Search results for: functional outcome

Authors: Denis Jordan, Daniel Golkowski, Mathias Lukas, Katharina Merz, Caroline Mlynarcik, Max Maurer, Valentin Riedl, Stefan Foerster, Eberhard F. Kochs, Andreas Bender, Ruediger Ilg

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Introduction: So far, clinical assessments that rely on behavioral responses to differentiate coma states or even predict outcome in coma patients are unreliable, e.g. because of some patients’ motor disabilities. The present study was aimed to provide prognosis in coma patients using markers from electroencephalogram (EEG), blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET). Unsuperwised principal component analysis (PCA) was used for multimodal integration of markers. Methods: Approved by the local ethics committee of the Technical University of Munich (Germany) 20 patients (aged 18-89) with severe brain damage were acquired through intensive care units at the Klinikum rechts der Isar in Munich and at the Therapiezentrum Burgau (Germany). At the day of EEG/fMRI/PET measurement (date I) patients (<3.5 month in coma) were grouped in the minimal conscious state (MCS) or vegetative state (VS) on the basis of their clinical presentation (coma recovery scale-revised, CRS-R). Follow-up assessment (date II) was also based on CRS-R in a period of 8 to 24 month after date I. At date I, 63 channel EEG (Brain Products, Gilching, Germany) was recorded outside the scanner, and subsequently simultaneous FDG-PET/fMRI was acquired on an integrated Siemens Biograph mMR 3T scanner (Siemens Healthineers, Erlangen Germany). Power spectral densities, permutation entropy (PE) and symbolic transfer entropy (STE) were calculated in/between frontal, temporal, parietal and occipital EEG channels. PE and STE are based on symbolic time series analysis and were already introduced as robust markers separating wakefulness from unconsciousness in EEG during general anesthesia. While PE quantifies the regularity structure of the neighboring order of signal values (a surrogate of cortical information processing), STE reflects information transfer between two signals (a surrogate of directed connectivity in cortical networks). fMRI was carried out using SPM12 (Wellcome Trust Center for Neuroimaging, University of London, UK). Functional images were realigned, segmented, normalized and smoothed. PET was acquired for 45 minutes in list-mode. For absolute quantification of brain’s glucose consumption rate in FDG-PET, kinetic modelling was performed with Patlak’s plot method. BOLD signal intensity in fMRI and glucose uptake in PET was calculated in 8 distinct cortical areas. PCA was performed over all markers from EEG/fMRI/PET. Prognosis (persistent VS and deceased patients vs. recovery to MCS/awake from date I to date II) was evaluated using the area under the curve (AUC) including bootstrap confidence intervals (CI, *: p<0.05). Results: Prognosis was reliably indicated by the first component of PCA (AUC=0.99*, CI=0.92-1.00) showing a higher AUC when compared to the best single markers (EEG: AUC<0.96*, fMRI: AUC<0.86*, PET: AUC<0.60). CRS-R did not show prediction (AUC=0.51, CI=0.29-0.78). Conclusion: In a multimodal analysis of EEG/fMRI/PET in coma patients, PCA lead to a reliable prognosis. The impact of this result is evident, as clinical estimates of prognosis are inapt at time and could be supported by quantitative biomarkers from EEG, fMRI and PET. Due to the small sample size, further investigations are required, in particular allowing superwised learning instead of the basic approach of unsuperwised PCA.

Keywords: coma states and prognosis, electroencephalogram, entropy, functional magnetic resonance imaging, machine learning, positron emission tomography, principal component analysis

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Authors: A.Zitouni, S.Bentata, B.Bouadjemi, T.Lantri, W. Benstaali, Z.Aziz, S.Cherid, A. Sefir

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Structural, electronic, and magnetic properties of Co and Mn-doped CdTe have been studied by employing the full potential linear augmented plane waves (FP-LAPW) method within the spin-polarized density functional theory (DFT). The electronic exchange-correlation energy is described by generalized gradient approximation (GGA) as exchange–correlation (XC) potential. We have calculated the lattice parameters, bulk modulii and the first pressure derivatives of the bulk modulii, spin-polarized band structures, and total and local densities of states. The value of calculated magnetic moment per Co and Mn impurity atoms is found to be 2.21 µB for CdCoTe and 3.20 µB for CdMnTe. The calculated densities of states presented in this study identify the half-metallic of Co and Mn-doped CdTe.

Keywords: electronic structure, density functional theory, band structures, half-metallic, magnetic moment

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Authors: R. R. Mankbadi

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There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is embedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating, and cooling, etc. In this work will present an overview of the development of this field. Some examples will include Airfoil Noise Suppression: Large-Eddy Simulations (LES) is used to simulate the effect of synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In vertical takeoff of Aircrafts or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protecting the structure and payload from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aeroacoustics, flow control, aerodynamics, large eddy simulations

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Authors: B. Nazari, M. A. Mohammadifar, S. Shojaee-Aliabadi, L. Mirmoghtadaie

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Millets as a new source of plant protein were not used in food applications due to its poor functional properties. In this study, the effect of high intensity ultrasound (frequency: 20 kHz, with contentious flow) (US) in 100% amplitude for varying times (5, 12.5, and 20 min) on solubility, emulsifying activity index (EAI), emulsion stability (ES), foaming capacity (FC), and foaming stability (FS) of millet protein concentrate (MPC) were evaluated. In addition, the structural properties of best treatments such as molecular weight and surface charge were compared with the control sample to prove the US effect. The US treatments significantly (P<0.05) increased the solubility of the native MPC (65.8±0.6%) at all sonicated times with the maximum solubility that is recorded at 12.5 min treatment (96.9±0.82 %). The FC of MPC was also significantly affected by the US treatment. Increase in sonicated time up to 12.5 min significantly increased the FC of native MPC (271.03±4.51 ml), but higher increase reduced it significantly. Minimal improvements were observed in the FS of all sonicated MPC compared to the native MPC. Sonicated time for 12.5 min affected the EAI and ES of the native MPC more markedly than 5 and 20 min that may be attributed to higher increase in proteins tendency to adsorption at the oil and water interfaces after the US treatment at this time. SDS-PAGE analysis showed changes in the molecular weight of MPC that attributed to shearing forces created by cavitation phenomenon. Also, this phenomenon caused an increase in the exposure of more amino acids with negative charge in the surface of US treated MPC, that was demonstrated by Zetasizer data. High intensity ultrasound, as a green technology, can significantly increase the functional properties of MPC and can make this usable for food applications.

Keywords: functional properties, high intensity ultrasound, millet protein concentrate, structural properties

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Authors: Salwa Hagag Abdelaziz, Dorria Salem, Hoda Zaki, Suzan Atteya

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Early detection of breast cancer saves many thousands of lives each year via application of mammography and genetic screening and many more lives could be saved if nurses are involved in breast care screening practices. So, the aim of the study was to identify nurse's role in early detection of breast cancer through mammography and genetic screening and its impact on patient's outcome. In order to achieve this aim, 400 women above 40 years, asymptomatic were recruited for mammography and genetic screening. In addition, 50 nurses and 6 technologists were involved in the study. A descriptive analytical design was used. Five tools were utilized: sociodemographic, mammographic examination and risk factors, women's before, during and after mammography, items relaying to technologists, and items related to nurses were also obtained. The study finding revealed that 3% of women detected for malignancy and 7.25% for fibroadenoma. Statistically, significant differences were found between mammography results and age, family history, genetic screening, exposure to smoke, and using contraceptive pills. Nurses have insufficient knowledge about screening tests. Based on these findings the present study recommended involvement of nurses in breast care which is very important to in force population about screening practices.

Keywords: mammography, early detection, genetic screening, breast cancer

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Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

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Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

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Authors: K. Maliki, A. Ajayi, O. M. Makanjuola, O. J. Adebowale

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Cocoyam is herbaceous perennial plant which belongs to the family Araceae and genus xanthosoma or cococasia is mostly cultivated as food crop. It is very rich in Vitamin B6, Magnesium and also in dietary fiber. Matured cocoyam is eaten boiled, Fried or roasted in Nigeria. It can also be dried and used to make flour. Food drying is a method of food preservation in which food is dried, thus inhibit the growth of bacteria yeast and mold through the removal of water. Drying effect on the proximate composition and functional properties of cocoyam flour were investigated. Freshly harvested cocoyam cultivars at matured level were washed with portable water, peeled, sliced into 0.3mm thickness blanch in boiling water at 100°C for 15 minutes and dried using sun drying oven and cabinet dryers. The blanched slices were divided into three lots and were subjected to different drying methods. The dried cocoyam slices were milled into flour using Apex mill and packed into Low Density Polyethylene Film (LDPE) 75 Micron 4 thickness and kept for four months under ambient temperature before analysis. The results showed that the moisture content, ash, crude fiber, fat, protein and carbohydrate ranged from 7.35% to 13.89%, 1.45% to 3.3%, 1.2% to 3.41%, 2.1% to 3.1%, 6.30% to 9.1% and 66% to 82% respectively. The functional properties of the cocoyam flour ranged from 1. 65ml/g to 4.24ml/g water absorption capacity, 0.85ml/g to 2.11ml/g oil absorption capacity 0.56ml/g and 0.78ml/g bulk density and 4.91% to 6.80% swelling capacity. The result showed that there was not significant difference (P ≥ 0.5) across the various drying methods used. Cabinet drying method was found to have the best quality characteristic values than the other drying methods. In conclusion, drying of cocoyam could be used for value addition and provide extension to shelf-life.

Keywords: cocoyam flour, drying, cabinet dryer, oven dryer

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Authors: Suman Singh, Myungho Lee, Insik Park, Yangjai Shin, Youn Suk Lee

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Active antimicrobial films prepared by incorporating AgSiO2, AgZn, and AgZ at 1%, 3%, 5%, 10% (w/w) into polypropylene (PP) matrix. Complete thermal, structural, mechanical and functional characterization were carried out of all formulations and determined the antimicrobial efficiency and returnable antimicrobial efficiency according to the Japanese Industrial Standard method. The morphology of the films showed agglomerates of particles in the composites. The active formulation had decreased elongation compared to the pure PP sample. Thermal analyses indicated that the active formulation compositions had increased thermal stability. The films showed 50% antimicrobial properties after the fifth wash against the tested microorganisms, presenting better activity against Gram negative organisms than Gram positive ones. These findings suggest that PP films with AgSiO2, AgZn, and AgZ particles could provide a significant contribution to the quality and safety of seafood in the distribution chain.

Keywords: antimicrobial film, properties and characterization, returnable packaging, sea food

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Authors: Adebola Ajayi, Francis B. Aiyeleye, Olakunke M. Makanjuola, Olalekan J. Adebowale

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Cocoyam, a generic term for both xanthoma and colocasia, is a traditional staple root crop in many developing countries in Africa, Asia and the Pacific. It is mostly cultivated as food crop which is very rich in vitamin B6, magnesium and also in dietary fiber. The cocoyam starch is easily digested and often used for baby food. Drying food is a method of food preservation that removes enough moisture from the food so bacteria, yeast and molds cannot grow. It is a one of the oldest methods of preserving food. The effect of drying methods on the proximate composition and functional properties of extracted cocoyam starch flour were studied. Freshly harvested cocoyam cultivars at matured level were washed with portable water, peeled, washed and grated. The starch in the grated cocoyam was extracted, dried using sun drying, oven and cabinet dryers. The extracted starch flour was milled into flour using Apex mill and packed and sealed in low-density polyethylene film (LDPE) 75 micron thickness with Nylon sealing machine QN5-3200HI and kept for three months under ambient temperature before analysis. The result showed that the moisture content, ash, crude fiber, fat, protein and carbohydrate ranged from 6.28% to 12.8% 2.32% to 3.2%, 0.89% to 2.24%%, 1.89% to 2.91%, 7.30% to 10.2% and 69% to 83% respectively. The functional properties of the cocoyam starch flour ranged from 2.65ml/g to 4.84ml/g water absorption capacity, 1.95ml/g to 3.12ml/g oil absorption capacity, 0.66ml/g to 7.82ml/g bulk density and 3.82% to 5.30ml/g swelling capacity. Significant difference (P≥0.5) was not obtained across the various drying methods used. The drying methods provide extension to the shelf-life of the extracted cocoyam starch flour.

Keywords: cocoyam, extraction, oven dryer, cabinet dryer

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Authors: Nik Azmah Nik Yusuff, Faridah Hassan Basri, Rosnidar Mansor

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The purpose of the study is to find out the effectiveness of using Graphic calculators (GC) with Calculator Based Laboratory 2 (CBL2) in teaching and learning of form four biology for these topics: Nutrition, Respiration and Dynamic Ecosystem. Sixty form four science stream students were the participants of this study. The participants were divided equally into the treatment and control groups. The treatment group used GC with CBL2 during experiments while the control group used the ordinary conventional laboratory apparatus without using GC with CBL2. Instruments in this study were a set of pre-test and post-test and a questionnaire. T-Test was used to compare the student’s biology achievement while a descriptive statistic was used to analyze the outcome of the questionnaire. The findings of this study indicated the use of GC with CBL2 in biology had significant positive effect. The highest mean was 4.43 for item stating the use of GC with CBL2 had saved collecting experiment result’s time. The second highest mean was 4.10 for item stating GC with CBL2 had saved drawing and labelling graphs. The outcome from the questionnaire also showed that GC with CBL2 were easy to use and save time. Thus, teachers should use GC with CBL2 in support of efforts by Malaysia Ministry of Education in encouraging technology-enhanced lessons.

Keywords: biology experiments, Calculator-Based Laboratory 2 (CBL2), graphic calculators, Malaysia Secondary School, teaching/learning

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Authors: Elham Azimzadeh, Fahimeh Khorshidi, Alireza Farsi

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Balance impairment and fear of falling in older adults may reduce their quality of life. Reactive balance training could improve rapid postural responses and fall prevention in the elderly during daily tasks. Performing postural training and simultaneously cognitive dual tasks could be similar to the daily circumstances. Purpose: This study aimed to determine the effect of balance training on stable and unstable surfaces under dual cognitive task conditions on postural control and fear of falling in the elderly. Methods: Thirty non-fallers of older adults (65-75 years) were randomly assigned to two training groups: stable-surface (n=10), unstable-surface (n=10), or a control group (n=10). The intervention groups underwent six weeks of balance training either on a stable (balance board) or an unstable (wobble board) surface while performing a cognitive dual task. The control group received no balance intervention. COP displacements in the anterioposterior (AP) and mediolateral (ML) directions using a computerized balance board, functional balance using TUG, and fear of falling using FES-I were measured in all participants before and after the interventions. Summary of Results: Mixed ANOVA (3 groups * 2 times) with repeated measures and post hoc test showed a significant improvement in both intervention groups in AP index (F= 11/652, P= 0/0002) and functional balance (F= 9/961, P= 0/0001). However, the unstable surface training group had more improvement. However, the fear of falling significantly improved after training on an unstable surface (p= 0/035). All groups had no significant improvement in the ML index (p= 0/817). In the present study, there was an improvement in the AP index after balance training. Conclusion: Unstable surface training may reduce reaction time in posterior ankle muscle activity. Furthermore, focusing attention on cognitive tasks can lead to maintaining balance unconsciously. Most of the daily activities need attention distribution among several activities. So, balance training concurrent to a dual cognitive task is challenging and more similar to the real world. According to the specificity of the training principle, it may improve functional independence and fall prevention in the elderly.

Keywords: cognitive dual task, elderly, fear of falling, postural control, unstable surface

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Authors: Joy Aworo-Okoroh

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Politics is about trust and trust is challenged by the speaker’s ability to manipulate language before the electorate. Critical discourse analysis investigates the role of language in constructing social relationships between a political speaker and his audience. This paper explores the linguistic choices made by President Muhammad Buhari that enshrines his ideologies as well as the socio-political relations of power between him and Nigerians in his speeches. Two speeches of President Buhari –inaugural and Independence Day speeches are analyzed using Norman Fairclough’s perspective on Halliday’s Systemic functional grammar. The analysis is at two levels. The first level of analysis is the identification of transitivity and modality choices in the speeches and how they reveal the covert ideologies. The second analysis is premised on Normal Fairclough’s model, the clauses are analyzed to identify elements of power, hesistation, persuasion, threat and religious statement. It was discovered that Buhari is a dominant character who manipulates the material processes a lot.

Keywords: politics, critical discourse analysis, Norman Fairclough, systemic functional grammar

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Authors: Chang-Jen Lan

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

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

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Authors: Hongxia Wang, Yanjie Wang, Xiuqin Wang, Linlin Mo, Shuangshuang Niu

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Special Education Resource Center (SERC) is the localized product in the development of inclusive education in People’s Republic of China, which provides professional support and service for the students with special education needs(SEN) and their parents, teachers as well as inclusive schools. The study investigated 155 administrators, resource teachers and inclusive education teachers from primary and secondary schools in Beijing. The results indicate that: (1) The surveyed teachers put highest expectation of SERC on specialized guidance and teacher training , instead of research and administration function; (2) Each dimension of professional support needs gets higher scores, in which individual guidance gets highest score, followed by instruction guidance, psychological counseling, proposing suggestions, informational support and teacher training; (3) locality and training experience of surveyed teachers significantly influence their expectations and support needs of SERC.

Keywords: special education resource center (SERC) , functional expectation, professional support needs, support system

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Authors: E. T. Svahn

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This article documents how open science policy is perceived in the scientific literature globally throughout the history. It also presents what policy needs are persistent to enable safe and effective dissemination of scientific knowledge. This information may be of interest to open science and science policy makers globally, especially in the view of recent adoption of supranational open science policies such as Plan S. Evaluation of open science policy landscape is in pressing need of assessment regarding its impact on the research community and society at wide as no previous literature review has been conducted on the topic. This study is a rigorous literature review based on constructivist grounded theory method on the full body of scientific open science policy publications. Selection of these articles has been conducted in 2019 and 2020 in major global knowledge databases. Through the analysis of these articles, two key themes emerged that are seen to shape the relationship between science and society. 1st is that of the policy enabling open science in a safe and effective way, and 2nd is that of the outcome of the science policy may have on the research community and the wider society. These findings accentuate that open science policies can have a major impact on not only research process and availability of knowledge but also on society itself. As an outcome of this study, a theoretical framework is constructed, and the need for further study on open science policy itself on a higher level becomes apparent.

Keywords: constructivist grounded theory, open science policy, rigorous literature review, science policy

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Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Louise Moles, Steve Riley, Sarah D. Lichenstein, Marzieh Babaeianjelodar, Robert Kohler, Annie Cheng, Corey Horien Abigail Greene, Wenjing Luo, Jonathan Ahern, Bohan Xu, Yize Zhao, Chun Chieh Fan, R. Todd Constable, Sarah W. Yip

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Background: Risks for depression are myriad and include both genetic and brain-based factors. However, relationships between these systems are poorly understood, limiting understanding of disease etiology, particularly at the developmental level. Methods: We use a data-driven machine learning approach connectome-based predictive modeling (CPM) to identify functional connectivity signatures associated with polygenic risk scores for depression (DEP-PRS) among youth from the Adolescent Brain and Cognitive Development (ABCD) study across diverse brain states, i.e., during resting state, during affective working memory, during response inhibition, during reward processing. Results: Using 10-fold cross-validation with 100 iterations and permutation testing, CPM identified connectivity signatures of DEP-PRS across all examined brain states (rho’s=0.20-0.27, p’s<.001). Across brain states, DEP-PRS was positively predicted by increased connectivity between frontoparietal and salience networks, increased motor-sensory network connectivity, decreased salience to subcortical connectivity, and decreased subcortical to motor-sensory connectivity. Subsampling analyses demonstrated that model accuracies were robust across random subsamples of N’s=1,000, N’s=500, and N’s=250 but became unstable at N’s=100. Conclusions: These data, for the first time, identify neural networks of polygenic depression risk in a large sample of youth before the onset of significant clinical impairment. Identified networks may be considered potential treatment targets or vulnerability markers for depression risk.

Keywords: genetics, functional connectivity, pre-adolescents, depression

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Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

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We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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Authors: Krenare Shabani, Kreshnike Dedushi Hoti, Serbeze Kabashi, Jeton Shatri, Arben Rroji, Mrikë Bunjaku, Leotrim Berisha, Jona Kosova, Edmond Puca, Bleriana Shabani

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Introduction: Workers in Kosovo's mining industry are subjected to hazardous working conditions and airborne particles, such as silica dust, which can cause silicosis and other severe respiratory illnesses. The purpose of this research is to assess the health impacts of such exposures, as well as the importance of imaging and functional testing in detecting pathological changes early on. Methodology: The study is prospective and cross-sectional and was carried out during the year 2024. 626 people (446 miners and 180 non-miners) were enrolled in the study. Subjects underwent spirometry and chest radiography. Data were analysed with SPSS24. Results: The average age of the participants is 48 years. Demographics and Smoking: Smoking was common among young miners. Radiological Changes: Radiographic abnormalities in the lungs were seen in 23.1% of miners and 10.6% of non-miners, including small irregular opacities and emphysematous changes. Lung Function: The FEV1/FVC ratio decreased with increased exposure time, indicating a decline in pulmonary function.Impact of Exposure Duration: Longer exposure duration was associated with a higher number of miners experiencing coughs and requiring medical consultations such as CT scans and biopsies. Conclusions: Medical imaging and functional testing are critical for early diagnosis of lung abnormalities in miners.Findings demonstrate a strong correlation between extended exposure to mine dust and the development of respiratory disorders, emphasising the importance of preventative measures and routine health monitoring.

Keywords: silicosis, miners, imaging, spirometry

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Authors: B. S. Premalatha, Kausalya Sahani

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Background: Voice is multidimensional which convey emotion, feelings, and communication. Voice disorders have an adverse effect on the physical, emotional and functional domains of an individual. Self-rating by clients about their voice problem helps the clinicians to plan intervention strategies. Voice handicap index is one such self-rating scale contains 30 questions that quantify the functional, physical and emotional impacts of a voice disorder on a patient’s quality of life. Each subsection has 10 questions. Though adapted and validated versions of VHI are available in other Indian languages but not in Telugu, which is a Dravidian language native to India. It is mainly spoken in Andhra Pradesh and neighbouring states in southern India. Objectives: To adapt and validate the English version of Voice Handicap Index (VHI) into Telugu language and evaluate its internal consistency and clinical validate in Telugu speaking population. Materials: The study carried out in three stages. First stage was a forward translation of English version of VHI, was given to ten experts, who were well proficient in writing and reading Telugu and five speech-language pathologists to translate into Telugu. Second Stage was backward translation where translated version of Telugu was given to a different group of ten experts (who were well proficient in writing and reading Telugu) and five speech-language pathologists who were native Telugu speakers and had good proficiency in Telugu and English. The third stage was an administration of translated version on Telugu to the targeted population. Totally 40 clinical subjects and 40 normal controls served as participants, and each group had 26 males and 14 females’ age range of 20 to 60 years. Clinical group comprised of individuals with laryngectomee with the Tracheoesophageal puncture (n=18), laryngitis (n=11), vocal nodules (n=7) and vocal fold palsy (n=4). Participants were asked to mark of their each experience on a 5 point equal appearing scale (0=never, 1=almost never, 2=sometimes, 3=almost always, 4=always) with a maximum total score of 120. Results: Statistical analysis was made by using SPSS software (22.0.0 Version). Mean, standard deviation and percentage (%) were calculated all the participants for both the groups. Internal consistency of VHI in Telugu was found to be excellent with the consistency scores for all the domains such as physical, emotional and functional are 0.742, 0.934and 0.938. The validity of scores showed a significant difference between clinical population and control group for domains like physical, emotional and functional and total scores. P value found to be less than 0.001( < 0.001). Negative correlation found in age and gender among self-domains such as physical, emotional and functional total scores in dysphonic and control group. Conclusion: The present study indicated that VHI in Telugu is able to discriminate participants having voice pathology from normal populations, which make this as a valid tool to collect information about their voice from the participants.

Keywords: adaptation, Telugu Version, translation, Voice Handicap Index (VHI)

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Authors: Chao Jen-Chih, Hsu Kuo-Wei

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Climate change and natural disasters take effect on urban development. It has been discussed urban renewals can prevent natural disasters. Integrating green infrastructure and urban renewals may have great effect on adapting the impact of climate change. To highlight the economic value of green infrastructure development on urban renewals, some strategies need to be carry on to reduce environmental impact. A number of urban renewals studies has been conducted on right transfer, financial risk, urban renewal policy, and public participation. Little research has been devoted on the subject of the economic value of green infrastructure development on urban renewals. The purpose of this study is to investigate the affecting factors on the economic value of green infrastructure development on urban renewals. This study will present the benefits of green infrastructure development and summarize the critical factors of green infrastructure develop on urban renewals for real essence and non-real essence on economic value from literature. Our results indicate that factors of housing price, land value, floor area incentive, and facilitation of the construction industry affect the outcome of real essence economic value. Factors of enhancement of urban disaster prevention, improvement of urban environment and landscape, crime reduction, climate control, pollution reduction, biological diversity, health impacts, and leisure space affects the outcome of non-real essence economic value.

Keywords: economic value, green infrastructure, urban renewals, urban development

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Authors: Claudia Martínez-Araneda, Mariella Gutiérrez, Pedro Gómez, Diego Maldonado, Alejandra Segura, Christian Vidal-Castro

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The purpose of this document is to showcase the preliminary work in developing an EduChatbot-type tool and measuring the effects of its use aimed at providing effective feedback to students in programming courses. This bot, hereinafter referred to as tutorBot+, was constructed based on chatGPT and is tasked with assisting and delivering timely positive feedback to students in the field of computer science at the Universidad Católica de Concepción. The proposed working method consists of four stages: (1) Immersion in the domain of Large Language Models (LLMs), (2) Development of the tutorBot+ prototype and integration, (3) Experiment design, and (4) Intervention. The first stage involves a literature review on the use of artificial intelligence in education and the evaluation of intelligent tutors, as well as research on types of feedback for learning and the domain of chatGPT. The second stage encompasses the development of tutorBot+, and the final stage involves a quasi-experimental study with students from the Programming and Database labs, where the learning outcome involves the development of computational thinking skills, enabling the use and measurement of the tool's effects. The preliminary results of this work are promising, as a functional chatBot prototype has been developed in both conversational and non-conversational versions integrated into an open-source online judge and programming contest platform system. There is also an exploration of the possibility of generating a custom model based on a pre-trained one tailored to the domain of programming. This includes the integration of the created tool and the design of the experiment to measure its utility.

Keywords: assessment, chatGPT, learning strategies, LLMs, timely feedback

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Authors: Beatrix Inah C. Mercado

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Bamboo shoots are the immature and edible culms from bamboos which contains high amount of dietary fibers. However, in spite of these functional properties of bamboo shoots it is still underutilized. Objectives: To develop bamboo shoot powder and incorporate it to biscuits as a source of dietary fiber and antioxidant. Materials and Methods: Bamboo shoot powder (BSP) was freeze-drying and grind and was incorporated to biscuits in 20% concentration. BSP and biscuits with BSP were analyzed for its proximate composition, dietary fiber, phytonutrients and antioxidant capacity. Results: BSP has 13.1 % moisture, 18.8% protein and 8% ash, 2.4g/100g total fat and 57.7% carbohydrate. BSP and biscuits with 20% BSP were good sources of dietary fiber containing 27.8g/100g and 7.1 g/100g, respectively. BSP is high in phytonutrient contents in terms of total polyphenols (1052mg gallic/100 g) and flavonoids (4046mg catechin/100g). Biscuits with BSP contained higher source of phytonutrients and antioxidant capacity as compared to biscuits without BSP. Sensory evaluation revealed that biscuits with BSP were more acceptable than biscuits without BSP. Conclusion: Bamboo shoots may be used as a potential functional ingredient in food products for broader application.

Keywords: bamboo shoots, phytonutrients, fiber, biscuit

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Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

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This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment

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Authors: Andrea Vasquez, Pedro Maldonado-Alvarado

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In general, 'gluten-free' foods like breadmaking products provide functional or nutraceutical benefits for the consumer's health and increased their demand on the market. In Ecuador, there is an overproduction of superfoods, and the food by-products are undervalued. For the first time, to the author's best knowledge, gluten-free bread mixtures from quinoa and banana flour, cassava starch, lupine flour (LF), or whey protein (WP) with hydroxypropylmethylcellulose (HPMC) and transglutaminase (TG) were evaluated on their functional and sensory properties. Free amino groups and thiols, rheology, and electrophoresis SDS PAGE were performed to analyze the crosslinking of TG at different concentrations with HC or PL proteins. Dough characterization, pasting properties were evaluated, respectively, by a MIXOLAB and a rheometer with a pasting cell. The texture, porosity, and loaf volume were characterized using a texturometer, ImageJ software, and breadmaking ability, respectively. Finally, a breadmaking aptitude and sensorial bread acceptability were performed. A significant decrease in the content of free amino groups (0.16 to 0.11 and 0.46 to 0.36 mM/mg of protein) and free thiol groups (0.37 to 0.21 and 1.79 to 1.32 mM/mg protein) was observed when 1.0% and 0.5% TG were added to LF and WP, respectively. In apparent viscosity analysis, the action of TG on HC proteins changes their viscosity, while the viscosity of LF is not modified by TG. Results of electrophoresis in PL showed bands of higher molecular weight of different fragments of proteins with 1% TG. Formulation with 59.8, 39.9, 160.8, 6.0, 1.0, and 1.5% of, respectively, QF, BF, CS, LF or WP, TG, and HPMC had the best properties in dough parameters, pasting parameters (lower pasting temperature and higher peak viscosity), best crumb structure, lower crumb hardness and higher loaf volume (2.24 and 2.28 mL/g). All the loaves of bread were acceptable in baking aptitude and general acceptability.

Keywords: breadmaking, gluten-free, superfoods, by-products, Ecuador

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Authors: Fundime Miri, Emanuela Sulaj

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Benthic ecosystems constitute important ecological habitats, providing fundamental services for spawning, foraging, and sheltering aquatic organisms. Benthic faunal communities are characterized by a large biological diversity, supported by a great physical variety of benthic habitats. Until late, the study of meiobenthic communities in Albania has been neglectedthus excluding an important component of benthos. The present study aims to bring characteristics of distribution pattern of meiofaunal communities with further focus on nematode genus-based diversity from different intertidal habitats along Albanian Adriatic Sea Coast. The investigation area is extended from Shkodra to Vlora District, including six sandy sampling sites in beaches and areas near river estuaries. Sediment samples were collected manually in low intertidal zone by using a cylindrical corer, with an internal diameter of 5 cm. The richness onmeiofaunalmajor taxon level did not show any significant change between different sampling sites compare to significant changes in nematode diversity at genus level, with distinct nematode assemblages per sampling sites and presence of exclusive genera. All meiofaunal communities under study were dominated by nematodes. Further assessment of functional diversity on nematode assemblages exhibited changes as well on trophic groups and life strategies due to diverse feeding behaviors and c-p values of nematode genera. This study emphasize the need for lower level taxonomic identification of meiofaunal organisms and extending of ecological assessments on trophic diversity and life strategies to understanding functional consequences.

Keywords: benthos, meiofauna, nematode genus-based diversity, functional diversity, intertidal, albanian adriatic coast

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Authors: Elif Tugce Aksun Tumerkan, Umran Cansu, Gokhan Boran, Fatih Ozogul

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Gelatin is a mixture of peptides obtained from collagen by partial thermal hydrolysis. It is an important and useful biopolymer that is used in the food, pharmacy, and photography products. Generally, gelatins are sourced from pig skin and bones, beef bone and hide, but within the last decade, using alternative gelatin resources has attracted some interest. In this study, functional properties of gelatin extracted from seafood and poultry by-products were evaluated. For this purpose, skins of skipjack tuna (Katsuwonus pelamis) and frog (Rana esculata) were used as seafood by-products and chicken skin as poultry by-product as raw material for gelatin extraction. Following the extraction of gelatin, all samples were lyophilized and stored in plastic bags at room temperature. For comparing gelatins obtained; chemical composition, common quality parameters including bloom value, gel strength, and viscosity in addition to some others like melting and gelling temperatures, hydroxyproline content, and colorimetric parameters were determined. The results showed that the highest protein content obtained in frog gelatin with 90.1% and the highest hydroxyproline content was in chicken gelatin with 7.6% value. Frog gelatin showed a significantly higher (P < 0.05) melting point (42.7°C) compared to that of fish (29.7°C) and chicken (29.7°C) gelatins. The bloom value of gelatin from frog skin was found higher (363 g) than chicken and fish gelatins (352 and 336 g, respectively) (P < 0.05). While fish gelatin had higher lightness (L*) value (92.64) compared to chicken and frog gelatins, redness/greenness (a*) value was significantly higher in frog skin gelatin. Based on the results obtained, it can be concluded that skins of different animals with high commercial value may be utilized as alternative sources to produce gelatin with high yield and desirable functional properties. Functional and quality analysis of gelatin from frog, chicken, and tuna skin showed by-product of poultry and seafood can be used as an alternative gelatine source to mammalian gelatine. The functional properties, including bloom strength, melting points, and viscosity of gelatin from frog skin were more admirable than that of the chicken and tuna skin. Among gelatin groups, significant characteristic differences such as gel strength and physicochemical properties were observed based on not only raw material but also the extraction method.

Keywords: chicken skin, fish skin, food industry, frog skin, gel strength

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