Search results for: fetal movements
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 823

Search results for: fetal movements

283 Investigation of the Functional Impact of Amblyopia on Visual Skills in Children

Authors: Chinmay V. Deshpande

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Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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282 Mentoring of Health Professionals to Ensure Better Child-Birth and Newborn Care in Bihar, India: An Intervention Study

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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281 Heat Stress a Risk Factor for Poor Maternal Health- Evidence from South India

Authors: Vidhya Venugopal, Rekha S.

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Introduction: Climate change and the growing frequency of higher average temperatures and heat waves have detrimental health effects, especially for certain vulnerable groups with limited socioeconomic status (SES) or physiological capacity to adapt to or endure high temperatures. Little research has been conducted on the effects of heat stress on pregnant women and fetuses in tropical regions such as India. Very high ambient temperatures may worsen Adverse Pregnancy Outcomes (APOs) and are a major worry in the scenario of climate change. The relationship between rising temperatures and APO must be better understood in order to design more effective interventions. Methodology: We conducted an observational cohort study involving 865 pregnant women in various districts of Tamil Nadu districts between 2014 and 2021. Physiological Heat Strain Indicators (HSI) such as morning and evening Core Body Temperature (CBT) and Urine Specific Gravity (USG) were monitored using an infrared thermometer and refractometer, respectively. A validated, modified version of the HOTHAPS questionnaire was utilised to collect self-reported health symptoms. A follow-up was undertaken with the mothers to collect information regarding birth outcomes and APOs, such as spontaneous abortions, stillbirths, Preterm Birth (PTB), birth abnormalities, and Low Birth Weight (LBW). Major findings of the study: According to the findings of our study, ambient temperatures (mean WBGT°C) were substantially higher (>28°C) for approximately 46% of women performing moderate daily life activities. 82% versus 43% of these women experienced dehydration and heat-related complaints. 34% of women had USG >1.020, which is symptomatic of dehydration. APOs, which include spontaneous abortions, were prevalent at 2.2%, stillbirth/preterm birth/birth abnormalities were prevalent at 2.2%, and low birth weight was prevalent at 16.3%. With exposures to WBGT>28°C, the incidence of miscarriage or unexpected abortion rose by approximately 2.7 times (95% CI: 1.1-6.9). In addition, higher WBGT exposures were associated with a 1.4-fold increased risk of unfavorable birth outcomes (95% Confidence Interval [CI]: 1.02-1.09). The risk of spontaneous abortions was 2.8 times higher among women who conceived during the hotter months (February – September) compared to those women who conceived in the cooler months (October – January) (95% CI: 1.04-7.4). Positive relationships between ambient heat and APOs found in this study necessitate further exploration into the underlying factors for extensive cohort studies to generate information to enable the formulation of policies that can effectively protect these women against excessive heat stress for enhanced maternal and fetal health.

Keywords: heat exposures, community, pregnant women, physiological strain, adverse outcome, interventions

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280 Impact of Maternal Nationality on Caesarean Section Rate Variation in a High-income Country

Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

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Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

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279 Growth and Differentiation of Mesenchymal Stem Cells on Titanium Alloy Ti6Al4V and Novel Beta Titanium Alloy Ti36Nb6Ta

Authors: Eva Filová, Jana Daňková, Věra Sovková, Matej Daniel

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Titanium alloys are biocompatible metals that are widely used in clinical practice as load bearing implants. The chemical modification may influence cell adhesion, proliferation, and differentiation as well as stiffness of the material. The aim of the study was to evaluate the adhesion, growth and differentiation of pig mesenchymal stem cells on the novel beta titanium alloy Ti36Nb6Ta compared to standard medical titanium alloy Ti6Al4V. Discs of Ti36Nb6Ta and Ti6Al4V alloy were sterilized by ethanol, put in 48-well plates, and seeded by pig mesenchymal stem cells at the density of 60×103/cm2 and cultured in Minimum essential medium (Sigma) supplemented with 10% fetal bovine serum and penicillin/streptomycin. Cell viability was evaluated using MTS assay (CellTiter 96® AQueous One Solution Cell Proliferation Assay;Promega), cell proliferation using Quant-iT™ ds DNA Assay Kit (Life Technologies). Cells were stained immunohistochemically using monoclonal antibody beta-actin, and secondary antibody conjugated with AlexaFluor®488 and subsequently the spread area of cells was measured. Cell differentiation was evaluated by alkaline phosphatase assay using p-nitrophenyl phosphate (pNPP) as a substrate; the reaction was stopped by NaOH, and the absorbance was measured at 405 nm. Osteocalcin, specific bone marker was stained immunohistochemically and subsequently visualized using confocal microscopy; the fluorescence intensity was analyzed and quantified. Moreover, gene expression of osteogenic markers osteocalcin and type I collagen was evaluated by real-time reverse transcription-PCR (qRT-PCR). For statistical evaluation, One-way ANOVA followed by Student-Newman-Keuls Method was used. For qRT-PCR, the nonparametric Kruskal-Wallis Test and Dunn's Multiple Comparison Test were used. The absorbance in MTS assay was significantly higher on titanium alloy Ti6Al4V compared to beta titanium alloy Ti36Nb6Ta on days 7 and 14. Mesenchymal stem cells were well spread on both alloys, but no difference in spread area was found. No differences in alkaline phosphatase assay, fluorescence intensity of osteocalcin as well as the expression of type I collagen, and osteocalcin genes were observed. Higher expression of type I collagen compared to osteocalcin was observed for cells on both alloys. Both beta titanium alloy Ti36Nb6Ta and titanium alloy Ti6Al4V Ti36Nb6Ta supported mesenchymal stem cellsˈ adhesion, proliferation and osteogenic differentiation. Novel beta titanium alloys Ti36Nb6Ta is a promising material for bone implantation. The project was supported by the Czech Science Foundation: grant No. 16-14758S, the Grant Agency of the Charles University, grant No. 1246314 and by the Ministry of Education, Youth and Sports NPU I: LO1309.

Keywords: beta titanium, cell growth, mesenchymal stem cells, titanium alloy, implant

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278 Blockchain Technology Applications in Patient Tracking Systems Regarding Privacy-Preserving Concerns and COVID-19 Pandemic

Authors: Farbod Behnaminia, Saeed Samet

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The COVID-19 pandemic has paralyzed many lives until a vaccine was available, which caused the so-called “new normal.” According to the World Health Organization (WHO), COVID-19 is an infectious disease. It can cause significant illness or death in anyone. Governments and health officials tried to impose rules and regulations to avoid and slow down transmission. Therefore, software engineers worldwide developed applications to trace and track patients’ movements and notify others, mainly using Bluetooth. In this way, everyone could be informed whether they come in close contact with someone who has COVID-19 and takes proper safety precautions. Because most of the applications use technologies that can potentially reveal the user’s identity and location, researchers have debated privacy preservation and how to improve user privacy during such pandemics. Thanks to Distributed Ledger Technology (DLT), there have been some proposed methods to develop privacy-preserving Patient Tracking Systems in the last two years. As an instance of the DLT, Blockchain is like a decentralized peer-to-peer database that maintains a record of transactions. Transactions are immutable, transparent, and anonymous in this system. We conducted a comprehensive evaluation of the literature by looking for papers in the relevant field and dividing them into pre- and post-pandemic systems. Additionally, we discussed the many uses of blockchain technology in pandemic control. We found that two major obstacles facing blockchain implementation across many healthcare systems are scalability and privacy. The Polkadot platform is presented, along with a review of its efficacy in tackling current concerns. A more scalable healthcare system is achievable in the near future using Polkadot as well as a much more privacy-preserving environment.

Keywords: blockchain, electronic record management, EHR, privacy-preserving, patient tracking, COVID-19, trust and confidence, Polkadot

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277 The Effectiveness of Kinesiotaping Methods in Rehabilitation Therapy

Authors: Ana-Katarina Nikich

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Background: The kinesiotaping method is often used in physiotherapy and rehabilitation. The purpose of this study was to evaluate the effectiveness of taping in the rehabilitation process of patients. Materials and methods: The study involved 90 male and female patients (the average age was 40-50 years) with various conditions requiring rehabilitation, such as injuries of the musculoskeletal system, sports injuries and other ailments. All patients were divided into two groups: experimental (n=40) and control (n=50). Both groups received 20 days of standard rehabilitation. In the experimental group, kinesiotaping methods were used, taking into account the individual characteristics of each patient. The control group performed regular exercises and physical therapy, but without using kinesiotape. During the study, physical parameters were monitored, interviews were conducted and the conditions of patients from both groups were compared. Results and discussion: The use of the kinesiotaping method in the rehabilitation process led to a significant improvement in physical parameters and pain reduction in patients. Significant improvement (p <0.005) was observed in all evaluated parameters among the patients of the experimental group. The control group also showed sufficient improvement (p <0.005), but the percentage of the experimental group was higher. As a result of the observation, the patients of the experimental group showed faster and more complete rehabilitation compared to the control group. The use of the kinesiotaping method allows to reduce the load on the damaged areas, improve blood circulation and lymphatic drainage, as well as increase stability and coordination of movements. Conclusions: Kinesiotaping as one of the modern therapeutic methods has shown its effectiveness in the rehabilitation process, contributing to the optimal recovery of patients with various conditions requiring rehabilitation. The use of tapes should be included in a comprehensive rehabilitation program to achieve the best results and reduce recovery time.

Keywords: kinesiotaping, rehabilitation, therapy, pain

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276 Use of Misoprostol in Pregnancy Termination in the Third Trimester: Oral versus Vaginal Route

Authors: Saimir Cenameri, Arjana Tereziu, Kastriot Dallaku

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Introduction: Intra-uterine death is a common problem in obstetrical practice, and can lead to complications if left to resolve spontaneously. The cervix is unprepared, making inducing of labor difficult. Misoprostol is a synthetic prostaglandin E1 analogue, inexpensive, and is presented valid thanks to its ability to bring about changes in the cervix that lead to the induction of uterine contractions. Misoprostol is quickly absorbed when taken orally, resulting in high initial peak serum concentrations compared with the vaginal route. The vaginal misoprostol peak serum concentration is not as high and demonstrates a more gradual serum concentration decline. This is associated with many benefits for the patient; fast induction of labor; smaller doses; and fewer side effects (dose-depended). Mostly it has been used the regime of 50 μg/4 hour, with a high percentage of success and limited side effects. Objective: Evaluation of the efficiency of the use of oral and vaginal misoprostol in inducing labor, and comparing it with its use not by a previously defined protocol. Methods: Participants in this study included patients at U.H.O.G. 'Koco Gliozheni', Tirana from April 2004-July 2006, presenting with an indication for inducing labor in the third trimester for pregnancy termination. A total of 37 patients were randomly admitted for birth inducing activity, according to protocol (26), oral or vaginal protocol (10 vs. 16), and a control group (11), not subject to the protocol, was created. Oral or vaginal misoprostol was administered at a dose of 50 μg/4 h, while the fourth group participants were treated individually by the members of the medical staff. The main result of interest was the time between induction of labor to birth. Kruskal-Wallis test was used to compare the average age, parity, women weight, gestational age, Bishop's score, the size of the uterus and weight of the fetus between the four groups in the study. The Fisher exact test was used to compare day-stay and causes in the four groups. Mann-Whitney test was used to compare the time of the expulsion and the number of doses between oral and vaginal group. For all statistical tests used, the value of P ≤ 0.05 was considered statistically significant. Results: The four groups were comparable with regard to woman age and weight, parity, abortion indication, Bishop's score, fetal weight and the gestational age. There was significant difference in the percentage of deliveries within 24 hours. The average time from induction to birth per route (vaginal, oral, according to protocol and not according to the protocol) was respectively; 10.43h; 21.10h; 15.77h, 21.57h. There was no difference in maternal complications in groups. Conclusions: Use of vaginal misoprostol for inducing labor in the third trimester for termination of pregnancy appears to be more effective than the oral route, and even more to uses not according to the protocols approved before, where complications are greater and unjustified.

Keywords: inducing labor, misoprostol, pregnancy termination, third trimester

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275 Revisiting the Link between Corporate Social Performance and Corporate Financial Performance Post 2008 Global Economic Crisis

Authors: Anand Choudhary

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Following the global economic crisis in 2008, businesses and more especially the big multinational conglomerates were increasingly viewed by the people world over as one of the major causes of the economic problems faced by millions globally, in terms of job loss and lifetime savings being wiped out as banks and pension funds went bankrupt and people stared at an insecure financial future. This caused a lot of resentment in the public against big businesses and fueled several protest movements by the people such as “Occupy Wall Street” in different parts of the world. This forced the big businesses to respond to the challenge by adopting more people-centric policies and initiatives for local communities in societies where they operate as part of their corporate social responsibility (CSR), in order to regain their social acceptance among the people whilst earning their ‘social license to operate’. The current paper studies many of such large MNCs across the United States of America, India and South Africa, which changed the way they did business earlier, following the global economic crisis in 2008, by incorporating capacity building initiatives for local communities as part of their CSR strategy and explores whether it has contributed to improving their financial performance. It is a conceptual research paper using secondary source data. The findings reveal that there is a positive correlation between the companies’ corporate social performance and corporate financial performance. In addition, the findings also bring to light that the MNCs examined as part of the current paper have improved their image in the eyes of their stakeholders following the change in their CSR strategy and initiatives.

Keywords: corporate social responsibility (CSR), Corporate Social Performance (CSP), Corporate Financial Performance (CFP), local communities

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274 Strain Sensing Seams for Monitoring Body Movement

Authors: Sheilla Atieno Odhiambo, Simona Vasile, Alexandra De Raeve, Ann Schwarz

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Strain sensing seams have been developed by integrating conductive sewing threads in different types of seams design on a fabric typical for sports clothing using sewing technology. The aim is to have a simple integrated textile strain sensor that can be applied to sports clothing to monitor the movements of the upper body parts of the user during sports. Different types of commercially available sewing threads were used as the bobbin thread in the production of different architectural seam sensors. These conductive sewing threads have been integrated into seams in particular designs using specific seam types. Some of the threads are delicate and needed to be laid into the seam with as little friction as possible and less tension; thus, they could only be sewn in as the bobbin thread and not the needle thread. Stitch type 304; 406; 506; 601;602; 605. were produced. The seams were made on a fabric of 80% polyamide 6.6 and 20% elastane. The seams were cycled(stretch-release-stretch) for five cycles and up to 44 cycles following EN ISO 14704-1: 2005 (modified), using a tensile instrument and the changes in the resistance of the seams with time were recorded using Agilent meter U1273A. Both experiments were conducted simultaneously on the same seam sample. Sensing functionality, among which is sensor gauge and reliability, were evaluated on the promising sensor seams. The results show that the sensor seams made from HC Madeira 40 conductive yarns performed better inseam stitch 304 and 602 compared to the other combination of stitch type and conductive sewing threads. These sensing seams 304, 406 and 602 will further be interconnected to our developed processing and communicating unit and further integrated into a sports clothing prototype that can track body posture. This research is done within the framework of the project SmartSeam.

Keywords: conductive sewing thread, sensing seams, smart seam, sewing technology

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273 Deprivation of Visual Information Affects Differently the Gait Cycle in Children with Different Level of Motor Competence

Authors: Miriam Palomo-Nieto, Adrian Agricola, Rudolf Psotta, Reza Abdollahipour, Ludvik Valtr

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The importance of vision and the visual control of movement have been labeled in the literature related to motor control and many studies have demonstrated that children with low motor competence may rely more heavily on vision to perform movements than their typically developing peers. The aim of the study was to highlight the effects of different visual conditions on motor performance during walking in children with different levels of motor coordination. Participants (n = 32, mean age = 8.5 years sd. ± 0.5) were divided into two groups: typical development (TD) and low motor coordination (LMC) based on the scores of the Movement Assessment Battery for Children (MABC-2). They were asked to walk along a 10 meters walkway where the Optojump-Next instrument was installed in a portable laboratory (15 x 3 m), which allows that all participants had the same visual information. They walked in self-selected speed under four visual conditions: full vision (FV), limited vision 100 ms (LV-100), limited vision 150 ms (LV-150) and non-vision (NV). For visual occlusion participants were equipped with Plato Goggles that shut for 100 and 150 ms, respectively, within each 2 sec. Data were analyzed in a two-way mixed-effect ANOVA including 2 (TD vs. LMC) x 4 (FV, LV-100, LV-150 & NV) with repeated-measures on the last factor (p ≤.05). Results indicated that TD children walked faster and with longer normalized steps length and strides than LMC children. For TD children the percentage of the single support and swing time were higher than for low motor competence children. However, the percentage of load response and pre swing was higher in the low motor competence children rather than the TD children. These findings indicated that through walking we could be able to identify different levels of motor coordination in children. Likewise, LMC children showed shorter percentages in those parameters regarding only one leg support, supporting the idea of balance problems.

Keywords: visual information, motor performance, walking pattern, optojump

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272 Evaluation of Ocular Changes in Hypertensive Disorders of Pregnancy

Authors: Rajender Singh, Nidhi Sharma, Aastha Chauhan, Meenakshi Barsaul, Jyoti Deswal, Chetan Chhikara

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Introduction: Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy with multisystem involvement and are common causes of morbidity and mortality in obstetrics. It is believed that changes in retinal arterioles may indicate similar changes in the placenta. Therefore, this study was undertaken to evaluate the ocular manifestations in cases of pre-eclampsia and eclampsia and to deduce any association between the retinal changes and blood pressure, the severity of disease, gravidity, proteinuria, and other lab parameters so that a better approach could be devised to ensure maternal and fetal well-being. Materials and Methods: This was a hospital-based cross-sectional study conducted over a period of one year, from April 2021 to May 2022. 350 admitted patients with diagnosed pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension were included in the study. A pre-structured proforma was used. After taking consent and ocular history, a bedside examination to record visual acuity, pupillary size, corneal curvature, field of vision, and intraocular pressure was done. Dilated fundus examination was done with a direct and indirect ophthalmoscope. Age, parity, BP, proteinuria, platelet count, liver and kidney function tests were noted down. The patients with positive findings only were followed up after 72 hours and 6 weeks of termination of pregnancy. Results: The mean age of patients was 26.18±4.33 years (range 18-39 years).157 (44.9%) were primigravida while 193(55.1%) were multigravida.53 (15.1%) patients had eclampsia, 128(36.5%) had mild pre-eclampsia,128(36.5%) had severe pre-eclampsia and 41(11.7%) had chronic hypertension with superimposed pre-eclampsia. Retinal changes were found in 208 patients (59.42%), and grade I changes were the most common. 82(23.14%) patients had grade I changes, 75 (21.4%) had grade II changes, 41(11.71%) had grade III changes, and 11(3.14%) had serous retinal detachment/grade IV changes. 36 patients had unaided visual acuity <6/9, of these 17 had refractive error and 19(5.4%) had varying degrees of retinal changes. 3(0.85%) out of 350 patients had an abnormal field of vision in both eyes. All 3 of them had eclampsia and bilateral exudative retinal detachment. At day 4, retinopathy in 10 patients resolved, and 3 patients had improvement in visual acuity. At 6 weeks, retinopathy in all the patients resolved spontaneously except persistence of grade II changes in 23 patients with chronic hypertension with superimposed pre-eclampsia, while visual acuity and field of vision returned to normal in all patients. Pupillary size, intraocular pressure, and corneal curvature were found to be within normal limits at all times of examination. There was a statistically significant positive association between retinal changes and mean arterial pressure. The study showed a positive correlation between fundus findings and severity of disease (p value<0.05) and mean arterial pressure (p value<0.005). Primigravida had more retinal changes than multigravida patients. A significant association was found between fundus changes and thrombocytopenia and deranged liver and kidney function tests (p value<0.005). Conclusion: As the severity of pre-eclampsia and eclampsia increases, the incidence of retinopathy also increases, and it affects visual acuity and visual fields of the patients. Thus, timely ocular examination should be done in all such cases to prevent complications.

Keywords: eclampsia, hypertensive, ocular, pre-eclampsia

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271 Effect of Ti, Nb, and Zr Additives on Biocompatibility of Injection Molded 316L Stainless Steel for Biomedical Applications

Authors: Busra Gundede, Ozal Mutlu, Nagihan Gulsoy

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Background: Over the years, material research has led to the development of numerous metals and alloys for using in biomedical applications. One of the major tasks of biomaterial research is the functionalization of the material surface to improve the biocompatibility according to a specific application. 316L and 316L alloys are excellent for various bio-applications. This research was investigated the effect of titanium (Ti), niobium (Nb), and zirconium (Zr) additives on injection molded austenitic grade 316L stainless steels in vitro biocompatibility. For this purpose, cytotoxic tests were performed to evaluate the potential biocompatibility of the specimens. Materials and Methods: 3T3 fibroblast were cultivated in DMEM supplemented with 10% fetal bovine serum and %1 penicillin-streptomycin at 37°C with 5% CO2 and 95%humidity. Trypsin/EDTA solution was used to remove cells from the culture flask. Cells were reseeded at a density of 1×105cell in 25T flasks. The medium change took place every 3 days. The trypan blue assay was used to determine cell viability. Cell viability is calculated as the number of viable cells divided by the total number of cells within the grids on the cell counter machine counted the number of blue staining cells and the number of total cells. Cell viability should be at least 95% for healthy log-phase cultures. MTT assay was assessed for 96-hours. Cells were cultivated in 6-well flask within 5 ml DMEM and incubated as same conditions. 0,5mg/ml MTT was added for 4-hours and then acid-isoprohanol was added for solubilize to formazan crystals. Cell morphology after 96h was investigated by SEM. The medium was removed, samples were washed with 0.15 M PBS buffer and fixed for 12h at 4- 8°C with %2,5 gluteraldehyte. Samples were treated with 1% osmium tetroxide. Samples were then dehydrated and dried, mounted on appropriate stubs with colloidal silver and sputter-coated with gold. Images were collected using a scanning electron microscope. ROS assay is a cell viability test for in vitro studies. Cells were grown for 96h, ROS solution added on cells in 6 well plate flask and incubated for 1h. Fluorescence signal indicates ROS generation by cells. Results: Trypan Blue exclusion assay results were 96%, 92%, 95%, 90%, 91% for negative control group, 316L, 316L-Ti, 316L-Nb and 316L-Zr, respectively. Results were found nearly similar to each other when compared with control group. Cell viability from MTT analysis was found to be 100%, 108%, 103%, 107%, and 105% for the control group, 316L, 316L-Ti, 316L-Nb and 316L-Zr, respectively. Fluorescence microscopy analysis indicated that all test groups were same as the control group in ROS assay. SEM images demonstrated that the attachment of 3T3 cells on biomaterials. Conclusion: We, therefore, concluded that Ti, Nb and Zr additives improved physical properties of 316L stainless. In our in vitro experiments showed that these new additives did not modify the cytocompatibility of stainless steel and these additives on 316L might be useful for biomedical applications.

Keywords: 316L stainles steel, biocompatibility, cell culture, Ti, Nb, Zr

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270 Analyzing the Permissibility of Demonstration in Islamic Perspective: Case Study of Former Governor of Jakarta Basuki Tjahaja Purnama

Authors: Ahmad Syauqi

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This paper analyzes the permissibility of demonstrations against a leader's decision, policies, as well as statements against Islamic values from an Islamic point of view. Recorded at the end of 2016, a large demonstration in Jakarta involving many people, mostly from Muslim society against the former Governor of Jakarta, Basuki Tjahaja Purnama, was considered a form of harm to the value of harmony and the unity of religious communities in Indonesia. Hence, this paper aims to answer the question that became a tough discussion and a long debate among Indonesian Muslims after an immense demonstration known as the 212 movements, ‘how exactly Islam sees such act of demonstration?’. Is there any particular historical source in Islamic history that mention information related to demonstration? A phenomenological qualitative method was implemented throughout the process of this research to study the perspective of various Muslims scholars by reviewing, and comparing their opinions through the classical source of Islamic history and Hadith literature. One of the main roots of this extensive debate is due to the extremist group, which bans all forms of demonstration, assuming that such acts had come from the West and unknown culture in the Islamic history. In addition, they also claim that all the demonstrators are Bughat. While some other groups, freely declare that demonstration can be done anytime and anywhere, without specific terms and regulations associated. The findings of this research illustrate that the protests which we now know of today, in terms of demonstration had existed since ancient times, even from the time of the prophet Muhammad (peace be upon him). This paper reveals that there is a strong evidence that demonstration is justified in Islamic law and has a historical root. This can, therefore, be a proposition of such permissibility. However, there are still a number of things one has to be aware of when it comes to the demonstration, and clearly, not all demonstrations are legal from the Islamic perspective.

Keywords: Basuki Tjahaja Purnama, demonstration, Muslim scholars, protest

Procedia PDF Downloads 114
269 Early Screening of Risk Ergonomics among Workers at Madura's Batik Industrial: Rapid Entire Body Assessment and Quick Exposure Checklist

Authors: Abdul Kadir, L. Meily Kurniawidjaja

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Batik Madura workers are exposed to many Musculoskeletal Disorders risk factors, particularly Low Back Pain (LBP). This study was conducted as an early detection of ergonomic risk level on Workers Industrial Sentra Batik Madura in Dusun Banyumas, Klampar Subdistrict, Proppo Pamekasan, Madura, East Java. This study includes 12 workers who 11 workers had pain in the upper and lower part of the neck, back, wrist right hand, also 10 workers had pain in the right shoulder. This is a descriptive observational study with cross-sectional approach. Qualitative research by observing workers activity such as draw and putting the wax motif, fabric dyeing, fabric painting, discoloration, washing, and drying. The results are workers have identified ergonomic hazards such as awkward postures, twisting movements, repetitive, and static work postures. Using the method of REBA and QEC, the results get a very high-risk level of activity in each of Madura batik making process is the draw and putting the wax motif, coloring, painting, discoloration, washing, and drying. The level of risk can be reduced by improvement of work equipment include the provision of seats, strut fabric, high settings furnaces, drums, coloring basin, and washing tub.

Keywords: activities of Madura's batik, ergonomic risk level, equipment, QEC (Quick Exposure Checklist), REBA (Rapid Entire Body Assessment)

Procedia PDF Downloads 164
268 Primary and Secondary Psychopathic Traits: Assessing Differences in Interpersonal Relationships through Friendship, Emotional Contagion, and Social Rewards

Authors: Silene Ten Seldam, Kiara Margarita Lu, Melina Nicole Kyranides

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Psychopathic traits are marked by a lack of empathy and an inability to maintain meaningful relationships. Yet little research has investigated differences in interpersonal relationships between primary and secondary psychopathic traits. Emotional contagion, the tendency to automatically mimic others’ facial expressions and movements, is a type of empathy contributing to relationship quality. Additionally, the motivating and pleasurable aspects of social interaction, social reward is integral to understanding relationships. Therefore, the current research investigated interpersonal relationships through relationship status, the quality of friendships, the susceptibility to positive (happiness, love) and negative (sadness, fear, anger) emotional contagion, and social reward. Recruited online, 389 participants between 18 and 76 years old (M = 33.61; of which 241 were female) completed self-report questionnaires assessing primary and secondary psychopathic traits, friendship, emotional contagion, and social rewards. Hierarchical multiple regression showed relationship status as a protective factor and that individuals with secondary psychopathic traits are less likely to be in a relationship. This study is the first to investigate emotional contagion with primary and secondary psychopathic traits. Emotional contagion for sadness predicted secondary psychopathic traits. Negative social potency (enjoying being cruel and antagonistic to others) predicted both primary and secondary traits. However, admiration and prosocial interactions only predicted primary psychopathic traits. Findings infer differences in maintaining relationships, regulating emotions, empathising with others through emotional contagion, and motivation to socially engage, perhaps due to each dimensions’distinct origins and manifestations.

Keywords: primary psychopathic traits, secondary psychopathic traits, interpersonal relationships, friendship, emotional contagion, social reward

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267 Retrofitting Adaptive Reuse into Palaces of Northern India

Authors: Shefali Nayak

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The architectural appeal, familiarity, and idiom of culturally significant structures are due to societal attachment to various movements, historical association or deviation. Generally, the urge to preserve a building in the northern part of India is driven either by emotional dogma or rational thinking, but, it is also influenced by traditional affinity. The northern region of India has an assortment of palaces and Havelis belonging to various time periods and families with vernacular yet signature style of architecture. Many of them are either successfully conserved by being put into adaptive reuse and some of them have been midst controversies and continued to remain in ruins. The research focuses on comparing successful examples of adaptive reuse such as Neemrana, Mehrangargh Fort palace with a few other merchant havelis converted into heritage hotels. Furthermore, evaluates the architectural aspects of structure, materials, plumbing and electrical installations, as well as specific challenges faced by heritage professionals practicing sustainability, while respecting traditional feelings of various stakeholders. This paper concludes through the analysis of the case study that, its highly unlikely for sustainable design cannot be used as a stand-alone application for heritage structures or cities, it needs the support of architecture conservation to be put into practice. However, it is often demanding to fit a new use of a building into an aged structure. This paper records modern-day generic requirements that reflect challenges faced by different architects, while conserving a heritage structure and retrofitting it into today's requisites. The research objective is to establish how conservation, restoration, and urban regeneration are closely related to sustainable architecture in historical cities.

Keywords: architecture conservation, architecture heritage, adaptive reuse, retrofitting, sustainability, urban regeneration

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266 Evaluating Probable Bending of Frames for Near-Field and Far-Field Records

Authors: Majid Saaly, Shahriar Tavousi Tafreshi, Mehdi Nazari Afshar

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Most reinforced concrete structures are designed only under heavy loads have large transverse reinforcement spacing values, and therefore suffer severe failure after intense ground movements. The main goal of this paper is to compare the shear- and axial failure of concrete bending frames available in Tehran using incremental dynamic analysis under near- and far-field records. For this purpose, IDA analyses of 5, 10, and 15-story concrete structures were done under seven far-fault records and five near-faults records. The results show that in two-dimensional models of short-rise, mid-rise and high-rise reinforced concrete frames located on Type-3 soil, increasing the distance of the transverse reinforcement can increase the maximum inter-story drift ratio values up to 37%. According to the existing results on 5, 10, and 15-story reinforced concrete models located on Type-3 soil, records with characteristics such as fling-step and directivity create maximum drift values between floors more than far-fault earthquakes. The results indicated that in the case of seismic excitation modes under earthquake encompassing directivity or fling-step, the probability values of failure and failure possibility increasing rate values are much smaller than the corresponding values of far-fault earthquakes. However, in near-fault frame records, the probability of exceedance occurs at lower seismic intensities compared to far-fault records.

Keywords: IDA, failure curve, directivity, maximum floor drift, fling step, evaluating probable bending of frames, near-field and far-field earthquake records

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265 Preparation of Electrospun PLA/ENR Fibers

Authors: Jaqueline G. L. Cosme, Paulo H. S. Picciani, Regina C. R. Nunes

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Electrospinning is a technique for the fabrication of nanoscale fibers. The general electrospinning system consists of a syringe filled with polymer solution, a syringe pump, a high voltage source and a grounded counter electrode. During electrospinning a volumetric flow is set by the syringe pump and an electric voltage is applied. This forms an electric potential between the needle and the counter electrode (collector plate), which results in the formation of a Taylor cone and the jet. The jet is moved towards the lower potential, the counter electrode, wherein the solvent of the polymer solution is evaporated and the polymer fiber is formed. On the way to the counter electrode, the fiber is accelerated by the electric field. The bending instabilities that occur form a helical loop movements of the jet, which result from the coulomb repulsion of the surface charge. Trough bending instabilities the jet is stretched, so that the fiber diameter decreases. In this study, a thermoplastic/elastomeric binary blend of non-vulcanized epoxidized natural rubber (ENR) and poly(latic acid) (PLA) was electrospun using polymer solutions consisting of varying proportions of PCL and NR. Specifically, 15% (w/v) PLA/ENR solutions were prepared in /chloroform at proportions of 5, 10, 25, and 50% (w/w). The morphological and thermal properties of the electrospun mats were investigated by scanning electron microscopy (SEM) and differential scanning calorimetry analysis. The SEM images demonstrated the production of micrometer- and sub-micrometer-sized fibers with no bead formation. The blend miscibility was evaluated by thermal analysis, which showed that blending did not improve the thermal stability of the systems.

Keywords: epoxidized natural rubber, poly(latic acid), electrospinning, chemistry

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264 Destination of the PhDs: Determinants of International Mobility of UK PhD Graduates

Authors: Anna Siuda-Bak

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This paper adopts a comparative approach to examining the determinants of international mobility of German, Italian and British researchers who completed their doctoral education in the UK. Structured sampling and data collection techniques have been developed in order to retrieve information on participants from publicly available sources. This systematically collected data was supplemented with an on-line survey which captures participants’ job trajectories, including movements between positions, institutions and countries. In total, data on 949 German, Italian and British PhDs was collected. Logistic regression was employed to identify factors associated with one’s probability of moving outside the UK after his or her graduation. The predictor variables included factors associated with one’s PhD (field of study, ranking of the university which awarded the PhD degree) and family factors (having a child, nationality of the partner). Then, 9 constrained models were estimated to test the effect each variable has on probability of going to a specific destination, being English-speaking country, non-English speaking country or returning to the home country. The results show that females, arts and humanities graduates, and respondents with a partner from the UK are less mobile than their counterparts. The effect of the ranking of the university differed in two groups. The UK graduates from higher ranked universities were more likely to move abroad than to stay in the UK after their graduation. In contrast, non-UK natives from the same universities were less likely to be internationally mobile than non-UK natives from lower ranked universities. The nationality of the partner was the most important predictor of the specific destination choices. Graduates with partner from the home county were more likely to return home and those with a partner from the third country least likely to return.

Keywords: doctoral graduates, international mobility, nationality, UK

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263 Using Songs as Direct and Indirect Vehicles of Peace

Authors: Johannes Van Der Sandt

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This paper explores and reflects on the power of music, and more specific singing as an instrument for integration, inclusion, group cohesion, collective cooperation, repairing social relationships and facilitating dialogue between groups in conflict. The General Assembly of the United Nations has declared the 21st of September as International Day of Peace. This day is dedicated to advocate and strengthen among all people, an annual day to strive for no violence and cease-fire. What role does music play in strengthening ideals of peace? The findings of this paper is a result of field and online research as well as a literature survey to identify the most important examples of institutions, instruments or initiatives where music serves as a vehicle for the transmission and promoting of peace ideals and acting to assist movements for social change. Important examples where singing and music were used as tools for peace activism are the 1987 Estonian Singing Revolution and the more recent peace engagement in the Afghan Conflict, both very good examples of the cultural capital of the local population used as catalyst for promoting peace. The author offers a concise and relevant overview of such initiatives with the aim to validate the power of music and song as tools to support the United Nation’s Declaration on the Promotion Among Youth of the Ideals of Peace, Mutual Respect and Understanding Between Peoples: Young people should be educated and made aware of the ideals of peace. They should be educated in a spirit of mutual understanding and respect for one another in order to develop an attitude of striving for equal rights for all human beings, believing in economic and social growth for all, together with a belief in disarmament and working towards the maintenance of peace and security worldwide.

Keywords: conflict, music, peace, singing

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262 Bactericidal Efficacy of Quaternary Ammonium Compound on Carriers with Food Additive Grade Calcium Hydroxide against Salmonella Infantis and Escherichia coli

Authors: M. Shahin Alam, Satoru Takahashi, Mariko Itoh, Miyuki Komura, Mayuko Suzuki, Natthanan Sangsriratanakul, Kazuaki Takehara

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Cleaning and disinfection are key components of routine biosecurity in livestock farming and food processing industry. The usage of suitable disinfectants and their proper concentration are important factors for a successful biosecurity program. Disinfectants have optimum bactericidal and virucidal efficacies at temperatures above 20°C, but very few studies on application and effectiveness of disinfectants at low temperatures have been done. In the present study, the bactericidal efficacies of food additive grade calcium hydroxide (FdCa(OH)), quaternary ammonium compound (QAC) and their mixture, were investigated under different conditions, including time, organic materials (fetal bovine serum: FBS) and temperature, either in suspension or in carrier test. Salmonella Infantis and Escherichia coli, which are the most prevalent gram negative bacteria in commercial poultry housing and food processing industry, were used in this study. Initially, we evaluated these disinfectants at two different temperatures (4°C and room temperature (RT) (25°C ± 2°C)) and 7 contact times (0, 5 and 30 sec, 1, 3, 20 and 30 min), with suspension tests either in the presence or absence of 5% FBS. Secondly, we investigated the bactericidal efficacies of these disinfectants by carrier tests (rubber, stainless steel and plastic) at same temperatures and 4 contact times (30 sec, 1, 3, and 5 min). Then, we compared the bactericidal efficacies of each disinfectant within their mixtures, as follows. When QAC was diluted with redistilled water (dW2) at 1: 500 (QACx500) to obtain the final concentration of didecyl-dimethylammonium chloride (DDAC) of 200 ppm, it could inactivate Salmonella Infantis within 5 sec at RT either with or without 5% FBS in suspension test; however, at 4°C it required 30 min in presence of 5% FBS. FdCa(OH)2 solution alone could inactivate bacteria within 1 min both at RT and 4°C even with 5% FBS. While FdCa(OH)2 powder was added at final concentration 0.2% to QACx500 (Mix500), the mixture could inactivate bacteria within 30 sec and 5 sec, respectively, with or without 5% FBS at 4°C. The findings from the suspension test indicated that low temperature inhibited the bactericidal efficacy of QAC, whereas Mix500 was effective, regardless of short contact time and low temperature, even with 5% FBS. In the carrier test, single disinfectant required bit more time to inactivate bacteria on rubber and plastic surfaces than on stainless steel. However, Mix500 could inactivate S. Infantis on rubber, stainless steel and plastic surfaces within 30 sec and 1 min, respectively, at RT and 4°C; but, for E. coli, it required only 30 sec at both temperatures. So, synergistic effects were observed on different carriers at both temperatures. For a successful enhancement of biosecurity during winter, the disinfectants should be selected that could have short contact times with optimum efficacy against the target pathogen. The present study findings help farmers to make proper strategies for application of disinfectants in their livestock farming and food processing industry.

Keywords: carrier, food additive grade calcium hydroxide (FdCa(OH)₂), quaternary ammonium compound, synergistic effects

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261 StockTwits Sentiment Analysis on Stock Price Prediction

Authors: Min Chen, Rubi Gupta

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Understanding and predicting stock market movements is a challenging problem. It is believed stock markets are partially driven by public sentiments, which leads to numerous research efforts to predict stock market trend using public sentiments expressed on social media such as Twitter but with limited success. Recently a microblogging website StockTwits is becoming increasingly popular for users to share their discussions and sentiments about stocks and financial market. In this project, we analyze the text content of StockTwits tweets and extract financial sentiment using text featurization and machine learning algorithms. StockTwits tweets are first pre-processed using techniques including stopword removal, special character removal, and case normalization to remove noise. Features are extracted from these preprocessed tweets through text featurization process using bags of words, N-gram models, TF-IDF (term frequency-inverse document frequency), and latent semantic analysis. Machine learning models are then trained to classify the tweets' sentiment as positive (bullish) or negative (bearish). The correlation between the aggregated daily sentiment and daily stock price movement is then investigated using Pearson’s correlation coefficient. Finally, the sentiment information is applied together with time series stock data to predict stock price movement. The experiments on five companies (Apple, Amazon, General Electric, Microsoft, and Target) in a duration of nine months demonstrate the effectiveness of our study in improving the prediction accuracy.

Keywords: machine learning, sentiment analysis, stock price prediction, tweet processing

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260 Economic and Financial Crime, Forensic Accounting and Sustainable Developments Goals (SDGs). Bibliometric Analysis

Authors: Monica Violeta Achim, Sorin Nicolae Borlea

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This aim of this work is to stress the needs for enhancing the role of forensic accounting in fighting economic and financial crime, in the context of the new international regulation movements in this area enhanced by the International Federation of Accountants (IFAC). Corruption, money laundering, tax evasion and other frauds significant hamper the economic growth and human development and, ultimately, the UN Sustainable Development Goals. The present paper also stresses the role of good governance in fighting the frauds, in order to achieve the most suitable sustainable development of the society. In this view, we made a bibliometric systematic review on forensic accounting and its contribution towards fraud detection and prevention and theirs relationship with good governance and Sustainable Developments Goals (SDGs). In this view, two powerful bibliometric visual software tools, VosViewer and CiteSpace are used in order to analyze published papers identifies in Scopus and Web of Science databases over the time. Our findings reveal the main red flags identified in literature as used tools by forensic accounting, the evolution in time of the interest of the topic, the distribution in space among world countries and connectivity with patterns of a good governance. Visual designs and scientific maps are useful to show these findings, in a visual way. Our findings are useful for managers and policy makers to provide important avenues that may help in reaching the 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, in the area of using forensic accounting in preventing frauds.

Keywords: forensic accounting, frauds, red flags, SDGs

Procedia PDF Downloads 98
259 Accuracy/Precision Evaluation of Excalibur I: A Neurosurgery-Specific Haptic Hand Controller

Authors: Hamidreza Hoshyarmanesh, Benjamin Durante, Alex Irwin, Sanju Lama, Kourosh Zareinia, Garnette R. Sutherland

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This study reports on a proposed method to evaluate the accuracy and precision of Excalibur I, a neurosurgery-specific haptic hand controller, designed and developed at Project neuroArm. Having an efficient and successful robot-assisted telesurgery is considerably contingent on how accurate and precise a haptic hand controller (master/local robot) would be able to interpret the kinematic indices of motion, i.e., position and orientation, from the surgeon’s upper limp to the slave/remote robot. A proposed test rig is designed and manufactured according to standard ASTM F2554-10 to determine the accuracy and precision range of Excalibur I at four different locations within its workspace: central workspace, extreme forward, far left and far right. The test rig is metrologically characterized by a coordinate measuring machine (accuracy and repeatability < ± 5 µm). Only the serial linkage of the haptic device is examined due to the use of the Structural Length Index (SLI). The results indicate that accuracy decreases by moving from the workspace central area towards the borders of the workspace. In a comparative study, Excalibur I performs on par with the PHANToM PremiumTM 3.0 and more accurate/precise than the PHANToM PremiumTM 1.5. The error in Cartesian coordinate system shows a dominant component in one direction (δx, δy or δz) for the movements on horizontal, vertical and inclined surfaces. The average error magnitude of three attempts is recorded, considering all three error components. This research is the first promising step to quantify the kinematic performance of Excalibur I.

Keywords: accuracy, advanced metrology, hand controller, precision, robot-assisted surgery, tele-operation, workspace

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258 ACL Tear Prevention Program

Authors: Ervin Meqikukiqi

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It is difficult to assess how athletes can best modify their movements to prevent non contact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance-or rehabilitation efforts after an injury has occurred. Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury. This is a 20 minute program designed to reduce the risk of tears of the Anterior Cruciate Ligament. It should be started at least four and preferably six weeks prior to start of competition.Ideally it is done five times per week preseason and three times per week in season.The coach or trainer must constantly observe athletes during these exercises to correct and maintain proper technique. Once the athletes understand the principles, they can monitor and coach each other. Four phases: Warm-up, Strengthening, Plyometrics, Agility and Balance.

Keywords: athletes, acl, prevention, injuries, plyoemtric, proprioception, agillity

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257 Modelling of Pipe Jacked Twin Tunnels in a Very Soft Clay

Authors: Hojjat Mohammadi, Randall Divito, Gary J. E. Kramer

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Tunnelling and pipe jacking in very soft soils (fat clays), even with an Earth Pressure Balance tunnel boring machine (EPBM), can cause large ground displacements. In this study, the short-term and long-term ground and tunnel response is predicted for twin, pipe-jacked EPBM 3 meter diameter tunnels with a narrow pillar width. Initial modelling indicated complete closure of the annulus gap at the tail shield onto the centrifugally cast, glass-fiber-reinforced, polymer mortar jacking pipe (FRP). Numerical modelling was employed to simulate the excavation and support installation sequence, examine the ground response during excavation, confirm the adequacy of the pillar width and check the structural adequacy of the installed pipe. In the numerical models, Mohr-Coulomb constitutive model with the effect of unloading was adopted for the fat clays, while for the bedrock layer, the generalized Hoek-Brown was employed. The numerical models considered explicit excavation sequences and different levels of ground convergence prior to support installation. The well-studied excavation sequences made the analysis possible for this study on a very soft clay, otherwise, obtaining the convergency in the numerical analysis would be impossible. The predicted results indicate that the ground displacements around the tunnel and its effect on the pipe would be acceptable despite predictions of large zones of plastic behaviour around the tunnels and within the entire pillar between them due to excavation-induced ground movements.

Keywords: finite element modeling (FEM), pipe-jacked tunneling, very soft clay, EPBM

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256 The Effects of Dynamic Training Shoes Exercises on Isokinetic Strength Performance

Authors: Bergun Meric Bingul, Yezdan Cinel, Murat Son, Cigdem Bulgan, Mensure Aydin

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The aim of this study was to determination of the effects of knee and hip isokinetic performance during the training with the special designed roller-shoes. 30 soccer players participated as subjects and these subjects were divided into 3 groups randomly. Training groups were; with the dynamic training shoes group, without the dynamic training shoes group and control group. Subjects were trained speed strength trainings during 8 weeks (3 days a week and 1 hour a day). 6 exercises were focused on the knee flexors and extensors, also hip adductor and abductor muscles were chosen and performed in 3x30secs at each sets. Control group was not paticipated to the training program. Before and after the training programs knee flexor and extensor muscles and hip abductor and adductor muscles’ peak torques were measured by Biodex III isokinetic dynamometer. Isokinetic strength data were analyzed by using SPSS program. A repeated measures analysis of variance (ANOVA) was used to determine differences among the peak torque values for three groups. The results indicated that soccer players’ peak torque values that the group of using the dynamic training shoes, were found higher. Also, hip adductor and abductor peak torques that the group of using the dynamic training shoes, were obtained better than the other groups. In conclusion, the ground friction forces are an important role of increasing strength. With these shoes, using rollers, soccer players were able to move easily because of the friction forces were reduced and created more range of motion. So, exercises were performed faster than before and strength movements in all angles, it ensured that the active state. This was resulted in a better use of force.

Keywords: isokinetic, soccer, dynamic training shoes, training

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255 Patrimonial Politics in 21ˢᵗ Century Central Africa, Evolution and Progress

Authors: Collins Nkapnwo Formella

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The democratic wave of the 1980s and 1990s brought a lot of hopes to the politics of African states as many nation-states adopted ‘democracy.’ The end of the Cold War ushered in, with a lot of rush, pro-democracy movements, which led to multi-party politics, following constitutional reviews. For the very first time since independence, Africans revolted against personalized dictatorship and adopted the idea of limited office terms for the presidents. This paper dives deep into the history of Africa post-independence with the aim of allowing the readers to understand the nature of the differences in the political setups that currently govern the continent and the central region in particular. Time has proven the euphoria that characterized post-Cold War African politics at least for many countries short-lived, as their leaders were unable to re-design the institutions of governance from the compromise and interest-oriented structures handed down after independence. The result has been that politics in many of the countries have been tailored down along the lines of winner takes all approach, with the accumulation of state power being the sole objective of the leaders. The paper contends that 21ˢᵗ Century African politics is exactly the politics of inclusion/exclusion based on ethnic and interest groups, leading to the flourishing of patrimonial authoritarian regimes. It also puts to the test, whether authoritarian responses to delivering growth (economic, political, social) and peace as has been the model adopted by many leaders is superior compared to democracy. This paper then concludes by adding that the practice of democracy in the Central African region in its current form is inherently flawed from its foundations, thus incapable of rooting out the crises faced in the region.

Keywords: authoritarianism, democracy, development, power, institutions

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254 External Vacuum Dressing: Optimising Non-Operative Management of Flail Sternum Post CPR

Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

Procedia PDF Downloads 133