Search results for: clinical simulation

Authors: Bi-Huei Tsai

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Previous studies on financial distress prediction choose the conventional failing and non-failing dichotomy; however, the distressed extent differs substantially among different financial distress events. To solve the problem, “non-distressed”, “slightly-distressed” and “reorganization and bankruptcy” are used in our article to approximate the continuum of corporate financial health. This paper explains different financial distress events using the two-stage method. First, this investigation adopts firm-specific financial ratios, corporate governance and market factors to measure the probability of various financial distress events based on multinomial logit models. Specifically, the bootstrapping simulation is performed to examine the difference of estimated misclassifying cost (EMC). Second, this work further applies macroeconomic factors to establish the credit cycle index and determines the distressed cut-off indicator of the two-stage models using such index. Two different models, one-stage and two-stage prediction models, are developed to forecast financial distress, and the results acquired from different models are compared with each other, and with the collected data. The findings show that the two-stage model incorporating financial ratios, corporate governance and market factors has the lowest misclassification error rate. The two-stage model is more accurate than the one-stage model as its distressed cut-off indicators are adjusted according to the macroeconomic-based credit cycle index.

Keywords: Multinomial logit model, corporate governance, company failure, reorganization, bankruptcy

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Authors: Olivier Mesly

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This research presents a conceptual framework termed “Consumer Financial Spinning” (CFS) to analyze consumer behavior in the financial/economic markets. This phenomenon occurs when consumers of high-stakes financial products accumulate unsustainable debt, leading them to detach from their initial financial hierarchy of needs, wealth-related goals, and preferences regarding their household portfolio of assets. The daring actions of these consumers, forming a dark financial triangle, are characterized by three behaviors: overconfidence, the use of rationed rationality, and deceitfulness. We show that we can incorporate CFS into the traditional CAPM and Markovitz’ portfolio optimization models to create a framework that explains such market phenomena as the global financial crisis, highlighting the antecedents and consequences of ill-conceived speculation. Because this is a conceptual paper, there is no methodology with respect to ground studies. However, we apply modeling principles derived from the data percolation methodology, which contains tenets explicating how to structure concepts. A simulation test of the proposed framework is conducted; it demonstrates the conditions under which the relationship between expected returns and risk may deviate from linearity. The analysis and conceptual findings are particularly relevant both theoretically and pragmatically as they shed light on the psychological conditions that drive intense speculation, which can lead to market turmoil. Armed with such understanding, regulators are better equipped to propose solutions before the economic problems become out of control.

Keywords: consumer financial spinning, rationality, deceitfulness, overconfidence, CAPM

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Authors: Rouhallah Bagheri, Morteza Mahmoudi, Hadi Moheb-Alizadeh

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This paper aims at developing a multi-objective model for supplier selection and order allocation problem in stochastic environment, where purchasing cost, percentage of delivered items with delay and percentage of rejected items provided by each supplier are supposed to be stochastic parameters following any arbitrary probability distribution. In this regard, dependent chance programming is used which maximizes probability of the event that total purchasing cost, total delivered items with delay and total rejected items are less than or equal to pre-determined values given by decision maker. The abovementioned stochastic multi-objective programming problem is then transformed into a stochastic single objective programming problem using minimum deviation method. In the next step, the further problem is solved applying a genetic algorithm, which performs a simulation process in order to calculate the stochastic objective function as its fitness function. Finally, the impact of stochastic parameters on the given solution is examined via a sensitivity analysis exploiting coefficient of variation. The results show that whatever stochastic parameters have greater coefficients of variation, the value of the objective function in the stochastic single objective programming problem is deteriorated.

Keywords: supplier selection, order allocation, dependent chance programming, genetic algorithm

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Authors: C. Babu Rao, Pandian Chelliah

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Owing to their reliability, a number of fluorescent spectra based fiber optic sensors have been developed for detection and identification of hazardous chemicals such as explosives, narcotics etc. In High security regions, such as airports, it is important to monitor simultaneously multiple locations. This calls for deployment of a portable sensor at each location. However, the selectivity and sensitivity of these techniques depends on the spectral resolution of the spectral analyzer. The better the resolution the larger the repertoire of chemicals that can be detected. A portable unit will have limitations in meeting these requirements. Optical fibers can be employed for collecting and transmitting spectral signal from the portable sensor head to a sensitive central spectral analyzer (CSA). For multipoint sensing, optical multiplexing of multiple sensor heads with CSA has to be adopted. However with multiplexing, when one sensor head is connected to CSA, the rest may remain unconnected for the turn-around period. The larger the number of sensor heads the larger this turn-around time will be. To circumvent this imitation, we propose in this paper, an optical encoding methodology to use multiple portable sensor heads connected to a single CSA. Each portable sensor head is assigned an unique address. Spectra of every chemical detected through this sensor head, are encoded by its unique address and can be identified at the CSA end. The methodology proposed is demonstrated through a simulation using Matlab SIMULINK.

Keywords: optical encoding, fluorescence, multipoint sensing

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Authors: Ziyad S. Haidar

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Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL), alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Opportunity: Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise and risk of immune reactions. For cases of dry sockets, specifically, the commercially-available and often-prescribed home remedies are highly lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Solution: Herein, SockGEL/PLUG (patent pending), an all-natural, drug-free and injectable stimuli-responsive hydrogel, was designed, formulated, characterized and evaluated as an osteogenic, angiogenic, anti-microbial and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in several oro-dental and cranio-maxillo-facial interventional applications; for example: in fresh dental extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (a) prevent the onset of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (b) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. Findings: The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physico-chemico-mechanically for safety (cell viability), viscosity, rheology, bio-distribution and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The performed animal model of cranial critical-sized and non-vascularized bone defects shall provide vitally critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease and speed in producing stable, biodegradable and sterilizable stimuli (thermo-sensitive and photo-responsive) matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for an intra-socket application, and beyond. Conclusions and Perspective: Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the bionanomaterial before engaging the market for feasibility, acceptance and cost-effectiveness studies. The SockGEL/PLUG platform is patent pending: SockGEL is a bio-inspired drug-free hydrogel; SockPLUG is a drug-loaded hydrogel designed for complex indications.

Keywords: hydrogel, injectable, dentistry, craniomaxillofacial complex, bioinspired, nanobiotechnology, biopolymer, sol-gel, stimuli-responsive, matrix, tissue engineering, regenerative medicine

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Authors: Bing–Jing Zhao, Chang-Kui Liu, Hong Wang, Min Hu

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Electron beam rapid manufacturing (EBRM) or Selective laser melting is an additive manufacturing process that uses 3D CAD data as a digital information source and energy in the form of a high-power laser beam or electron beam to create three-dimensional metal parts by fusing fine metallic powders together.Object:The present study was conducted to evaluate the mechanical properties ,the phase transformation,the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM,SLM and forging technique.Method: Ti-6Al-4V alloy standard test pieces were manufactured by EBRM, SLM and forging technique according to AMS4999,GB/T228 and ISO 10993.The mechanical properties were analyzed by universal test machine. The phase transformation was analyzed by X-ray diffraction and scanning electron microscopy. The corrosivity was analyzed by electrochemical method. The biocompatibility was analyzed by co-culturing with mesenchymal stem cell and analyzed by scanning electron microscopy (SEM) and alkaline phosphatase assay (ALP) to evaluate cell adhesion and differentiation, respectively. Results: The mechanical properties, the phase transformation, the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM、SLM were similar to forging and meet the mechanical property requirements of AMS4999 standard. a­phase microstructure for the EBM production contrast to the a’­phase microstructure of the SLM product. Mesenchymal stem cell adhesion and differentiation were well. Conclusion: The property of the Ti-6Al-4V alloy manufactured by EBRM and SLM technique can meet the medical standard from this study. But some further study should be proceeded in order to applying well in clinical practice.

Keywords: 3D printing, Electron Beam Rapid Manufacturing (EBRM), Selective Laser Melting (SLM), Computer Aided Design (CAD)

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Authors: Clement Leroy, Guillaume Boitel

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This paper presents a comparative benchmarking review of a steady and transient three-dimensional (3D) flow computations in centrifugal pump using commercial (AnsysCFX) and open source (OpenFOAM) computational fluid dynamics (CFD) software. In centrifugal rotor-dynamic pump, the fluid enters in the impeller along to the rotating axis to be accelerated in order to increase the pressure, flowing radially outward into another stage, vaned diffuser or volute casing, from where it finally exits into a downstream pipe. Simulations are carried out at the best efficiency point (BEP) and part load, for single-phase flow with several turbulence models. The results are compared with overall performance report from experimental data. The use of CFD technology in industry is still limited by the high computational costs, and even more by the high cost of commercial CFD software and high-performance computing (HPC) licenses. The main objectives of the present study are to define OpenFOAM methodology for high-quality 3D steady and transient turbomachinery CFD simulation to conduct a thorough time-accurate performance analysis. On the other hand a detailed comparisons between computational methods, features on latest Ansys release 18 and OpenFOAM is investigated to assess the accuracy and industrial applications of those solvers. Finally an automated connected workflow (IoT) for turbine blade applications is presented.

Keywords: benchmarking, CFX, internet of things, openFOAM, time-accurate, turbomachinery

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Authors: Fadime Eroglu

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Acanthamoeba genus belongs to kingdom protozoa, and it is known as free-living amoebae. Acanthamoeba genus has been isolated from human bodies, swimming pools, bottled mineral water, contact lens solutions, dust, and soil. The members of the genus Acanthamoeba causes Acanthamoeba Keratitis which is a painful sight-threatening disease of the eyes. In recent years, the prevalence of Acanthamoeba keratitis has been high rate reported. The eight different Acanthamoeba species are known to be effective in Acanthamoeba keratitis. These species are Acanthamoeba castellanii, Acanthamoeba polyphaga, Acanthamoeba griffini, Acanthamoeba hatchetti, Acanthamoeba culbertsoni and Acanhtamoeba rhysodes. The conventional diagnosis of Acanthamoeba Keratitis has relied on cytological preparations and growth of Acanthamoeba in culture. However molecular methods such as real-time PCR has been found to be more sensitive. The real-time PCR has now emerged as an effective method for more rapid testing for the diagnosis of infectious disease in decade. Therefore, a real-time PCR assay for the detection of Acanthamoeba keratitis and Acanthamoeba species have been developed in this study. The 18S rRNA sequences from Acanthamoeba species were obtained from National Center for Biotechnology Information and sequences were aligned with MEGA 6 programme. Primers and probe were designed using Custom Primers-OligoPerfectTMDesigner (ThermoFisherScientific, Waltham, MA, USA). They were also assayed for hairpin formation and degree of primer-dimer formation with Multiple Primer Analyzer ( ThermoFisherScientific, Watham, MA, USA). The eight different ATCC Acanthamoeba species were obtained, and DNA was extracted using the Qiagen Mini DNA extraction kit (Qiagen, Hilden, Germany). The DNA of Acanthamoeba species were analyzed using newly designed primer and probe set in real-time PCR assay. The early definitive laboratory diagnosis of Acanthamoeba Keratitis and the rapid initiation of suitable therapy is necessary for clinical prognosis. The results of the study have been showed that new primer and probes could be used for detection and distinguish for Acanthamoeba species. These new developing methods are helpful for diagnosis of Acanthamoeba Keratitis.

Keywords: Acathamoeba Keratitis, Acanthamoeba species, fast diagnosis, Real-Time PCR

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Md. Samsuzzaman, M. T. Islam, J. S. Mandeep, N. Misran

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In this article, a compact simple structure modified Swastika shape patch multiband antenna on a substrate of available low cost polymer resin composite material is designed for Wi-Fi and WiMAX applications. The substrate material consists of an epoxy matrix reinforced by woven glass. The designed micro-strip line fed compact antenna comprises of a planar wide square slot ground with four slits and Swastika shape radiation patch with a rectangular slot. The effect of the different substrate materials on the reflection coefficients of the proposed antennas was also analyzed. It can be clearly seen that the proposed antenna provides a wider bandwidth and acceptable return loss value compared to other reported materials. The simulation results exhibits that the antenna has an impedance bandwidth with -10 dB return loss at 3.01-3.89 GHz and 4.88-6.10 GHz which can cover both the WLAN, WiMAX and public safety WLAN bands. The proposed swastika shape antenna was designed and analyzed by using a finite element method based simulator HFSS and designed on a low cost FR4 (polymer resin composite material) printed circuit board. The electrical performances and superior frequency characteristics make the proposed material antenna desirable for wireless communications.

Keywords: epoxy resin polymer, multiband, swastika shaped, wide slot, WLAN/WiMAX

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Authors: R. Suresh, C. B. Singh, A. K. Sarda

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Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

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Authors: Anas Rao, Hao Duan, Fanhua Ma

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The dependency on the fossil fuels can be minimized by using the hydrogen enriched compressed natural gas (HCNG) in the transportation vehicles. However, the NOx emissions of HCNG engines are significantly higher, and this turned to be its major drawback. Therefore, the study of NOx emission of HCNG engines is a very important area of research. In this context, the experiments have been performed at the different hydrogen percentage, ignition timing, air-fuel ratio, manifold-absolute pressure, load and engine speed. Afterwards, the simulation has been accomplished by the quasi-dimensional combustion model of HCNG engine. In order to investigate the NOx emission, the NO mechanism has been coupled to the quasi-dimensional combustion model of HCNG engine. The three NOx mechanism: the thermal NOx, prompt NOx and N2O mechanism have been used to predict NOx emission. For the validation purpose, NO curve has been transformed into NO packets based on the temperature difference of 100 K for the lean-burn and 60 K for stoichiometric condition. While, the width of the packet has been taken as the ratio of crank duration of the packet to the total burnt duration. The combustion chamber of the engine has been divided into three zones, with the zone equal to the product of summation of NO packets and space. In order to check the accuracy of the model, the percentage error of NOx emission has been evaluated, and it lies in the range of ±6% and ±10% for the lean-burn and stoichiometric conditions respectively. Finally, the percentage contribution of each NO formation has been evaluated.

Keywords: quasi-dimensional combustion , thermal NO, prompt NO, NO packet

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Authors: Melkamu A., Woldu B., Sitotaw C., Seyoum M., Aynalem M.

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Background: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. Methods: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood was collected and analyzed by the Genrui CA51 coagulation analyzer. Data was entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. Result: In this study, a total of 307 study participants were included. Of them, the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. Conclusion: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

Keywords: coagulation, liver disease, PT, Aptt

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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Authors: Nelson Bii, Christopher Ouma, John Odhiambo

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Non-response is a potential source of errors in sample surveys. It introduces bias and large variance in the estimation of finite population parameters. Regression models have been recognized as one of the techniques of reducing bias and variance due to random non-response using auxiliary data. In this study, it is assumed that random non-response occurs in the survey variable in the second stage of cluster sampling, assuming full auxiliary information is available throughout. Auxiliary information is used at the estimation stage via a regression model to address the problem of random non-response. In particular, the auxiliary information is used via an improved Nadaraya-Watson kernel regression technique to compensate for random non-response. The asymptotic bias and mean squared error of the estimator proposed are derived. Besides, a simulation study conducted indicates that the proposed estimator has smaller values of the bias and smaller mean squared error values compared to existing estimators of finite population mean. The proposed estimator is also shown to have tighter confidence interval lengths at a 95% coverage rate. The results obtained in this study are useful, for instance, in choosing efficient estimators of the finite population mean in demographic sample surveys.

Keywords: mean squared error, random non-response, two-stage cluster sampling, confidence interval lengths

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Authors: Brigitta Szabo, Miklosi Monika

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Background/Aims: In early childhood, the context of development is the caregiver-child relationship. Maternal attachment style plays a major role in the intergenerational transmission of psychopathology. The aim of this study was to explore the relationship between the mothers’ attachment style, mindful parenting, and perception of the child. Method: Data was collected from 144 non-clinical mothers who have a child below the age of 3 years. Mothers completed self-report questionnaires, including the following scales: a demographic questionnaire, Attachment Style Questionnaire (ASQ), Interpersonal Mindfulness in Parenting Scale (IMP), and the Mothers’ Object Relations Scale (MORS-SF). K-means cluster analysis was used to identify the mothers’ attachment styles. Mediation analyses with Mothers’ Object Relations Scale (MORS-SF) positive emotions and dominance subscales as dependent variables, mothers’ attachment style (ASQ) as an independent variable, and mindful parenting (IMP) as a mediator were conducted. Results: Four attachment styles (secure, preoccupied, fearful, dismissing) were identified. The relationship between mothers’ attachment style and mindful parenting was significant (R2 = .51; F(4,139) = 36.60; p < .001). Compared to the secure attachment style as a reference group, both preoccupied and dismissing styles were related to lower levels of mindful parenting; however, this relationship was the strongest in case of fearful style. In mediation analysis the direct effects of mothers’ attachment style on the perception of the child were not significant (MORS positive emotions: R2= .29; F(5,138) = 11.22; p < .001; MORS dominance: R2= .39 F(5,138) = 17.54, p < .001). However, indirect effects through mindful parenting were significant; higher levels of mindful parenting were associated with higher levels of MORS positive emotions and lower levels of MORS dominance. Conclusions: These findings suggest that attachment styles are related to the perception of the child through mindful parenting. Mindfulness-based parenting training might be useful in case of attachment-related problems to improve the parent-child relationship.

Keywords: mindfulness, mindful parenting, attachement, perception

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Authors: Ipek Sensu

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Comorbid Axis I disorders are highly common for suicidal borderline personality disorder (BPD) patients, especially substance use disorder and anxiety disorders. Since interpersonal dysfunction is one of the core symptoms in BPD, the purpose of the current study is to examine perceived criticism and anxiety disorders and also substance abuse disorders (SUD) for women with borderline personality disorder (BPD) who attempt suicide at least once in their lifetime. In the current study, it was suggested that the perceived criticism from others and being upset by criticism differ between suicidal women with BPD with comorbidity of anxiety disorders and SUD (separately) and suicidal women with BPD without anxiety disorders and without SUD (separately). The participants in this study included ninety-nine women who have already been diagnosed with borderline personality disorder and also have had at least two episodes of deliberate self-harm, in other words, suicide attempts and/or non-suicidal self-injury (NSSI) in the last five years and at least one episode in the 8-week period before joining the research study and at least one suicide attempt in the previous year. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and Social History Interview (SHI) were conducted to determine the comorbid axis I disorders and level of perceived criticism. As a result of the independent sample t-tests, the first hypothesis was rejected, in other words, women with BPD and a comorbid anxiety disorder did not show significantly higher levels of ‘criticized by others’, compared to women with BPD alone. However, the levels of ‘upset at criticism’ were significantly different between suicidal women with BPD with or without any anxiety disorders, which is the second hypothesis. In addition, the third hypothesis was also accepted; this means, women with BPD who had any substance use dependence would show significantly higher levels of 'criticized by others' compared to women with BPD alone. Finally, the fourth hypothesis was partly accepted: that is, women with BPD with alcohol dependence had significantly higher levels of ‘how upset when they expose to criticism’, compared to those without alcohol dependence. Limitations, implications, and directions for future research are discussed.

Keywords: anxiety disorders, borderline personality disorders, perceived criticism, substance use disorders

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Authors: Sabiha S. Marine, Nicole Flint, John Rolfe

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The Queensland state government introduced commercial gill net fishing closures in Cairns, Mackay, and Rockhampton in November 2015 to increase the recreational fishing opportunities, nature-based tourism, and economic benefits in these three regional areas. This management change is likely to improve the potential for more desirable stock structures through natural recruitment. Barramundi (Lates calcarifer) is one of the popular target fish for recreational and commercial fishers in Northern Australia. This investigation examines the effects of reduced commercial fishing from both biological and economic perspectives, particularly on the local Barramundi population of the Fitzroy River in Rockhampton, the largest river catchment flowing to the eastern coast of Australia. Data on different parameters of biological and economic aspects have been collated from secondary sources for analysis through a system simulation approach to identify the effectiveness of the commercial netting closures on recreational fishing effort, especially for the Barramundi population. The results have the potential to explain certain consequences of the netting closures in Queensland, which could serve to inform future fisheries management decisions. The study output as a whole will help in the better management of fisheries resources by evaluating recreational fishing opportunities in Queensland, where the potential for increases in recreation is high.

Keywords: Barramundi, bioeconomic model, fishery management, recreational fishing

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Authors: Waddah Abdelbagi Talha, Mohammed Abdullah Elmaleeh, John Ojur Dennis

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This paper focuses on the simulation and implementation of a resonator micro-sensor for low magnetic field sensing based on a U-shaped cantilever and piezoresistive configuration, which works based on Lorentz force physical phenomena. The resonance frequency is an important parameter that depends upon the highest response and sensitivity through the frequency domain (frequency response) of any vibrated micro-scale of an electromechanical system (MEMS) device. And it is important to determine the direction of the detected magnetic field. The deflection of the cantilever is considered for vibrated mode with different frequencies in the range of (0 Hz to 7000 Hz); for the purpose of observing the frequency response. A simple electronic circuit-based polysilicon piezoresistors in Wheatstone's bridge configuration are used to transduce the response of the cantilever to electrical measurements at various voltages. Microcontroller-based Arduino program and PROTEUS electronic software are used to analyze the output signals from the sensor. The highest output voltage amplitude of about 4.7 mV is spotted at about 3 kHz of the frequency domain, indicating the highest sensitivity, which can be called resonant sensitivity. Based on the resonant frequency value, the mode of vibration is determined (up-down vibration), and based on that, the vector of the magnetic field is also determined.

Keywords: resonant frequency, sensitivity, Wheatstone bridge, UNO-microcontroller

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Authors: Ankita Sharma, Satish Kumar Meena, Neha Kawatra Madan

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Background and Aims: Pediatric septic shock, a life-threatening condition, is associated with significant morbidity and mortality. Dysregulation of thyroid function, presenting as Non-Thyroidal Illness Syndrome (NTIS), is a common observation in critically ill patients and may impact clinical outcomes. This study investigates the thyroid hormone profile in pediatric septic shock and its correlation with disease outcomes. Methods: A cross-sectional study was conducted in the Pediatric Department of VMMC and Safdarjung Hospital, New Delhi. Ninety-one children, aged 1 month to 12 years, diagnosed with septic shock were included. Thyroid function tests (Total T3, Total T4, Free T3, Free T4, and TSH) were measured upon admission. Outcomes were categorized as favorable (shock reversal within 24 hours, ICU stay <7 days) or unfavorable (prolonged shock, ICU stay >7 days, multiorgan dysfunction syndrome [MODS], or death). Statistical analysis included logistic regression and receiver operating characteristic (ROC) curve evaluation. Results: Thyroid hormone abnormalities were prevalent, with low Total T3 (84.6%), low Total T4 (70.3%), and low Free T3 (76.9%) being the most common findings. Significant associations were observed between low levels of Total T3, Total T4, Free T3, and Free T4 with unfavorable outcomes (p<0.001 for all). ROC analysis identified Free T3 as the strongest predictor of unfavorable outcomes, with an AUROC of 0.842. Conclusions: Thyroid hormone levels, particularly Free T3, are critical prognostic markers in pediatric septic shock. Timely monitoring of thyroid function could aid in risk stratification and therapeutic decision-making. Future research should focus on the potential benefits of thyroid hormone replacement therapy in this population.

Keywords: pediatric septic shock, thyroid function, non-thyroidal illness syndrome, prognostic markers, free T3

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Authors: Scholastic Nangila Adeli, Francisca Mbutitia Ngithi

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Stigma is commonly associated with mental health patients and may act as a barrier to individuals who may seek or engage in treatment services. Stigmatization among university students is common whether they know someone with a mental health problem, or have a good knowledge and experience of mental health issues. The objective of this study was to establish the various barriers that prevent university students who have mental health challenges from seeking treatment and care. The study was a descriptive in nature where 320 respondents helped to establish the barriers to treatment or participation in mental health care among university students. A questionnaire was used to help establish the barriers and attitude towards mental illness among the respondents. Results from this study revealed that mental illnesses are common among university students and they are manifested in different forms like; anxiety and panic attacks, mood and eating disorders, Impulse control leading to gambling, alcohol and drug addictions, anger and depression leading to loneliness. Mental stigma (both social and self) was the major barrier with 62% of the respondents stating that social stigma was worse than self-stigma. This is because of the social discrimination towards the victim of mental challenges. On issues of attitude, 71% of the respondents said that they can never admit that they have a mental issue and would rather secretly seek clinical or psychological help for fear of being discriminated or excluded by peers. This view is informed by the societal belief that people with mental health challenges were dangerous (associating them with criminal behavior) and hard to socialize with or help. From the findings of this study, it is concluded that mental health problems are real among university students in Kenya and it is important for the university environment to minimize or eradicate stigma within the social circles. Stigma can be minimized or eradicated by creating awareness among university students and fostering social inclusion so that the students who have mental health challenges can experience a sense of belonging and acceptance hence build their self-esteem.

Keywords: disorders, impulse control, mental health problems, stigma

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Authors: Huang Ying

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The present study was to investigate factors affecting children's improvement through the first two years of elementary school on a population-based sample of children with autism in Taiwan. All the children were diagnosed with autism spectrum disorder (ASD) by clinical psychologists according to DSM-IV. Children's development was assessed by the Vineland Adaptive Behavior Scales-Chinese version (VABS-C) on the first and the third grade. Children's improvement was measured by the difference between the standardized total score of the third and the first year. In Taiwan, school-age children with special-education needs will be arranged into different classes, including normal classes (NC), resource classes (RC), and special classes (SC) by the government. Therefore, type of class was one of the independent variables. Moreover, as early intervention is considered to be crucial, the earliest age when intervention begins was collected from parents. Attention was also included in the analysis. Teachers were asked to evaluate children's attention with a 3-item Likert Scale. The frequency of paying attention to the class or the task was recorded and scores were summed up. Additionally, standardized scores of the VABS-C in the first grade were used as pretest scores representing children's developmental level at the beginning of elementary school. Multiple regression was conducted with improvement as the dependent variable. Results showed that children in special classes had smaller improvement compared to those in normal or resource classes. Attention positively predicted improvement yet the effect of earliest intervention age was not significant. Furthermore, scores in the first grade negatively predicted improvement, which indicated that children with higher developmental levels would make less progress in the following years. Results were to some degree consistent with previous findings through meta-analysis that the effectiveness of conventional intervention methods lacked sufficient evidence to support.

Keywords: attention, early intervention, elementary school, special education in Taiwan

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Authors: Naufal Ahmed, Michael Lwin

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Background: MPFL reconstructions are ideally performed with au-tografts like gracilis semitendinosus tendon, which may be associated with donor site morbidity and complications. In this case series, we have tried to use fiber tape, which avoids the above complications and also keeps the graft virgin. This kind of synthetic graft has been used successfully in rotator cuffs and ACJ reconstructions with good results. Materials and methods: It was a retrospective data analysis of 45 patients who underwent this procedure from 2014-2020 under a single consultant in a DGH . These patiens have been followed up at 6 weeks, 6 months, 1 year, and 1 ½ years with clinical assessment and KOOS scores. We compared the results with the NJR and also with the Belgium report and was found to be satisfactory and comparable with them. Surgical technique : We used Arthrex fiber tape for the reconstruction of MPFL . Initially, two parallel holes drilled over sup aspect of the patella with help of an image intensifier, and then fiber wire passed through them from the medial to the lateral side and back to the medial side. The fiber wire was attached to the schottle point on the femoral side, giving a good extra articular internal brac-ing to the MPFL. All patients were scoped before the procedure, and the final tightening over the femoral side was done directly under vision to see the position of the patella. Results: We had 45 MPFL reconstructions along with 4 additional procedures 1 ACLR, 2 ACL REPAIR, 1 TTT advancement ( revision MPFL ). There were 14 males and 31 females, and their average age was 25 (13-55 ). We did not have any donor site morbidity, no infection, no fractures, no recurrent dislocations, no reoperations yet. Conclusion: Fiber tape is a feasible and appropriate option for MPFL reconstruction. We haven’t seen any re -operation in our 5 year follow up. This technique avoids the use of autograft, which can be used in the future if needed for revision surgeries. We don’t lose anything by following this simple novel technique.

Keywords: arthroscopy, fibertape, MPFL reconstruction, recurrent patella dislocation

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Authors: Hicham Gourgue, Ahmed Aharoune, Ahmed Ihlal

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We present in this work our model of road traffic emissions (line sources) and dispersion of these emissions, named DISPOLSPEM (Dispersion of Poly Sources and Pollutants Emission Model). In its emission part, this model was designed to keep the consistent bottom-up and top-down approaches. It also allows to generate emission inventories from reduced input parameters being adapted to existing conditions in Morocco and in the other developing countries. While several simplifications are made, all the performance of the model results are kept. A further important advantage of the model is that it allows the uncertainty calculation and emission rate uncertainty according to each of the input parameters. In the dispersion part of the model, an improved line source model has been developed, implemented and tested against a reference solution. It provides improvement in accuracy over previous formulas of line source Gaussian plume model, without being too demanding in terms of computational resources. In the case study presented here, the biggest errors were associated with the ends of line source sections; these errors will be canceled by adjacent sections of line sources during the simulation of a road network. In cases where the wind is parallel to the source line, the use of the combination discretized source and analytical line source formulas minimizes remarkably the error. Because this combination is applied only for a small number of wind directions, it should not excessively increase the calculation time.

Keywords: air pollution, dispersion, emissions, line sources, road traffic, urban transport

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Authors: Ngoc Trung Ngo, Buddhima Indraratna, Cholachat Rujikiathmakjornr

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For several hundred years, the design of railway tracks has practically remained unchanged. Traditionally, rail tracks are placed on a ballast layer due to several reasons, including economy, rapid drainage, and high load bearing capacity. The primary function of ballast is to distributing dynamic track loads to sub-ballast and subgrade layers, while also providing lateral resistance and allowing for rapid drainage. Upon repeated trainloads, the ballast becomes fouled due to ballast degradation and the intrusion of fines which adversely affects the strength and deformation behaviour of ballast. This paper presents the use of three-dimensional discrete element method (DEM) in studying the shear behaviour of the fouled ballast subjected to direct shear loading. Irregularly shaped particles of ballast were modelled by grouping many spherical balls together in appropriate sizes to simulate representative ballast aggregates. Fouled ballast was modelled by injecting a specified number of miniature spherical particles into the void spaces. The DEM simulation highlights that the peak shear stress of the ballast assembly decreases and the dilation of fouled ballast increases with an increase level of fouling. Additionally, the distributions of contact force chain and particle displacement vectors were captured during shearing progress, explaining the formation of shear band and the evolutions of volumetric change of fouled ballast.

Keywords: railway ballast, coal fouling, discrete element modelling, discrete element method

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Authors: Pratibha Srivastava, Chithra V. J., Sudhakar S., Nitin K. D.

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A closed-loop system comprises of a controller, a response system, and an actuating system. The controller, which is the system under test for us, excites the actuators based on feedback from the sensors in a periodic manner. The sensors should provide the feedback to the System Under Test (SUT) within a deterministic time post excitation of the actuators. Any delay or miss in the generation of response or acquisition of excitation pulses may lead to control loop controller computation errors, which can be catastrophic in certain cases. Such systems categorised as hard real-time systems that need special strategies. The real-time operating systems available in the market may be the best solutions for such kind of simulations, but they pose limitations like the availability of the X Windows system, graphical interfaces, other user tools. In this paper, we present strategies that can be used on a general purpose operating system (Bare Linux Kernel) to achieve a deterministic deadline and hence have the added advantages of a GPOS with real-time features. Techniques shall be discussed how to make the time-critical application run with the highest priority in an uninterrupted manner, reduced network latency for distributed architecture, real-time data acquisition, data storage, and retrieval, user interactions, etc.

Keywords: real time data acquisition, real time kernel preemption, scheduling, network latency

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Authors: Benoit Landi, Hervé Pingaud, Jean-Benoit Culie, Michel Galaup

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Serious games have been widely disseminated in the field of digital learning. They have proved their utility in improving skills through virtual environments that simulate the field where new competencies have to be improved and assessed. This paper describes how we created CLONE, a serious game whose purpose is to help nurses create an efficient work plan in a hospital care unit. In CLONE, the number of patients to take care of is similar to the reality of their job, going far beyond what is currently practiced in nurse school classrooms. This similarity with the operational field increases proportionally the number of activities to be scheduled. Moreover, very often, the team of nurses is composed of regular nurses and nurse assistants that must share the work with respect to the regulatory obligations. Therefore, on the one hand, building a short-term planning is a complex task with a large amount of data to deal with, and on the other, good clinical practices have to be systematically applied. We present how reference planning has been defined by addressing an optimization problem formulation using the expertise of teachers. This formulation ensures the gameplay feasibility for the scenario that has been produced and enhanced throughout the game design process. It was also crucial to steer a player toward a specific gaming strategy. As one of our most important learning outcomes is a clear understanding of the workload concept, its factual calculation for each caregiver along time and its inclusion in the nurse reasoning during planning elaboration are focal points. We will demonstrate how to modify the game scenario to create a digital environment in which these somewhat abstract principles can be understood and applied. Finally, we give input on an experience we had on a pilot of a thousand undergraduate nursing students.

Keywords: care planning, workload, game design, hospital nurse, organizational skills, digital learning, serious game

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Authors: O. Afshar

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Unlike other renewable energy sources, tidal current energy is an extremely reliable, predictable and continuous energy source as the current pattern and speed can be predicted throughout the year. A key concern associated with tidal turbines is their long-term reliability when operating in the hostile marine environment. Bio-fouling changes the physical shape and roughness of turbine components, hence altering the overall turbine performance. This paper seeks to employ Computational Fluid Dynamics (CFD) method to quantify the effects of this problem based on the obtained flow field information. The simulation is carried out on a NACA 63-618 aerofoil. The Reynolds Averaged Navier-Stokes (RANS) equations with Shear Stress Transport (SST) turbulent model are used to simulate the flow around the model. Different levels of fouling are studied on 2D aerofoil surface with quantified fouling height and density. In terms of lift and drag coefficient results, numerical results show good agreement with the experiment which was carried out in wind tunnel. Numerical results of research indicate that an increase in fouling thickness causes an increase in drag coefficient and a reduction in lift coefficient. Moreover, pressure gradient gradually becomes adverse as height of fouling increases. In addition, result by turbulent kinetic energy contour reveals it increases with fouling height and it extends into wake due to flow separation.

Keywords: tidal energy, lift coefficient, drag coefficient, roughness

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Authors: Alison Brown

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Through stories, children make sense of their world, see themselves through the eyes of another, and process emotions and lived experiences in a non-threatening and indirect manner. Building on research around the use of narrative techniques with adults and families, this research looked directly at the use of narratives as a therapeutic technique with children in counseling. Based on individual therapy sessions with children over a six-year period, this work of collective case studies tells the story of a practice incorporating children’s narratives, of children’s experiences in writing and sharing their narratives, and of the clinical impact of the use of narratives with children. Not all stories were narratives of success or happiness. Children documented their fears and anger as well as their achievements and hope for the future. What emerged through this study was an awareness of recurring themes in the way children responded to the narrative process and in the benefits and limitations of story writing with children. Consistent with previous studies focusing on narrative work with adults and families, the use of narratives with children provided opportunities for healing, acceptance, developing greater understanding, externalizing, and re-authoring a preferred future. In terms of the children’s experiences in writing and sharing their narratives, consistent themes emerged again, with many children finding the experience cathartic and liberating, empowering and hopeful, but most importantly, an opportunity that allowed them to feel and understand that they were not alone. Whilst a small collection of case studies tells the stories of a limited number of children, it is hoped that this research provides both a model and inspiration for others to explore similar uses of narratives with children. As a greater number of children’s narratives are created, the potential to share and benefit from the many rich stories and experiences of other children becomes more of a reality. Across cultures, economic and social settings, rural and urban environments, and varying family structures, it is important that we hear the voices of our children – ‘In their own words’.

Keywords: narrative therapy children counselling, social, emotional, zone of proximal development, scaffolding

Procedia PDF Downloads 94