Search results for: general hospital
Commenced in January 2007
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Edition: International
Paper Count: 7063

Search results for: general hospital

1633 Effects of Modified Low-Dye Taping on First Ray Mobility Test and Sprint Time

Authors: Yu-Ju Tsai, Ching-Chun Wang, Wen-Tzu Tang, Huei-Ming Chai

Abstract:

A pronated foot is frequently associated with a hypermobile first ray, then developing further severe foot problems. Low-Dye taping with athletic tape has been widely used to restrict excessive first ray motion and re-build height of the medial longitudinal arch in general population with pronated foot. It is not the case, however, for sprinters since they feel too much restriction of foot motions. Currently, the kinesio tape, more elastic than the athletic tape, has been widely used to re-adjust joint positions. It was interesting whether modified low-Dye taping using kinesio tape was beneficial for altering first ray mobility and still giving enough arch support. The purpose of this study was to investigate the effect of modified low-Dye taping on first ray mobility test and 60-m sprint time for sprinters with pronated foot. The significance of this study provides new insight into a treatment alternative of modified low-Dye taping for sprinter with pronated foot. Ten young male sprinters, aged 20.8±1.6 years, with pronated foot were recruited for this study. The pronated foot was defined as the foot that the navicular drop test was greater than 1.0 cm. Three optic shutters were placed at the start, 30-m, and 60-m sites to record sprint time. All participants were asked to complete 3 trials of the 60-m dash with both taping and non-taping conditions in a random order. The low-Dye taping was applied using the method postulated by Ralph Dye in 1939 except the kinesio tape was used instead. All outcome variables were recorded for taping and non-taping conditions. Paired t-tests were used to analyze all outcome variables between 2 conditions. Although there were no statistically significant differences in dorsal and plantar mobility between taping and non-taping conditions, a statistical significance was found in a total range of motion (dorsiflexion plus plantarflexion angle) of the first ray when a modified low-Dye taping was applied (p < 0.05). Time to complete 60-m sprint was significantly increased with low-Dye taping (p < 0.05) while no significance was found for time to 30-m. it indicated that modified low-Dye taping changed maximum sprint speed of 60-m dash. Conclusively, modified low-Dye taping was capable of increasing first ray mobility and further altered maximum sprint speed.

Keywords: first ray mobility, kinesio taping, pronated foot, sprint time

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1632 Passive Seismic in Hydrogeological Prospecting: The Case Study from Hard Rock and Alluvium Plain

Authors: Prarabdh Tiwari, M. Vidya Sagar, K. Bhima Raju, Joy Choudhury, Subash Chandra, E. Nagaiah, Shakeel Ahmed

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Passive seismic, a wavefield interferometric imaging, low cost and rapid tool for subsurface investigation is used for various geotechnical purposes such as hydrocarbon exploration, seismic microzonation, etc. With the recent advancement, its application has also been extended to groundwater exploration by means of finding the bedrock depth. Council of Scientific & Industrial Research (CSIR)-National Geophysical Research Institute (NGRI) has experimented passive seismic studies along with electrical resistivity tomography for groundwater in hard rock (Choutuppal, Hyderabad). Passive Seismic with Electrical Resistivity (ERT) can give more clear 2-D subsurface image for Groundwater Exploration in Hard Rock area. Passive seismic data were collected using a Tromino, a three-component broadband seismometer, to measure background ambient noise and processed using GRILLA software. The passive seismic results are found corroborating with ERT (Electrical Resistivity Tomography) results. For data acquisition purpose, Tromino was kept over 30 locations consist recording of 20 minutes at each station. These location shows strong resonance frequency peak, suggesting good impedance contrast between different subsurface layers (ex. Mica rich Laminated layer, Weathered layer, granite, etc.) This paper presents signature of passive seismic for hard rock terrain. It has been found that passive seismic has potential application for formation characterization and can be used as an alternative tool for delineating litho-stratification in an urban condition where electrical and electromagnetic tools cannot be applied due to high cultural noise. In addition to its general application in combination with electrical and electromagnetic methods can improve the interpreted subsurface model.

Keywords: passive seismic, resonant frequency, Tromino, GRILLA

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1631 Compare the Effectiveness of Web Based and Blended Learning on Paediatric Basic Life Support

Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

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Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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1630 Impact of Two Herbal Seeds Supplementation on Growth Performance and Some Biochemical Blood and Tissue Parameters of Broiler Chickens

Authors: Hamada A. Ahmed, Kadry M. Sadek, Ayman E. Taha

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The effects of basil and/or chamomile seed supplementation on the growth of Hubbard broiler chicks were evaluated. The antioxidant effects of these supplements were also assessed. One hundred and twenty 1-day-old broiler chicks were randomly divided into four equal groups. The control group (group 1) was fed a basal diet (BD) without supplementation. Groups 2, 3, and 4 were fed the BD supplemented with 10g basil, 10g chamomile, and 5g basil plus 5g chamomile per kg of food, respectively. Basil supplementation alone or in combination with chamomile non-significantly (P≥0.05) increased final body weight (3.2% and 0.3%, respectively) and weight gain (3.5% and 3.6%, respectively) over the experimental period. Chamomile supplementation alone non-significantly (P≥0.05) reduced final body weight and weight gain over the experimental period by 1.7% and 1.7%, respectively. In comparison to the control group, herbal seed supplementation reduced feed intake and improved the feed conversion and protein efficiency ratios. In general, basil seed supplementation stimulated chicken growth and improved the feed efficiency more effectively than chamomile seed supplementation. The antioxidant activities of basil and/or chamomile supplementation were examined in the thymus, bursa, and spleen. In chickens that received supplements, the level of malondialdehyde was significantly decreased, whereas the activities of glutathione, superoxide dismutase, and catalase were significantly increased (P<0.05). Supplementation of basil and/or chamomile did not affect blood protein levels, but had lipid-lowering effects as evidenced by reduced serum levels of total lipids, triglycerides, and cholesterol. In conclusion, supplementation of basil and/or chamomile improved growth parameters in broiler chicks and had antioxidant and blood lipid-lowering effects. These beneficial effects of basil and/or chamomile supplementation resulted in economically viable production of high-quality white meat containing no harmful residues.

Keywords: herbal additives, basil, chamomile, broiler, growth performance, antioxidant

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1629 Discourse Analysis and Semiotic Researches: Using Michael Halliday's Sociosemiotic Theory

Authors: Deyu Yuan

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Discourse analysis as an interdisciplinary approach has more than 60-years-history since it was first named by Zellig Harris in 'Discourse Analysis' on Language in 1952. Ferdinand de Saussure differentiated the 'parole' from the 'langue' that established the principle of focusing on language but not speech. So the rising of discourse analysis can be seen as a discursive turn for the entire language research that closely related to the theory of Speech act. Critical discourse analysis becomes the mainstream of contemporary language research through drawing upon M. A. K. Halliday's socio-semiotic theory and Foucault, Barthes, Bourdieu's views on the sign, discourse, and ideology. So in contrast to general semiotics, social semiotics mainly focuses on parole and the application of semiotic theories to some applicable fields. The article attempts to discuss this applicable sociosemiotics and show the features of it that differ from the Saussurian and Peircian semiotics in four aspects: 1) the sign system is about meaning-generation resource in the social context; 2) the sign system conforms to social and cultural changes with the form of metaphor and connotation; 3) sociosemiotics concerns about five applicable principles including the personal authority principle, non-personal authority principle, consistency principle, model demonstration principle, the expertise principle to deepen specific communication; 4) the study of symbolic functions is targeted to the characteristics of ideational, interpersonal and interactional function in social communication process. Then the paper describes six features which characterize this sociosemiotics as applicable semiotics: social, systematic, usable interdisciplinary, dynamic, and multi-modal characteristics. Thirdly, the paper explores the multi-modal choices of sociosemiotics in the respects of genre, discourse, and style. Finally, the paper discusses the relationship between theory and practice in social semiotics and proposes a relatively comprehensive theoretical framework for social semiotics as applicable semiotics.

Keywords: discourse analysis, sociosemiotics, pragmatics, ideology

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1628 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients on Anticoagulation

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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1627 A Study on Effect of Almahdi Aluminium Factory of Bandar Abbas on Environment Status of the Region with an Emphasis on Measuring of Some Scarce Metals Existing in the Air (Atmosphere)

Authors: Maryam Ehsanpour, Maryam Malekpour, Rastin Afkhami

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Today, industry is one of the indices of growth and development of countries and is a suitable applicable criterion to compare the countries. Bandar Abbas has a high industrial centralization in term of geographical redundancy of industries in comparison with other rural and urban places of Hormozgan province. Most important and major industries of the province are located in Bandar abbas eighth refinery, power plant, zinc melting company, Almahdi Aluminium, Hormozgan steel, south steel, which are the most important of these industries. So, it is necessary to study pollution from these industries and their destructive effects on environment of region. In respect of these things, general purpose of this research is codling and presenting managing solution of Almahdi Aluminium factory in them of measuring of air (atmosphere) parameters. For gaining this purpose it is necessary to determine measure of heavy metals suspension in the air (atmosphere) in the neighborhood of industries and also in residential regions close to them as partial purposes. So, for achieving the purposes above, operation of sampling from the air in two hot and cold seasons of the year (2010-2011) was performed, after field reviews to recognize the sources of effluence and to choose place of sampling stations. Sampling and preparation way to read was based on EPA and NIOSH. Also, decreasing process was included Fe>Al>Cd>Pb>Ni respectively, in term of results gaining from sampling of ingredients existing in the air (atmosphere). Also Ni and Fe elements in samples of air were higher than permissive measure in both of cold and hot season. Average of these two metals was 34% and 33% in cold season and 44% and 34% micrograms/m3 in hot season. Finally, suitable managing solutions to improve existing situation is presented in term for all results.

Keywords: Almahdi aluminium factory, Bandar Abbas, scarce metals, atmosphere

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1626 Expression of Inflammatory and Cell Death Genes and DNA Damage Induced by Endotoxic Shock in Laying Hens

Authors: Mariam G. Eshak, Ahmed Abbas, M. I. El-Sabry, M. M. Mashaly

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This investigation was conducted to determine the physiological response and evaluate the expression of inflammatory and cell death genes and DNA damage induced by endotoxic shock in laying hens. Endotoxic shock was induced by a single intravenous injection of 107 Escherichia coli (E. coli,) colony/hen. In the present study, 240 forty-week-old laying hens (H&N) were randomly assigned into 2 groups with 3 replicates of 40 birds each. Hens were reared in battery cages with wire floors in an open-sided housing system under natural conditions. Housing and general management practices were similar for all groups. At 42-wk of age, 45 hens from the first group (15 replicate) were infected with E. coli, while the same number of hens from the second group was injected with saline and served as a control. Heat shock protein-70 (HSP-70) expression, plasma corticosterone concentration, body temperature, and the gene expression of bax, caspase-3 activity, P38, Interlukin-1β (Il-1β), and tumor necrosis factor alpha (TNF-α) genes and DNA damage in the brain and liver were measured. Hens treated with E. coli showed significant (P≤0.05) increase of body temperature by 1.2 ᴼC and plasma corticosterone by 3 folds compared to the controls. Further, hens injected with E.Coli showed markedly over-expression of HSP-70 and increase DNA damage in brain and liver. These results were synchronized with activating cell death program since our data showed significant (P≤0.05) high expression of bax and caspase-3 activity genes in the brain and liver. These results were related to remarkable over-inflammation gene expression of P38, IL-1β, and TNF-α in brain and liver. In conclusion, our results indicate that endotoxic shock induces inflammatory physiological response and triggers cell death program by promoting P38, IL-1β, and TNF-α gene expression in the brain and liver.

Keywords: chicken, DNA damage, Escherichia coli, gene expression, inflammation

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1625 Using Machine Learning to Classify Different Body Parts and Determine Healthiness

Authors: Zachary Pan

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Our general mission is to solve the problem of classifying images into different body part types and deciding if each of them is healthy or not. However, for now, we will determine healthiness for only one-sixth of the body parts, specifically the chest. We will detect pneumonia in X-ray scans of those chest images. With this type of AI, doctors can use it as a second opinion when they are taking CT or X-ray scans of their patients. Another ad-vantage of using this machine learning classifier is that it has no human weaknesses like fatigue. The overall ap-proach to this problem is to split the problem into two parts: first, classify the image, then determine if it is healthy. In order to classify the image into a specific body part class, the body parts dataset must be split into test and training sets. We can then use many models, like neural networks or logistic regression models, and fit them using the training set. Now, using the test set, we can obtain a realistic accuracy the models will have on images in the real world since these testing images have never been seen by the models before. In order to increase this testing accuracy, we can also apply many complex algorithms to the models, like multiplicative weight update. For the second part of the problem, to determine if the body part is healthy, we can have another dataset consisting of healthy and non-healthy images of the specific body part and once again split that into the test and training sets. We then use another neural network to train on those training set images and use the testing set to figure out its accuracy. We will do this process only for the chest images. A major conclusion reached is that convolutional neural networks are the most reliable and accurate at image classification. In classifying the images, the logistic regression model, the neural network, neural networks with multiplicative weight update, neural networks with the black box algorithm, and the convolutional neural network achieved 96.83 percent accuracy, 97.33 percent accuracy, 97.83 percent accuracy, 96.67 percent accuracy, and 98.83 percent accuracy, respectively. On the other hand, the overall accuracy of the model that de-termines if the images are healthy or not is around 78.37 percent accuracy.

Keywords: body part, healthcare, machine learning, neural networks

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1624 The Sublimation Of Personal Drama Into Mythological Tale: ‘‘The Search Of Golden Fleece’’ By Alexander Mcqueen, Givenchy

Authors: Ani Hambardzumyan

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The influence of Greek culture and Greek mythology on the fashion industry is enormous. The first reason behind this is that Greek culture is one of the core elements to form the clothing tradition in Europe. French fashion houses have always been considered one of the leading cloth representatives in the world. As we could perceive in the first chapter, they are among the first ones to get inspired from Greek cultural heritage and apply it while creating their garments. The French fashion industry has kept traditional classical elements in clothes for decades. However, from the second half of the 20th century, this idea started to alter step by step. Society was transforming its vision with the influence of avant-garde movements. Hence, the fashion industry needed to transform its conception as well. However, it should be mentioned that fashion brands never stopped looking at the past when creating a new perspective or vision. Paradoxically, Greek mythology and clothing tradition continued to be applied even in the search of new ideas or new interpretations. In 1997 Alexander McQueen presents his first Haute Couture collection for French fashion house Givenchy, inspired by Greek mythology and titled ‘‘Search for The Golden Fleece.’’ Perhaps, this was one of the most controversial Haute Couture shows that French audience could expect to see and French media could capture and write about. The paper discuss Spring/Summer 1997 collection ‘‘The Search of Golden Fleece’’ by Alexander McQueen. It should be mentioned that there has not been yet conducted researches to analyze the mythological and archetypal nature of the collection, as well as general observations that go beyond traditional historical reviews are few in number. Here we will observe designer’s transformative new approach regarding Greek heritage and the media’s perception of it while collection was presented. On top of that, we will observe Alexander McQueen life in the parallel line with the fashion show since the collection is nothing else but the sublimation of his personal journey and drama.

Keywords: mythology, mcqueen, the argonaut, french fashion, golden fleece, givenchy

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1623 Hydrodynamic Characteristics of Single and Twin Offshore Rubble Mound Breakwaters under Regular and Random Waves

Authors: M. Alkhalidi, S. Neelamani, Z. Al-Zaqah

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This paper investigates the interaction of single and twin offshore rubble mound breakwaters with regular and random water waves through physical modeling to assess their reflection, transmission and energy dissipation characteristics. Various combinations of wave heights and wave periods were utilized in a series of experiments, along with three different water depths. The single and twin permeable breakwater models were both constructed with one layer of rubbles. Both models had the same total volume; however, the single breakwater was of trapezoidal type while the twin breakwaters were of triangular type. Physical modeling experiments were carried out in the wave flume of the coastal engineering laboratory of Kuwait Institute for Scientific Research (KISR). Measurements of the six wave probes which were fixed in the two-dimensional wave flume were collected and used to determine the generated incident wave heights, as well as the reflected and transmitted wave heights resulting from the wave-breakwater interaction. The possible factors affecting the wave attenuation efficiency of the breakwater models are the relative water depth (d/L), wave steepness (H/L), relative wave height ((h-d)/Hi), relative height of the breakwater (h/d), and relative clear spacing between the twin breakwaters (S/h). The results indicated that the single and double breakwaters show different responds to the change in their relative height as well as the relative wave height which demonstrates that the effect of the relative water depth on wave reflection, transmission, and energy dissipation is highly influenced by the change in the relative breakwater height, the relative wave height and the relative breakwater spacing. In general, within the range of the relative water depth tested in this study, and under both regular and random waves, it is found that the single breakwater allows for lower wave transmission and shows higher energy dissipation effect than both of the tested twin breakwaters, and hence has the best overall performance.

Keywords: random waves, regular waves, relative water depth, relative wave height, single breakwater, twin breakwater, wave steepness

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1622 A Benchmark System for Testing Medium Voltage Direct Current (MVDC-CB) Robustness Utilizing Real Time Digital Simulation and Hardware-In-Loop Theory

Authors: Ali Kadivar, Kaveh Niayesh

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The integration of green energy resources is a major focus, and the role of Medium Voltage Direct Current (MVDC) systems is exponentially expanding. However, the protection of MVDC systems against DC faults is a challenge that can have consequences on reliable and safe grid operation. This challenge reveals the need for MVDC circuit breakers (MVDC CB), which are in infancies of their improvement. Therefore will be a lack of MVDC CBs standards, including thresholds for acceptable power losses and operation speed. To establish a baseline for comparison purposes, a benchmark system for testing future MVDC CBs is vital. The literatures just give the timing sequence of each switch and the emphasis is on the topology, without in-depth study on the control algorithm of DCCB, as the circuit breaker control system is not yet systematic. A digital testing benchmark is designed for the Proof-of-concept of simulation studies using software models. It can validate studies based on real-time digital simulators and Transient Network Analyzer (TNA) models. The proposed experimental setup utilizes data accusation from the accurate sensors installed on the tested MVDC CB and through general purpose input/outputs (GPIO) from the microcontroller and PC Prototype studies in the laboratory-based models utilizing Hardware-in-the-Loop (HIL) equipment connected to real-time digital simulators is achieved. The improved control algorithm of the circuit breaker can reduce the peak fault current and avoid arc resignation, helping the coordination of DCCB in relay protection. Moreover, several research gaps are identified regarding case studies and evaluation approaches.

Keywords: DC circuit breaker, hardware-in-the-loop, real time digital simulation, testing benchmark

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1621 Examining Patterns in Ethnoracial Diversity in Los Angeles County Neighborhoods, 2016, Using Geographic Information System Analysis and Entropy Measure of Diversity

Authors: Joseph F. Cabrera, Rachael Dela Cruz

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This study specifically examines patterns that define ethnoracially diverse neighborhoods. Ethnoracial diversity is important as it facilitates cross-racial interactions within neighborhoods which have been theorized to be associated with such outcomes as intergroup harmony, the reduction of racial and ethnic prejudice and discrimination, and increases in racial tolerance. Los Angeles (LA) is an ideal location to study ethnoracial spatial patterns as it is one of the most ethnoracially diverse cities in the world. A large influx of Latinos, as well as Asians, have contributed to LA’s urban landscape becoming increasingly diverse over several decades. Our dataset contains all census tracts in Los Angeles County in 2016 and incorporates Census and ACS demographic and spatial data. We quantify ethnoracial diversity using a derivative of Simpson’s Diversity Index and utilize this measure to test previous literature that suggests Latinos are one of the key drivers of changing ethnoracial spatial patterns in Los Angeles. Preliminary results suggest that there has been an overall increase in ethnoracial diversity in Los Angeles neighborhoods over the past sixteen years. Patterns associated with this trend include decreases in predominantly white and black neighborhoods, increases in predominantly Latino and Asian neighborhoods, and a general decrease in the white populations of the most diverse neighborhoods. A similar pattern is seen in neighborhoods with large Latino increases- a decrease in white population, but with an increase in Asian and black populations. We also found support for previous research that suggests increases in Latino and Asian populations act as a buffer, allowing for black population increases without a sizeable decrease in the white population. Future research is needed to understand the underlying causes involved in many of the patterns and trends highlighted in this study.

Keywords: race, race and interaction, racial harmony, social interaction

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1620 Countering Violent Extremism in Pakistan: Case Study of Sectarian Divide

Authors: Muqarrab Akbar

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Pakistan is considered as a state confronting different internal and external challenges. Extremism is one of the most vital internal challenges faced by Pakistani society. The state’s contradictory policies, political instability, socio-economic injustice, absence of the rule of law are the major reasons behind the proliferation of violence and extremism in society. The fall of the Shah of Iran, the Iranian revolution, the 1979 Afghan war of 1979, the emergence of Al-Qaeda, Talibanisation, war against terrorism, and involvement of Saudia and Iran have further aggravated the culture of violence and extremism in Pakistan. The absence of a narrative of peaceful coexistence and harmony has created a vacuum for youth in Pakistani society. In the contemporary era, civil society and the government of Pakistan has initiated different steps to introduce a narrative to counter violent extremism. These narratives have helped a lot in creating community resilience to promote peace and harmony among Pakistani society in general and to bridge the gap between the Sunni Shia divide in particular. This paper will highlight those factors in detail that threw the society into extremism and violence, particularly with reference to Sunni Shia divide in Pakistan. This paper explores the impact of sectarian violence in Pakistan and highlights the different initiatives and their impacts on Pakistani society at large. A quantitative method has been adopted to explore the results. Empirical study used in the paper was based on the survey conducted by distributing questionnaires among 300 people from both community Sunni and Shia in Pakistan. Some interviews of the religious scholars of both communities are also conducted for this research. The recent developments on the government level and society levels have created community resilience. The results of the survey show that Pakistani society in the contemporary era is more peaceful and tolerant as compared to the past. The research concludes that the counter-narrative approach is positively affecting the peaceful environment in Pakistan.

Keywords: extremism, Pakistan, Shia, Sunni, violence

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1619 Concealing Breast Cancer Status: A Qualitative Study in India

Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

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Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

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1618 Accumulation of Pollutants, Self-Purification and Impact on Peripheral Urban Areas: A Case Study in Shantytowns in Argentina

Authors: N. Porzionato, M. Mantiñan, E. Bussi, S. Grinberg, R. Gutierrez, G. Curutchet

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This work sets out to debate the tensions involved in the processes of contamination and self-purification in the urban space, particularly in the streams that run through the Buenos Aires metropolitan area. For much of their course, those streams are piped; their waters do not come into contact with the outdoors until they have reached deeply impoverished urban areas with high levels of environmental contamination. These are peripheral zones that, until thirty years ago, were marshlands and fields. They are now densely populated areas largely lacking in urban infrastructure. The Cárcova neighborhood, where this project is underway, is in the José León Suárez section of General San Martín country, Buenos Aires province. A stretch of José León Suarez canal crosses the neighborhood. Starting upstream, this canal carries pollutants due to the sewage and industrial waste released into it. Further downstream, in the neighborhood, domestic drainage is poured into the stream. In this paper, we formulate a hypothesis diametrical to the one that holds that these neighborhoods are the primary source of contamination, suggesting instead that in the stretch of the canal that runs through the neighborhood the stream’s waters are actually cleaned and the sediments accumulate pollutants. Indeed, the stretches of water that runs through these neighborhoods act as water processing plants for the metropolis. This project has studied the different organic-load polluting contributions to the water in a certain stretch of the canal, the reduction of that load over the course of the canal, and the incorporation of pollutants into the sediments. We have found that the surface water has considerable ability to self-purify, mostly due to processes of sedimentation and adsorption. The polluting load is accumulated in the sediments where that load stabilizes slowly by means of anaerobic processes. In this study, we also investigated the risks of sediment management and the use of the processes studied here in controlled conditions as tools of environmental restoration.

Keywords: bioremediation, pollutants, sediments, urban streams

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1617 Disease Trajectories in Relation to Poor Sleep Health in the UK Biobank

Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

Abstract:

Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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1616 Ergonomics Management and Sustainability: An Exploratory Study Applied to Automaker Industry in South of Brazil

Authors: Giles Balbinotti, Lucas Balbinotti, Paula Hembecker

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The management of the productive process project activities, for the conception of future work and for the financial health of the companies, is an important condition in an organizational model that corroborates the management of the human aspects and their variabilities existing in the work. It is important to seek, at all levels of the organization, understanding and consequent cultural change, and so that factors associated with human aspects are considered and prioritized in the projects. In this scenario, the central question of research for this study is placed from the context of the work, in which the managers and project coordinators are inserted, as follows: How is the top management convinced, in the design stages, to take The ‘Ergonomics’ as strategy for the performance and sustainability of the business? In this perspective, this research has as general objective to analyze how the application of the management of the human aspects in a real project of productive process in the automotive industry, including the activity of the manager and coordinator of the project beyond the strategies of convincing to act in the ergonomics of design. For this, the socio-technical and ergonomic approach is adopted, given its anthropocentric premise in the sense of acting on the social system simultaneously to the technical system, besides the support of the Modapts system that measures the non-value-added times and the correlation with the Critical positions. The methodological approach adopted in this study is based on a review of the literature and the analysis of the activity of the project coordinators of an industry, including the management of human aspects in the context of work variability and the strategies applied in project activities. It was observed in the study that the loss of performance of the serial production lines reaches the important number of the order of 30%, which can make the operation with not value-added, and this loss has as one of the causes, the ergonomic problems present in the professional activity.

Keywords: human aspects in production process project, ergonomics in design, sociotechnical project management, sociotechnical, ergonomic principles, sustainability

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1615 Epidemiological Analysis of Measles Outbreak in North-Kazakhstan Region of the Republic of Kazakhstan

Authors: Fatima Meirkhankyzy Shaizadina, Alua Oralovna Omarova, Praskovya Mikhailovna Britskaya, Nessipkul Oryntayevna Alysheva

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In recent years in the Republic of Kazakhstan there have been registered outbreaks of measles among the population. The objective of work was the analysis of outbreak of measles in 2014 among the population of North-Kazakhstan region of the Republic of Kazakhstan. For the analysis of the measles outbreak descriptive and analytical research, techniques were used and threshold levels of morbidity were calculated. The increase of incidence was noted from March to July. The peak was registered in May and made 9.0 per 100000 population. High rates were registered in April – 5.7 per 100000 population, and in June and July they made 5.7 and 3.1 respectively. Duration of the period of increase made 5 months. The analysis of monthly incidence of measles revealed spring and summer seasonality. Across the territory it was established that 69.2% of cases were registered in the city, 29.1% in rural areas and 1.7% of cases were brought in from other regions of Kazakhstan. The registered cases and threshold values of measles during the outbreak revealed that from 12 to 24 week, and also during the 40th week the cases exceeding the threshold levels are registered. Thus, for example, for the analyzed 1 week the number of the revealed patients made 4, which exceeds the calculated threshold value (3) by 33.3%. The data exceeding the threshold values confirm the emergence of a disease outbreak or the beginning of epidemic rise in morbidity. Epidemic rise in incidence of the population of North-Kazakhstan region was observed throughout 2014. The risk group includes 0-4 year-old children, who made 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The analysis of measles cases registration by gender revealed that women are registered 1.1 times more often than men. The ratio of women to men made 1:0.87. In social and professional groups often ill are unorganized children – 23.3% and students – 19.8%. Studying clinical manifestations of measles in the hospitalized patients, the typical beginning of a disease with expressed intoxication symptoms – weakness, sickliness was established. In individual cases expressed intoxication symptoms, hemorrhagic and dyspeptic syndromes, complications in the form of overlay of a secondary bacterial infection, which defined high severity of the illness, were registered both in adults and in children. The average duration of stay of patients in the hospital made 6.9 days. The average duration of time between date of getting the disease and date of delivery of health care made 3.6 days. Thus, the analysis of monthly incidence of measles revealed spring and summer seasonality, the peak of which was registered in May. Urban dwellers are ill more often (69.2%), while in rural areas people are ill more rarely (29.1%). Throughout 2014 an epidemic rise in incidence of the population of North-Kazakhstan region was observed. Risk group includes: children under 4 – 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The ratio of women and men made 1:0.87. The typical beginning of a disease in all hospitalized with the expressed intoxication symptoms – weakness, sickliness was established.

Keywords: epidemiological analysis, measles, morbidity, outbreak

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1614 Intrastromal Donor Limbal Segments Implantation as a Surgical Treatment of Progressive Keratoconus: Clinical and Functional Results

Authors: Mikhail Panes, Sergei Pozniak, Nikolai Pozniak

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Purpose: To evaluate the effectiveness of intrastromal donor limbal segments implantation for treatment of progressive keratoconus considering on main characteristics of corneal endothelial cells. Setting: Outpatient ophthalmic clinic. Methods: Twenty patients (20 eyes) with progressive keratoconus II-III of Amsler classification were recruited. The worst eye was treated with the transplantation of donor limbal segments in the recipient corneal stroma, while the fellow eye was left untreated as a control of functional and morphological changes. Furthermore, twenty patients (20 eyes) without progressive keratoconus was used as a control of corneal endothelial cells changes. All patients underwent a complete ocular examination including uncorrected and corrected distance visual acuity (UDVA, CDVA), slit lamp examination fundus examination, corneal topography and pachymetry, auto-keratometry, Anterior Segment Optical Coherence Tomography and Corneal Endothelial Specular Microscopy. Results: After two years, statistically significant improvement in the UDVA and CDVA (on the average on two lines for UDVA and three-four lines for CDVA) were noted. Besides corneal astigmatism decreased from 5.82 ± 2.64 to 1.92 ± 1.4 D. Moreover there were no statistically significant differences in the changes of mean spherical equivalent, keratometry and pachymetry indicators. It should be noted that after two years there were no significant differences in the changes of the number and form of corneal endothelial cells. It can be regarded as a process stabilization. In untreated control eyes, there was a general trend towards worsening of UDVA, CDVA and corneal thickness, while corneal astigmatism was increased. Conclusion: Intrastromal donor segments implantation is a safe technique for keratoconus treatment. Intrastromal donor segments implantation is an efficient procedure to stabilize and improve progressive keratoconus.

Keywords: corneal endothelial cells, intrastromal donor limbal segments, progressive keratoconus, surgical treatment of keratoconus

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1613 Characteristics and Guiding Strategies of College Students' Online Discourse: Based on the Analysis of One Student Forum

Authors: Hanwei Cheng, Chengbei Xu, Yijie Wang

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More and more college students are accustomed to surfing the Internet everyday. As community members, college students have ability to express opinions and participate in social affairs, they not only accept information passively, but also voice their concerns on the Internet. We interpret the online discourses featured with anonymization, so it helps us more effectively and conveniently understand the behaviors and thoughts of college students, and educators can thus grasp the scales and directions in guiding online language. We analyzed online comments in both content and form aspects in one student forum (named Dandan, the BNU’s campus forum), and through methods of literature review and interview, we found that in term of content, college students pay attention to practical information online, emphasize on personal development and pursue hot issues; in term of form, college students' online language displays cross-border quality sometimes under the general feature of normative, and they often explore a certain topic in the form of question or discussion, and they like to show feelings in ironic and stream-of-consciousness ways. It is argued that college students intend to establish a community to facilitate personal development and meet emotional needs through the student forum, and by making comments at the forum they are also able to get involved in public affairs. We should pay attention to problems of college students' online discourse, such as boundary issues (like informal advertisement and information authenticity), emotional issues and the spread of gossip. Some possible solutions to solving online discourse problems can be applied, like we can improve access systems of student forum, clarify principles of Internet langue use, change oversimplified management approaches and use some other tactics, in order to form a mechanism of student self-regulation, also deepen the trust and cooperation between school administrators and students.

Keywords: online language, youth discourse, content and form, implication and strategy

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1612 Psychological Distress and Quality of Life in Inflammatory Bowel Disease Patients: The Role of Dispositional Mindfulness

Authors: Kelly E. Tow, Peter Caputi, Claudia Rogge, Thomas Lee, Simon R. Knowles

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Inflammatory Bowel Disease (IBD) is a serious chronic health condition, characterised by inflammation of the gastrointestinal tract. Individuals with active IBD experience severe abdominal symptoms, which can adversely impact their physical and mental health, as well as their quality of life (QoL). Given that stress may exacerbate IBD symptoms and is frequently highlighted as a contributing factor for the development of psychological difficulties and poorer QoL, it is vital to investigate stress-management strategies aimed at improving the lives of those with IBD. The present study extends on the limited research in IBD cohorts by exploring the role of dispositional mindfulness and its impact on psychological well-being and QoL. The study examined how disease activity and dispositional mindfulness were related to psychological distress and QoL in a cohort of IBD patients. The potential role of dispositional mindfulness as a moderator between stress and anxiety, depression and QoL in these individuals was also examined. Participants included 47 patients with a clinical diagnosis of IBD. Each patient completed a series of psychological questionnaires and was assessed by a gastroenterologist to determine their disease activity levels. Correlation analyses indicated that disease activity was not significantly related to psychological distress or QoL in the sample of IBD patients. However, dispositional mindfulness was inversely related to psychological distress and positively related to QoL. Furthermore, moderation analyses demonstrated a significant interaction between stress and dispositional mindfulness on anxiety. These findings demonstrate that increased levels of dispositional mindfulness may be beneficial for individuals with IBD. Specifically, the results indicate positive links between dispositional mindfulness, general psychological well-being and QoL, and suggest that dispositional mindfulness may attenuate the negative impacts of stress on levels of anxiety in IBD patients. While further research is required to validate and expand on these findings, the current study highlights the importance of addressing psychological factors in IBD and indicates support for the use of mindfulness-based interventions for patients with the disease.

Keywords: anxiety, depression, dispositional mindfulness, inflammatory bowel disease, quality of life, stress

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1611 Comparison of Cyclone Design Methods for Removal of Fine Particles from Plasma Generated Syngas

Authors: Mareli Hattingh, I. Jaco Van der Walt, Frans B. Waanders

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A waste-to-energy plasma system was designed by Necsa for commercial use to create electricity from unsorted municipal waste. Fly ash particles must be removed from the syngas stream at operating temperatures of 1000 °C and recycled back into the reactor for complete combustion. A 2D2D high efficiency cyclone separator was chosen for this purpose. During this study, two cyclone design methods were explored: The Classic Empirical Method (smaller cyclone) and the Flow Characteristics Method (larger cyclone). These designs were optimized with regard to efficiency, so as to remove at minimum 90% of the fly ash particles of average size 10 μm by 50 μm. Wood was used as feed source at a concentration of 20 g/m3 syngas. The two designs were then compared at room temperature, using Perspex test units and three feed gases of different densities, namely nitrogen, helium and air. System conditions were imitated by adapting the gas feed velocity and particle load for each gas respectively. Helium, the least dense of the three gases, would simulate higher temperatures, whereas air, the densest gas, simulates a lower temperature. The average cyclone efficiencies ranged between 94.96% and 98.37%, reaching up to 99.89% in individual runs. The lowest efficiency attained was 94.00%. Furthermore, the design of the smaller cyclone proved to be more robust, while the larger cyclone demonstrated a stronger correlation between its separation efficiency and the feed temperatures. The larger cyclone can be assumed to achieve slightly higher efficiencies at elevated temperatures. However, both design methods led to good designs. At room temperature, the difference in efficiency between the two cyclones was almost negligible. At higher temperatures, however, these general tendencies are expected to be amplified so that the difference between the two design methods will become more obvious. Though the design specifications were met for both designs, the smaller cyclone is recommended as default particle separator for the plasma system due to its robust nature.

Keywords: Cyclone, design, plasma, renewable energy, solid separation, waste processing

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1610 A General Form of Characteristics Method Applied on Minimum Length Nozzles Design

Authors: Merouane Salhi, Mohamed Roudane, Abdelkader Kirad

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In this work, we present a new form of characteristics method, which is a technique for solving partial differential equations. Typically, it applies to first-order equations; the aim of this method is to reduce a partial differential equation to a family of ordinary differential equations along which the solution can be integrated from some initial data. This latter developed under the real gas theory, because when the thermal and the caloric imperfections of a gas increases, the specific heat and their ratio do not remain constant anymore and start to vary with the gas parameters. The gas doesn’t stay perfect. Its state equation change and it becomes for a real gas. The presented equations of the characteristics remain valid whatever area or field of study. Here we need have inserted the developed Prandtl Meyer function in the mathematical system to find a new model when the effect of stagnation pressure is taken into account. In this case, the effects of molecular size and intermolecular attraction forces intervene to correct the state equation, the thermodynamic parameters and the value of Prandtl Meyer function. However, with the assumptions that Berthelot’s state equation accounts for molecular size and intermolecular force effects, expressions are developed for analyzing the supersonic flow for thermally and calorically imperfect gas. The supersonic parameters depend directly on the stagnation parameters of the combustion chamber. The resolution has been made by the finite differences method using the corrector predictor algorithm. As results, the developed mathematical model used to design 2D minimum length nozzles under effect of the stagnation parameters of fluid flow. A comparison for air with the perfect gas PG and high temperature models on the one hand and our results by the real gas theory on the other of nozzles shapes and characteristics are made.

Keywords: numerical methods, nozzles design, real gas, stagnation parameters, supersonic expansion, the characteristics method

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1609 Accountability Mechanisms of Leaders and Its Impact on Performance and Value Creation: Comparative Analysis (France, Germany, United Kingdom)

Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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1608 KTiPO4F: The Negative Electrode Material for Potassium Batteries

Authors: Vahid Ramezankhani, Keith J. Stevenson, Stanislav. S. Fedotov

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Lithium-ion batteries (LIBs) play a pivotal role in achieving the key objective “zero-carbon emission” as countries agreed to reach a 1.5ᵒC global warming target according to the Paris agreement. Nowadays, due to the tremendous mobile and stationary consumption of small/large-format LIBs, the demand and consequently the price for such energy storage devices have been raised. The aforementioned challenges originate from the shrinkage of the major applied critical materials in these batteries, such as cobalt (Co), nickel (Ni), Lithium (Li), graphite (G), and manganese (Mn). Therefore, it is imperative to consider alternative elements to address issues corresponding to the limitation of resources around the globe. Potassium (K) is considered an effective alternative to Li since K is a more abundant element, has a higher operating potential, a faster diffusion rate, and the lowest stokes radius in comparison to the closest neighbors in the periodic table (Li and Na). Among all reported materials for metal-ion batteries, some of them possess the general formula AMXO4L [A = Li, Na, K; M = Fe, Ti, V; X = P, S, Si; L= O, F, OH] is of potential to be applied both as anode and cathode and enable researchers to investigate them in the full symmetric battery format. KTiPO4F (KTP structural material) has been previously reported by our group as a promising cathode with decent electronic properties. Herein, we report a synthesis, crystal structure characterization, morphology, as well as K-ion storage properties of KTiPO4F. Our investigation reveals that KTiPO4F delivers discharge capacity > 150 mAh/g at 26.6 mA/g (C/5 current rate) in the potential window of 0.001-3 V. Surprisingly, the cycling performance of C-KTiPO4F//K cell is stable for 1000 cycles at 130 mA/g (C current rate), presenting capacity > 130 mAh/g. More interestingly, we achieved to assemble full symmetric batteries where carbon-coated KTiPO4F serves as both negative and positive electrodes, delivering >70 mAh/g in the potential range of 0.001-4.2V.

Keywords: anode material, potassium battery, chemical characterization, electrochemical properties

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1607 The Voluntary Audit of Semi-Annual Consolidated Financial Statements Decision and Accounting Conservatism

Authors: Shuofen Hsu, Ya-Yi Chao, Chao-Wei Li

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This paper investigates the relationship between voluntary audit (hereafter, VA) of semi-annual consolidated financial statements decision and accounting conservatism. In general, there are four kinds of auditors' assurance services, which include audit, review, agreed-upon procedure and compliance engagements base on degree of assurance. The VA work by auditors may not only have the higher audit quality but an important signal of more reliable information than the review work. In Taiwan, The listed companies must prepare the semi-annual consolidated financial statements and with auditors' review before 2012, but some of the listed companies choose the assurance work from review to audit voluntarily. Due to the adoption of International Financial Reporting Standards, the listed companies were required to prepare the second quarterly consolidated financial statements which should be reviewed by auditors since 2013. This rule will change some of the assurance work from audit to review by auditors, and the information asymmetry maybe increased. To control the selection bias, we use two-stage model to test the relationship between VA decision and accounting conservatism. Our empirical results indicate that the VA decision and accounting conservatism have a significant positive relationship in firms with family-controlled. That is, firms with family-controlled are more likely to do VA and to prepare more conservative consolidated financial statements to reduce the information asymmetry, meaning that there is a complementary effect between VA and accounting conservatism for firms with more information asymmetry. But on the contrary, we find that the VA decision and accounting conservatism have a significant negative relationship in firms with professional managers-controlled, meaning that there is a substitution effect between VA and accounting conservatism for firms with less information asymmetry. Finally, the accounting conservatism of consolidated financial statements decrease after the adoption of IFRSs (International Financial Reporting Standards) in Taiwan. It means that the disclosure and transparency of consolidated financial statements had be improved.

Keywords: voluntary audit, accounting conservatism, audit quality, information asymmetry

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1606 User-Centered Design in the Development of Patient Decision Aids

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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1605 Comparison and Improvement of the Existing Cone Penetration Test Results: Shear Wave Velocity Correlations for Hungarian Soils

Authors: Ákos Wolf, Richard P. Ray

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Due to the introduction of Eurocode 8, the structural design for seismic and dynamic effects has become more significant in Hungary. This has emphasized the need for more effort to describe the behavior of structures under these conditions. Soil conditions have a significant effect on the response of structures by modifying the stiffness and damping of the soil-structural system and by modifying the seismic action as it reaches the ground surface. Shear modulus (G) and shear wave velocity (vs), which are often measured in the field, are the fundamental dynamic soil properties for foundation vibration problems, liquefaction potential and earthquake site response analysis. There are several laboratory and in-situ measurement techniques to evaluate dynamic soil properties, but unfortunately, they are often too expensive for general design practice. However, a significant number of correlations have been proposed to determine shear wave velocity or shear modulus from Cone Penetration Tests (CPT), which are used more and more in geotechnical design practice in Hungary. This allows the designer to analyze and compare CPT and seismic test result in order to select the best correlation equations for Hungarian soils and to improve the recommendations for the Hungarian geologic conditions. Based on a literature review, as well as research experience in Hungary, the influence of various parameters on the accuracy of results will be shown. This study can serve as a basis for selecting and modifying correlation equations for Hungarian soils. Test data are taken from seven locations in Hungary with similar geologic conditions. The shear wave velocity values were measured by seismic CPT. Several factors are analyzed including soil type, behavior index, measurement depth, geologic age etc. for their effect on the accuracy of predictions. The final results show an improved prediction method for Hungarian soils

Keywords: CPT correlation, dynamic soil properties, seismic CPT, shear wave velocity

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1604 Habitat-Specific Divergences in the Gene Repertoire among the Reference Prevotella Genomes of the Human Microbiome

Authors: Vinod Kumar Gupta, Narendrakumar M. Chaudhari, Suchismitha Iskepalli, Chitra Dutta

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Background-The community composition of the human microbiome is known to vary at distinct anatomical niches. But little is known about the nature of variations if any, at the genome/sub-genome levels of a specific microbial community across different niches. The present report aims to explore, as a case study, the variations in gene repertoire of 28 Prevotella reference draft genomes derived from different body-sites of human, as reported earlier by the Human Microbiome Consortium. Results-The analysis reveals the exclusive presence of 11798, 3673, 3348 and 934 gene families and exclusive absence of 17, 221, 115 and 645 gene families in Prevotella genomes derived from the human oral cavity, gastro-intestinal tracts (GIT), urogenital tract (UGT) and skin, respectively. The pan-genome for Prevotella remains “open”. Distribution of various functional COG categories differs appreciably among the habitat-specific genes, within Prevotella pan-genome and between the GIT-derived Bacteroides and Prevotella. The skin and GIT isolates of Prevotella are enriched in singletons involved in Signal transduction mechanisms, while the UGT and oral isolates show higher representation of the Defense mechanisms category. No niche-specific variations could be observed in the distribution of KEGG pathways. Conclusion-Prevotella may have developed distinct genetic strategies for adaptation to different anatomical habitats through selective, niche-specific acquisition and elimination of suitable gene-families. In addition, individual microorganisms tend to develop their own distinctive adaptive stratagems through large repertoires of singletons. Such in situ, habitat-driven refurbishment of the genetic makeup can impart substantial intra-lineage genome diversity within the microbes without perturbing their general taxonomic heritage.

Keywords: body niche adaptation, human microbiome, pangenome, Prevotella

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