Search results for: critical diagnostic distinctions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6129

Search results for: critical diagnostic distinctions

5499 Importance of CT and Timed Barium Esophagogram in the Contemporary Treatment of Patients with Achalasia

Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic

Abstract:

Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.

Keywords: achalasia, computed tomography, esophagography, myotomy

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5498 2D Monte Carlo Simulation of Grain Growth under Transient Conditions

Authors: K. R. Phaneesh, Anirudh Bhat, G. Mukherjee, K. T. Kashyap

Abstract:

Extensive Monte Carlo Potts model simulations were performed on 2D square lattice to investigate the effects of simulated higher temperatures effects on grain growth kinetics. A range of simulation temperatures (KTs) were applied on a matrix of size 10002 with Q-state 64, dispersed with a wide range of second phase particles, ranging from 0.001 to 0.1, and then run to 100,000 Monte Carlo steps. The average grain size, the largest grain size and the grain growth exponent were evaluated for all particle fractions and simulated temperatures. After evaluating several growth parameters, the critical temperature for a square lattice, with eight nearest neighbors, was found to be KTs = 0.4.

Keywords: average grain size, critical temperature, grain growth exponent, Monte Carlo steps

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5497 Influence of Flexible Plate's Contour on Dynamic Behavior of High Speed Flexible Coupling of Combat Aircraft

Authors: Dineshsingh Thakur, S. Nagesh, J. Basha

Abstract:

A lightweight High Speed Flexible Coupling (HSFC) is used to connect the Engine Gear Box (EGB) with an Accessory Gear Box (AGB) of the combat aircraft. The HSFC transmits the power at high speeds ranging from 10000 to 18000 rpm from the EGB to AGB. The HSFC is also accommodates larger misalignments resulting from thermal expansion of the aircraft engine and mounting arrangement. The HSFC has the series of metallic contoured annular thin cross-sectioned flexible plates to accommodate the misalignments. The flexible plates are accommodating the misalignment by the elastic material flexure. As the HSFC operates at higher speed, the flexural and axial resonance frequencies are to be kept away from the operating speed and proper prediction is required to prevent failure in the transmission line of a single engine fighter aircraft. To study the influence of flexible plate’s contour on the lateral critical speed (LCS) of HSFC, a mathematical model of HSFC as a elven rotor system is developed. The flexible plate being the bending member of the system, its bending stiffness which results from the contoured governs the LCS. Using transfer matrix method, Influence of various flexible plate contours on critical speed is analyzed. In the above analysis, the support bearing flexibility on critical speed prediction is also considered. Based on the study, a model is built with the optimum contour of flexible plate, for validation by experimental modal analysis. A good correlation between the theoretical prediction and model behavior is observed. From the study, it is found that the flexible plate’s contour is playing vital role in modification of system’s dynamic behavior and the present model can be extended for the development of similar type of flexible couplings for its computational simplicity and reliability.

Keywords: flexible rotor, critical speed, experimental modal analysis, high speed flexible coupling (HSFC), misalignment

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5496 Flame Volume Prediction and Validation for Lean Blowout of Gas Turbine Combustor

Authors: Ejaz Ahmed, Huang Yong

Abstract:

The operation of aero engines has a critical importance in the vicinity of lean blowout (LBO) limits. Lefebvre’s model of LBO based on empirical correlation has been extended to flame volume concept by the authors. The flame volume takes into account the effects of geometric configuration, the complex spatial interaction of mixing, turbulence, heat transfer and combustion processes inside the gas turbine combustion chamber. For these reasons, flame volume based LBO predictions are more accurate. Although LBO prediction accuracy has improved, it poses a challenge associated with Vf estimation in real gas turbine combustors. This work extends the approach of flame volume prediction previously based on fuel iterative approximation with cold flow simulations to reactive flow simulations. Flame volume for 11 combustor configurations has been simulated and validated against experimental data. To make prediction methodology robust as required in the preliminary design stage, reactive flow simulations were carried out with the combination of probability density function (PDF) and discrete phase model (DPM) in FLUENT 15.0. The criterion for flame identification was defined. Two important parameters i.e. critical injection diameter (Dp,crit) and critical temperature (Tcrit) were identified, and their influence on reactive flow simulation was studied for Vf estimation. Obtained results exhibit ±15% error in Vf estimation with experimental data.

Keywords: CFD, combustion, gas turbine combustor, lean blowout

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5495 Impact of the Action Antropic in the Desertification of Steppe in Algeria

Authors: Kadi-Hanifi Halima

Abstract:

Stipa tenacissima is a plant with a big ecological value (against desertification) and economical stake (paper industry). It is important by its pastoral value due to the inflorescence. It occupied large areas between the Tellian atlas and the Saharian atlas, at the present, these areas of alfa have regressed a lot. This regression is estimated at 1% per year. The principal cause is a human responsibility. The drought is just an aggravating circumstance. The eradication of such a kind of species will have serious consequences upon the equilibrium of all the steppic ecosystem. Thus, we have thought necessary and urgent to know the alfa ecosystem, under all its aspects (climatic, floristic, and edaphic), this diagnostic could direct the fight actions against desertification

Keywords: desertification, anthropic action, soils, Stipa tenacissima

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5494 Identity (Mis)Representation and Ideological Struggles in Discourses on Boko Haram in Nigeria

Authors: Temitope Ogungbemi

Abstract:

Jama'atu Ahlis Sunna Lidda'awati wal-Jihad (also called Boko Haram) in the North-East of Nigeria has facilitated ideological binarity in discourses on the crisis. Since its proliferation, media representation of the crisis has facilitated identity contamination and ideological struggle through which other critical issues, such as religious intolerance, ethnic diversity and other forms of class conflict in the Nigerian state, are brought to public notice. Though Boko Haram insurgency is ideological laden, the manifestation of the inherent ideologies requires extensive scholarly attention in order deconstruct the veiled ideologies. Therefore, the thrust of this study is to critically investigate identity (mis)representation as a basis for ideological mapping in discourses on Boko Haram in Nigeria, adopting critical discourse analytical tools supported with insights from systemic functional linguistics and critical discourse analysis. The data for this study consist of articles on Boko Haram in Nigerian newspapers published in English. The data selection is purposive and aimed at responding to challenges that are inherent in Nigeria's multifaithism and multiculturalism, and their effects on the construction of narratives on Boko Haram. The study reveals that identity manipulation is a constructive device for ideological mapping, realised through labeling, agency activation, and transitivity. Identity representation in discourses on Boko Haram depicted four dichotomous binarities using exclusion, generalisation, contrasting and attribution.

Keywords: identity representation, ideology, Boko Haram, newspapers

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5493 Attention Deficit Disorders (ADD) among Stressed Pre-NCE Students in Federal College of Education, Kano-Nigeria

Authors: A. S. Haruna, M. L. Mayanchi

Abstract:

Pre Nigeria Certificate in Education otherwise called Pre-NCE is an intensive two semester course designed to assist candidates who could not meet the requirements for admission into NCE programme. The task of coping with the stressors in the course can interfere with the students’ ability to regulate attention skills and stay organized. The main objectives of the study were to find out the prevalence of stress; determine the association between stress and ADD and reveal gender difference in the prevalence of ADD among stressed pre-NCE students. Cross–Sectional Correlation Design was employed in which 333 (Male=65%; Female=35%) students were proportionately sampled and administered Stress Assessment Scale [SAS r=0.74) and those identified with stress were thereafter rated with Cognitive Processing Inventory [CPI]. Data collected was used to analyze the three null hypotheses through One-sample Kolmogorov-Smirnov (K-S) Z-score, Pearson Product Moment Correlation Coefficients (PPMCC) and t-test statistics respectively at 0.05 confidence level. Results revealed significant prevalence of stress [Z-calculated =2.24; Z-critical = ±1.96], and a positive relationship between Stress and ADD among Pre-NCE students [r-calculated =0.450; r-critical =0.138]. However, there was no gender difference in the prevalence of ADD among stressed Pre-NCE students in the college [t-calculated =1.49; t-critical =1.645]. The study concludes that while stress and ADD prevail among pre-NCE students, there was no gender difference in the prevalence of ADD. Recommendations offered suggest the use of Learners Assistance Programs (LAP) for stress management, and Teacher-Students ratio of 1:25 be adopted in order to cater for stressed pre-NCE students with ADD.

Keywords: attention deficit disorder, pre-NCE students, stress, Pearson Product Moment Correlation Coefficients (PPMCC)

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5492 Students’ and Clinical Supervisors’ Experiences of Occupational Therapy Practice Education: A Structured Critical Review

Authors: Hamad Alhamad, Catriona Khamisha, Emma Green, Yvonne Robb

Abstract:

Introduction: Practice education is a key component of occupational therapy education. This critical review aimed to explore students’ and clinical supervisors’ experiences of practice education, and to make recommendations for research. Method: The literature was systematically searched using five databases. Qualitative, quantitative and mixed methods studies were included. Critical Appraisal Skills Programme checklist for qualitative studies and Mixed Methods Assessment Tool for quantitative and mixed methods studies were used to assess study quality. Findings: Twenty-two studies with high quality scores were included: 16 qualitative, 3 quantitative and 3 mixed methods. Studies were conducted in Australia, Canada, USA and UK. During practice education, students learned professional skills, practical skills, clinical skills and problem-solving skills, and improved confidence and creativity. Supervisors had an opportunity to reflect on their practice and get experience of supervising students. However, clear objectives and expectations for students, and sufficient theoretical knowledge, preparation and resources for supervisors were required. Conclusion: Practice education provides different skills and experiences, necessary to become competent professionals; but some areas of practice education need to improve. Studies in non-western countries are needed to explore the perspectives of students and clinical supervisors in different cultures, to ensure the practice education models adopted are relevant.

Keywords: occupational therapy, practice education, fieldwork, students, clinical supervisors

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5491 Critical and Strategic Issues in Compensation, Staffing and Personnel Management in Nigeria

Authors: Shonuga Olajumoke Adedoyinsola

Abstract:

Staffing and Compensation are at the core of any employment exchange, and they serve as the defining characteristics of any employment relationship. Most organizations understand the benefits that a longer term approach to staff planning can bring and the answer to this problem lies not in trying to implement the traditional approach more effectively, but in implementing a completely different kind of process for strategic staffing. The study focuses on critical points of compensation, staffing and personnel management. The fundamentals of these programs include the elements of vision, potential, communication and motivation. The aim of the paper is to identify the most important attributes of compensation and incentives, staffing and personnel management. Research method is the analysis and synthesis of scientific literature, logical, comparative and graphic representation. On the basis of analysis, the author presents the models of these systems for positive employee attitudes and behaviors.

Keywords: compensation, employees, incentives, staffing, personnel management

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5490 Gadolinium-Based Polymer Nanostructures as Magnetic Resonance Imaging Contrast Agents

Authors: Franca De Sarno, Alfonso Maria Ponsiglione, Enza Torino

Abstract:

Recent advances in diagnostic imaging technology have significantly contributed to a better understanding of specific changes associated with diseases progression. Among different imaging modalities, Magnetic Resonance Imaging (MRI) represents a noninvasive medical diagnostic technique, which shows low sensitivity and long acquisition time and it can discriminate between healthy and diseased tissues by providing 3D data. In order to improve the enhancement of MRI signals, some imaging exams require intravenous administration of contrast agents (CAs). Recently, emerging research reports a progressive deposition of these drugs, in particular, gadolinium-based contrast agents (GBCAs), in the body many years after multiple MRI scans. These discoveries confirm the need to have a biocompatible system able to boost a clinical relevant Gd-chelate. To this aim, several approaches based on engineered nanostructures have been proposed to overcome the common limitations of conventional CAs, such as the insufficient signal-to-noise ratios due to relaxivity and poor safety profile. In particular, nanocarriers, labeling or loading with CAs, capable of carrying high payloads of CAs have been developed. Currently, there’s no a comprehensive understanding of the thermodynamic contributions enable of boosting the efficacy of conventional CAs by using biopolymers matrix. Thus, considering the importance of MRI in diagnosing diseases, here it is reported a successful example of the next generation of these drugs where the commercial gadolinium chelate is incorporate into a biopolymer nanostructure, formed by cross-linked hyaluronic acid (HA), with improved relaxation properties. In addition, they are highlighted the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA by adopting a multidisciplinary experimental approach. On the basis of these discoveries, it is clear that the main point consists in increasing the rigidification of readily-available Gd-CAs within the biopolymer matrix by controlling the water dynamics, the physicochemical interactions, and the polymer conformations. In the end, the acquired knowledge about polymer-CA systems has been applied to develop of Gd-based HA nanoparticles with enhanced relaxometric properties.

Keywords: biopolymers, MRI, nanoparticles, contrast agent

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5489 Epidemiological Patterns of Pediatric Fever of Unknown Origin

Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

Abstract:

Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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5488 Expert and Novice Problem-Solvers Differences: A Discourse for Effective Teaching Delivery in Physics Classrooms

Authors: Abubakar Sa’adatu Mohammed

Abstract:

This paper reports on a study of problem solving differences between expert and novice Problem solvers for effective physics teaching. Significant differences were found both at the conceptual level and at the level of critical thinking, creative thinking and reasoning. It is suggested for a successful solution of a problem, conceptual knowledge alone may not be sufficient. There is the need of the knowledge of how the conceptual knowledge should be applied (problem solving skills). It is hoped that this research might contribute to efforts of exploring ways for students to acquire a powerful conceptual toolkit based on experts like problem solvers approach for effective teaching delivery.

Keywords: conceptual knowledge, procedural knowledge, critical thinking, creative thinking, reasoning ability

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5487 Developing a Staff Education Program on Subglottic Suction Endotracheal Tubes

Authors: Emily Toon

Abstract:

Nurses play a critical role in the prevention of ventilator-associated pneumonia through the maintenance of endotracheal tubes and use of subglottic secretion drainage via subglottic suctioning endotracheal tubes. The purpose of this evidence based practice project is to develop a staff education program on subglottic suctioning endotracheal tubes for critical care nurses at Middlesex Health with the aim of determining and documenting increased knowledge and/or practice change. The setting included registered nurses within Middlesex Health’s critical care unit who were recruited to complete a pre-test (n=14), view a presentation, and complete a post-test (n=10). Average pre-test scores were compared to average post-test scores to determine an increase in knowledge and/or practice change. The overall mean pre-test score was 59.7 percent, compared with the mean post-test score of 88.1 percent. Pre- and post-test scores were unmatched, so statistical significance could not be determined. The hypothesis that a staff education program on subglottic suctioning endotracheal tubes would demonstrate an increase in knowledge was supported, but not statistically. By integrating a pre-test/post-test design into educational presentations to evaluate increased knowledge, data generated may be used to improve methods and practices of delivering education and enhance staff learning.

Keywords: endotracheal tubes, staff education, subglottic secretion drainage, ventilator-associated pneumonia

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5486 Upon One Smoothing Problem in Project Management

Authors: Dimitri Golenko-Ginzburg

Abstract:

A CPM network project with deterministic activity durations, in which activities require homogenous resources with fixed capacities, is considered. The problem is to determine the optimal schedule of starting times for all network activities within their maximal allowable limits (in order not to exceed the network's critical time) to minimize the maximum required resources for the project at any point in time. In case when a non-critical activity may start only at discrete moments with the pregiven time span, the problem becomes NP-complete and an optimal solution may be obtained via a look-over algorithm. For the case when a look-over requires much computational time an approximate algorithm is suggested. The algorithm's performance ratio, i.e., the relative accuracy error, is determined. Experimentation has been undertaken to verify the suggested algorithm.

Keywords: resource smoothing problem, CPM network, lookover algorithm, lexicographical order, approximate algorithm, accuracy estimate

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5485 Critical Factors Affecting the Implementation of Total Quality Management in the Construction Industry in U. A. E.

Authors: Firas Mohamad Al-Sabek

Abstract:

The Purpose of the paper is to examine the most critical and important factor which will affect the implementation of Total Quality Management (TQM) in the construction industry in the United Arab Emirates. It also examines the most effected Project outcome from implementing TQM. A framework was also proposed depending on the literature studies. The method used in this paper is a quantitative study. A survey with a sample of 60 respondents was created and distributed in a construction company in Abu Dhabi, which includes 15 questions to examine the most critical factor that will affect the implementation of TQM in addition to the most effected project outcome from implementing TQM. The survey showed that management commitment is the most important factor in implementing TQM in a construction company. Also it showed that Project cost is most effected outcome from the implementation of TQM. Management commitment is very important for implementing TQM in any company. If the management loose interest in quality then everyone in the organization will do so. The success of TQM will depend mostly on the top of the pyramid. Also cost is reduced and money is saved when the project team implement TQM. While if no quality measures are present within the team, the project will suffer a commercial failure. Based on literature, more factors can be examined and added to the model. In addition, more construction companies could be surveyed in order to obtain more accurate results. Also this study could be conducted outside the United Arab Emirates for further enchantment.

Keywords: construction project, total quality management, management commitment, cost, theoretical framework

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5484 Dynamic Test for Stability of Bar Loaded by a Compression Force Directed Towards the Pole

Authors: Elia Efraim, Boris Blostotsky

Abstract:

The phenomenon of buckling of structural elements under compression is revealed in many cases of loading and found consideration in many structures and mechanisms. In the present work the method and results of dynamic test for buckling of bar loaded by a compression force directed towards the pole are considered. Experimental determination of critical force for such system has not been made previously. The tested object is a bar with semi-rigid connection to the base at one of its ends, and with a hinge moving along a circle at the other. The test includes measuring the natural frequency of the bar at different values of compression load. The lateral stiffness is calculated based on natural frequency and reduced mass on the bar's movable end. The critical load is determined by extrapolation the values of lateral stiffness up to zero value. For the experimental investigation the special test-bed was created that allows the stability testing at positive and negative curvature of the movable end's trajectory, as well as varying the rotational stiffness of the other end connection. Decreasing a friction at the movable end allows extend the diapason of applied compression force. The testing method includes : - methodology of the experiment planning, that allows determine the required number of tests under various loads values in the defined range and the type of extrapolating function; - methodology of experimental determination of reduced mass at the bar's movable end including its own mass; - methodology of experimental determination of lateral stiffness of uncompressed bar rotational semi-rigid connection at the base. For planning the experiment and for comparison of the experimental results with the theoretical values of critical load, the analytical dependencies of lateral stiffness of the bar with defined end conditions on compression load. In the particular case of perfectly rigid connection of the bar to the base, the critical load value corresponds to solution by S.P. Timoshenko. Correspondence of the calculated and experimental values was obtained.

Keywords: buckling, dynamic method, end-fixity factor, force directed towards a pole

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5483 An Unusual Cause of Electrocardiographic Artefact: Patient's Warming Blanket

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

Abstract:

In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

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5482 Comparison of Stereotactic Body Radiation Therapy Virtual Treatment Plans Obtained With Different Collimators in the Cyberknife System in Partial Breast Irradiation: A Retrospective Study

Authors: Öznur Saribaş, Si̇bel Kahraman Çeti̇ntaş

Abstract:

It is aimed to compare target volume and critical organ doses by using CyberKnife (CK) in accelerated partial breast irradiation (APBI) in patients with early stage breast cancer. Three different virtual plans were made for Iris, fixed and multi-leaf collimator (MLC) for 5 patients who received radiotherapy in the CyberKnife system. CyberKnife virtual plans were created, with 6 Gy per day totaling 30 Gy. Dosimetric parameters for the three collimators were analyzed according to the restrictions in the NSABP-39/RTOG 0413 protocol. The plans ensured critical organs were protected and GTV received 95 % of the prescribed dose. The prescribed dose was defined by the isodose curve of a minimum of 80. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses taken by critical organs were compared. As a result of the comparison of the plans, a significant difference was found for the duration of treatment, MU. However, no significant difference was found for HI, CI. V30 and V15 values of the ipsi-lateral breast were found in the lowest MLC. There was no significant difference between Dmax values for lung and heart. However, the mean MU and duration of treatment were found in the lowest MLC. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contralateral lung doses were the lowest in the Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. The use of fixed collimators may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization.

Keywords: APBI, CyberKnife, early stage breast cancer, radiotherapy.

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5481 Implementing Total Quality Management in Higher Education

Authors: Abbos Utkirov

Abstract:

Total Quality Management (TQM) in the context of educational institutions requires careful planning and the implementation of an annual quality program to achieve its vision effectively. By applying TQM concepts, the higher education system can experience significant improvements. This study aims to examine TQM in higher education, focusing on Critical Success Factors (CSF) and their implementation across all areas. The study ultimately concludes that CSF and their execution play a crucial role in higher education institutions. Some institutions have already benefited from TQM methods by dedicating themselves to the system and using it to achieve their objectives. Through this review, recent studies shed light on how the TQM system can employ various strategies and hypotheses to empower employees, foster a positive and supportive environment, and emphasize the importance of enabling students to unleash their full potential.

Keywords: total quality management (TQM), critical success factor (CSF), organizational performance, quality management practices

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5480 Discursive Construction of Strike in the Media Coverage of Academic Staff Union of Universities vs Federal Government of Nigeria Industrial Conflict of 2013

Authors: Samuel Alaba Akinwotu

Abstract:

Over the years, Nigeria’s educational system has greatly suffered from the menace of industrial conflict. The smooth running of the nation’s public educational institutions has been hampered by incessant strikes embarked upon by workers of these institutions. Even though industrial conflicts in Nigeria have enjoyed wide reportage in the media, there has been a dearth of critical examination of the language use that index the conflict’s discourse in the media. This study which is driven by a combination of Critical Discourse Analysis (CDA) and Conceptual Metaphor (CM) examines the discursive and ideological features of language indexing the industrial conflict between the Academic Staff Union of Universities (ASUU) and the Federal Government of Nigeria (FGN) in 2013. It aims to identify and assess the conceptual and cognitive motivations of the stances expressed by the parties and the public and the role of the media in the management and resolution of the conflict. For data, media reports and readers’ comments were purposively sampled from six print and online news sources (The Punch, This Day, Vanguard, The Nation, Osun Defender and AITonline) published between July and December 2013. The study provides further insight into industrial conflict and proves to be useful for the management and resolution of industrial conflicts especially in our public educational institutions.

Keywords: industrial conflict, critical discourse analysis, conceptual metaphor, federal government of Nigeria, academic staff union of universities

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5479 Direct Transient Stability Assessment of Stressed Power Systems

Authors: E. Popov, N. Yorino, Y. Zoka, Y. Sasaki, H. Sugihara

Abstract:

This paper discusses the performance of critical trajectory method (CTrj) for power system transient stability analysis under various loading settings and heavy fault condition. The method obtains Controlling Unstable Equilibrium Point (CUEP) which is essential for estimation of power system stability margins. The CUEP is computed by applying the CTrjto the boundary controlling unstable equilibrium point (BCU) method. The Proposed method computes a trajectory on the stability boundary that starts from the exit point and reaches CUEP under certain assumptions. The robustness and effectiveness of the method are demonstrated via six power system models and five loading conditions. As benchmark is used conventional simulation method whereas the performance is compared with and BCU Shadowing method.

Keywords: power system, transient stability, critical trajectory method, energy function method

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5478 Evaluation of Hydrocarbons in Tissues of Bivalve Mollusks from the Red Sea Coast

Authors: Asma Ahmed Aljohani, Mohammed Orif

Abstract:

The concentration of polycyclic aromatic hydrocarbons (PAH) in clam (A. glabrata) was examined in samples collected from Alseef Beach, 30 km south of Jeddah city. Gas chromatography-mass spectrometry (GC-MS) was used to analyse the 14 PAHs. The concentration of total PAHs was found to range from 11.521 to 40.149 ng/gdw with a mean concentration of 21.857 ng/gdw, which is lower compared to similar studies. The lower molecular weight PAHs with three rings comprised 18.14% of the total PAH concentrations in the clams, while the high molecular weight PAHs with four rings, five rings, and six rings account for 81.86%. Diagnostic ratios for PAH source distinction suggested pyrogenic or anthropogenic sources.

Keywords: bivalves, biomonitoring, hydrocarbons, PAHs

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5477 Oriental Tradition, Taoism:A Critical Option for Peace Building Initiative in the Contemporary Society

Authors: Kingsley Okoro Nwannennaya

Abstract:

The 21st century seems to have been eclipsed by social conflict, giving vent to a mentality construct that accepts conflict as inextricable part of the social system. This is justified by the escalation of conflict in all the zones of the world. We therefore, query whether a peaceful society is a mere illusion? It is in an attempt to give lucid answer to this question that the researcher began critical investigations on various peace building and conflict management models. Here the researcher discovered that these models as good as they may be have not addressed the root of conflicts which revolves on the social structure in place in any society. Hence the current social structure is organized around class system, which gave birth to competition, greed, selfishness, power struggle etc. and also promotes mono-culture based on Euro-American traditions. This placed some cultures on a disadvantageous position, with conflict as its outgrowth. However, the researcher being interested to finding a peace building and conflict management model that will address this gap discovered that Taoism has the seed that can offer the world the desired peace. This tradition anchors on the principles of Tao, Yin-yang and Wu-wei. Basic to the trio concepts are the idea of Pluralism, non-interference, non-action and flowing with the order of nature. This paper, having adopted, historical and sociological methods of investigations opines that if Taoist tradition shall be adopted as a peace building model, the desired peace of our dream shall soon become a reality.

Keywords: critical option, oriental traditions, peace initiative, taoism

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5476 Practical Method for Failure Prediction of Mg Alloy Sheets during Warm Forming Processes

Authors: Sang-Woo Kim, Young-Seon Lee

Abstract:

An important concern in metal forming, even at elevated temperatures, is whether a desired deformation can be accomplished without any failure of the material. A detailed understanding of the critical condition for crack initiation provides not only the workability limit of a material but also a guide-line for process design. This paper describes the utilization of ductile fracture criteria in conjunction with the finite element method (FEM) for predicting the onset of fracture in warm metal working processes of magnesium alloy sheets. Critical damage values for various ductile fracture criteria were determined from uniaxial tensile tests and were expressed as the function of strain rate and temperature. In order to find the best criterion for failure prediction, Erichsen cupping tests under isothermal conditions and FE simulations combined with ductile fracture criteria were carried out. Based on the plastic deformation histories obtained from the FE analyses of the Erichsen cupping tests and the critical damage value curves, the initiation time and location of fracture were predicted under a bi-axial tensile condition. The results were compared with experimental results and the best criterion was recommended. In addition, the proposed methodology was used to predict the onset of fracture in non-isothermal deep drawing processes using an irregular shaped blank, and the results were verified experimentally.

Keywords: magnesium, AZ31 alloy, ductile fracture, FEM, sheet forming, Erichsen cupping test

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5475 The Factors for Developing Trainers in Auto Parts Manufacturing Factories at Amata Nakon Industrial Estate in Cholburi Province

Authors: Weerakarj Dokchan

Abstract:

The purposes of this research are to find out the factors for developing trainers in the auto part manufacturing factories (AMF) in Amata Nakon Industrial Estate Cholburi. Population in this study included 148 operators to complete the questionnaires and 10 trainers to provide the information on the interview. The research statistics consisted of percentage, mean, standard deviation and step-wise multiple linear regression analysis.The analysis of the training model revealed that: The research result showed that the development factors of trainers in AMF consisted of 3 main factors and 8 sub-factors: 1) knowledge competency consisting of 4 sub-factors; arrangement of critical thinking, organizational loyalty, working experience of the trainers, analysis of behavior, and work and organization loyalty which could predict the success of the trainers at 55.60%. 2) Skill competency consisted of 4 sub-factors, arrangement of critical thinking, organizational loyalty and analysis of behavior and work and the development of emotional quotient. These 4 sub-factors could predict the success of the trainers in skill aspect 55.90%. 3) The attitude competency consisted of 4 sub-factors, arrangement of critical thinking, intention of trainee computer competency and teaching psychology. In conclusion, these 4 sub-factors could predict the success of the trainers in attitude aspect 58.50%.

Keywords: the development factors, trainers development, trainer competencies, auto part manufacturing factory (AMF), AmataNakon Industrial Estate Cholburi

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5474 Acoustic Analysis of Psycho-Communication Disorders within Moroccan Students

Authors: Brahim Sabir

Abstract:

Psycho-Communication disorders negatively affect the academic curriculum for students in higher education. Thus, understanding these disorders, their causes and effects will give education specialists a tool for the decision, which will lead to the resolution of problems related to the integration of students with Psycho-Communication disorders. It is in this context that a statistical study was conducted, targeting the population object of study, namely Moroccan students. Pathological voice samples were recorded and analyzed acoustically with PRAAT software, in order to build a model that will be the basis for the objective diagnostic.

Keywords: psycho-communication disorders, acoustic analysis, PRAAT

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5473 Counter-Terrorism Policies in the Wider Black Sea Region: Evaluating the Robustness of Constantza Port under Potential Terror Attacks

Authors: A. V. Popa, C. Barna, V. Mihalache

Abstract:

Being the largest port at the Black Sea and functioning as a civil and military nodal point between Europe and Asia, Constantza Port has become a potential target on the terrorist international agenda. The authors use qualitative research based on both face-to-face and online semi-structured interviews with relevant stakeholders (top decision-makers in the Romanian Naval Authority, Romanian Maritime Training Centre, National Company "Maritime Ports Administration" and military staff) in order to detect potential vulnerabilities which might be exploited by terrorists in the case of Constantza Port. Likewise, this will enable bringing together the experts’ opinions on potential mitigation measures. Subsequently, this paper formulates various counter-terrorism policies to enhance the robustness of Constantza Port under potential terror attacks and connects them with the attributions in the field of critical infrastructure protection conferred by the law to the lead national authority for preventing and countering terrorism, namely the Romanian Intelligence Service. Extending the national counterterrorism efforts to an international level, the authors propose the establishment – among the experts of the NATO member states of the Wider Black Sea Region – of a platform for the exchange of know-how and best practices in the field of critical infrastructure protection.

Keywords: Constantza Port, counter-terrorism policies, critical infrastructure protection, security, Wider Black Sea Region

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5472 Ischemic Stroke Detection in Computed Tomography Examinations

Authors: Allan F. F. Alves, Fernando A. Bacchim Neto, Guilherme Giacomini, Marcela de Oliveira, Ana L. M. Pavan, Maria E. D. Rosa, Diana R. Pina

Abstract:

Stroke is a worldwide concern, only in Brazil it accounts for 10% of all registered deaths. There are 2 stroke types, ischemic (87%) and hemorrhagic (13%). Early diagnosis is essential to avoid irreversible cerebral damage. Non-enhanced computed tomography (NECT) is one of the main diagnostic techniques used due to its wide availability and rapid diagnosis. Detection depends on the size and severity of lesions and the time spent between the first symptoms and examination. The Alberta Stroke Program Early CT Score (ASPECTS) is a subjective method that increases the detection rate. The aim of this work was to implement an image segmentation system to enhance ischemic stroke and to quantify the area of ischemic and hemorrhagic stroke lesions in CT scans. We evaluated 10 patients with NECT examinations diagnosed with ischemic stroke. Analyzes were performed in two axial slices, one at the level of the thalamus and basal ganglion and one adjacent to the top edge of the ganglionic structures with window width between 80 and 100 Hounsfield Units. We used different image processing techniques such as morphological filters, discrete wavelet transform and Fuzzy C-means clustering. Subjective analyzes were performed by a neuroradiologist according to the ASPECTS scale to quantify ischemic areas in the middle cerebral artery region. These subjective analysis results were compared with objective analyzes performed by the computational algorithm. Preliminary results indicate that the morphological filters actually improve the ischemic areas for subjective evaluations. The comparison in area of the ischemic region contoured by the neuroradiologist and the defined area by computational algorithm showed no deviations greater than 12% in any of the 10 examination tests. Although there is a tendency that the areas contoured by the neuroradiologist are smaller than those obtained by the algorithm. These results show the importance of a computer aided diagnosis software to assist neuroradiology decisions, especially in critical situations as the choice of treatment for ischemic stroke.

Keywords: ischemic stroke, image processing, CT scans, Fuzzy C-means

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5471 Potential of Landslides Based On Maximum Monthly Rainfall in Sumber Sari Village Watershed Tirtomoyo Wonogiri Indonesia

Authors: Heny Pratiwi, Niken Silmi Surjandari, Noegroho Djarwanti

Abstract:

This study was conducted to determine the potential for landslides as a result of monthly rainfall in a watershed. Rainfall data that will be used is rainfall from years 2007-2011. Research methods created by modeling the slope on some variation of angle in a row 30◦, 45◦, and 60◦ with a homogeneous layer of soil. Slope Stability Analysis using Method Fellenius. The results of the slope stability analysis without rain on slope 30◦, 45◦, and 60◦ respectively 1.3846, 1.0115, and 0.7284. Results in the absence of rain showed that the slope on the slope 45◦ are in critical condition and on a slope with a slope 60◦ already avalanche with safety factor value <1. The results in the rainy conditions shows slopes 30◦ are in critical condition with a value factor <1 due to the intensity of monthly rainfall> 250 mm/month.

Keywords: slope stability, monthly rainfall, infiltration, safety factor, Fellenius method

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5470 An Audit of the Diagnosis of Asthma in Children in Primary Care and the Emergency Department

Authors: Abhishek Oswal

Abstract:

Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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