Search results for: statistical randomness tests

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

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The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

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Authors: Vibha Devi, Shabina Khanam

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Hemp (Cannabis sativa) possesses a rich content of ω-6 linoleic and ω-3 linolenic essential fatty acid in the ratio of 3:1, which is a rare and most desired ratio that enhances the quality of hemp oil. These components are beneficial for the development of cell and body growth, strengthen the immune system, possess anti-inflammatory action, lowering the risk of heart problem owing to its anti-clotting property and a remedy for arthritis and various disorders. The present study employs supercritical fluid extraction (SFE) approach on hemp seed at various conditions of parameters; temperature (40 - 80) °C, pressure (200 - 350) bar, flow rate (5 - 15) g/min, particle size (0.430 - 1.015) mm and amount of co-solvent (0 - 10) % of solvent flow rate through central composite design (CCD). CCD suggested 32 sets of experiments, which was carried out. As SFE process includes large number of variables, the present study recommends the application of resampling techniques for cross-validation of the obtained data. Cross-validation refits the model on each data to achieve the information regarding the error, variability, deviation etc. Bootstrap and jackknife are the most popular resampling techniques, which create a large number of data through resampling from the original dataset and analyze these data to check the validity of the obtained data. Jackknife resampling is based on the eliminating one observation from the original sample of size N without replacement. For jackknife resampling, the sample size is 31 (eliminating one observation), which is repeated by 32 times. Bootstrap is the frequently used statistical approach for estimating the sampling distribution of an estimator by resampling with replacement from the original sample. For bootstrap resampling, the sample size is 32, which was repeated by 100 times. Estimands for these resampling techniques are considered as mean, standard deviation, variation coefficient and standard error of the mean. For ω-6 linoleic acid concentration, mean value was approx. 58.5 for both resampling methods, which is the average (central value) of the sample mean of all data points. Similarly, for ω-3 linoleic acid concentration, mean was observed as 22.5 through both resampling. Variance exhibits the spread out of the data from its mean. Greater value of variance exhibits the large range of output data, which is 18 for ω-6 linoleic acid (ranging from 48.85 to 63.66 %) and 6 for ω-3 linoleic acid (ranging from 16.71 to 26.2 %). Further, low value of standard deviation (approx. 1 %), low standard error of the mean (< 0.8) and low variance coefficient (< 0.2) reflect the accuracy of the sample for prediction. All the estimator value of variance coefficients, standard deviation and standard error of the mean are found within the 95 % of confidence interval.

Keywords: resampling, supercritical fluid extraction, hemp oil, cross-validation

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Authors: Zaima Umar, Anas S. Qureshi, Adeel Sarfraz, Saqib Umar, Talha Umar, Muhammad Usman

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Ostrich has been a good source of food and income for people across the world. To get a better understanding of health and health-related problems, the knowledge of its digestive system is of utmost importance. The present study was conducted to determine the morphological and histometrical variations in the digestive system and associated glands of ostrich (Struthio camelus) as regard to the gender and progressive age. A total of 40 apparently healthy ostriches of both genders and two progressive age groups; young one (less than two year, group A); and adult (2-15 years, group B) in equal number were used in this study. Digestive organs including tongue, esophagus, proventriculus, gizzard, small and large intestines and associated glands like liver and pancreas were collected immediately after slaughtering the birds. The organs of the digestive system and associated glands of each group were studied grossly and histologically. Grossly colour, shape consistency, weight and various dimensions (length, width, and circumference) of organs of the digestive tract and associated glands were recorded. The mean (± SEM) of all gross anatomical parameters in group A were significantly (p ≤ 0.01) different from that of group B. For microscopic studies, 1-2 cm tissue samples of organs of the digestive system and associated glands were taken. The tissue was marked and fixed in the neutral buffer formaldehyde solution for histological studies. After fixation, the sections of 5-7 µm were cut and stained by haematoxylin and eosin stain. All the layers (epithelium, lamina propria, lamina muscularis, submucosa and tunica muscularis) were measured (µm) with the help of automated computer software Image J®. The results of this study provide valuable information on the gender and age-related histological and histometrical variations in the digestive organs of ostrich (Struthio camelus). The microscopic studies of different parts of the digestive system revealed highly significant differences (p ≤ 0.01) among the two groups. The esophagus was lined by non-keratinized stratified squamous epithelium. The duodenum, jejunum, and ileum showed similar histological structures. Statistical analysis revealed significant (p ≤ 0.05) increase in the thickness of different tunics of the gastrointestinal tract in adult birds (up to 15 years) as compared with young ones (less than two years). Therefore, it can be concluded that there is a gradual but consistent growth in the observed digestive organs mimicking that of other poultry species and may be helpful in determining the growth pattern in this bird. However, there is a need to record the changes at closer time intervals.

Keywords: ostrich, digestive system, histomorphometry, grossly

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Authors: Nan Yang, Hye Pae

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English as a second language (ESL) learners are often observed to have transferred traits of their first languages (L1) and habits of using their L1s to their use of English (second language, L2), and this phenomenon is coined as language transfer. In addition to the transfer of linguistic features (e.g., grammar, vocabulary, etc.), which are relatively easy to observe and quantify, many cross-cultural theorists emphasized on a much subtle and fundamental transfer existing on a higher conceptual level that is referred to as conceptual transfer. Although a growing body of literature in linguistics has demonstrated evidence of L1 transfer in various discourse genres, very limited studies address the underlying conceptual transfer that is happening along with the language transfer, especially with the extended form of spontaneous discourses such as personal narrative. To address this issue, this study situates itself in the context of Chinese ESL learners’ written narratives, examines evidence of L1 conceptual transfer in comparison with native English speakers’ narratives, and provides discussion from the perspective of the conceptual transfer. It is hypothesized that Chinese ESL learners’ English narrative strategies are heavily influenced by the strategies that they use in Chinese as a result of the conceptual transfer. Understanding language transfer cognitively is of great significance in the realm of SLA, as it helps address challenges that ESL learners around the world are facing; allow native English speakers to develop a better understanding about how and why learners’ English is different; and also shed light in ESL pedagogy by providing linguistic and cultural expectations in native English-speaking countries. To achieve the goals, 40 college students were recruited (20 Chinese ESL learners and 20 native English speakers) in the United States, and their written narratives on the prompt 'The most frightening experience' were collected for quantitative discourse analysis. 40 written narratives (20 in Chinese and 20 in English) were collected from Chinese ESL learners, and 20 written narratives were collected from native English speakers. All written narratives were coded according to the coding scheme developed by the authors prior to data collection. Statistical descriptive analyses were conducted, and the preliminary results revealed that native English speakers included more narrative elements such as events and explicit evaluation comparing to Chinese ESL students’ both English and Chinese writings; the English group also utilized more evaluation device (i.e., physical state expressions, indirectly reported speeches, delineation) than Chinese ESL students’ both English and Chinese writings. It was also observed that Chinese ESL students included more orientation elements (i.e., the introduction of time/place, the introduction of character) in their Chinese and English writings than the native English-speaking participants. The findings suggest that a similar narrative strategy was observed in Chinese ESL learners’ Chinese narratives and English narratives, which is considered as the evidence of conceptual transfer from Chinese (L1) to English (L2). The results also indicate that distinct narrative strategies were used by Chinese ESL learners and native English speakers as a result of cross-cultural differences.

Keywords: Chinese ESL learners, language transfer, thinking-for-speaking, written narratives

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Authors: Sara A. Pakvis, Giulia Scalet, Stefania Marconi, Ferdinando Auricchio, Matthijs Langelaar

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In recent developments in the field of multi-material additive manufacturing, differences in material properties are exploited to create printed shape-memory structures, which are referred to as 4D-printed structures. New printing techniques allow for the deliberate introduction of prestresses in the specimen during manufacturing, and, in combination with the right design, this enables new functionalities. This research focuses on bi-polymer 4D-printed structures, where the transformation process is based on a heat-induced glass transition in one material lowering its Young’s modulus, combined with an initial prestress in the other material. Upon the decrease in stiffness, the prestress is released, which results in the realization of an essentially pre-programmed deformation. As the design of such functional multi-material structures is crucial but far from trivial, a systematic methodology to find the design of 4D-printed structures is developed, where a finite element model is combined with a density-based topology optimization method to describe the material layout. This modeling approach is verified by a convergence analysis and validated by comparing its numerical results to analytical and published data. Specific aspects that are addressed include the interplay between the definition of the prestress and the material interpolation function used in the density-based topology description, the inclusion of a temperature-dependent stiffness relationship to simulate the glass transition effect, and the importance of the consideration of geometric nonlinearity in the finite element modeling. The efficacy of topology optimization to design 4D-printed structures is explored by applying the methodology to a variety of design problems, both in 2D and 3D settings. Bi-layer designs composed of thermoplastic polymers are printed by means of the fused deposition modeling (FDM) technology. Acrylonitrile butadiene styrene (ABS) polymer undergoes the glass transition transformation, while polyurethane (TPU) polymer is prestressed by means of the 3D-printing process itself. Tests inducing shape transformation in the printed samples through heating are performed to calibrate the prestress and validate the modeling approach by comparing the numerical results to the experimental findings. Using the experimentally obtained prestress values, more complex designs have been generated through topology optimization, and samples have been printed and tested to evaluate their performance. This study demonstrates that by combining topology optimization and 4D-printing concepts, stimuli-responsive structures with specific properties can be designed and realized.

Keywords: 4D-printing, glass transition, shape memory polymer, topology optimization

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

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Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Abrar Almutairi, Alyaa Farouk, Amal Gouda

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Background: Social capital is a factor that helps in bonding in a social network. The individual and the neighborhood social capital affect the health status of members of a particular society. In addition, to the influence of social health on the health of the population, social health has a significant effect on women, especially those with pregnancy. Study objective was to assess the impact of the social capital on the health status of pregnant women Design: A descriptive crosssectional correlational design was utilized in this study. Methods: A convenient sample of 210 pregnant women who attended the outpatient antenatal clinicsfor follow-up in King Fahad hospital (Ministry of National Guard Health Affairs/Riyadh) and King Abdullah bin Abdelaziz University Hospital (KAAUH, Ministry of Education /Riyadh) were included in the study. Data was collected using a self-administered questionnaire that was developed by the researchers based on the “World Bank Social Capital Assessment Tool” and SF-36 questionnaire (Short Form Health Survey). The questionnaire consists of 4 parts to collect information regarding socio-demographic data, obstetric and gynecological history, general scale of health status and social activity during pregnancy and the social capital of the study participants, with different types of questions such as multiple-choice questions, polar questions, and Likert scales. Data analysis was carried out by using Statistical Package for the Social Sciences version 23. Descriptive statistic as frequency, percentage, mean, and standard deviation was used to describe the sample characteristics, and the simple linear regression test was used to assess the relationship between the different variables, with level of significance P≤0.005. Result: This study revealed that only 31.1% of the study participants perceived that they have good general health status. About two thirds (62.8%) of the participants have moderate social capital, more than one ten (11.2٪) have high social capital and more than a quarter (26%) of them have low social capital. All dimensions of social capital except for empowerment and political action had positive significant correlations with the health status of pregnant women with P value ranging from 0.001 to 0.010in all dimensions. In general, the social capital showed high statistically significant association with the health status of the pregnant (P=0.002). Conclusion: Less than one third of the study participants had good perceived health status, and the majority of the study participants have moderate social capital, with only about one ten of them perceived that they have high social capital. Finally, neighborhood residency area, family size, sufficiency of income, past medical and surgical history and parity of the study participants were all significantly impacting the assessed health domains of the pregnant women.

Keywords: impact, social capital, health status, pregnant women

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Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah

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Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.

Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Teruya Goto, Hokuto Chiba, Tatsuhiro Takahashi

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Carbon fiber reinforced thermoplastic resin using short carbon fiber has been produced by melt mixing and the improvement of mechanical properties has been frequently reported up to now. One of the most frequently reported enhancement has been seen in carbon fiber / polypropylene (PP) composites by adding small amount of maleic anhydride grafted polypropylene (MA-g-PP) into PP matrix. However, the further enhancement of tensile strength and tensile modules has been expected for lightning the composite more. Our present research aims to improve the mechanical property by using a highly reactive monolayer polymer, which can react with both COOH of carbon fiber surface and maleic anhydride of MA-g-PP in the matrix, on carbon fiber for PP/CF composite. It has been known that oxazoline has much higher reactivity with COOH without catalysts, compared with amine group and alcohol OH group. However, oxazoline group has not been used for the interface. To achieve the purpose, poly-2-vinyl-2-oxazoline (Pvozo), having highly reactivity with COOH and maleic anhydride, has been originally synthesized through radical polymerization using 2-vinyl-2-oxazoline as a monomer, resulting in the Mw around 140,000. Monolayer Pvozo chemically reacted on CF was prepared in 1-methoxy-2-propanol solution of Pvozo by heating at 100oC for 3 hours. After this solution treatment, unreacted Pvozo was completely washed out by methanol, resulting the uniform formation of the monolayer Pvozo on CF. Monolayer Pvozo coated CF was melt mixed by with PP and a small amount of MA-g-PP for the preparation of the composite samples using a batch type melt mixer. With performing the tensile strength tests of the composites, the tensile strength of CF/MA-g-PP/PP showed 40% increase, compared to that of CF/PP. While, that of Pvozo coated CF/MA-g-PP/PP exhibited 80% increase, compared to that of CF/PP. To get deeper insight of the dramatic increase, the weight percentage of chemically grafted polymer based on CF was evaluated by dissolving and removing the matrix polymer by xylene using by thermos gravimetric analysis (TGA). The chemically grafted remained polymer was found to be 0.69wt% in CF/PP, 0.98wt% in CF/MA-g-PP/PP, 1.51wt% in Pvozo coated CF/MA-g-PP/PP, suggesting that monolayer Pvozo contributed to the increase of the grafted polymer amount. In addition, the very strong adhesion by Pvozo was confirmed by observing the fractured cross-sectional surface of the composite by scanning electron micrograph (SEM). As a conclusion, the effectiveness of a highly reactive monolayer Pvozo on CF for the enhancement of the mechanical properties of CF/PP composite was demonstrated, which can be interpreted by the clear evidence of the increase of the grafting polymer on CF.

Keywords: CFRTP, interface, oxazoline, polymer graft, mechanical property

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Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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Authors: Saori Fujimoto, Hiromi Kawasaki, Mari Murakami, Yoko Ueno

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Background: Coronavirus disease (COVID-19) has been spreading throughout the world. In Japan, many nursing universities have conducted online clinical practices to secure students’ learning opportunities. In the field of women’s health nursing, even after the pandemic ended, it will be worthwhile to utilize online practice in declining birthrate and reducing the burden of mothers. This study examined the learning effects of conducting online visits for mothers with infants during the COVID-19 pandemic by nursing students to enhance the students’ ability to carry out the online practice even in ordinary times effectively. Methods: Students were divided into groups of three, and information on the mothers was assessed, and the visits were planned. After role-play was conducted by the students and teachers, an online visit was conducted. The analysis target was the self-evaluation score of nine students who conducted online visits in June 2020 and had consented to participate. The evaluation contents included three items for assessment, two items for planning, one item for ethical consideration, five items for nursing practice, and two items for evaluation. The self-evaluation score ranged from 4 (‘Can do with a little advice’) to 1 (‘Can’t do with a little advice’). A univariate statistical analysis was performed. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. Results: The items with the highest mean (standard deviation) scores were ‘advocates for the dignity and the rights of mothers’ (3.89 (0.31)) and ‘communication behavior needed to create a trusting relationship’ (3.89 (0.31)).’ Next were the ‘individual nursing practice tailored to mothers (3.78 (0.42))’ and ‘review own practice and work on own task (3.78 (0.42)).’ The mean (standard deviation) of the items by type were as follows: three assessment items, 3.26 (0.70), two planning items, 3.11 (0.49), one ethical consideration item, 3.89 (0.31), five nursing practice items, 3.56 (0.54), and two evaluation items, 3.67 (0.47). Conclusion: The highest self-evaluations were for ‘advocates for the dignity and the rights of mothers’ and ‘communication behavior needed to create a trusting relationship.’ These findings suggest that the students were able to form good relationships with the mothers by improving their ability to effectively communicate and by presenting a positive attitude, even when conducting health visits online. However, the self-evaluation scores for assessment and planning were lower than those of ethical consideration, nursing practice, and evaluation. This was most likely due to a lack of opportunities and time to gather information and the need to modify and add plans in a short amount of time during one online visit. It is necessary to further consider the methods used in conducting online visits from the following viewpoints: methods of gathering information and the ability to make changes through multiple visits.

Keywords: infants, learning effects, mothers, online visit practice

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

Procedia PDF Downloads 109

Authors: Saman Ahani, Aboozar Dehghan, Roham Vali, Hamid Salehian, Amin Ebrahimi

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Pulsed-wave (PW) doppler ultrasonography is a non-invasive, relatively accurate imaging technique that can measure blood speed. The imaging could be obtained via the common carotid artery, as one of the main vessels supplying the blood of vital organs. In horses, factors such as susceptibility to depression of the cardiovascular system and their large muscular mass have rendered them vulnerable to changes in blood speed. One of the most important factors causing blood velocity changes is the administration of anesthetic drugs, including Ketamine and Acepromazine. Thus, in this study, the Pulsed-wave doppler technique was performed to assess the highest blood velocity in the common carotid artery following administration of Ketamine and Acepromazine. Six male and six female healthy Kurdish horses weighing 351 ± 46 kg (mean ± SD) and aged 9.2 ± 1.7 years (mean ± SD) were housed under animal welfare guidelines. After fasting for six hours, the normal blood flow velocity in the common carotid artery was measured using a Pulsed-wave doppler ultrasonography machine (BK Medical, Denmark), and a high-frequency linear transducer (12 MHz) without applying any sedative drugs as a control group. The same procedure was repeated after each individual received the following medications: 1.1, 2.2 mg/kg Ketamine (Pfizer, USA), and 0.5, 1 mg/kg Acepromizine (RACEHORSE MEDS, Ukraine), with an interval of 21 days between the administration of each dose and/or drug. The ultrasonographic study was done five (T5) and fifteen (T15) minutes after injecting each dose intravenously. Lastly, the statistical analysis was performed using SPSS software version 22 for Windows and a P value less than 0.05 was considered to be statistically significant. Five minutes after administration of Ketamine (1.1, 2.2 mg/kg) in both male and female horses, the blood velocity decreased to 38.44, 34.53 cm/s in males, and 39.06, 34.10 cm/s in females in comparison to the control group (39.59 and 40.39 cm/s in males and females respectively) while administration of 0.5 mg/kg Acepromazine led to a significant rise (73.15 and 55.80 cm/s in males and females respectively) (p<0.05). It means that the most drastic change in blood velocity, regardless of gender, refers to the latter dose/drug. In both medications and both genders, the increase in doses led to a decrease in blood velocity compared to the lower dose of the same drug. In all experiments in this study, the blood velocity approached its normal value at T15. In another study comparing the blood velocity changes affected by Ketamine and Acepromazine through femoral arteries, the most drastic changes were attributed to Ketamine; however, in this experiment, the maximum blood velocity was observed following administration of Acepromazine via the common carotid artery. Therefore, further experiments using the same medications are suggested using Pulsed-wave doppler measuring the blood velocity changes in both femoral and common carotid arteries simultaneously.

Keywords: Acepromazine, common carotid artery, horse, ketamine, pulsed-wave doppler ultrasonography

Procedia PDF Downloads 106

Authors: M. S. Raza, A. Kapil, Sonu Tyagi, H. Gautam, S. Mohapatra, R. Chaudhry, S. Sood, V. Goyal, R. Lodha, V. Sreenivas, B. K. Das

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Background: Acute bacterial meningitis remains the major cause of mortality and morbidity. More than half of the survivors develop the significant lifelong neurological abnormalities. Diagnosis of the hospital acquired acute bacterial meningitis (HAABM) is challenging as it appears either in the post operative patients or patients acquire the organisms from the hospital environment. In both the situations, pathogens are exposed to high dose of antibiotics. Chances of getting multidrug resistance organism are very high. We have performed this experiment to find out the etiological agents of HAABM and its antibiotics susceptibility pattern. Methodology: A perspective study was conducted at the Department of Microbiology, All India Institute of Medical Sciences, New Delhi. From March 2015 to April 2018 total 400 Cerebro spinal fluid samples were collected aseptically. Samples were processed for cell count, Gram staining, and culture. Culture plates were incubated at 37°C for 18-24 hours. Organism grown on blood and MacConkey agar were identified by MALDI-TOF Vitek MS (BioMerieux, France) and antibiotic susceptibility tests were performed by Kirby Bauer disc diffusion method as per CLSI 2015 guideline. Results: Of the 400 CSF samples processed, 43 (10.75%) were culture positive for different bacteria. Out of 43 isolates, the most prevalent Gram-positive organisms were S. aureus 4 (9.30%) followed by E. faecium 3 (6.97%) & CONS 2 (4.65%). Similarly, E. coli 13 (30.23%) was the commonest Gram-negative isolates followed by A. baumannii 12 (27.90%), K. pneumonia 5 (11.62%) and P. aeruginosa 4(9.30%). Most of the antibiotics tested against the Gram-negative isolates were resistance to them. Colistin was most effective followed by Meropenem and Imepenim for all Gram-negative HAABM isolates. Similarly, most of antibiotics tested were susceptible to S. aureus and CONS. However, E. faecium (100%) were only susceptible to vancomycin and teicoplanin. Conclusion: Hospital acquired acute bacterial meningitis (HAABM) is becoming the emerging challenge as most of isolates are showing resistance to commonly used antibiotics. Gram-negative organisms are emerging as the major player of HAABM. Great care needs to be taken especially in tertiary care hospitals. Similarly, antibiotic stewardship should be followed and antibiotic susceptibility test (AST) should be performed regularly to update the antibiotic patter and to prevent from the emergence of resistance. Updated information of the AST will be helpful for the better management of the meningitis patient.

Keywords: CSF, MALDI-TOF, hospital acquired acute bacterial meningitis, AST

Procedia PDF Downloads 139

Authors: Mahsa Jalili, Essa Ehsan Khan, Signe Dille Lovmo, Augustine Akruwe, Egil Lien, Rolf Erik Olsen, Trygve Sigholt, Atle Magnus Bones

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Data from the Norwegian Directorate of Fisheries reported that >1.2 million tons of Atlantic salmon were produced in Norway aquaculture industry in 2016. Peroxisome proliferator-activated receptors (PPARs) are one of the key transcription factor families that respond to nutritional ligands. Recent studies have shown the connection between PPARs with lipid and carbohydrate metabolism in aquaculture. To our knowledge, there is no published data about the effects of krill meal, soybean meal, Bactocell ® and butyrate feedings compared to control group on PPARs gene and protein expressions in Atlantic salmon. Fish, 1year +postsmolt, average weight 250 gram were cultured for 12 weeks after acclimatization by control commercial feeding in 2 weeks after hatchery. Water oxygen rate, salinity, and temperature were monitored every second day. At the end of the trial, fish were taken from tanks randomly, and four replicates per group were collected and stored in -80 freezers until analysis. Total RNA extracted from posterior part of dorsal fin muscle tissues and Nanodrop and Bioanalyzer was used to check the quality of RNA. Gene expression of PPAR α, β and γ were determined by RT-PCR. The expression of genes of interest was measured relative to control group after normalization to three reference genes. Total protein concentration was calculated by Bradford method, and protein expression was determined with primary PPARγ antibody by western blot. All data were analyzed by ANOVA followed by Benjamini-Hochberg and Bonferroni tests. Probability values <0.05 considered significant. Bactocell® and butyrate groups showed significantly lower PPARα expression. PPARβ and γ were not significantly different among groups. PPARγ mRNA expression was approximately consistent with protein expression pattern, except than butyrate group showed lower mRNA level. The order of PPARγ expression was Bactocell® > soy meal > butyrate > krill meal > control respectively. PPARβ gene expression decreased more in soy meal > butyrate > krill meal > Bactocell® > control groups respectively. In conclusion, the increased expression of PPARγ and α is proposed to represent a reduction tendency of lipid storage in fish fed by Bactocell®, butyrate, soy and krill meal.

Keywords: aquaculture, blotting western, gene expression, krill protein extract, prebiotics, probiotics, Salmo salar

Procedia PDF Downloads 210

Authors: Umer Malik, David Armstrong, Mark Ashworth, Alex Dregan, Veline L'Esperance, Lucy McDonnell, Mariam Molokhia, Patrick White

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Introduction: The microbiota lining epithelial surfaces is thought to play an important role in many human physiological functions including defense against pathogens and modulation of immune response. The microbiota is susceptible to disruption from external influences such as exposure to antibiotic medication. It is thought that antibiotic-induced disruption of the microbiota could predispose to pathogen overgrowth and invasion. We hypothesized that antibiotic use would be associated with increased risk of future infections. We carried out a systematic review of evidence of associations between antibiotic use and subsequent risk of community-acquired infections. Methods: We conducted a review of the literature for observational studies assessing the association between antibiotic use and subsequent community-acquired infection. Eligible studies were published before April 29th, 2016. We searched MEDLINE, EMBASE, and Web of Science and screened titles and abstracts using a predefined search strategy. Infections caused by Clostridium difficile, drug-resistant organisms and fungal organisms were excluded as their association with prior antibiotic use has been examined in previous systematic reviews. Results: Eighteen out of 21,518 retrieved studies met the inclusion criteria. The association between past antibiotic exposure and subsequent increased risk of infection was reported in 16 studies, including one study on Campylobacter jejuni infection (Odds Ratio [OR] 3.3), two on typhoid fever (ORs 5.7 and 12.2), one on Staphylococcus aureus skin infection (OR 2.9), one on invasive pneumococcal disease (OR 1.57), one on recurrent furunculosis (OR 16.6), one on recurrent boils and abscesses (Risk ratio 1.4), one on upper respiratory tract infection (OR 2.3) and urinary tract infection (OR 1.1), one on invasive Haemophilus influenzae type b (Hib) infection (OR 1.51), one on infectious mastitis (OR 5.38), one on meningitis (OR 2.04) and five on Salmonella enteric infection (ORs 1.4, 1.59, 1.9, 2.3 and 3.8). The effect size in three studies on Salmonella enteric infection was of marginal statistical significance. A further two studies on Salmonella infection did not demonstrate a statistically significant association between prior antibiotic exposure and subsequent infection. Conclusion: We have found an association between past antibiotic exposure and subsequent risk of a diverse range of infections in the community setting. Our findings provide evidence to support the hypothesis that prior antibiotic usage may predispose to future infection risk, possibly through antibiotic-induced alteration of the microbiota. The findings add further weight to calls to minimize inappropriate antibiotic prescriptions.

Keywords: antibiotic, infection, risk factor, side effect

Procedia PDF Downloads 212

Authors: Hilal Keklicek, Fatih Erbahceci, Elif Kirdi, Ali Yalcin, Semra Topuz, Ozlem Ulger, Gul Sener

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Objectives and Goals: The stride-to-stride fluctuations in gait is a determinant of qualified locomotion as known as gait variability. Gait variability is an important predictive factor of fall risk and useful for monitoring the effects of therapeutic interventions and rehabilitation. Comparison of gait variability in individuals with trans-tibial lower limb loss and trans femoral lower limb loss was the aim of the study. Methods: Ten individuals with traumatic unilateral trans femoral limb loss(TF), 12 individuals with traumatic transtibial lower limb loss(TT) and 12 healthy individuals(HI) were the participants of the study. All participants were evaluated with treadmill. Gait characteristics including mean step length, step length variability, ambulation index, time on each foot of participants were evaluated with treadmill. Participants were walked at their preferred speed for six minutes. Data from 4th minutes to 6th minutes were selected for statistical analyses to eliminate learning effect. Results: There were differences between the groups in intact limb step length variation, time on each foot, ambulation index and mean age (p < .05) according to the Kruskal Wallis Test. Pairwise analyses showed that there were differences between the TT and TF in residual limb variation (p=.041), time on intact foot (p=.024), time on prosthetic foot(p=.024), ambulation index(p = .003) in favor of TT group. There were differences between the TT and HI group in intact limb variation (p = .002), time on intact foot (p<.001), time on prosthetic foot (p < .001), ambulation index result (p < .001) in favor of HI group. There were differences between the TF and HI group in intact limb variation (p = .001), time on intact foot (p=.01) ambulation index result (p < .001) in favor of HI group. There was difference between the groups in mean age result from HI group were younger (p < .05).There were similarity between the groups in step lengths (p>.05) and time of prosthesis using in individuals with lower limb loss (p > .05). Conclusions: The pilot study provided basic data about gait stability in individuals with traumatic lower limb loss. Results of the study showed that to evaluate the gait differences between in different amputation level, long-range gait analyses methods may be useful to get more valuable information. On the other hand, similarity in step length may be resulted from effective prosthetic using or effective gait rehabilitation, in conclusion, all participants with lower limb loss were already trained. The differences between the TT and HI; TF and HI may be resulted from the age related features, therefore, age matched population in HI were recommended future studies. Increasing the number of participants and comparison of age-matched groups also recommended to generalize these result.

Keywords: lower limb loss, amputee, gait variability, gait analyses

Procedia PDF Downloads 264

Authors: Jayeon Kim, Eunjung Yu, Taeki Yoon

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Most spontaneous miscarriage is believed to be a consequence of embryo aneuploidies. Transferring eukaryotic embryos selected by PGS is expected to decrease the miscarriage rate. Current PGS indications include advanced maternal age, recurrent pregnancy loss, repeated implantation failure. Recently, use of PGS for healthy women without above indications for the purpose of improving in vitro fertilization (IVF) outcomes is on the rise. However, it is still controversy about the beneficial effect of PGS in this population, especially, in women with a history of no more than 2 miscarriages or miscarriage of eukaryotic abortus. This study aimed to investigate if karyotyping result of abortus is a good indicator of preimplantation genetic screening (PGS) in subsequent IVF cycle in women with a history of spontaneous abortion. A single-center retrospective cohort study was performed. Women who had spontaneous abortion(s) (less than 3) and dilatation and evacuation, and subsequent IVF from January 2016 to November 2016 were included. Their medical information was extracted from the charts. Clinical pregnancy was defined as presence of a gestational sac with fetal heart beat detected on ultrasound in week 7. Statistical analysis was performed using SPSS software. Total 234 women were included. 121 out of 234 (51.7%) underwent karyotyping of the abortus, and 113 did not have the abortus karyotyped. Embryo biopsy was performed on 3 or 5 days after oocyte retrieval, followed by embryo transfer (ET) on a fresh or frozen cycle. The biopsied materials were subjected to microarray comparative genomic hybridization. Clinical pregnancy rate per ET was compared between PGS and non-PGS group in each study group. Patients were grouped by two criteria: karyotype of the abortus from previous miscarriage (unknown fetal karyotype (n=89, Group 1), eukaryotic abortus (n=36, Group 2) or aneuploidy abortus (n=67, Group 3)), and pursuing PGS in subsequent IVF cycle (pursuing PGS (PGS group, n=105) or not pursuing PGS (non-PGS group, n=87)). The PGS group was significantly older and had higher number of retrieved oocytes and prior miscarriages compared to non-PGS group. There were no differences in BMI and AMH level between those two groups. In PGS group, the mean number of transferable embryos (eukaryotic embryo) was 1.3 ± 0.7, 1.5 ± 0.5 and 1.4 ± 0.5, respectively (p = 0.049). In 42 cases, ET was cancelled because all embryos biopsied turned out to be abnormal. In all three groups (group 1, 2, and 3), clinical pregnancy rates were not statistically different between PGS and non-PGS group (Group 1: 48.8% vs. 52.2% (p=0.858), Group 2: 70% vs. 73.1% (p=0.730), Group 3: 42.3% vs. 46.7% (p=0.640), in PGS and non-PGS group, respectively). In both groups who had miscarriage with eukaryotic and aneuploidy abortus, the clinical pregnancy rate between IVF cycles with and without PGS was not different. When we compare miscarriage and ongoing pregnancy rate, there were no significant differences between PGS and non-PGS group in all three groups. Our results show that the routine application of PGS in women who had less than 3 miscarriages would not be beneficial, even in cases that previous miscarriage had been caused by fetal aneuploidy.

Keywords: preimplantation genetic diagnosis, miscarriage, kpryotyping, in vitro fertilization

Procedia PDF Downloads 161

Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

Procedia PDF Downloads 85

Authors: Sinem Bulkan

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This study introduces the construct of psychopathic manager behaviour and aims for the development of psychopathic manager behaviour (Psycho-Man B) measure. The study also aims for the understanding of the relationship between psychopathic manager behaviour and workplace deviance while investigating the mediating role of a revenge motive and the moderating roles of the core self-evaluations and the attitude importance. Data were collected from 519 employees from a wide variety of jobs and industries who currently work for or previously worked for a manager in a collectivist culture, Turkey. Psycho-Man B Measure was developed resulting in five dimensions as opposed to the proposed ten dimensions. Simple linear and hierarchical regression analyses were conducted to test the hypotheses. The results of simple linear regression analyses showed that psychopathic manager behaviour was positively significantly related to supervisor-directed and organisation-directed deviance. Revenge motive towards the manager partially mediated the relationship between psychopathic manager behaviour and supervisor-directed deviance. Similarly, revenge motive towards the organisation partially mediated the relationship between psychopathic manager behaviour and organisation-directed deviance. Furthermore, no support was found for the expected moderating role of core self-evaluations in the revenge motive towards the manager-supervisor-directed deviance and revenge motive towards the organisation-organisation-directed deviance relationships. Attitude importance moderated the relationship between revenge motive towards the manager and supervisor-directed deviance; revenge motive towards the organisation and organisation-directed deviance. Moderated-mediation hypotheses were not supported for core self-evaluations but were supported for the attitude importance. Additional analyses for sub-dimensions were conducted to further examine the hypotheses. Demographic variables were examined through independent samples t-tests, and one way ANOVA. Finally, findings are discussed; limitations, suggestions and implications are presented. The major contribution of this study is that ‘psychopathic manager behaviour’ construct was introduced to the literature and a scale for the reliable identification of psychopathic manager behaviour was developed in to evaluate managers’ level of sub-clinical psychopathy in the workforce. The study introduced that employees engage in different forms of supervisor-directed deviance and organisation-directed deviance depending on the level of the emotions and personal goals. Supervisor-directed deviant behaviours and organisation-directed deviant behaviours became distinct in a way as impulsive and premeditated, active or passive, direct and indirect actions. Accordingly, it is important for organisations to notice that employees’ level of affective state and attitude importance for psychopathic manager behaviours predetermine the certain type of employee deviant behaviours.

Keywords: attitude importance, core self evaluations, psychopathic manager behaviour, revenge motive, workplace deviance

Procedia PDF Downloads 247

Authors: R. A. Abdel Rahman, A. E. Abdel Wahab, E. A. Goghneimy, H. F. Mohamed, E. M. Salama

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Infectious diseases are a major cause of death worldwide. The treatment of infections continues to be problematic in modern time because of the severe side effects of some drugs and the growing resistance to antimicrobial agents. Hence, the search for newer, safer and more potent antimicrobials is a pressing need. Herbal medicines have received much attention as a source of new antibacterial drugs since they are considered time-tested and comparatively safe both for human use and the environment. In the present study, the antimicrobial activity of marjoram (Origanum majorana L.) essential oil on some gram positive and gram negative reference bacteria, as well as some hospital resistant microbes, was tested. Marjoram oil was extracted and the oil chemical constituents were identified using GC/MS analysis. Staphylococcus aureas ATCC 6923, Pseudomonus auregonosa ATCC 9027, Bacillus subtilis ATCC 6633, E. coli ATCC 8736 and two hospital resistant microbes isolates 16 and 21 were used. The two isolates were identified by biochemical tests and 16s rRNA as proteus spp. and Enterococcus facielus. The effect of different concentrations of essential oils on bacterial growth was tested using agar disk diffusion assay method to determine the minimum inhibitory concentrations and using micro dilution method to determine the minimum bactericidal concentrations. Marjoram oil was found to be effective against both reference and hospital resistance strains. Hospital strains were more resistant to marjoram oil than reference strains. P. auregonosa growth was completely inhibited at a low concentration of oil (4µl/ml). The other reference strains showed sensitivity to marjoram oil at concentrations ranged from 5 to 7µl/ml. The two hospital strains showed sensitivity at media containing 10 and 15µl/ml oil. The major components of oil were terpineol, cis-beta (23.5%), 1,6 – octadien –3-ol,3,7-dimethyl, 2 aminobenzoate (10.9%), alpha terpieol (8.6%) and linalool (6.3%). Scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis were used to determine the difference between treated and untreated hospital strains. SEM results showed that treated cells were smaller in size than control cells. TEM data showed that cell lysis has occurred to treated cells. Treated cells have ruptured cell wall and appeared empty of cytoplasm compared to control cells which shown to be intact with normal volume of cytoplasm. The results indicated that marjoram oil has a positive antimicrobial effect on hospital resistance microbes. Natural crude extracts can be perfect resources for new antimicrobial drugs.

Keywords: antimicrobial activity, essential oil, hospital resistance microbes, marjoram

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Authors: Merve Yünlü, Nihat Kandemir, Aylin Ersoy

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Temperature sensors are used in home appliances not only to monitor the basic functions of the machine but also to minimize energy consumption and ensure safe operation. In parallel with the development of smart home applications and IoT algorithms, these sensors produce important data such as the frequency of use of the machine, user preferences, and the compilation of critical data in terms of diagnostic processes for fault detection throughout an appliance's operational lifespan. Commercially available thin-film resistive temperature sensors have a well-established manufacturing procedure that allows them to operate over a wide temperature range. However, these sensors are over-designed for white goods applications. The operating temperature range of these sensors is between -70°C and 850°C, while the temperature range requirement in home appliance applications is between 23°C and 500°C. To ensure the operation of commercial sensors in this wide temperature range, usually, a platinum coating of approximately 1-micron thickness is applied to the wafer. However, the use of platinum in coating and the high coating thickness extends the sensor production process time and therefore increases sensor costs. In this study, an attempt was made to develop a low-cost temperature sensor design and production method that meets the technical requirements of white goods applications. For this purpose, a custom design was made, and design parameters (length, width, trim points, and thin film deposition thickness) were optimized by using statistical methods to achieve the desired resistivity value. To develop thin film resistive temperature sensors, one side polished sapphire wafer was used. To enhance adhesion and insulation 100 nm silicon dioxide was coated by inductively coupled plasma chemical vapor deposition technique. The lithography process was performed by a direct laser writer. The lift-off process was performed after the e-beam evaporation of 10 nm titanium and 280 nm platinum layers. Standard four-point probe sheet resistance measurements were done at room temperature. The annealing process was performed. Resistivity measurements were done with a probe station before and after annealing at 600°C by using a rapid thermal processing machine. Temperature dependence between 25-300 °C was also tested. As a result of this study, a temperature sensor has been developed that has a lower coating thickness than commercial sensors but can produce reliable data in the white goods application temperature range. A relatively simplified but optimized production method has also been developed to produce this sensor.

Keywords: thin film resistive sensor, temperature sensor, household appliance, sustainability, energy efficiency

Procedia PDF Downloads 54

Authors: Mohd Azman Abdul Latif, Erwan Basiron

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A flaw or drift from expected operational performance in one component (NAND, PMIC, controller, DRAM, etc.) may affect the reliability of the entire Solid State Drive (SSD) system. Therefore, it is important to ensure the required quality of each individual component through qualification testing specified using standards or user requirements. Qualification testing is time-consuming and comes at a substantial cost for product manufacturers. A highly technical team, from all the eminent stakeholders is embarking on reliability prediction from beginning of new product development, identify critical to reliability parameters, perform full-blown characterization to embed margin into product reliability and establish control to ensure the product reliability is sustainable in the mass production. The paper will discuss a comprehensive development framework, comprehending SSD end to end from design to assembly, in-line inspection, in-line testing and will be able to predict and to validate the product reliability at the early stage of new product development. During the design stage, the SSD will go through intense reliability margin investigation with focus on assembly process attributes, process equipment control, in-process metrology and also comprehending forward looking product roadmap. Once these pillars are completed, the next step is to perform process characterization and build up reliability prediction modeling. Next, for the design validation process, the reliability prediction specifically solder joint simulator will be established. The SSD will be stratified into Non-Operating and Operating tests with focus on solder joint reliability and connectivity/component latent failures by prevention through design intervention and containment through Temperature Cycle Test (TCT). Some of the SSDs will be subjected to the physical solder joint analysis called Dye and Pry (DP) and Cross Section analysis. The result will be feedbacked to the simulation team for any corrective actions required to further improve the design. Once the SSD is validated and is proven working, it will be subjected to implementation of the monitor phase whereby Design for Assembly (DFA) rules will be updated. At this stage, the design change, process and equipment parameters are in control. Predictable product reliability at early product development will enable on-time sample qualification delivery to customer and will optimize product development validation, effective development resource and will avoid forced late investment to bandage the end-of-life product failures. Understanding the critical to reliability parameters earlier will allow focus on increasing the product margin that will increase customer confidence to product reliability.

Keywords: e2e reliability prediction, SSD, TCT, solder joint reliability, NUDD, connectivity issues, qualifications, characterization and control

Procedia PDF Downloads 156

Authors: Cindy Sithole, Didier Nyembwe, Peter Olubambi

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The sand casting process involves pattern making, mould making, metal pouring and shake out. Every step in the sand moulding process is very critical for production of good quality castings. However, waste generated during the sand moulding operation and lack of quality are matters that influences performance inefficiencies and lack of competitiveness in South African foundries. Defects produced from the sand moulding process are only visible in the final product (casting) which results in increased number of scrap, reduced sales and increases cost in the foundry. The purpose of this Research is to propose six sigma technique (DMAIC, Define, Measure, Analyze, Improve and Control) intervention in sand moulding foundries and to reduce variation caused by deficiencies in the sand moulding process in South African foundries. Its objective is to create sustainability and enhance productivity in the South African foundry industry. Six sigma is a data driven method to process improvement that aims to eliminate variation in business processes using statistical control methods .Six sigma focuses on business performance improvement through quality initiative using the seven basic tools of quality by Ishikawa. The objectives of six sigma are to eliminate features that affects productivity, profit and meeting customers’ demands. Six sigma has become one of the most important tools/techniques for attaining competitive advantage. Competitive advantage for sand casting foundries in South Africa means improved plant maintenance processes, improved product quality and proper utilization of resources especially scarce resources. Defects such as sand inclusion, Flashes and sand burn on were some of the defects that were identified as resulting from the sand moulding process inefficiencies using six sigma technique. The courses were we found to be wrong design of the mould due to the pattern used and poor ramming of the moulding sand in a foundry. Six sigma tools such as the voice of customer, the Fishbone, the voice of the process and process mapping were used to define the problem in the foundry and to outline the critical to quality elements. The SIPOC (Supplier Input Process Output Customer) Diagram was also employed to ensure that the material and process parameters were achieved to ensure quality improvement in a foundry. The process capability of the sand moulding process was measured to understand the current performance to enable improvement. The Expected results of this research are; reduced sand moulding process variation, increased productivity and competitive advantage.

Keywords: defects, foundries, quality improvement, sand moulding, six sigma (DMAIC)

Procedia PDF Downloads 173

Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Silvia Portarena, Chiara Anselmi, Chiara Baldacchini, Enrico Brugnoli

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Extra virgin olive oil (EVOO) is a complex matrix mainly composed by fatty acid and other minor compounds, among which carotenoids are well known for their antioxidative function that is a key mechanism of protection against cancer, cardiovascular diseases, and macular degeneration in humans. EVOO composition in terms of such constituents is generally the result of a complex combination of genetic, agronomical and environmental factors. To selectively improve the quality of EVOOs, the role of each factor on its biochemical composition need to be investigated. By selecting fruits from four different cultivars similarly grown and harvested, it was demonstrated that Raman spectroscopy, combined with chemometric analysis, is able to discriminate the different cultivars, also as a function of the harvest date, based on the relative content and composition of fatty acid and carotenoids. In particular, a correct classification up to 94.4% of samples, according to the cultivar and the maturation stage, was obtained. Moreover, by using gas chromatography and high-performance liquid chromatography as reference techniques, the Raman spectral features further allowed to build models, based on partial least squares regression, that were able to predict the relative amount of the main fatty acids and the main carotenoids in EVOO, with high coefficients of determination. Besides genetic factors, climatic parameters, such as light exposition, distance from the sea, temperature, and amount of precipitations could have a strong influence on EVOO composition of both major and minor compounds. This suggests that the Raman spectra could act as a specific fingerprint for the geographical discrimination and authentication of EVOO. To understand the influence of environment on EVOO Raman spectra, samples from seven regions along the Italian coasts were selected and analyzed. In particular, it was used a dual approach combining Raman spectroscopy and isotope ratio mass spectrometry (IRMS) with principal component and linear discriminant analysis. A correct classification of 82% EVOO based on their regional geographical origin was obtained. Raman spectra were obtained by Super Labram spectrometer equipped with an Argon laser (514.5 nm wavelenght). Analyses of stable isotope content ratio were performed using an isotope ratio mass spectrometer connected to an elemental analyzer and to a pyrolysis system. These studies demonstrate that RR spectroscopy is a valuable and useful technique for the analysis of EVOO. In combination with statistical analysis, it makes possible the assessment of specific samples’ content and allows for classifying oils according to their geographical and varietal origin.

Keywords: authentication, chemometrics, olive oil, raman spectroscopy

Procedia PDF Downloads 313

Authors: Marjorie Miguel

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Globalization offers better career opportunities hence demands more competent professionals efficient for the job. With the transformation of the world industry from competition to collaboration coupled with the rapid development in the field of science and technology, engineers need not only to be technically proficient, but also multilingual-skilled: two characteristics that a global engineer possesses. English often serves as the global language between people from different cultures being the medium mostly used in international business. Ironically, most universities worldwide adapt engineering curriculum heavily built around the language of mathematics not realizing that the goal of an engineer is not only to create and design, but more importantly to promote his creations and designs to the general public through effective communication. This premise led to some developments in the teaching process of English subjects in the tertiary level which include the integration of the technical knowledge related to the area of specialization of the students in the English subjects that they are taking. This is also known as English for Specific Purposes. This study focused on the development of English for Specific Purposes-Based Instructional Materials for Engineering Students of Bulacan State University (BulSU). The materials were tailor-made in which the contents and structure were designed to meet the specific needs of the students as well as the industry. Based on the needs analysis, the needs of the students and the industry were determined to make the study descriptive in nature. The major respondents included fifty engineering students and ten professional engineers from selected institutions. The needs analysis was done and the results showed the common writing difficulties of the students and the writing skills needed among the engineers in the industry. The topics in the instructional materials were established after the needs analysis was conducted. Simple statistical treatment including frequency distribution, percentages, mean, standard deviation, and weighted mean were used. The findings showed that the greatest number of the respondents had an average proficiency rating in writing, and the much-needed skills that must be developed by the engineers are directly related to the preparation and presentation of technical reports about their projects, as well as to the different communications they transmit to their colleagues and superiors. The researcher undertook the following phases in the development of the instructional materials: a design phase, development phase, and evaluation phase. Evaluations are given by some college instructors about the instructional materials generally helped in its usefulness and significance making the study beneficial not only as a career enhancer for BulSU engineering students, but also creating the university one of the educational institutions ready for the new millennium.

Keywords: English for specific purposes, instructional materials, needs analysis, write (right) job description

Procedia PDF Downloads 223

Authors: Shahrukh Ahmad, Purnendu Bose

Abstract:

Algal-Bacterial photobioreactors (ABPBRs) have emerged as a promising technology for sustainable biomass production and wastewater treatment. Nutrient removal is seldom done in sewage treatment plants and large volumes of wastewater which still have nutrients are being discharged and that can lead to eutrophication. That is why ABPBR plays a vital role in wastewater treatment. However, improving the efficiency of ABPBR remains a significant challenge. This study aims to enhance ABPBR efficiency by focusing on two key aspects: nutrient removal and cost-effective optimization of the light source. By integrating nutrient removal and cost analysis for light source optimization, this study proposes practical strategies for improving ABPBR efficiency. To reduce organic carbon and convert ammonia to nitrates, domestic wastewater from a 130 MLD sewage treatment plant (STP) was aerated with a hydraulic retention time (HRT) of 2 days. The treated supernatant had an approximate nitrate and phosphate values of 16 ppm as N and 6 ppm as P, respectively. This supernatant was then fed into the ABPBR, and the removal of nutrients (nitrate as N and phosphate as P) was observed using different colored LED bulbs, namely white, blue, red, yellow, and green. The ABPBR operated with a 9-hour light and 3-hour dark cycle, using only one color of bulbs per cycle. The study found that the white LED bulb, with a photosynthetic photon flux density (PPFD) value of 82.61 µmol.m-2 .sec-1 , exhibited the highest removal efficiency. It achieved a removal rate of 91.56% for nitrate and 86.44% for phosphate, surpassing the other colored bulbs. Conversely, the green LED bulbs showed the lowest removal efficiencies, with 58.08% for nitrate and 47.48% for phosphate at an HRT of 5 days. The quantum PAR (Photosynthetic Active Radiation) meter measured the photosynthetic photon flux density for each colored bulb setting inside the photo chamber, confirming that white LED bulbs operated at a wider wavelength band than the others. Furthermore, a cost comparison was conducted for each colored bulb setting. The study revealed that the white LED bulb had the lowest average cost (Indian Rupee)/light intensity (µmol.m-2 .sec-1 ) value at 19.40, while the green LED bulbs had the highest average cost (INR)/light intensity (µmol.m-2 .sec-1 ) value at 115.11. Based on these comparative tests, it was concluded that the white LED bulbs were the most efficient and costeffective light source for an algal photobioreactor. They can be effectively utilized for nutrient removal from secondary treated wastewater which helps in improving the overall wastewater quality before it is discharged back into the environment.

Keywords: algal bacterial photobioreactor, domestic wastewater, nutrient removal, led bulbs

Procedia PDF Downloads 48