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Authors: M. N. Ofokansi, Onyemelukwe Chisom, Amauche Chukwuemeka, Ezema Onyinye

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The leaves of Clerodendrumcapitatum(Lamiaceae) is mostly used in the treatment of gastric ulcer in Nigerian folk medicine. The aim of this study was to evaluate the antiulcer activity of its crude methanol leaf extract and its ethyl acetate fraction in white albino rats. The effect of crude methanol leaf extract and its ethyl acetate fraction(250mg/kg, 500mg/kg) was evaluated using an absolute ethanol induced ulcer model. Crude methanol leaf extract and the ethyl acetate fraction was treated with distilled water and 6% Tween 80, respectively. crude methanol leaf extract was further investigated using a pylorus ligation induced ulcer model. Omeprazole was used as the standard treatment. Four groups of five albino rats of either sex were used. Parameters such as mean ulcer index and percentage ulcer protection were assessed in the ethanol-induced ulcer model, while the gastric volume, pH, and total acidity were assessed in the pyloric ligation induced ulcer model. Crude methanol leaf extract of Clerodendrumcapitatum(500mg/kg) showed a very highly significant reduction in mean ulcer index(p<0.001) in the absolute ethanol-induced model. ethyl acetate fraction of crude methanol leaf extract of Clerodendrumcapitatum(250mg/kg,500mg/kg) showed a very highly significant dose-dependent reduction in mean ulcer indices (p<0.001) in the absolute ethanol-induced model. The mean ulcer indices (1.6,2.2) with dose concentration (250mg/kg, 500mg/kg) of ethyl acetate fraction increased with ulcer protection (82.85%,76.42%) respectively when compared to the control group in the absolute ethanol-induced ulcer model. Crude methanol leaf extract of Clerodendrumcapitatum(250mg/kg, 500mg/kg) treated animals showed a highly significant dose-dependent reduction in mean ulcer index(p<0.01) with an increase in ulcer protection (56.77%,63.22%) respectively in pyloric ligated induced, ulcer model. Gastric parameters such as volume of gastric juice, pH, and total acidity were of no significance in the different doses of the crude methanol leaf extract when compared to the control group. The phytochemical investigation showed that the crude methanol leaf extracts Possess Saponins and Flavonoids while its ethyl acetate fraction possess only Flavonoids. The results of the study indicate that the crude methanol leaf extract and its ethyl acetate fraction is effective and has gastro protective and ulcer healing capacity. Ethyl acetate fraction is more potent than crude methanol leaf extract against ethanol-induced This result provides scientific evidence as a validation for its folkloric use in the treatment of gastric ulcer.

Keywords: gastroprotective, herbal medicine, anti-ulcer, pharmacology

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Authors: Havva Tutar Kahraman, Erol Pehlivan

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In recent years, environmental pollution by wastewater rises very critically. Effluents discharged from various industries cause this challenge. Different type of pollutants such as organic compounds, oxyanions, and heavy metal ions create this threat for human bodies and all other living things. However, heavy metals are considered one of the main pollutant groups of wastewater. Therefore, this case creates a great need to apply and enhance the water treatment technologies. Among adopted treatment technologies, adsorption process is one of the methods, which is gaining more and more attention because of its easy operations, the simplicity of design and versatility. Ion exchange process is one of the preferred methods for removal of heavy metal ions from aqueous solutions. It has found widespread application in water remediation technologies, during the past several decades. Therefore, the purpose of this study is to the removal of hexavalent chromium, Cr(VI), from aqueous solutions. Cr(VI) is considered as a well-known highly toxic metal which modifies the DNA transcription process and causes important chromosomic aberrations. The treatment and removal of this heavy metal have received great attention to maintaining its allowed legal standards. The purpose of the present paper is an attempt to investigate some aspects of the use of three anion exchange resins: Eichrom 1-X4, Lewatit Monoplus M800 and Lewatit A8071. Batch adsorption experiments were carried out to evaluate the adsorption capacity of these three commercial resins in the removal of Cr(VI) from aqueous solutions. The chromium solutions used in the experiments were synthetic solutions. The parameters that affect the adsorption, solution pH, adsorbent concentration, contact time, and initial Cr(VI) concentration, were performed at room temperature. High adsorption rates of metal ions for the three resins were reported at the onset, and then plateau values were gradually reached within 60 min. The optimum pH for Cr(VI) adsorption was found as 3.0 for these three resins. The adsorption decreases with the increase in pH for three anion exchangers. The suitability of Freundlich, Langmuir and Scatchard models were investigated for Cr(VI)-resin equilibrium. Results, obtained in this study, demonstrate excellent comparability between three anion exchange resins indicating that Eichrom 1-X4 is more effective and showing highest adsorption capacity for the removal of Cr(VI) ions. Investigated anion exchange resins in this study can be used for the efficient removal of chromium from water and wastewater.

Keywords: adsorption, anion exchange resin, chromium, kinetics

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Authors: Tirtha Raj Adhikari, Lochan Prasad Devkota

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This research studied the hydrological regime of three glacierized river basins in Khumbu, Langtang and Annapurna regions of Nepal using the Hydraologiska Byrans Vattenbalansavde (HBV), HVB-light 3.0 model. Future scenario of discharge is also studied using downscaled climate data derived from statistical downscaling method. General Circulation Models (GCMs) successfully simulate future climate variability and climate change on a global scale; however, poor spatial resolution constrains their application for impact studies at a regional or a local level. The dynamically downscaled precipitation and temperature data from Coupled Global Circulation Model 3 (CGCM3) was used for the climate projection, under A2 and A1B SRES scenarios. In addition, the observed historical temperature, precipitation and discharge data were collected from 14 different hydro-metrological locations for the implementation of this study, which include watershed and hydro-meteorological characteristics, trends analysis and water balance computation. The simulated precipitation and temperature were corrected for bias before implementing in the HVB-light 3.0 conceptual rainfall-runoff model to predict the flow regime, in which Groups Algorithms Programming (GAP) optimization approach and then calibration were used to obtain several parameter sets which were finally reproduced as observed stream flow. Except in summer, the analysis showed that the increasing trends in annual as well as seasonal precipitations during the period 2001 - 2060 for both A2 and A1B scenarios over three basins under investigation. In these river basins, the model projected warmer days in every seasons of entire period from 2001 to 2060 for both A1B and A2 scenarios. These warming trends are higher in maximum than in minimum temperatures throughout the year, indicating increasing trend of daily temperature range due to recent global warming phenomenon. Furthermore, there are decreasing trends in summer discharge in Langtang Khola (Langtang region) which is increasing in Modi Khola (Annapurna region) as well as Dudh Koshi (Khumbu region) river basin. The flow regime is more pronounced during later parts of the future decades than during earlier parts in all basins. The annual water surplus of 1419 mm, 177 mm and 49 mm are observed in Annapurna, Langtang and Khumbu region, respectively.

Keywords: temperature, precipitation, water discharge, water balance, global warming

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Authors: Hsing Yuan Liu

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Background: Considerable theoretical and empirical work has identified a relationship between collaboration interactions and creativity in an organizational context. The mechanisms underlying this link, however, are not well understood in healthcare education. Objectives: The aims of this study were to explore the impact of collaboration interactions on team creativity and its underlying mechanism and to verify a moderated mediation model. Design, setting, and participants: This study utilized a cross-sectional, quantitative, descriptive design. The survey data were collected from 177 nursing students who enrolled in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Methods: Questionnaires assessed the nursing students' perceptions about their teams' swift trust (of cognition- and affect-based), conflicts (of task, process, and relationship), interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication), and creativity. This study used descriptive statistics to compare demographics, swift trust scores, conflict scores, interaction behavior scores, and creativity scores for interdisciplinary teams. Data were analyzed using Pearson’s correlation coefficient and simple and hierarchical multiple regression models. Results: Pearson’s correlation analysis showed the cognition-based team swift trust was positively correlated with team creativity. The mediation model indicated constructive controversy fully mediated the effect of cognition-based team swift trust on student teams’ creativity. The moderated mediation model indicated that task conflict negatively moderates the mediating effect of the constructive controversy on the link between cognition-based team swift trust and team creativity. Conclusion: Our findings suggest nursing student teams’ interaction behaviors and task conflict are crucial mediating and moderated mediation variables on the relationship between collaboration interactions and team creativity, respectively. The empirical data confirms the validity of our proposed moderated mediation models of team creativity. Therefore, this study's validated moderated mediation model could provide guidance for nursing educators to improve collaboration interaction outcomes and creativity on nursing student teams.

Keywords: team swift trust, team conflict, team interaction behavior, moderated mediating effects, interdisciplinary education, nursing students

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Authors: Bruno R. Mendes, Francisco J. Caldeira, Rita S. Luís

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Population ageing is directly correlated to an increase in medicine consumption. Beyond the latter and the polymedicated profile of elderly, it is possible to see a need for pharmacotherapeutic monitoring due to cognitive and physical impairment. In this sense, the tracking, organization and administration of medicines become a daily challenge and the pill-box dispenser system a solution. The pill-box dispenser (system) consists in a small compartmentalized container to unit dose organization, which means a container able to correlate the patient’s prescribed dose regimen and the time schedule of intake. In many European countries, this system is part of pharmacist’s role in clinical pharmacy. Despite this simple solution, therapy compliance is only possible if the patient adheres to the system, so it is important to establish a qualitative and quantitative analysis on the perception of the patient on the benefits and risks of the pill-box dispenser as well as the identification of the ideal system. The analysis was conducted through an observational study, based on the application of a standardized questionnaire structured with the numerical scale of Likert (5 levels) and previously validated on the population. The study was performed during a limited period of time and under a randomized sample of 188 participants. The questionnaire consisted of 22 questions: 6 background measures and 16 specific measures. The standards for the final comparative analysis were obtained through the state-of-the-art on the subject. The study carried out using the Likert scale afforded a degree of agreement and discordance between measures (Sample vs. Standard) of 56,25% and 43,75%, respectively. It was concluded that the pill-box dispenser has greater acceptance among a younger population, that was not the initial target of the system. However, this allows us to guarantee a high adherence in the future. Additionally, it was noted that the cost associated with this service is not a limiting factor for its use. The pill-box dispenser system, as currently implemented, demonstrates an important weakness regarding the quality and effectiveness of the medicines, which is not understood by the patient, revealing a significant lack of literacy when it concerns with medicine area. The characteristics of an ideal system remain unchanged, which means that the size, appearance and availability of information in the pill-box continue to be indispensable elements for the compliance with the system. The pill-box dispenser remains unsuitable regarding container size and the type of treatment to which it applies. Despite that, it might be a future standard for clinical pharmacy, allowing a differentiation of the pharmacist role, as well as a wider range of applications to other age groups and treatments.

Keywords: clinical pharmacy, medicines, patient safety, pill-box dispenser

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Authors: M. S. Alatas, H. D. Umucalilar

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SARA is a common and serious metabolic disorder in early lactation in dairy cattle and in finishing beef cattle, caused by diets with high inclusion of cereal grain. This experiment was performed to determine the efficacy of Megasphaera elsdenii, a major lactate-utilizing bacterium in prevention/treatment of SARA in vivo. In vivo experimentation, it was used eight ruminally cannulated rams and it was applied the rapid adaptation with the mixture of grain based on wheat (%80 wheat, %20 barley) and barley (%80 barley, %20 wheat). During the systematic adaptation, it was followed the probability of SARA formation by being measured the rumen pH with two hours intervals after and before feeding. After being evaluated the data, it was determined the ruminal pH ranged from 5,2-5,6 on the condition of feeding with 60 percentage of grain mixture based on barley and wheat, that assured the definite form of subacute acidosis. In four days SARA period, M. elsdenii (1010 cfu ml-1) was inoculated during the first two days. During the SARA period, it was observed the decrease of feed intake with M. elsdenii inoculation. Inoculation of M. elsdenii was caused to differentiation of rumen pH (P < 0,0001), while it was found the pH level approximately 5,55 in animals applied the inoculation, it was 5,63 pH in other animals. It was observed that total VFA with the bacterium inoculation tended to change in terms of grain feed (P < 0,07). It increased with the effect of total VFA inoculation in barley based diet, but it was more stabilized in wheat based diet. Bacterium inoculation increased the ratio of propionic acid (18,33%-21,38%) but it caused to decrease the butyric acid, and acetic/propionic acid. During the rapid adaptation, the concentration of lactic acid in the rumen liquid increased depending upon grain level (P<0,0001). On the other hand bacterium inoculation did not have an effect on concentration of lactic acid. M. elsdenii inoculation did not affect ruminal ammonia concentration. In the group that did not apply inoculation, the level of ruminal ammonia concentration was higher than the others applied inoculation. M. elsdenii inoculation did not changed protozoa count in barley-based diet whereas it decreased in wheat-based diet. In the period of SARA, it was observed that the level of blood glucose, lactate and hematocrit increased greatly after inoculation (P < 0,0001). When it is generally evaluated, it is seen that M. elsdenii inoculation has not a positive impact on rumen parameters. Therefore, to reveal the full impact of the inoculation with different strains, feedstuffs and animal groups, further research is required.

Keywords: In vivo, Subactute ruminal acidosis, Megasphaera elsdenii, Rumen fermentation

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Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.

Keywords: H7N9 virus, Avian Influenza, mortality, China

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Authors: Stephanie Lehmann, Esther Ruf, Sabina Misoch

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Background: Due to demographic change and shortage of skilled nursing staff, assistive robots are built to support older adults at home and nursing staff in care institutions. When assistive robots facilitate tasks that are usually performed by humans, user acceptance is essential. Even though they are an important aspect of acceptance, emotions towards different assistive robots and different situations of robot-use have so far not been examined in detail. The appearance of assistive robots can trigger emotions that affect their acceptance. Acceptance of robots is assumed to be greater when they look more human-like; however, too much human similarity can be counterproductive. Regarding different groups, it is assumed that older adults have a more negative attitude towards robots than younger adults. Within the framework of a simulated robot study, the aim was to investigate emotions of older adults compared to students towards robots with different appearances and in different situations and so contribute to a deeper view of the emotions influencing acceptance. Methods: In a questionnaire study, vignettes were used to assess emotions toward robots in different situations and of different appearance. The vignettes were composed of two situations (service and care) shown by video and four pictures of robots varying in human similarity (machine-like to android). The combination of the vignettes was randomly distributed to the participants. One hundred forty-two older adults and 35 bachelor students of nursing participated. They filled out a questionnaire that surveyed 30 positive and 30 negative emotions. For each group, older adults and students, a sum score of “positive emotions” and a sum score of “negative emotions” was calculated. Mean value, standard deviation, or n for sample size and % for frequencies, according to the scale level, were calculated. For differences in the scores of positive and negative emotions for different situations, t-tests were calculated. Results: Overall, older adults reported significantly more positive emotions than students towards robots in general. Students reported significantly more negative emotions than older adults. Regarding the two different situations, the results were similar for the care situation, with older adults reporting more positive emotions than students and less negative emotions than students. In the service situation, older adults reported significantly more positive emotions; negative emotions did not differ significantly from the students. Regarding the appearance of the robot, there were no significant differences in emotions reported towards the machine-like, the mechanical-human-like and the human-like appearance. Regarding the android robot, students reported significantly more negative emotions than older adults. Conclusion: There were differences in the emotions reported by older adults compared to students. Older adults reported more positive emotions, and students reported more negative emotions towards robots in different situations and with different appearances. It can be assumed that older adults have a different attitude towards the use of robots than younger people, especially young adults in the health sector. Therefore, the use of robots in the service or care sector should not be rejected rashly based on the attitudes of younger persons, without considering the attitudes of older adults equally.

Keywords: emotions, robots, seniors, young adults

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Authors: Bernard Tan

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The paper presents a conceptual framework which serves as an art model of Singapore artistic identity. Specifically, the study examines Singapore's artistic identity through the artworks of the country’s significant artists covering the period 1950s to the present. Literature review will discuss the challenges of favouring or choosing one artist over the other. Methodology provides an overview of the perspectives of local artists and surveys Singapore’s artistic histories through qualitative interviews and case studies. Analysis from qualitative data reveals that producing works of accrued visual significance for the country which captures it zeitgeist further strengthens artist’s artistic identity, and consequently, their works remembered by future generations. The paper presents a conceptual framework for Singapore’s artistic identity by categorising it into distinctive categories or Periods: Colonial Period (pre-1965); Nation Building Period (1965-1988); Globalisation Period (1989-2000); Paternal Production Period (2001-2015); and A New Era (2015-present). Godalisation, coined from God and Globalisation – by artist and art collector, Teng Jee Hum – is a direct reference to the godlike influence on Singapore by its founding Father, Mr Lee Kuan Yew, the country’s first Prime Minister who steered the city state “from Third World to First” for close to half a century, from 1965 to his passing in 2015. A detailed schema showing important factors in different art categories: key global geopolitics, key local social-politics, and significant events will be analysed in depth. Main artist groups or artist initiatives which evolved in Singapore during the different Periods from pre-1965 to the present will be categorized and discussed. Taken as a whole, all these periods collectively add up to the Godalisation Era; impacted by the social-political events and historical period of the nation, and captured through the visual representation of the country’s significant artists in their attempt at either visualizing or mythologizing the Singapore Story. The author posits a co-relation between a nation’s economic success and the value or price appreciation of the country’s artist of significance artworks. The paper posed a rhetorical question: “Which Singapore’s artist will historian of the future – and by extension, the people of the country from future generations – remember? Who will remain popular? Whilst which artists will be forgotten.” The searching question: “Who will survive, be remembered in the annals of history and, above all, how to ensure the survival of one’s nation artistic identity? The art that last will probably be determined by the future, in the future, where art historians pontificate from a later vantage point.

Keywords: artistic identity, art collection, godalisation, singapore

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Authors: Matjaž Šraml, Marko Renčelj, Tomaž Tollazzi, Chiara Gruden

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Road safety is a worldwide issue with numerous and heterogeneous factors influencing it. On the side, driver state – comprising distraction/inattention, fatigue, drowsiness, extreme emotions, and socio-cultural factors highly affect road safety. On the other side, the vehicle state has an important role in mitigating (or not) the road risk. Finally, the road environment is still one of the main determinants of road safety, defining driving task complexity. At the same time, thanks to technological development, a lot of detailed data is easily available, creating opportunities for the detection of driver state, vehicle characteristics and road conditions and, consequently, for the design of ad hoc interventions aimed at improving driver performance, increase awareness and mitigate road risks. This is the challenge faced by the i-DREAMS project. i-DREAMS, which stands for a smart Driver and Road Environment Assessment and Monitoring System, is a 3-year project funded by the European Union’s Horizon 2020 research and innovation program. It aims to set up a platform to define, develop, test and validate a ‘Safety Tolerance Zone’ to prevent drivers from getting too close to the boundaries of unsafe operation by mitigating risks in real-time and after the trip. After the definition and development of the Safety Tolerance Zone concept and the concretization of the same in an Advanced driver-assistance system (ADAS) platform, the system was tested firstly for 2 months in a driving simulator environment in 5 different countries. After that, naturalistic driving studies started for a 10-month period (comprising a 1-month pilot study, 3-month baseline study and 6 months study implementing interventions). Currently, the project team has approved a common evaluation approach, and it is developing the assessment of the usage and outcomes of the i-DREAMS system, which is turning positive insights. The i-DREAMS consortium consists of 13 partners, 7 engineering universities and research groups, 4 industry partners and 2 partners (European Transport Safety Council - ETSC - and POLIS cities and regions for transport innovation) closely linked to transport safety stakeholders, covering 8 different countries altogether.

Keywords: advanced driver assistant systems, driving simulator, safety tolerance zone, traffic safety

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Authors: Eugene Y. J. Aw, J. W. Koh, S. H. Chew, K. E. Chua, P. L. Goh, Grace H. B. Foo, M. L. Leong

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This paper presents the evaluation of various soil testing methods such as the four-probe soil electrical resistivity method and cone penetration test (CPT) that can complement a newly developed novel rapid soil classification scheme using computer vision, to improve the accuracy and productivity of on-site classification of excavated soil. In Singapore, excavated soils from the local construction industry are transported to Staging Grounds (SGs) to be reused as fill material for land reclamation. Excavated soils are mainly categorized into two groups (“Good Earth” and “Soft Clay”) based on particle size distribution (PSD) and water content (w) from soil investigation reports and on-site visual survey, such that proper treatment and usage can be exercised. However, this process is time-consuming and labor-intensive. Thus, a rapid classification method is needed at the SGs. Four-probe soil electrical resistivity and CPT were evaluated for their feasibility as suitable additions to the computer vision system to further develop this innovative non-destructive and instantaneous classification method. The computer vision technique comprises soil image acquisition using an industrial-grade camera; image processing and analysis via calculation of Grey Level Co-occurrence Matrix (GLCM) textural parameters; and decision-making using an Artificial Neural Network (ANN). It was found from the previous study that the ANN model coupled with ρ can classify soils into “Good Earth” and “Soft Clay” in less than a minute, with an accuracy of 85% based on selected representative soil images. To further improve the technique, the following three items were targeted to be added onto the computer vision scheme: the apparent electrical resistivity of soil (ρ) measured using a set of four probes arranged in Wenner’s array, the soil strength measured using a modified mini cone penetrometer, and w measured using a set of time-domain reflectometry (TDR) probes. Laboratory proof-of-concept was conducted through a series of seven tests with three types of soils – “Good Earth”, “Soft Clay,” and a mix of the two. Validation was performed against the PSD and w of each soil type obtained from conventional laboratory tests. The results show that ρ, w and CPT measurements can be collectively analyzed to classify soils into “Good Earth” or “Soft Clay” and are feasible as complementing methods to the computer vision system.

Keywords: computer vision technique, cone penetration test, electrical resistivity, rapid and non-destructive, soil classification

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Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

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Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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Authors: Lugean K. Alomari, Rahaf K. Sharif, Basil K. Alomari, Hind M. Aljabri, Faisal F. Aljahdali, Amal A. Alomari, Saeed A. Alghamdi

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Background: The thermal pulsation system is a therapy that uses heat and massage to treat dry eye disease; thus, some trials have been published to compare it with the conventional treatment. The aim of this study is to conduct a systematic review and meta-analysis comparing the efficacy of thermal pulsation systems with conventional treatment in patients undergoing cataract surgery. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible trials. We included three randomized controlled trials (RCTs) that compared the thermal pulsation system with the conventional treatment in patients undergoing cataract surgery. A table of characteristics was plotted, and the Quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Forest plots were plotted using the Random-effect Inverse Variance method. χ2 test and the Higgins-I-squared (I2) model were used to assess heterogeneity. A total of 201 cataract surgery patients were included, with 105 undergoing preoperative pulsation therapy and 96 receiving conventional treatment. Demographic analysis revealed comparable distributions across groups. Results: All the studies in our analysis are of good quality with a low risk of bias. A total of 201 patients were included in the analysis, out of which 105 underwent pulsation therapy, and 95 were in the control group. Tear Break-up Time (TBUT) analysis revealed no significant baseline differences, except pulsation therapy being better at 1 month. (SMD 0.42 [95%CI 0.14 - 0.70] p=0.004). This positive trend continued at three months (SMD 0.52 [95% CI (0.20 – 0.84)] p=0.002). Corneal fluorescein staining scores and Meibomian gland-yielding secretion scores showed no significant differences at baseline. However, at one month, pulsation therapy significantly improved Meibomian gland function (SMD -0.86 [95% CI (-1.20 - -0.53)] p<0.00001), indicating a reduced risk of dry eye syndrome. Conclusion: Preoperative pulsation therapy appears to enhance post-cataract surgery outcomes, particularly in terms of tear film stability and Meibomian gland secretory function. The sustained positive effects observed at one and three months post-surgery suggest the potential for long-term benefits.

Keywords: lipiflow, cataract, thermal pulsation, dry eye

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Authors: Dammika Bandara Herath

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A group of people who inherits a long history of existence within a particular country may be known as early inhabitants or indigenous peoples. In other words, they have not migrated to the particular territory from another part of the world and at the same time, they have inhabited the territory in issue prior to the time of a major invasion/migration. According to the UN, there are a number of unique attributes of the indigenous peoples: Self-identification as indigenous people,Historical continuity with pre-colonial and/or pre-settler societies, Distinct social, economic or political systems, Distinct language, culture and beliefs, Form non-dominant groups of society, Resolve to maintain and reproduce their ancestral environments and systems as distinctive peoples and communities. Indigenous peoples constitute 5% of the world’s population. They are also known as tribal people, first people, native people, and indigenous people. Various indigenous communities can be found in about 90 countries in the world. Asia is home to approximately 70 % of these indigenous communities who have their own unique socio-cultural identities. Most indigenous communities remain isolated from the mainstream social, cultural, and economic institutions of their homeland. Yet, they inherited their own unique rights and responsible peculiar to their own group. These include: Protecting the socio-cultural heritage of the group, Protecting the unique identity of their community from socio-cultural changes in the mainstream communities,Protecting their land, Diffusing their cultural heritage to the future generation, Co-existing peacefully with other community .However, indigenous peoples encounter a lot of challenges as a result of socio-cultural change and legal restrictions in the world today. To assist the communities to face these challenges, the mass –media can play a significant role and the radio media has a purpose-built mechanism for this mission, known as the indigenous radio. In Sri Lanka, Dambana FM is such a radio channel based on the indigenous radio model. The target audience of this channel is the vedda / indigenous community of Sri Lanka. This study intends to the current role of the indigenous radio based on Dambana FM, of which the target audience is the indigenous community of Dambana. For the purpose of this study, interviews were conducted among fifty randomly selected respondents from the indigenous community of Dambana. As far as the findings of this study are concerned, problems in the quality of the programmed broadcasted and problems of transmission are the key issues faced by the indigenous radio in Sri Lanka. Based on the findings, the researcher seeks to develop a model to enhance the impact of the indigenous radio on its listeners in Sri Lanka.

Keywords: indigenous, communities, radio, vedda, culture

Procedia PDF Downloads 411

Authors: Y. I. Tretyakova, S. G. Shulkina, T. Y. Kravtsova, A. A. Antipova, N. Y. Kolomeets

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The research aimed to assess the functional significance of tumor necrosis factor-alpha (TNF-α) gene polymorphism at the -308G/A (rs1800629) region and vascular endothelial growth factor A (VEGFA) gene polymorphism at the -634G/C (rs 2010963) region in the development of ulcerative colitis (UC), focusing on patients from the Perm region, Russia. We examined 70 UC patients and 50 healthy donors during the active phase of the disease. Our focus was on TNF-α and VEGF concentration in the blood serum, as well as TNF-α and VEGFA gene polymorphisms at the -308G/А and -634G/C regions, respectively. We found that TNF-α and VEGF levels were significantly higher in patients with severe UC and high endoscopic activity compared to those with milder forms of the disease and low endoscopic activity. These tests could serve as additional non-invasive markers for assessing mucosal damage in the large intestine of UC patients. The frequency of allele variations in the TNF-α gene -308G/A (rs1800629) revealed a significantly higher occurrence of the unfavorable homozygote AA in UC patients compared to donors. Additionally, the major allele G and the allele pair GG were more frequent in patients with mild to moderate disease and 1-2 degree of endoscopic activity than in those with severe UC and 3-4 degree of endoscopic activity (χ2=14.19; p=0.000). We also observed a mutant allele A and the unfavorable homozygote AA associated with severe progressive UC. The occurrence of the mutant allele increased the risk of severe UC by 5 times (OR 5.03; CI 12.07-12.21). We did not find any significant differences in the frequency of the CC homozygote (χ2=1.02; p=0.6; OR=1.32) and the mutant allele C of the VEGFA gene -634G/C (rs 2010963) (χ2=0.01; p=0.913; OR=0.97) between groups of UC patients and healthy individuals. However, we detected that the mutant allele C and the unfavorable homozygote CC of the VEGFA gene were associated with more severe endoscopic changes in the colonic mucosa of UC patients (χ2=25,76; р=0,000; OR=0,15). The presence of the mutant allele increased the risk of severe UC by 6 times (OR 6,78; CI 3,13–14,7). We found a direct correlation between TNF-α and VEGFA gene polymorphisms, increased production of the same factors, disease severity, and endoscopic activity (р=0.000). Therefore, the presence of the mutant allele A and homozygote AA of the TNF-α gene at the -308G/A region and the mutant allele C and homozygote CC of the VEGFA gene at the -634G/C region are associated with risks related to an unfavorable clinical course of UC, frequent recurrences, and rapid progression. These findings should be considered when making prognoses regarding the clinical course of the disease and selecting treatment strategies. The presence of the homozygote AA in the TNF-α gene (rs1800629) is considered a sign of genetic predisposition to UC.

Keywords: gene polymorphism, TNF-α, ulcerative colitis, VEGF

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Authors: Amy Pullen, Samantha Rodrigues, David Kieser, Brian Shaw

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The aim of the study was to determine if a projectile interacting with the lungs increases the severity of injury in comparison to a projectile interacting with the ribs or intercostal muscle. This comparative study employed a 10% gelatine based model with either porcine ribs or balloons embedded to represent a lung. Four sample groups containing five samples were evaluated; these were control (plain gel), intercostal impact, rib impact, and lung impact. Two ammunition natures were evaluated at a range of 10m; these were 5.56x45mm and 7.62x51mm. Aspects of projectile behavior were quantified including exiting projectile weight, location of yawing, projectile fragmentation and distribution, location and area of the temporary cavity, permanent cavity formation, and overall energy deposition. Major findings included the cavity showing a higher percentage of the projectile weight exit the block than the intercostal and ribs, but similar to the control for the 5.56mm ammunition. However, for the 7.62mm ammunition, the lung was shown to have a higher percentage of the projectile weight exit the block than the control, intercostal and ribs. The total weight of projectile fragments as a function of penetration depth revealed large fluctuations and significant intra-group variation for both ammunition natures. Despite the lack of a clear trend, both plots show that the lung leads to greater projectile fragments exiting the model. The lung was shown to have a later center of the temporary cavity than the control, intercostal and ribs for both ammunition types. It was also shown to have a similar temporary cavity volume to the control, intercostal and ribs for the 5.56mm ammunition and a similar temporary cavity to the intercostal for the 7.62mm ammunition The lung was shown to leave a similar projectile tract than the control, intercostal and ribs for both ammunition types. It was also shown to have larger shear planes than the control and the intercostal, but similar to the ribs for the 5.56mm ammunition, whereas it was shown to have smaller shear planes than the control but similar shear planes to the intercostal and ribs for the 7.62mm ammunition. The lung was shown to have less energy deposited than the control, intercostal and ribs for both ammunition types. This comparative study provides insights into the influence of the lungs on thoracic gunshot trauma. It indicates that the lungs limits projectile deformation and causes a later onset of yawing and subsequently limits the energy deposited along the wound tract creating a deeper and smaller cavity. This suggests that lung impact creates an altered pattern of local energy deposition within the target which will affect the severity of trauma.

Keywords: ballistics, lung, trauma, wounding

Procedia PDF Downloads 172

Authors: Anthony Coogan

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Born’s probability interpretation of wave functions would have led to nearly identical results had he chosen a frequency interpretation instead. Logically, Born may have assumed that only one electron was under consideration, making it nonsensical to propose a frequency wave. Author’s suggestion: the actual experimental results were not of a single electron; rather, they were groups of reflected x-ray photons. The vertical waveform used by Scrhödinger in his Particle in the Box Theory makes sense if it was intended to represent a quantum leap. The author extended the single vertical panel to form a bar chart: separate panels would represent different energy levels. The proposed bar chart would be populated by reflected photons. Expansion of basic ideas: Part of Scrhödinger’s ‘Particle in the Box’ theory may be valid despite negative criticism. The waveform used in the diagram is vertical, which may seem absurd because real waves decay at a measurable rate, rather than instantaneously. However, there may be one notable exception. Supposedly, following from the theory, the Uncertainty Principle was derived – may a Quantum Leap not be represented as an instantaneous waveform? The great Scrhödinger must have had some reason to suggest a vertical waveform if the prevalent belief was that they did not exist. Complex wave forms representing a particle are usually assumed to be continuous. The actual observations made were x-ray photons, some of which had struck an electron, been reflected, and then moved toward a detector. From Born’s perspective, doing similar work the years in question 1926-7, he would also have considered a single electron – leading him to choose a probability distribution. Probability Distributions appear very similar to Frequency Distributions, but the former are considered to represent the likelihood of future events. Born’s interpretation of the results of quantum experiments led (or perhaps misled) many researchers into claiming that humans can influence events just by looking at them, e.g. collapsing complex wave functions by 'looking at the electron to see which slit it emerged from', while in reality light reflected from the electron moved in the observer’s direction after the electron had moved away. Astronomers may say that they 'look out into the universe' but are actually using logic opposed to the views of Newton and Hooke and many observers such as Romer, in that light carries information from a source or reflector to an observer, rather the reverse. Conclusion: Due to the controversial nature of these ideas, especially its implications about the nature of complex numbers used in applications in science and engineering, some time may pass before any consensus is reached.

Keywords: complex wave functions not necessary, frequency distributions instead of wave functions, information carried by light, sketch graph of uncertainty principle

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Authors: Sevim Ugur, Cemile Kutmec Yilmaz, Omer Us, Sevdenur Koksaldi

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Aim: This study aims to investigate the effect of digital game playing and Internet addiction on perceived stress levels in university students. Method: The descriptive study was conducted through face-to-face interview method with a total of 364 university students studying at Aksaray University between November 15 and December 30, 2017. The research data were collected using personal information form, a questionnaire to determine the characteristics of playing digital game, the Internet addiction scale and the perceived stress scale. In the evaluation of the data, Mann-Whitney U test was used for two-group comparison of the sample with non-normal distribution, Kruskal-Wallis H-test was used in the comparison of more than two groups, and the Spearman correlation test was used to determine the relationship between Internet addiction and the perceived stress level. Results: It was determined that the mean age of the students participated in the study was 20.13 ± 1.7 years, 67.6% was female, 35.7% was sophomore, and 62.1% had an income 500 TL or less. It was found that 83.5% of the students use the Internet every day and 70.6% uses the Internet for 5 hours or less per day. Of the students, 12.4% prefers digital games instead of spending time outdoors, 8% plays a game as the first activity in leisure time, 12.4% plays all day, 15.7% feels anger when he/she is prevented from playing, 14.8% prefers playing games to get away from his/her problems, 23.4% had his/her school achievement affected negatively because of game playing, and 8% argues with family members due to the time spent for gaming. Students who play games on the computer for a long time were found to feel back pain (30.8%), headache (28.6%), insomnia (26.9%), dryness and pain in the eyes (26.6%), pain in the wrist (21.2%), feeling excessive tension and anger (16.2%), humpback (12.9), vision loss (9.6%) and pain in the wrist and fingers (7.4%). In our study, students' Internet addiction scale mean score was found to be 45.47 ± 16.1 and mean perceived stress scale score was 28.56 ± 2.7. A significant and negative correlation (p=0.037) was found between the total score of the Internet addiction scale and the total score of the perceived stress scale (r=-0.110). Conclusion: It was found in the study that Internet addiction and perceived stress of the students were at a moderate level and that there was a negative correlation between Internet addiction and perceived stress levels. Internet addiction was found to increase with the increasing perceived stress levels of students, and students were found to have health problems such as back pain, dryness in the eyes, pain, insomnia, headache, and humpback. Therefore, it is recommended to inform students about different coping methods other than spending time on the Internet to cope with the stress they perceive.

Keywords: digital game, internet addiction, student, stress level

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Authors: Martina Šutovská, Marta Jošková, Ivana Kazimierová, Lenka Pappová, Maroš Adamkov, Soňa Fraňová

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Bronchial asthma is characterized by increased bronchoconstrictor responses to provoking agonists, airway inflammation and remodeling. All these processes involve Ca2+ influx through Ca2+-release-activated Ca2+ channels (CRAC) that are widely expressed in immune, respiratory epithelium and airway smooth muscle (ASM) cells. Our previous study pointed on possible therapeutic potency of CRAC blockers using experimental guinea pigs asthma model. Presented work analyzed complex anti-asthmatic effect of long-term administered CRAC blocker, including impact on allergic inflammation, airways hyperreactivity, and remodeling and mucociliary clearance. Ovalbumin-induced allergic inflammation of the airways according to Franova et al. was followed by 14 days lasted administration of CRAC blocker (3-fluoropyridine-4-carboxylic acid, FPCA) in the dose 1.5 mg/kg bw. For comparative purposes salbutamol, budesonide and saline were applied to control groups. The anti-inflammatory effect of FPCA was estimated by serum and bronchoalveolar lavage fluid (BALF) changes in IL-4, IL-5, IL-13 and TNF-α analyzed by Bio-Plex® assay as well as immunohistochemical staining focused on assessment of tryptase and c-Fos positivity in pulmonary samples. The in vivo airway hyperreactivity was evaluated by Pennock et al. and by organ tissue bath methods in vitro. The immunohistochemical changes in ASM actin and collagen III layer as well as mucin secretion evaluated anti-remodeling effect of FPCA. The measurement of ciliary beat frequency (CBF) in vitro using LabVIEW™ Software determined impact on mucociliary clearance. Long-term administration of FPCA to sensitized animals resulted in: i. Significant decrease in cytokine levels, tryptase and c-Fos positivity similar to budesonide effect; ii.Meaningful decrease in basal and bronchoconstrictors-induced in vivo and in vitro airway hyperreactivity comparable to salbutamol; iii. Significant inhibition of airway remodeling parameters; iv. Insignificant changes in CBF. All these findings confirmed complex anti-asthmatic effect of CRAC channels blocker and evidenced these structures as the rational target in the treatment of allergic bronchial asthma.

Keywords: allergic asthma, CRAC channels, cytokines, respiratory epithelium

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Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement

Procedia PDF Downloads 241

Authors: Li-Jia Chiu

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The purpose of this study is to integrate the content of professional ethics curriculum into life education. This course is a required course for the third-year students of the university. The curriculum is based on professional ethics, which can help students gain insights into a conceptual understanding of professional theory, learning the meaning and the value of life. This study enhances students' attitude toward learning through multi-teaching methods. It takes ‘professionalism’ as the subject of discussion. Additionally, the course combines the connotation and issues of the student's career development. Using the world cafe discussion method, students can think about the role of the future career, and inspire students to integrate their career development and life value reflection and connection. This study recruited the third-year undergraduate students as samples to collect data. This study was conducted in the course of the fall semester in 2016 for thematic discussions, classroom observations, course study forms, coursework, and results in publication reports, etc. The researcher conducted induction data analysis to reflect the practice and reflection of the course. The subjects included 117 students from two classes, including 54 male and 63 female students. The findings of this study comprised the following two parts: the student’s learning and teacher’s teaching reflection. The students’ gains were that: 1) The curriculum design is different from that of other subjects; 2) The curriculum is highly interactive with teachers and classmates; 3) These students are willing to actively participate and share ideas in group discussions; 4 ) They thought the possibility of further discussions with other groups of students through table-to-table discussions; 5) They experienced the respect from other students in the learning process and their appreciation of other students in the same group. The instruction reflections were as follows: 1) Students learned to get link to the value of life and future development through topical discussions; 2) After the main course design guided through gradual guidance, the students’ psychology reached a certain degree of cognition, and further themes then added would cause more sensuous learning effects; 3) Combining students’ expertise in drawing in this department (digital media design department) into curriculum design is effective in stimulating learning motivation and sense of accomplishment; 4) In order to compare and explore learning benefits, future researches are recommended to conduct the similar studies with different departments. Finally, the researcher looks forward to providing research results and findings to the related curriculum teachers as a reference for practical curriculum planning and teaching methods.

Keywords: life education, World Cafe, professional ethics, professionalism

Procedia PDF Downloads 141

Authors: Bill D. Geis

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Even with significantly increased spending, suicide rates continue to climb—with alarming increases among traditionally low-risk groups. This has caused clinicians and researchers to call for a complete rethinking of all assumptions about suicide prevention, assessment, and intervention. A form of therapy--Internal Family Systems Therapy--affords tremendous promise in sustained diminishment of lethal suicide risk. Though a form of therapy that is most familiar to trauma therapists, Internal Family Systems Therapy, involving direct work with suicidal parts, is a promising therapy for meaningful and sustained reduction in suicide deaths. Developed by Richard Schwartz, Internal Family Systems Therapy proposes that we are all influenced greatly by internal parts, frozen by development adversities, and these often-contradictory parts contribute invisibly to mood, distress, and behavior. In making research videos of patients from our database and discussing their suicide attempts, it is clear that many persons who attempt suicide are in altered states at the time of their attempt and influenced by factors other than conscious intent. Suicide intervention using this therapy involves direct work with suicidal parts and other interacting parts that generate distress and despair. Internal Family Systems theory posits that deep experiences of pain, fear, aloneness, and distress are defended by a range of different parts that attempt to contain these experiences of pain through various internal activities that unwittingly push forward inhibition, fear, self-doubt, hopelessness, desires to cut and engage in destructive behavior, addictive behavior, and even suicidal actions. These suicidal parts are often created (and “frozen”) at young ages, and these very young parts do not understand the consequences of this influence. Experience suggests that suicidal parts can create impulsive risk behind the scenes when pain is high and emotional support reduced—with significant crisis potential. This understanding of latent suicide risk is consistent with many of our video accounts of serious suicidal acts—compiled in a database of 1104 subjects. Since 2016, consent has been obtained and records kept of 23 highly suicidal patients, with initial Intention-to-Die ratings (0= no intent, 10 = conviction to die) between 5 and 10. In 67% of these cases using IFST parts-work intervention, these highly suicidal patients’ risk was reduced to 0-1, and 83% of cases were reduced to 4 or lower. There were no suicide deaths. Case illustrations will be offered.

Keywords: suicide, internal family systems therapy, crisis management, suicide prevention

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Authors: Alia Aldarmaki, Ahmad Elshennawy

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There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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Authors: Pei-Ying Lo, Jing-Hao Ciou, Kai-Cheng Yang, Jia-Huei Zheng, Shih-Hsiang Huang, Kuen-Chan Lee, Er-Chieh Cho

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As-produced CNTs are insoluble in all organic solvents and aqueous solutions have imposed limitations to the use of CNTs. Therefore, how to debundle carbon nanotubes and to modify them for further uses is an important issue. There are several methods for the dispersion of CNTs in water using covalent attachment of hydrophilic groups to the surface of tubes. These methods, however, alter the electronic structure of the nanotubes by disrupting the network of sp2 hybridized carbons. In order to keep the nanotubes’ intrinsic mechanical and electrical properties intact, non-covalent interactions are increasingly being explored as an alternative route for dispersion. Apart from conventional surfactants such as sodium dodecylsulfate (SDS) or sodium dodecylbenzenesulfonate (SDBS) which are highly effective in dispersing CNTs, biopolymers have received much attention as dispersing agents due to the anticipated biocompatibility of the dispersed CNTs. Also, The pyrenyl group is known to interact strongly with the basal plane of graphene via π-stacking. In this study, a highly re-dispersible biopolymer is reported for the synthesis of pyrene-modified poly-L-lysine (PBPL) and poly(D-Glu, D-Lys) (PGLP). To provide the evidence of the safety of the PBPL/CNT & PGLP/CNT materials we use in this study, H1299 and HCT116 cells were incubated with PBPL/CNT & PGLP/CNT materials for toxicity analysis, MTS assays. The results from MTS assays indicated that no significant cellular toxicity was shown in H1299 and HCT116 cells. Furthermore, the fluorescence marker fluorescein isothiocyanate (FITC) was added to PBPL & PGLP dispersions. From the fluorescent measurements showed that the chemical functionalisation of the PBPL/CNT & PGLP/CNT conjugates with the fluorescence marker were successful. The fluorescent PBPL/CNT & PGLP/CNT conjugates could find application in medical imaging. In the next step, the GFP gene is immobilized onto PBPL/CNT conjugates by introducing electrostatic interaction. GFP-transfected cells that emitted fluorescence were imaged and counted under a fluorescence microscope. Due to the unique biocompatibility of PBPL modified CNTs, the GFP gene could be transported into H1299 cells without using antibodies. The applicability of such soluble and chemically functionalised polypeptide/CNT conjugates in biomedicine is currently investigated. We expect that this polypeptide/CNT system will be a safe and multi-functional nanomedical delivery platform and contribute to future medical therapy.

Keywords: carbon nanotube, nanotoxicology, GFP transfection, polypeptide/CNT hybrids

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Authors: Nezha Badi

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It has been shown in the literature that Algerian university students suffer from low levels of reading comprehension proficiency, which hinder their overall proficiency in English. This low level is mainly related to the methodology of teaching reading which is employed by the teacher in the classroom (a teacher-centered environment), as well as students’ poor sense of self-efficacy to undertake reading comprehension activities. Arguably, what is needed is an approach necessary for enhancing students’ self-beliefs about their abilities to deal with different reading comprehension activities. This can be done by providing them with opportunities to take responsibility for their own learning (learners’ autonomy). As a result of learning autonomy, learners’ beliefs about their abilities to deal with certain language tasks may increase, and hence, their language learning ability. Therefore, this experimental research study attempts to assess the extent to which an integrated approach combining one particular reading approach known as ‘collaborative strategic reading’ (CSR), and teacher’s attributional feedback (on students’ reading performance and strategy use) can improve the reading comprehension skill and the sense of self-efficacy of EFL Algerian university students. It also seeks to examine students’ main reasons for their successful or unsuccessful achievements in reading comprehension activities, and whether students’ attributions for their reading comprehension outcomes can be modified after exposure to the instruction. To obtain the data, different tools including a reading comprehension test, questionnaires, an observation, an interview, and learning logs were used with 105 second year Algerian EFL university students. The sample of the study was divided into three groups; one control group (with no treatment), one experimental group (CSR group) who received a CSR instruction, and a second intervention group (CSR Plus group) who received teacher’s attribution feedback in addition to the CSR intervention. Students in the CSR Plus group received the same experiment as the CSR group using the same tools, except that they were asked to keep learning logs, for which teacher’s feedback on reading performance and strategy use was provided. The results of this study indicate that the CSR and the attributional feedback intervention was effective in improving students’ reading comprehension proficiency and sense of self-efficacy. However, there was not a significant change in students’ adaptive and maladaptive attributions for their success and failure d from the pre-test to the post-test phase. Analysis of the perception questionnaire, the interview, and the learning logs shows that students have positive perceptions about the CSR and the attributional feedback instruction. Based on the findings, this study, therefore, seeks to provide EFL teachers in general and Algerian EFL university teachers in particular with pedagogical implications on how to teach reading comprehension to their students to help them achieve well and feel more self-efficacious in reading comprehension activities, and in English language learning more generally.

Keywords: attributions, attributional feedback, collaborative strategic reading, self-efficacy

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Authors: Blanka Havlickova

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In the last ten years, there are growing numbers of troops with machine guns serving on streets of European cities. We can see them around government buildings, major transport hubs, synagogues, galleries and main tourist landmarks. As the main purpose of armed soldier’s presence in European cities authorities declare the prevention of terrorist attacks and psychological support for tourists and domestic population. The main objective of the following study is to find out whether the deployment of armed soldiers in European cities has a calming and reassuring effect on Czech citizens (if the presence at armed soldiers make the Czech population feel more secure) or rather becomes a stress factor (the presence of soldiers standing guard in full military fatigues recalls serious criminality and terrorist attacks which are reflected in the fears and insecurity of Czech population). The initial hypothesis of this study is connected with the priming theory, the idea that when we are exposed to an image (armed soldier), it makes us unconsciously focus on a topic connected with this image (terrorism). This paper is based on a quantitative public survey, which was carried out in the form of electronic questioning among the citizens of the Czech Republic. Respondents answered 14 questions about two European cities – London and Paris. Besides general questions investigating the respondents' awareness of these cities, some of the questions focused on the fear that the respondents had when picturing themselves leaving next Monday for the given city (London or Paris). The questions asking about respondent´s travel fears and concerns were accompanied by different photos. When answering the question about fear some respondents have been presented with a photo of Westminster Palace and the Eiffel with ordinary citizens while other respondents have been presented with a picture of the Westminster Palace, the and Eiffel's tower not only with ordinary citizens, but also with one soldier holding a machine gun. The main goal of this paper is to analyse and compare data about concerns for these two groups of respondents (presented with different pictures) and find out if and how an armed soldier with a machine gun in front of the Westminster Palace or the Eiffel Tower affects the public's concerns about visiting the site. In other words, the aim of this paper is to confirm or rebut the hypothesis that the look at a soldier with a machine gun in front of the Eiffel Tower or the Westminster Palace automatically triggers the association with a terrorist attack leading to an increase in fear and insecurity among Czech population.

Keywords: terrorism, security measures, priming, risk perception

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Authors: P. Vindin, R. Cordier, N. J. Wilson, H. Lee

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Engagement in community-based activities such as education, employment, and social relationships can improve the quality of life for individuals with Autism Spectrum Disorder (ASD). Community mobility is vital to attaining independence for individuals with ASD. Learning to drive and gaining a driver’s license is a critical link to community mobility; however, for individuals with ASD acquiring safe driving skills can be a challenging process. Issues related to anxiety, executive function, and social communication may affect driving behaviours. Driving training and education aimed at addressing barriers faced by learner drivers with ASD can help them improve their driving performance. A multi-site randomized controlled trial (RCT) was conducted to evaluate the effectiveness of an autism-specific driving training intervention for improving the on-road driving performance of learner drivers with ASD. The intervention was delivered via a training manual and interactive website consisting of five modules covering varying driving environments starting with a focus on off-road preparations and progressing through basic to complex driving skill mastery. Seventy-two learner drivers with ASD aged 16 to 35 were randomized using a blinded group allocation procedure into either the intervention or control group. The intervention group received 10 driving lessons with the instructors trained in the use of an autism-specific driving training protocol, whereas the control group received 10 driving lessons as usual. Learner drivers completed a pre- and post-observation drive using a standardized driving route to measure driving performance using the Driving Performance Checklist (DPC). They also completed anxiety, executive function, and social responsiveness measures. The findings showed that there were significant improvements in driving performance for both the intervention (d = 1.02) and the control group (d = 1.15). However, the differences were not significant between groups (p = 0.614) or study sites (p = 0.842). None of the potential moderator variables (anxiety, cognition, social responsiveness, and driving instructor experience) influenced driving performance. This study is an important step toward improving community mobility for individuals with ASD showing that an autism-specific driving training intervention can improve the driving performance of leaner drivers with ASD. It also highlighted the complexity of conducting a multi-site design even when sites were matched according to geography and traffic conditions. Driving instructors also need more and clearer information on how to communicate with learner drivers with restricted verbal expression.

Keywords: autism spectrum disorder, community mobility, driving training, transportation

Procedia PDF Downloads 132

Authors: Samantha Meyerholz

Abstract:

MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

Procedia PDF Downloads 223

Authors: Anis Al-Yakhiri

Abstract:

Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Carolin Schulze

Abstract:

Characterized by a positive interdependence of learners, cooperative learning (CL) is one possibility of successfully dealing with the increasing heterogeneity of students. Various positive effects of CL on the mental, physical and social health of students have already been documented. However, this structure is still rarely used in physical education (PE). Moreover, there is a lack of information about factors that determine the successful implementation of CL in PE. Therefore, the objective of the current study was to find out factors that determine the successful implementation of CL in PE using a digital questionnaire that was conducted from November to December 2022. In addition to socio-demographic data (age, gender, teaching experience, and education level), frequency of using CL, implementation strategies (theory-led, student-centred), and positive and negative effects of CL were measured. Furthermore, teachers were asked to rate the success of implementation on a 6-point rating scale (1-very successful to 6-not successful at all). For statistical analysis, multiple linear regression was performed, setting the success of implementation as the dependent variable. A total of 224 teachers (mean age=44.81±10.60 years; 58% male) took part in the current study. Overall, 39% of participants stated that they never use CL in their PE classes. Main reasons against the implementations of CL in PE were no time for preparation (74%) or for implementation (61%) and high heterogeneity of students (55%). When using CL, most of the reported difficulties are related to uncertainties about the correct procedure (54%) and the heterogeneous performance of students (54%). The most frequently mentioned positive effect was increased motivation of students (42%) followed by an improvement of psychological abilities (e.g. self-esteem, self-concept; 36%) and improved class cohesion (31%). Reported negative effects were unpredictability (29%), restlessness (24%), confusion (24%), and conflicts between students (17%). The successful use of CL is related to a theory-based preparation (e.g., heterogeneous formation of groups, use of rules and rituals) and a flexible implementation tailored to the needs and conditions of students (e.g., the possibility of individual work, omission of CL phases). Compared to teachers who solely implemented CL theory-led or student-adapted, teachers who switched from theory-led preparation to student-centred implementation of CL reported more successful implementation (t=5.312; p<.001). Neither frequency of using CL in PE nor the gender, age, the teaching experience, or the education level of the teacher showed a significant connection with the successful use of CL. Corresponding to the results of the current study, it is advisable that teachers gather enough knowledge about CL during their education and to point out the need to adapt the learning structure according to the diversity of their students. In order to analyse implementation strategies of teachers more deeply, qualitative methods and guided interviews with teachers are needed.

Keywords: diversity, educational technology, physical education, teaching styles

Procedia PDF Downloads 81