction patterns were identified among the restriction maps of the studied samples. The most abundant mitochondrial lineage is the Z lineage constituting about 60% of the identified samples. Al-Dreib region reported the lowest introgression with foreign mtDNA of 21% making it the most suitable area for a genetic reserve of syriaca in Akkar based on its lowest introgression and suitable environment in addition to the attitude of local beekeepers to conserve the local strain. Finally, this study is the first step in constructing conservation programs for the preservation of the local strain and should be generalized to the whole Lebanese population, consistent with the effort done in neighboring countries.

Keywords: Akkar Lebanon, Apis millefera syriaca, DraI-COI-COII test, mitochondrial DNA

Procedia PDF Downloads 256

Authors: Ramez F. Saad, Ahmad Kobaissi, Bernard Amiaud, Julien Ruelle, Emile Benizri

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Agromining is a new technology that establishes agricultural systems on ultramafic soils in order to produce valuable metal compounds such as nickel (Ni), with the final aim of restoring a soil's agricultural functions. But ultramafic soils are characterized by low fertility levels and this can limit yields of hyperaccumulators and metal phytoextraction. The objectives of the present work were to test if the association of a hyperaccumulating plant (Alyssum murale) and a Fabaceae (Vicia sativa var. Prontivesa) could induce changes in physicochemical characteristics of a serpentine soil and in root architecture of a hyperaccumulating plant then lead to efficient agromining practices through soil quality improvement. Based on standard agricultural systems, consisting in the association of legumes and another crop such as wheat or rape, a three-month rhizobox experiment was carried out to study the effect of the co-cropping (Co) or rotation (Ro) of a hyperaccumulating plant (Alyssum murale) with a legume (Vicia sativa) and incorporating legume biomass to soil, in comparison with mineral fertilization (FMo), on the structure and physicochemical properties of an ultramafic soil and on root architecture. All parameters measured (biomass, C and N contents, and taken-up Ni) on Alyssum murale conducted in co-cropping system showed the highest values followed by the mineral fertilization and rotation (Co > FMo > Ro), except for root nickel yield for which rotation was better than the mineral fertilization (Ro > FMo). The rhizosphere soil of Alyssum murale in co-cropping had larger soil particles size and better aggregates stability than other treatments. Using geostatistics, co-cropped Alyssum murale showed a greater root surface area spatial distribution. Moreover, co-cropping and rotation-induced lower soil DTPA-extractable nickel concentrations than other treatments, but higher pH values. Alyssum murale co-cropped with a legume showed a higher biomass production, improved soil physical characteristics and enhanced nickel phytoextraction. This study showed that the introduction of a legume into Ni agromining systems could improve yields of dry biomass of the hyperaccumulating plant used and consequently, the yields of Ni. Our strategy can decrease the need to apply fertilizers and thus minimizes the risk of nitrogen leaching and underground water pollution. Co-cropping of Alyssum murale with the legume showed a clear tendency to increase nickel phytoextraction and plant biomass in comparison to rotation treatment and fertilized mono-culture. In addition, co-cropping improved soil physical characteristics and soil structure through larger and more stabilized aggregates. It is, therefore, reasonable to conclude that the use of legumes in Ni-agromining systems could be a good strategy to reduce chemical inputs and to restore soil agricultural functions. Improving the agromining system by the replacement of inorganic fertilizers could simultaneously be a safe way of rehabilitating degraded soils and a method to restore soil quality and functions leading to the recovery of ecosystem services.

Keywords: plant association, legumes, hyperaccumulating plants, ultramafic soil physicochemical properties

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Authors: Jiahui You, Kyung Jae Lee

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Hydraulic fracturing fluid (HFF) is widely used in shale reservoir productions. HFF contains diverse chemical additives, which result in the dissolution and precipitation of minerals through multiple chemical reactions. In this study, a new pore-scale Darcy–Brinkman–Stokes (DBS) model coupled with Level Set Method (LSM) is developed to address the microscopic phenomena occurring during the iron–HFF interaction, by numerically describing mass transport, chemical reactions, and pore structure evolution. The new model is developed based on OpenFOAM, which is an open-source platform for computational fluid dynamics. Here, the DBS momentum equation is used to solve for velocity by accounting for the fluid-solid mass transfer; an advection-diffusion equation is used to compute the distribution of injected HFF and iron. The reaction–induced pore evolution is captured by applying the LSM, where the solid-liquid interface is updated by solving the level set distance function and reinitialized to a signed distance function. Then, a smoothened Heaviside function gives a smoothed solid-liquid interface over a narrow band with a fixed thickness. The stated equations are discretized by the finite volume method, while the re-initialized equation is discretized by the central difference method. Gauss linear upwind scheme is used to solve the level set distance function, and the Pressure–Implicit with Splitting of Operators (PISO) method is used to solve the momentum equation. The numerical result is compared with 1–D analytical solution of fluid-solid interface for reaction-diffusion problems. Sensitivity analysis is conducted with various Damkohler number (DaII) and Peclet number (Pe). We categorize the Fe (III) precipitation into three patterns as a function of DaII and Pe: symmetrical smoothed growth, unsymmetrical growth, and dendritic growth. Pe and DaII significantly affect the location of precipitation, which is critical in determining the injection parameters of hydraulic fracturing. When DaII<1, the precipitation uniformly occurs on the solid surface both in upstream and downstream directions. When DaII>1, the precipitation mainly occurs on the solid surface in an upstream direction. When Pe>1, Fe (II) transported deeply into and precipitated inside the pores. When Pe<1, the precipitation of Fe (III) occurs mainly on the solid surface in an upstream direction, and they are easily precipitated inside the small pore structures. The porosity–permeability relationship is subsequently presented. This pore-scale model allows high confidence in the description of Fe (II) dissolution, transport, and Fe (III) precipitation. The model shows fast convergence and requires a low computational load. The results can provide reliable guidance for injecting HFF in shale reservoirs to avoid clogging and wellbore pollution. Understanding Fe (III) precipitation, and Fe (II) release and transport behaviors give rise to a highly efficient hydraulic fracture project.

Keywords: reactive-transport , Shale, Kerogen, precipitation

Procedia PDF Downloads 149

Authors: Saurabh Sharma

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Introduction: The case study deals with the ground stabilisation of Nabi Karim Metro Station in Delhi, India, wherein an extremely complex geology was encountered while excavating the tunnelling shaft for launching Tunnel Boring Machine. The borelog investigation and the Seismic Refraction Technique (SRT) indicated towards the presence of an extremely hard rocky mass from a depth of 3-4 m itself, and accordingly, the Geotechnical Interpretation Report (GIR) concluded the presence of Grade-IV rock from 3m onwards and presence of Grade-III and better rock from 5-6m onwards. Accordingly, it was planned to retain the ground by providing secant piles all around the launching shaft and then excavating the shaft vertically after leaving a berm of 1.5m to prevent secant piles from getting exposed. To retain the side slopes, rock bolting with shotcreting and wire meshing were proposed, which is a normal practice in such strata. However, with the increase in depth of excavation, the rock quality kept on decreasing at an unexpected and surprising pace, with the Grade-III rock mass at 5-6 m converting to conglomerate formation at the depth of 15m. This worsening of geology from high grade rock to slushy conglomerate formation can never be predicted and came as a surprise to even the best geotechnical engineers. Since the excavation had already been cut down vertically to manage the shaft size, the execution was continued with enhanced cautions to stabilise the side slopes. But, when the shaft work was about to finish, a collapse was encountered on one side of the excavation shaft. This collapse was unexpected and surprising since all measures to stabilise the side slopes had been taken after face mapping, and the grid size, diameter, and depth of the rockbolts had already been readjusted to accommodate rock fractures. The above scenario was baffling even to the best geologists and geotechnical engineers, and it was decided that any further slope stabilisation scheme shall have to be designed in such a way to ensure safe completion of works. Accordingly, following revisions to excavation scheme were made: The excavation would be carried while maintaining a slope based on type of soil/rock. The rock bolt type was changed from SN rockbolts to Self Drilling type anchor. The grid size of the bolts changed on real time assessment. the excavation carried out by implementing a ‘Bench Release Approach’. Aggressive Real Time Instrumentation Scheme. Discussion: The above case Study again asserts vitality of correct interpretation of the geological strata and the need of real time revisions of the construction schemes based on the actual site data. The excavation is successfully being done with the above revised scheme, and further details of the Revised Slope Stabilisation Scheme, Instrumentation Schemes, Monitoring results, along with the actual site photographs, shall form the part of the final Paper.

Keywords: unconfined compressive strength (ucs), rock mass rating (rmr), rock bolts, self drilling anchors, face mapping of rock, secant pile, shotcrete

Procedia PDF Downloads 52

Authors: Tamar Trop

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Bike sharing systems can be important elements of smart cities as they have the potential for impact on multiple levels. These systems can add a significant alternative to other modes of mass transit in cities that are continuously looking for measures to become more livable and maintain their attractiveness for citizens, businesses and tourism. Bike-sharing began in Europe in 1965, and a viable format emerged in the mid-2000s thanks to the introduction of information technology. The rate of growth in bike-sharing schemes and fleets has been very rapid since 2008 and has probably outstripped growth in every other form of urban transport. Today, public bike-sharing systems are available on five continents, including over 700 cities, operating more than 800,000 bicycles at approximately 40,000 docking stations. Since modern bike sharing systems have become prevalent only in the last decade, the existing literature analyzing these systems and their sustainability is relatively new. The purpose of the presented study is to assess the sustainability of these newly emerging transportation systems, by using the Envision™ rating system as a methodological framework and the Israeli 'Tel -O-Fun' – bike sharing project as a case study. The assessment was conducted by project team members. Envision™ is a new guidance and rating system used to assess and improve the sustainability of all types and sizes of infrastructure projects. This tool provides a holistic framework for evaluating and rating the community, environmental, and economic benefits of infrastructure projects over the course of their life cycle. This evaluation method has 60 sustainability criteria divided into five categories: Quality of life, leadership, resource allocation, natural world, and climate and risk. 'Tel -O-Fun' project was launched in Tel Aviv-Yafo on 2011 and today provides about 1,800 bikes for rent, at 180 rental stations across the city. The system is based on a complex computer terminal that is located in the docking stations. The highest-rated sustainable features that the project scored include: (a) Improving quality of life by: offering a low cost and efficient form of public transit, improving community mobility and access, enabling the flexibility of travel within a multimodal transportation system, saving commuters time and money, enhancing public health and reducing air and noise pollution; (b) improving resource allocation by: offering inexpensive and flexible last-mile connectivity, reducing space, materials and energy consumption, reducing wear and tear on public roads, and maximizing the utility of existing infrastructure, and (c) reducing of greenhouse gas emissions from transportation. Overall, 'Tel -O-Fun' project was highly scored as an environmentally sustainable and socially equitable infrastructure. The use of this practical framework for evaluation also yielded various interesting insights on the shortcoming of the system and the characteristics of good solutions. This can contribute to the improvement of the project and may assist planners and operators of bike sharing systems to develop a sustainable, efficient and reliable transportation infrastructure within smart cities.

Keywords: bike sharing, Envision™, sustainability rating system, sustainable infrastructure

Procedia PDF Downloads 318

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

Procedia PDF Downloads 83

Authors: Ioan Rusu

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In the operation of power transformers of 110 kV/MV from substations, these are traveled by fault current resulting from MV line damage. Defect electrical contacts are heated when they are travelled from fault currents. In the case of high temperatures when 135 °C is reached, the electrical insulating oil in the vicinity of the electrical faults comes into contact with these contacts releases gases, and activates the electrical protection. To avoid auto-flammability of electro-insulating oil, we designed a security system thermal of electrical contact defects by pouring fire-resistant polyurethane foam, mastic or mortar fire inside a cardboard electro-insulating cylinder. From practical experience, in the exploitation of power transformers of 110 kV/MT in oil electro-insulating were recorded some passing disconnecting commanded by the gas protection at internal defects. In normal operation and in the optimal load, nominal currents do not require thermal secure contacts inside electrical transformers, contacts are made at the fabrication according to the projects or to repair by solder. In the case of external short circuits close to the substation, the contacts inside electrical transformers, even if they are well made in sizes of Rcontact = 10^‑6 Ω, are subjected to short-circuit currents of the order of 10 kA-20 kA which lead to the dissipation of some significant second-order electric powers, 100 W-400 W, on contact. At some internal or external factors which action on electrical contacts, including electrodynamic efforts at short-circuits, these factors could be degraded over time to values in the range of 10^-4 Ω to 10^-5 Ω and if the action time of protection is great, on the order of seconds, power dissipation on electrical contacts achieve high values of 1,0 kW to 40,0 kW. This power leads to strong local heating, hundreds of degrees Celsius and can initiate self-ignition and burning oil in the vicinity of electro-insulating contacts with action the gas relay. Degradation of electrical contacts inside power transformers may not be limited for the duration of their operation. In order to avoid oil burn with gas release near electrical contacts, at short-circuit currents 10 kA-20 kA, we have outlined the following solutions: covering electrical contacts in fireproof materials that would avoid direct burn oil at short circuit and transmission of heat from electrical contact along the conductors with heat dissipation gradually over time, in a large volume of cooling. Flame retardant materials are: polyurethane foam, mastic, cement (concrete). In the normal condition of operation of transformer, insulating of conductors coils is with paper and insulating oil. Ignition points of its two components respectively are approximated: 135 °C heat for oil and 200 ⁰C for paper. In the case of a faulty electrical contact, about 10^-3 Ω, at short-circuit; the temperature can reach for a short time, a value of 300 °C-400 °C, which ignite the paper and also the oil. By burning oil, there are local gases that disconnect the power transformer. Securing thermal electrical contacts inside the transformer, in cardboard tube with polyurethane foams, mastik or cement, ensures avoiding gas release and also gas protection working.

Keywords: power transformer, oil insulatation, electric contacts, Bucholtz relay

Procedia PDF Downloads 135

Authors: Wei Xu, Abdo S. Haidar, Jianxin Gao

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Prosthetic socket is a component that connects the residual limb of an amputee with an artificial prosthesis. It is widely recognized as the most critical component that determines the comfort of a patient when wearing the prosthesis in his/her daily activities. Through the socket, the body weight and its associated dynamic load are distributed and transmitted to the prosthesis during walking, running or climbing. In order to achieve a good-fit socket for an individual amputee, it is essential to obtain the biomechanical properties of the residual limb. In current clinical practices, this is achieved by a touch-and-feel approach which is highly subjective. Although there have been significant advancements in prosthetic technologies such as microprocessor controlled knee and ankle joints in the last decade, the progress in designing a comfortable socket has been rather limited. This means that the current process of socket design is still very time-consuming, and highly dependent on the expertise of the prosthetist. Supported by the state-of-the-art sensor technologies and numerical simulations, a new socket design system is being developed to help prosthetists achieve rapid design of comfortable sockets for above knee amputees. This paper reports the research work related to establishing biomechanical models for socket design. Through numerical simulation using finite element method, comprehensive relationships between pressure on residual limb and socket geometry were established. This allowed local topological adjustment for the socket so as to optimize the pressure distributions across the residual limb. When the full body weight of a patient is exerted on the residual limb, high pressures and shear forces between the residual limb and the socket occur. During numerical simulations, various hyperplastic models, namely Ogden, Yeoh and Mooney-Rivlin, were used, and their effectiveness in representing the biomechanical properties of soft tissues of the residual limb was evaluated. This also involved reverse engineering, which resulted in an optimal representative model under compression test. To validate the simulation results, a range of silicone models were fabricated. They were tested by an indentation device which yielded the force-displacement relationships. Comparisons of results obtained from FEA simulations and experimental tests showed that the Ogden model did not fit well the soft tissue material indentation data, while the Yeoh model gave the best representation of the soft tissue mechanical behavior under indentation. Compared with hyperplastic model, the result showed that elastic model also had significant errors. In addition, normal and shear stress distributions on the surface of the soft tissue model were obtained. The effect of friction in compression testing and the influence of soft tissue stiffness and testing boundary conditions were also analyzed. All these have contributed to the overall goal of designing a good-fit socket for individual above knee amputees.

Keywords: above knee amputee, finite element simulation, hyperplastic model, prosthetic socket

Procedia PDF Downloads 184

Authors: S. H. Chew, Z. X. Eng, K. E. Chuah, T. Y. Lim, H. M. A. Yim

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In recent years, geotextile tube has been widely used in the hydraulic engineering and dewatering industry. To construct a stable containment bund with geotextile tubes, the sand slurry is always the preference infilling material. However, the shortage of sand supply posts a problem in Singapore to adopt this construction method in the actual construction of long containment bund. Hence, utilizing the soft dredged clay or the excavated soft clay as the infilling material of geotextile tubes has a great economic benefit. There are any technical issues with using this soft clayey material as infilling material, especially on the excessive settlement and stability concerns. To minimize the shape deformation and settlement of geotextile tube associated with the use of this soft clay infilling material, a modified innovative infilling material is proposed – lightly cemented soft clay. The preliminary laboratory studies have shown that the dewatering mechanism via geotextile material of the tube skin, and the introduction of cementitious chemical action of the lightly cemented soft clay will accelerate the consolidation and improve the shear strength of infill material. This study aims to extend the study by conducting a pilot test of the geotextile tube filled with lightly cemented clay. This study consists of testing on a series of miniature geo-tubes and two full-size geotextile tube. In the miniature geo-tube tests, a number of small scaled-down size of geotextile tubes were filled with cemented clay (at water content of 150%) with cement content of 0% to 8% (by weight). The shear strength development of the lightly cemented clay under dewatering mechanism was evaluated using a modified in-situ Cone Penetration Test (CPT) at 0 days, 3 days, 7 days and 28 days after the infilling. The undisturbed soil samples of lightly cemented infilled clay were also extracted at 3-days and 7-days for triaxial tests and evaluation of final water content. The results suggested that the geotextile tubes filled with un-cemented soft clay experienced very significant shape change over the days (as control test). However, geotextile mini-tubes filled with lightly cemented clay experienced only marginal shape changed, even that the strength development of this lightly cemented clay inside the tube may not show significant strength gain at the early stage. The shape stability is believed to be due to the confinement effect of the geotextile tube with clay at non-slurry state. Subsequently, a full-scale instrumented geotextile tube filled with lightly cemented clay was performed. The extensive results of strain gauges and pressure transducers installed on this full-size geotextile tube demonstrated a substantial mobilization of tensile forces on the geotextile skin corresponding to the filling activity and the subsequent dewatering stage. Shape change and the in-fill material strength development was also monitored. In summary, the construction of containment bund with geotextile tube filled with lightly cemented clay is found to be technically feasible and stable with the use of the sufficiently strong (i.e. adequate tensile strength) geotextile tube, the adequate control on the dosage of cement content, and suitable water content of infilling soft clay material.

Keywords: cemented clay, containment bund, dewatering, geotextile tube

Procedia PDF Downloads 249

Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp

Abstract:

Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.

Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation

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Authors: S. Mamoucha, N. Tsafantakis, Α. Ioannidis, S. Chatzipanagiotou, C. Nikolaou, L. Skaltsounis, N. Fokialakis, N. Christodoulakis

Abstract:

Introduction: Plant secondary metabolites (SM) can be grouped into three chemically distinct groups: terpenes, phenolics, and nitrogen-containing compounds. For many years the adaptive significance of SM was unknown. They were thought to be functionless end-products. Currently it is accepted that many secondary metabolites (also known as natural products) have important ecological roles in plants. For instance, they serve as attractants (odor, color, taste) for pollinators and seed-dispersing animals. Moreover, they protect plants from herbivores, microbial pathogens and from environmental stress (high and low temperatures, drought, alkalinity, salinity, radiation etc). It is well known that both biotic and abiotic stress often increase the accumulation of SM. The local climatic conditions, seasonal changes, external factors such as light, temperature, humidity affect the biosynthesis and composition of secondary metabolites. A well known dioecious evergreen plant, Pistacia lentiscus L. (mastic tree), was selected in order to study the metabolic variations occur in response to the different climate conditions, due to the seasonal variation and its effect on the biosynthesis of bioactive compounds. Materials-methods: Young and mature leaves were collected in January and July 2014, dried and extracted by accelerated solvent extraction (Dionex ASE™ 350) using solvents of increased polarity (DCM, MeOH, and H2O). GC-MS and UHPLC-HRMS analysis were carried out in order to define the nature and the relative abundance of SM. The antibacterial activity was evaluated by using the Agar Disc Diffusion Assay against ATCC and clinical isolates strains: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Streptococcus mutans and Klebsiella pneumoniae. All tests were carried out in duplicate and the average radii of the inhibition zones were calculated for each extract. Results: According to the phytochemical profile obtained from each extract, the biosynthesis of SM varied both qualitatively and quantitatively under the two different types of seasonal stress. With exception of the biologically inactive nonpolar DCM extract of July, all extracts inhibited the growth of most of the investigated microorganisms. A clear positive correlation has been observed between the relative abundance of SM and the bioactivity of the DCM extracts of January and July. Observed changes during phytochemical analysis were mainly focused on the triterpenoid content. On the other hand, the bioactivity of the polar extracts (MeOH and H2O) of January and July resulted practically invariable against most of the microorganisms, besides the significant variation of the SM content due to the seasonal variation. Conclusion: Our results clearly confirmed the hypothesis of abiotic stress as an important regulating factor that significantly affects the biosynthesis of secondary metabolites and thus the presence of bioactive compounds. Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: antibacterial screening, phytochemical profile, Pistacia lentiscus, abiotic stress

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Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

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Authors: Ruairi J. McMillan

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Introduction: This critical analysis aims to ascertain how well neuroanatomical aetiologies are communicated within 20 case reports of aphasia. Neuroanatomical visualisations based on dissected brain specimens were produced and combined with white matter tract and vascular taxonomies of function in order to address the most consistently underreported features found within the aphasic case study reports. Together, these approaches are intended to integrate aphasiological knowledge from the past 20 years with aphasiological diagnostics, and to act as prototypal resources for both researchers and clinical professionals. The medico-legal precedent for aphasia diagnostics under Canadian, US and UK case law and the neuroimaging/neurological diagnostics relative to the functional capacity of aphasic patients are discussed in relation to the major findings of the literary analysis, neuroimaging protocols in clinical use today, and the neuroanatomical aetiologies of different aphasias. Basic Methodology: Literature searches of relevant scientific databases (e.g, OVID medline) were carried out using search terms such as aphasia case study (year) & stroke induced aphasia case study. A series of 7 diagnostic reporting criteria were formulated, and the resulting case studies were scored / 7 alongside clinical stroke criteria. In order to focus on the diagnostic assessment of the patient’s condition, only the case report proper (not the discussion) was used to quantify results. Statistical testing established if specific reporting criteria were associated with higher overall scores and potentially inferable increases in quality of reporting. Statistical testing of whether criteria scores were associated with an unclear/adjusted diagnosis were also tested, as well as the probability of a given criterion deviating from an expected estimate. Major Findings: The quantitative analysis of neuroanatomically driven diagnostics in case studies of aphasia revealed particularly low scores in the connection of neuroanatomical functions to aphasiological assessment (10%), and in the inclusion of white matter tracts within neuroimaging or assessment diagnostics (30%). Case studies which included clinical mention of white matter tracts within the report itself were distributed among higher scoring cases, as were case studies which (as clinically indicated) related the affected vascular region to the brain parenchyma of the language network. Concluding Statement: These findings indicate that certain neuroanatomical functions are integrated less often within the patient report than others, despite a precedent for well-integrated neuroanatomical aphasiology also being found among the case studies sampled, and despite these functions being clinically essential in diagnostic neuroimaging and aphasiological assessment. Therefore, ultimately the integration and specificity of aetiological neuroanatomy may contribute positively to the capacity and autonomy of aphasic patients as well as their clinicians. The integration of a full aetiological neuroanatomy within the reporting of aphasias may improve patient outcomes and sustain autonomy in the event of medico-ethical investigation.

Keywords: aphasia, language network, functional neuroanatomy, aphasiological diagnostics, medico-legal ethics

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Authors: K. Yu Vlasova, M. A. Abakumov, H. Wishwarsao, M. Sokolsky, N. V. Nukolova, A. G. Majouga, Y. I. Golovin, N. L. Klyachko, A. V. Kabanov

Abstract:

Introduction:Nowadays pharmaceutical medicine is aimed to create systems for combined therapy, diagnostic, drug delivery and controlled release of active molecules to target cells. Magnetic nanoparticles (MNPs) are used to achieve this aim. MNPs can be applied in molecular diagnostics, magnetic resonance imaging (T1/T2 contrast agents), drug delivery, hyperthermia and could improve therapeutic effect of drugs. The most common drug containers, containing MNPs, are liposomes, micelles and polymeric molecules bonded to the MNPs surface. Usually superparamagnetic nanoparticles are used (the general diameter is about 5-6 nm) and all effects of high frequency magnetic field (MF) application are based on Neel relaxation resulting in heating of surrounded media. In this work we try to develop a new method to improve drug release from MNPs under super low frequency MF. We suppose that under low frequency MF exposures the Brown’s relaxation dominates and MNPs rotation could occur leading to conformation changes and release of bioactive molecules immobilized on MNPs surface.The aim of this work was to synthesize different systems with active drug (biopolymers coated MNPs nanoclusters with immobilized enzymes and doxorubicin (Dox) loaded magnetic liposomes/micelles) and investigate the effect of super low frequency MF on these drug containers. Methods: We have synthesized MNPs of magnetite with magnetic core diameter 7-12 nm . The MNPs were coated with block-copolymer of polylysine and polyethylene glycol. Superoxide dismutase 1 (SOD1) was electrostatically adsorbed on the surface of the clusters. Liposomes were prepared as follow: MNPs, phosphatidylcholine and cholesterol were dispersed in chloroform, dried to get film and then dispersed in distillated water, sonicated. Dox was added to the solution, pH was adjusted to 7.4 and excess of drug was removed by centrifugation through 3 kDa filters. Results: Polylysine coated MNPs formed nanosized clusters (as observed by TEM) with intensity average diameter of 112±5 nm and zeta potential 12±3 mV. After low frequency AC MF exposure we observed change of immobilized enzyme activity and hydrodynamic size of clusters. We suppose that the biomolecules (enzymes) are released from the MNPs surface followed with additional aggregation of complexes at the MF in medium. Centrifugation of the nanosuspension after AC MF exposures resulted in increase of positive charge of clusters and change in enzyme concentration in comparison with control sample without MF, thus confirming desorption of negatively charged enzyme from the positively charged surface of MNPs. Dox loaded magnetic liposomes had average diameter of 160±8 nm and polydispersity index (PDI) 0.25±0.07. Liposomes were stable in DW and PBS at pH=7.4 at 370C during a week. After MF application (10 min of exposure, 50 Hz, 230 mT) diameter of liposomes raised to 190±10 nm and PDI was 0.38±0.05. We explain this by destroying and/or reorganization of lipid bilayer, that leads to changes in release of drug in comparison with control without MF exposure. Conclusion: A new application of low frequency AC MF for drug delivery and controlled drug release was shown. Investigation was supported by RSF-14-13-00731 grant, K1-2014-022 grant.

Keywords: magnetic nanoparticles, low frequency magnetic field, drug delivery, controlled drug release

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Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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Authors: Izabela P. Vatanabe, Rafaela Peron, Patricia Manzine, Marcia R. Cominetti

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Introduction: Considering the increase in life expectancy of world population, there is an emerging concern in health services to allocate better care and care to elderly, through promotion, prevention and treatment of health. It has been observed that frailty syndrome is prevalent in elderly people worldwide and this complex and heterogeneous clinical syndrome consist of the presence of physical frailty associated with cognitive dysfunction, though in absence of dementia. This can be characterized by exhaustion, unintentional weight loss, decreased walking speed, weakness and low level of physical activity, in addition, each of these symptoms may be a predictor of adverse outcomes such as hospitalization, falls, functional decline, institutionalization, and death. Cognitive frailty is a recent concept in literature, which is defined as the presence of physical frailty associated with mild cognitive impairment (MCI) however in absence of dementia. This new concept has been considered as a subtype of frailty, which along with aging process and its interaction with physical frailty, accelerates functional declines and can result in poor quality of life of the elderly. MCI represents a risk factor for Alzheimer's disease (AD) in view of high conversion rate for this disease. Comorbidities and physical frailty are frequently found in AD patients and are closely related to heterogeneity and clinical manifestations of the disease. The decreased platelets ADAM10 levels in AD patients, compared to cognitively healthy subjects, matched by sex, age and education. Objective: Based on these previous results, this study aims to evaluate whether ADAM10 platelet levels of could act as a biomarker of cognitive frailty. Methods: The study was approved by Ethics Committee of Federal University of São Carlos (UFSCar) and conducted in the municipality of São Carlos, headquarters of Federal University of São Carlos (UFSCar). Biological samples of subjects were collected, analyzed and then stored in a biorepository. ADAM10 platelet levels were analyzed by western blotting technique in subjects with MCI and compared to subjects without cognitive impairment, both with and without presence of frailty. Statistical tests of association, regression and diagnostic accuracy were performed. Results: The results have shown that ADAM10/β-actin ratio is decreased in elderly individuals with cognitive frailty compared to non-frail and cognitively healthy controls. Previous studies performed by this research group, already mentioned above, demonstrated that this reduction is still higher in AD patients. Therefore, the ADAM10/β-actin ratio appears to be a potential biomarker for cognitive frailty. The results bring important contributions to an accurate diagnosis of cognitive frailty from the perspective of ADAM10 as a biomarker for this condition, however, more experiments are being conducted, using a high number of subjects, and will help to understand the role of ADAM10 as biomarker of cognitive frailty and contribute to the implementation of tools that work in the diagnosis of cognitive frailty. Such tools can be used in public policies for the diagnosis of cognitive frailty in the elderly, resulting in a more adequate planning for health teams and better quality of life for the elderly.

Keywords: ADAM10, biomarkers, cognitive frailty, elderly

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