Search results for: clinical nursing practice guideline
926 The Effect of Seated Distance on Muscle Activation and Joint Kinematics during Seated Strengthening in Patients with Stroke with Extensor Synergy Pattern in the Lower Limbs
Authors: Y. H. Chen, P. Y. Chiang, T. Sugiarto, I. Karsuna, Y. J. Lin, C. C. Chang, W. C. Hsu
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Task-specific training with intense practice of functional tasks has been emphasized for the approaches in motor rehabilitation in patients with hemiplegic strokes. Although reciprocal actions which may increase demands on motor control during seated stepping exercise, motor control is not explicitly trained with emphasis and instruction focused on traditional strengthening. Apart from cycling and treadmill, various forms of seated exerciser are becoming available for the lower extremity exercise. The benefit of seated exerciser has been focused on the effect on the cardiopulmonary system. Thus, the aim of current study is to investigate the effect of seated distance on muscle activation during seated strengthening in patients with stroke with extensor synergy pattern in the lower extremities. Electrodes were placed on the surface of lower limbs muscles, including rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF) and gastrocnemius (GT) of both sides. Maximal voluntary contraction (MVC) of the muscles were obtained to normalize the EMG amplitude obtained during dynamic trials with analog raw data digitized with a sampling frequency of 2000 Hz, fully rectified and the linear enveloped. Movement cycle was separated into two phases by pushing (PP) and Return (RP). Integral EMG (iEMG) is then used to quantify level of activation during each of the phases. Subjects performed strengthening with moderate resistance with speed of 60 rpm in two different distances (D1, short) and (D2, long). The results showed greater iEMG in RF and smaller iEMG in VL and BF with obvious increase range of motion of hip flexion in D1 condition. On the contrary, no significant involvement of RF while greater level of muscular activation in VL and BF during RP was found during PP in D2 condition. In addition, greater hip internal rotation was observed in D2 condition. In patients with stroke with abnormal tone revealed by extensor synergy in the lower extremities, shorter seated distance is suggested to facilitate hip flexor muscle activation while avoid inducing hyper extensor tone which may prevent a smooth repetitive motion. Repetitive muscular contraction exercise of hip flexor may be helpful for further gait training as it may assist hip flexion during swing phase of the walking.Keywords: seated strengthening, patients with stroke, electromyography, synergy pattern
Procedia PDF Downloads 215925 Identifying Protein-Coding and Non-Coding Regions in Transcriptomes
Authors: Angela U. Makolo
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Protein-coding and Non-coding regions determine the biology of a sequenced transcriptome. Research advances have shown that Non-coding regions are important in disease progression and clinical diagnosis. Existing bioinformatics tools have been targeted towards Protein-coding regions alone. Therefore, there are challenges associated with gaining biological insights from transcriptome sequence data. These tools are also limited to computationally intensive sequence alignment, which is inadequate and less accurate to identify both Protein-coding and Non-coding regions. Alignment-free techniques can overcome the limitation of identifying both regions. Therefore, this study was designed to develop an efficient sequence alignment-free model for identifying both Protein-coding and Non-coding regions in sequenced transcriptomes. Feature grouping and randomization procedures were applied to the input transcriptomes (37,503 data points). Successive iterations were carried out to compute the gradient vector that converged the developed Protein-coding and Non-coding Region Identifier (PNRI) model to the approximate coefficient vector. The logistic regression algorithm was used with a sigmoid activation function. A parameter vector was estimated for every sample in 37,503 data points in a bid to reduce the generalization error and cost. Maximum Likelihood Estimation (MLE) was used for parameter estimation by taking the log-likelihood of six features and combining them into a summation function. Dynamic thresholding was used to classify the Protein-coding and Non-coding regions, and the Receiver Operating Characteristic (ROC) curve was determined. The generalization performance of PNRI was determined in terms of F1 score, accuracy, sensitivity, and specificity. The average generalization performance of PNRI was determined using a benchmark of multi-species organisms. The generalization error for identifying Protein-coding and Non-coding regions decreased from 0.514 to 0.508 and to 0.378, respectively, after three iterations. The cost (difference between the predicted and the actual outcome) also decreased from 1.446 to 0.842 and to 0.718, respectively, for the first, second and third iterations. The iterations terminated at the 390th epoch, having an error of 0.036 and a cost of 0.316. The computed elements of the parameter vector that maximized the objective function were 0.043, 0.519, 0.715, 0.878, 1.157, and 2.575. The PNRI gave an ROC of 0.97, indicating an improved predictive ability. The PNRI identified both Protein-coding and Non-coding regions with an F1 score of 0.970, accuracy (0.969), sensitivity (0.966), and specificity of 0.973. Using 13 non-human multi-species model organisms, the average generalization performance of the traditional method was 74.4%, while that of the developed model was 85.2%, thereby making the developed model better in the identification of Protein-coding and Non-coding regions in transcriptomes. The developed Protein-coding and Non-coding region identifier model efficiently identified the Protein-coding and Non-coding transcriptomic regions. It could be used in genome annotation and in the analysis of transcriptomes.Keywords: sequence alignment-free model, dynamic thresholding classification, input randomization, genome annotation
Procedia PDF Downloads 68924 Bacterial Decontamination of Nurses' White Coats by Application of Antimicrobial Finish
Authors: Priyanka Gupta, Nilanjana Bairagi, Deepti Gupta
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New pathogenic strains of microbes are continually emerging and resistance of bacteria to antibiotics is growing. Hospitals in India have a high burden of infections in their intensive care units and general wards. Rising incidence of hospital infections is a matter of great concern in India. This growth is often attributed to the absence of effective infection control strategies in healthcare facilities. Government, therefore, is looking for cost effective strategies that are effective against HAIs. One possible method is by application of an antimicrobial finish on the uniform. But there are limited studies to show the effect of antimicrobial activity of antimicrobial finish treated nurses’ uniforms in a real hospital set up. This paper proposes a prospective non-destructive sampling technique, based on the use of a detachable fabric patch, to assess the effectiveness of silver based antimicrobial agent across five wards in a tertiary care government hospital in Delhi, India. Fabrics like polyester and polyester cotton blend fabric which are more prevalent for making coats were selected for the study. Polyester and polyester cotton blend fabric was treated with silver based antimicrobial (AM) finish. At the beginning of shift, a composite patch of untreated and treated fabric respectively was stitched on the abdominal region on the left and right side of the washed white coat of participating nurse. At the end of the shift, the patch was removed and taken for bacterial sampling on Brain Heart Infusion (BHI) plates. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). All patches treated with silver based antimicrobial agent showed decreased bacterial counts. Percent reduction in the bacterial colonies after the antimicrobial treatment in both fabrics was 81.0 %. Antimicrobial finish was equally effective in reducing microbial adhesion on both fabric types. White coats of nurses become progressively contaminated during clinical care. Type of fabric used to make the coat can affect the extent of contamination which is higher on polyester cotton blend as compared to 100% polyester. The study highlights the importance of silver based antimicrobial finish in the area of uniform hygiene. Bacterial load can be reduced by using antimicrobial finish on hospital uniforms. Hospital staff uniforms endowed with antimicrobial properties may be of great help in reducing the occurrence and spread of infections.Keywords: antimicrobial finish, bacteria, infection control, silver, white coat
Procedia PDF Downloads 216923 Industry Symbiosis and Waste Glass Upgrading: A Feasibility Study in Liverpool Towards Circular Economy
Authors: Han-Mei Chen, Rongxin Zhou, Taige Wang
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Glass is widely used in everyday life, from glass bottles for beverages to architectural glass for various forms of glazing. Although the mainstream of used glass is recycled in the UK, the single-use and then recycling procedure results in a lot of waste as it incorporates intact glass with smashing, re-melting, and remanufacturing. These processes bring massive energy consumption with a huge loss of high embodied energy and economic value, compared to re-use, which’s towards a ‘zero carbon’ target. As a tourism city, Liverpool has more glass bottle consumption than most less leisure-focused cities. It’s therefore vital for Liverpool to find an upgrading approach for the single-use glass bottles with low carbon output. This project aims to assess the feasibility of industrial symbiosis and upgrading the framework of glass and to investigate the ways of achieving them. It is significant to Liverpool’s future industrial strategy since it provides an opportunity to target economic recovery for post-COVID by industry symbiosis and up-grading waste management in Liverpool to respond to the climate emergency. In addition, it will influence the local government policy for glass bottle reuse and recycling in North West England and as a good practice to be further recommended to other areas of the UK. First, a critical literature review of glass waste strategies has been conducted in the UK and worldwide industrial symbiosis practices. Second, mapping, data collection, and analysis have shown the current life cycle chain and the strong links of glass reuse and upgrading potentials via site visits to 16 local waste recycling centres. The results of this research have demonstrated the understanding of the influence of key factors on the development of a circular industrial symbiosis business model for beverage glass bottles. The current waste management procedures of the glass bottle industry, its business model, supply chain, and material flow have been reviewed. The various potential opportunities for glass bottle up-valuing have been investigated towards an industrial symbiosis in Liverpool. Finally, an up-valuing business model has been developed for an industrial symbiosis framework of glass in Liverpool. For glass bottles, there are two possibilities 1) focus on upgrading processes towards re-use rather than single-use and recycling and 2) focus on ‘smart’ re-use and recycling, leading to optimised values in other sectors to create a wider industry symbiosis for a multi-level and circular economy.Keywords: glass bottles, industry symbiosis, smart re-use, waste upgrading
Procedia PDF Downloads 107922 A Review on Stormwater Harvesting and Reuse
Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir
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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database
Procedia PDF Downloads 373921 A Practical Approach Towards Disinfection Challenges in Sterile Manufacturing Area
Authors: Doris Lacej, Eni Bushi
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Cleaning and disinfection procedures are essential for maintaining the cleanliness status of the pharmaceutical manufacturing environment particularly of the cleanrooms and sterile unit area. The Good Manufacturing Practice (GMP) Annex 1 recommendation highly requires the implementation of the standard and validated cleaning and disinfection protocols. However, environmental monitoring has shown that even a validated cleaning method with certified agents may result in the presence of atypical microorganisms’ colony that exceeds GMP limits for a specific cleanroom area. In response to this issue, this case study aims to arrive at the root cause of the microbial contamination observed in the sterile production environment in Profarma pharmaceutical industry in Albania through applying a problem-solving practical approach that ensures the appropriate sterility grade. The guidelines and literature emphasize the importance of several factors in the prevention of possible microbial contamination occurring in cleanrooms, grade A and C. These factors are integrated into a practical framework, to identify the root cause of the presence of Aspergillus Niger colony in the sterile production environment in Profarma pharmaceutical industry in Albania. In addition, the application of a semi-automatic disinfecting system such as H2O2 FOG into sterile grade A and grade C cleanrooms has been an effective solution in eliminating the atypical colony of Aspergillus Niger. Selecting the appropriate detergents and disinfectants at the right concentration, frequency, and combination; the presence of updated and standardized guidelines for cleaning and disinfection as well as continuous training of operators on these practices in accordance with the updated GMP guidelines are some of the identified factors that influence the success of achieving sterility grade. However, to ensure environmental sustainability it is important to be prepared for identifying the source of contamination and making the appropriate decision. The proposed case-based practical approach may help pharmaceutical companies to achieve sterile production and cleanliness environmental sustainability in challenging situations. Apart from the integration of valid agents and standardized cleaning and disinfection protocols according to GMP Annex 1, pharmaceutical companies must be careful and investigate the source and all the steps that can influence the results of an abnormal situation. Subsequently apart from identifying the root cause it is important to solve the problem with a successful alternative approach.Keywords: cleanrooms, disinfectants, environmental monitoring, GMP Annex 1
Procedia PDF Downloads 216920 First Documented Anesthesia with Use of Low Doses of Tiletamine-Zolazepam Combination in Ovoviparous Amazon Tree Boa Undergoing Emergency Coeliotomy-Case Report
Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk
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Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam
Procedia PDF Downloads 247919 An Analytical Review of Tourism Management in India with Special Reference to Maharashtra State
Authors: Anilkumar L. Rathod
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This paper examines event tourism as a field of study and area of professional practice updating the previous review article published in 2015. In this substantially extended review, a deeper analysis of the field's evolution and development is presented, charting the growth of the literature, focusing both chronologically and thematically. A framework for understanding and creating knowledge about events and tourism is presented, forming the basis which signposts established research themes and concepts and outlines future directions for research. In addition, the review article focuses on constraining and propelling forces, ontological advances, contributions from key journals, and emerging themes and issues. It also presents a roadmap for research activity in event tourism. Published scholarly studies within this period are examined through content analysis, using such keywords as knowledge management, organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals. All contributions found are then screened for a hospitality and tourism theme. Researchers mostly discuss knowledge management approach in improving information technology, marketing and strategic planning in order to gain competitive advantage. Overall, knowledge management research is still limited. Planned events in tourism are created for a purpose, and what was once the realm of individual and community initiatives has largely become the realm of professionals and entrepreneurs provides a typology of the four main categories of planned events within an event-tourism context, including the main venues associated with each. It also assesses whether differences exist between socio-demographic groupings. An analysis using primarily descriptive statistics indicated both sub-samples had similar viewpoints although Maharashtra residents tended to have higher scores pertaining to the consequences of gambling. It is suggested that the differences arise due to the greater exposure of Maharashtra residents to the influences of casino development.Keywords: organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals
Procedia PDF Downloads 238918 Higher Education and Students with Disabilities in Azerbaijan
Authors: Rima Mammadova
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Azerbaijan is a developing country that tries to keep its own culture and traditions. At the same time tries to get benefit from the experience and knowledge of the developed countries. After the collapse of the Soviet Union, Azerbaijan got its independence and currently, implements various programs and policy initiatives to the development of different fields, such as an education, human rights, etc. Disability related issues are also in the main priority list of the country. During the Soviet Union, children with disabilities studied in the special schools, which called boarding schools. They were isolated from the society and most of them were not able to get their higher education. As the result of this kind of tendency, they were in dependence on their parents, relatives and especially the government, as there were several kind of pensions provided by the government depending on the level of disability. Although Azerbaijan maintain different programs, the remnants of the Soviet period still exists. This paper investigates the current situation in Azerbaijan concerning the higher education of people with disabilities. Qualitative and quantitative research methods used in this paper. As a qualitative method a literature review was done on what the term “disability” is and what kind of education rights possess people with disabilities in Azerbaijan. A detailed research also was done on legislation of the Republic of Azerbaijan concerning the education rights of people with disabilities in Azerbaijan. As a quantitative method, questionnaire was used. The questionnaires were sent to the 8 Azerbaijani Higher Education Institutions (HEIs) which are located in different regions of Azerbaijan in order to assess and evaluate the situation concerning the students with disabilities. The main aims of these questionnaires were to find out how many students with disabilities study in Higher Education Institutions in 8 HEIs and what kind of obstacles and challenges Institutions face concerning the education of students with disabilities. The researches provided for the project brought up the results that people with disabilities possess all rights concerning the education rights legally. However in the practice they face various types of obstacles and challenges. The number of students with disabilities in HEIs in Azerbaijan is significantly low. There are several kind of reasons that affect the number of students with disabilities in HEIs. As was mentioned before the remnants of the Soviet period exists in Azerbaijan and children with disabilities get their education in boarding schools and in most cases, these boarding schools give education till the 9th class, but to enter the University, pupils have to finish 11 classes in Azerbaijan. As a result, pupils with disabilities automatically disqualify to enter the university. The paper comes into conclusion that to eliminate the isolation of pupils with disabilities from HEIs, the government should pay more attention to the special schools for the pupils with disabilities, the boarding schools should be cancelled and etc. By the applying these kind of changes the rights of people with disabilities will be provided not only theoretically but also practically.Keywords: Azerbaijan, disability, students with disabilities, boarding schools
Procedia PDF Downloads 267917 Implementation of Correlation-Based Data Analysis as a Preliminary Stage for the Prediction of Geometric Dimensions Using Machine Learning in the Forming of Car Seat Rails
Authors: Housein Deli, Loui Al-Shrouf, Hammoud Al Joumaa, Mohieddine Jelali
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When forming metallic materials, fluctuations in material properties, process conditions, and wear lead to deviations in the component geometry. Several hundred features sometimes need to be measured, especially in the case of functional and safety-relevant components. These can only be measured offline due to the large number of features and the accuracy requirements. The risk of producing components outside the tolerances is minimized but not eliminated by the statistical evaluation of process capability and control measurements. The inspection intervals are based on the acceptable risk and are at the expense of productivity but remain reactive and, in some cases, considerably delayed. Due to the considerable progress made in the field of condition monitoring and measurement technology, permanently installed sensor systems in combination with machine learning and artificial intelligence, in particular, offer the potential to independently derive forecasts for component geometry and thus eliminate the risk of defective products - actively and preventively. The reliability of forecasts depends on the quality, completeness, and timeliness of the data. Measuring all geometric characteristics is neither sensible nor technically possible. This paper, therefore, uses the example of car seat rail production to discuss the necessary first step of feature selection and reduction by correlation analysis, as otherwise, it would not be possible to forecast components in real-time and inline. Four different car seat rails with an average of 130 features were selected and measured using a coordinate measuring machine (CMM). The run of such measuring programs alone takes up to 20 minutes. In practice, this results in the risk of faulty production of at least 2000 components that have to be sorted or scrapped if the measurement results are negative. Over a period of 2 months, all measurement data (> 200 measurements/ variant) was collected and evaluated using correlation analysis. As part of this study, the number of characteristics to be measured for all 6 car seat rail variants was reduced by over 80%. Specifically, direct correlations for almost 100 characteristics were proven for an average of 125 characteristics for 4 different products. A further 10 features correlate via indirect relationships so that the number of features required for a prediction could be reduced to less than 20. A correlation factor >0.8 was assumed for all correlations.Keywords: long-term SHM, condition monitoring, machine learning, correlation analysis, component prediction, wear prediction, regressions analysis
Procedia PDF Downloads 50916 Efficacy of Pooled Sera in Comparison with Commercially Acquired Quality Control Sample for Internal Quality Control at the Nkwen District Hospital Laboratory
Authors: Diom Loreen Ndum, Omarine Njimanted
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With increasing automation in clinical laboratories, the requirements for quality control materials have greatly increased in order to monitor daily performance. The constant use of commercial control material is not economically feasible for many developing countries because of non-availability or the high-cost of the materials. Therefore, preparation and use of in-house quality control serum will be a very cost-effective measure with respect to laboratory needs.The objective of this study was to determine the efficacy of in-house prepared pooled sera with respect to commercially acquired control sample for routine internal quality control at the Nkwen District Hospital Laboratory. This was an analytical study, serum was taken from leftover serum samples of 5 healthy adult blood donors at the blood bank of Nkwen District Hospital, which had been screened negative for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and Hepatitis B antigens (HBsAg), and were pooled together in a sterile container. From the pooled sera, sixty aliquots of 150µL each were prepared. Forty aliquots of 150µL each of commercially acquired samples were prepared after reconstitution and stored in a deep freezer at − 20°C until it was required for analysis. This study started from the 9th June to 12th August 2022. Every day, alongside with commercial control sample, one aliquot of pooled sera was removed from the deep freezer and allowed to thaw before analyzed for the following parameters: blood urea, serum creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), potassium and sodium. After getting the first 20 values for each parameter of pooled sera, the mean, standard deviation and coefficient of variation were calculated, and a Levey-Jennings (L-J) chart established. The mean and standard deviation for commercially acquired control sample was provided by the manufacturer. The following results were observed; pooled sera had lesser standard deviation for creatinine, urea and AST than commercially acquired control samples. There was statistically significant difference (p<0.05) between the mean values of creatinine, urea and AST for in-house quality control when compared with commercial control. The coefficient of variation for the parameters for both commercial control and in-house control samples were less than 30%, which is an acceptable difference. The L-J charts revealed shifts and trends (warning signs), so troubleshooting and corrective measures were taken. In conclusion, in-house quality control sample prepared from pooled serum can be a good control sample for routine internal quality control.Keywords: internal quality control, levey-jennings chart, pooled sera, shifts, trends, westgard rules
Procedia PDF Downloads 79915 Integrating a Six Thinking Hats Approach Into the Prewriting Stage of Argumentative Writing In English as a Foreign Language: A Chinese Case Study of Generating Ideas in Action
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Argumentative writing is the most prevalent genre in diverse writing tests. How to construct academic arguments is often regarded as a difficult task by most English as a foreign language (EFL) learners. A failure to generate enough ideas and organise them coherently and logically as well as a lack of competence in supporting their arguments with relevant evidence are frequent problems faced by EFL learners when approaching an English argumentative writing task. Overall, these problems are closely related to planning, and planning an argumentative writing at pre-writing stage plays a vital role in a good academic essay. However, how teachers can effectively guide students to generate ideas is rarely discussed in planning English argumentative writing, apart from brainstorming. Brainstorming has been a common practice used by teachers to help students generate ideas. However, some limitations of brainstorming suggest that it can help students generate many ideas, but ideas might not necessarily be coherent and logic, and could sometimes impede production. It calls for a need to explore effective instructional strategies at pre-writing stage of English argumentative writing. This paper will first examine how a Six Thinking Hats approach can be used to provide a dialogic space for EFL learners to experience and collaboratively generate ideas from multiple perspectives at pre-writing stage. Part of the findings of the impact of a twelve-week intervention (from March to July 2021) on students learning to generate ideas through engaging in group discussions of using Six Thinking Hats will then be reported. The research design is based on the sociocultural theory. The findings present evidence from a mixed-methods approach and fifty-nine participants from two first-year undergraduate natural classes in a Chinese university. Analysis of pre- and post- questionnaires suggests that participants had a positive attitude toward the Six Thinking Hats approach. It fosters their understanding of prewriting and argumentative writing, helps them to generate more ideas not only from multiple perspectives but also in a systematic way. A comparison of participants writing plans confirms an improvement in generating counterarguments and rebuttals to support their arguments. Above all, visual and transcripts data of group discussion collected from different weeks throughout the intervention enable teachers and researchers to ‘see’ the hidden process of learning to generate ideas in action.Keywords: argumentative writing, innovative pedagogy, six thinking hats, dialogic space, prewriting, higher education
Procedia PDF Downloads 89914 Health Behaviors Related to Preventing Disease of Hand Foot and Mouth Disease of Child Caregivers in Child Development Center Ubon Ratchathani Province, Thailand
Authors: Comsun Thongchai, Vorapoj Promasatayaprot
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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand
Procedia PDF Downloads 197913 Developing a Culturally Adapted Family Intervention for Relatives Living with Schizophrenia in Oman
Authors: Aziza Al-Sawafi
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Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.Keywords: cultural-adaptation, family intervention, Oman, schizophrenia
Procedia PDF Downloads 147912 Diagnostic Delays and Treatment Dilemmas: A Case of Drug-Resistant HIV and Tuberculosis
Authors: Christi Jackson, Chuka Onaga
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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.Keywords: drug-resistance, HIV, line probe assay, tuberculosis
Procedia PDF Downloads 173911 Pharmacovigilance in Hospitals: Retrospective Study at the Pharmacovigilance Service of UHE-Oran, Algeria
Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi
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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification
Procedia PDF Downloads 175910 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.
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
Procedia PDF Downloads 316909 Disparities in Language Competence and Conflict: The Moderating Role of Cultural Intelligence in Intercultural Interactions
Authors: Catherine Peyrols Wu
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Intercultural interactions are becoming increasingly common in organizations and life. These interactions are often the stage of miscommunication and conflict. In management research, these problems are commonly attributed to cultural differences in values and interactional norms. As a result, the notion that intercultural competence can minimize these challenges is widely accepted. Cultural differences, however, are not the only source of a challenge during intercultural interactions. The need to rely on a lingua franca – or common language between people who have different mother tongues – is another important one. In theory, a lingua franca can improve communication and ease coordination. In practice however, disparities in people’s ability and confidence to communicate in the language can exacerbate tensions and generate inefficiencies. In this study, we draw on power theory to develop a model of disparities in language competence and conflict in a multicultural work context. Specifically, we hypothesized that differences in language competence between interaction partners would be positively related to conflict such that people would report greater conflict with partners who have more dissimilar levels of language competence and lesser conflict with partners with more similar levels of language competence. Furthermore, we proposed that cultural intelligence (CQ) an intercultural competence that denotes an individual’s capability to be effective in intercultural situations, would weaken the relationship between disparities in language competence and conflict such that people would report less conflict with partners who have more dissimilar levels of language competence when the interaction partner has high CQ and more conflict when the partner has low CQ. We tested this model with a sample of 135 undergraduate students working in multicultural teams for 13 weeks. We used a round-robin design to examine conflict in 646 dyads nested within 21 teams. Results of analyses using social relations modeling provided support for our hypotheses. Specifically, we found that in intercultural dyads with large disparities in language competence, partners with the lowest level of language competence would report higher levels of interpersonal conflict. However, this relationship disappeared when the partner with higher language competence was also high in CQ. These findings suggest that communication in a lingua franca can be a source of conflict in intercultural collaboration when partners differ in their level of language competence and that CQ can alleviate these effects during collaboration with partners who have relatively lower levels of language competence. Theoretically, this study underscores the benefits of CQ as a complement to language competence for intercultural effectiveness. Practically, these results further attest to the benefits of investing resources to develop language competence and CQ in employees engaged in multicultural work.Keywords: cultural intelligence, intercultural interactions, language competence, multicultural teamwork
Procedia PDF Downloads 166908 The Changing Role of Technology-Enhanced University Library Reform in Improving College Student Learning Experience and Career Readiness – A Qualitative Comparative Analysis (QCA)
Authors: Xiaohong Li, Wenfan Yan
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Background: While it is widely considered that the university library plays a critical role in fulfilling the institution's mission and providing students’ learning experience beyond the classrooms, how the technology-enhanced library reform changed college students’ learning experience hasn’t been thoroughly investigated. The purpose of this study is to explore how technology-enhanced library reform affects students’ learning experience and career readiness and further identify the factors and effective conditions that enable the quality learning outcome of Chinese college students. Methodologies: This study selected the qualitative comparative analysis (QCA) method to explore the effects of technology-enhanced university library reform on college students’ learning experience and career readiness. QCA is unique in explaining the complex relationship between multiple factors from a holistic perspective. Compared with the traditional quantitative and qualitative analysis, QCA not only adds some quantitative logic but also inherits the characteristics of qualitative research focusing on the heterogeneity and complexity of samples. Shenyang Normal University (SNU) selected a sample of the typical comprehensive university in China that focuses on students’ learning and application of professional knowledge and trains professionals to different levels of expertise. A total of 22 current university students and 30 graduates who joined the Library Readers Association of SNU from 2011 to 2019 were selected for semi-structured interviews. Based on the data collected from these participating students, qualitative comparative analysis (QCA), including univariate necessity analysis and the multi-configuration analysis, was conducted. Findings and Discussion: QCA analysis results indicated that the influence of technology-enhanced university library restructures and reorganization on student learning experience and career readiness is the result of multiple factors. Technology-enhanced library equipment and other hardware restructured to meet the college students learning needs and have played an important role in improving the student learning experience and learning persistence. More importantly, the soft characteristics of technology-enhanced library reform, such as library service innovation space and culture space, have a positive impact on student’s career readiness and development. Technology-enhanced university library reform is not only the change in the building's appearance and facilities but also in library service quality and capability. The study also provides suggestions for policy, practice, and future research.Keywords: career readiness, college student learning experience, qualitative comparative analysis (QCA), technology-enhanced library reform
Procedia PDF Downloads 79907 Using Locus Equations for Berber Consonants Labiovellarization
Authors: Ali Benali Djouher Leila
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Labiovelarization of velar consonants and labials is a very widespread phenomenon. It is attested in all the major northern Berber dialects. Only the Tuareg is totally unaware of it. But, even within the large Berber-speaking regions of the north, it is very unstable: it may be completely absent in certain dialects (such as the Bougie region in Kabylie), and its extension and frequency can vary appreciably between the dialects which know it. Some dialects of Great Kabylia or the Chleuh domain, for example, "labiovélarize" more than others from the same region. Thus, in Great Kabylia, the adjective "large" will be pronounced: amqqwran with the At Yiraten and amqqran with the At Yanni, a few kilometers away. One of the problems with them is deciding whether it is one or two phonemes. All the criteria used by linguists in this kind of case lead to the conclusion that they are unique phonemes (a phoneme and not a succession of two phonemes, / k + w /, for example). The phonetic and phonological criteria are moreover clearly confirmed by the morphological data since, in the system of verbal alternations, these complex segments are treated as single phonemes: agree, "to draw, to fetch water," akwer, "to fly," have exactly the same morphology as as "jealous," arem" taste," Ames, "dirty" or afeg, "steal" ... verbs with two radical consonants (type aCC). At the level of notation, both scientific and usual, it is, therefore, necessary to represent the labiovélarized by a single letter, possibly accompanied by a diacritic. In fact, actual practices are diverse. - The scientific representation of type does not seem adequate for current use because its realization is easy only on a microcomputer. The Berber Documentation File used a small ° (of n °) above the writing line: k °, g ° ... which has the advantage of being easy to achieve since it is part of general typographical conventions in Latin script and that it is present on a typewriter keyboard. Mouloud Mammeri, then the Berber Study Group of Vincennes (Tisuraf review), and a majority of Kabyle practitioners over the last twenty years have used the succession "consonant +" semi-vowel / w / "(CW) on the same line of writing; for all the reasons explained previously, this practice is not a good solution and should be abandoned, especially as it particularizes Kabyle in the Berber ensemble. In this study, we were interested in two velar consonants, / g / and / k /, labiovellarized: / gw / and the / kw / (we adopted the addition of the "w") for the representation for ease of writing in graphical mode. It is a question of trying to characterize these four consonants in order to see if they have different places of articulation and if they are distinct (if these velars are distinct from their labiovellarized counterpart). This characterization is done using locus equations.Keywords: berber consonants;, labiovelarization, locus equations, acoustical caracterization, kabylian dialect, algerian language
Procedia PDF Downloads 76906 Degradation and Detoxification of Tetracycline by Sono-Fenton and Ozonation
Authors: Chikang Wang, Jhongjheng Jian, Poming Huang
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Among a wide variety of pharmaceutical compounds, tetracycline antibiotics are one of the largest groups of pharmaceutical compounds extensively used in human and veterinary medicine to treat and prevent bacterial infections. Because it is water soluble, biologically active, stable and bio-refractory, release to the environment threatens aquatic life and increases the risk posed by antibiotic-resistant pathogens. In practice, due to its antibacterial nature, tetracycline cannot be effectively destructed by traditional biological methods. Hence, in this study, two advanced oxidation processes such as ozonation and sono-Fenton processes were conducted individually to degrade the tetracycline for investigating their feasibility on tetracycline degradation. Effect of operational variables on tetracycline degradation, release of nitrogen and change of toxicity were also proposed. Initial tetracycline concentration was 50 mg/L. To evaluate the efficiency of tetracycline degradation by ozonation, the ozone gas was produced by an ozone generator (Model LAB2B, Ozonia) and introduced into the reactor with different flows (25 - 500 mL/min) at varying pH levels (pH 3 - pH 11) and reaction temperatures (15 - 55°C). In sono-Fenton system, an ultrasonic transducer (Microson VCX 750, USA) operated at 20 kHz combined with H₂O₂ (2 mM) and Fe²⁺ (0.2 mM) were carried out at different pH levels (pH 3 - pH 11), aeration gas and flows (air and oxygen; 0.2 - 1.0 L/min), tetracycline concentrations (10 - 200 mg/L), reaction temperatures (15 - 55°C) and ultrasonic powers (25 - 200 Watts), respectively. Sole ultrasound was ineffective on tetracycline degradation, where the degradation efficiencies were lower than 10% with 60 min reaction. Contribution of Fe²⁺ and H₂O₂ on the degradation of tetracycline was significant, where the maximum tetracycline degradation efficiency in sono-Fenton process was as high as 91.3% followed by 45.8% mineralization. Effect of initial pH level on tetracycline degradation was insignificant from pH 3 to pH 6 but significantly decreased as the pH was greater than pH 7. Increase of the ultrasonic power was slightly increased the degradation efficiency of tetracycline, which indicated that the hydroxyl radicals dominated the oxidation of tetracycline. Effects of aeration of air or oxygen with different flows and reaction temperatures were insignificant. Ozonation showed better efficiencies in tetracycline degradation, where the optimum reaction condition was found at pH 3, 100 mL O₃/min and 25°C with 94% degradation and 60% mineralization. The toxicity of tetracycline was significantly decreased due to the mineralization of tetracycline. In addition, less than 10% of nitrogen content was released to solution phase as NH₃-N, and the most degraded tetracycline cannot be full mineralized to CO₂. The results shown in this study indicated that both the sono-Fenton process and ozonation can effectively degrade the tetracycline and reduce its toxicity at profitable condition. The costs of two systems needed to be further investigated to understand the feasibility in tetracycline degradation.Keywords: degradation, detoxification, mineralization, ozonation, sono-Fenton process, tetracycline
Procedia PDF Downloads 269905 Reconstruction of Alveolar Bone Defects Using Bone Morphogenetic Protein 2 Mediated Rabbit Dental Pulp Stem Cells Seeded on Nano-Hydroxyapatite/Collagen/Poly(L-Lactide)
Authors: Ling-Ling E., Hong-Chen Liu, Dong-Sheng Wang, Fang Su, Xia Wu, Zhan-Ping Shi, Yan Lv, Jia-Zhu Wang
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Objective: The objective of the present study is to evaluate the capacity of a tissue-engineered bone complex of recombinant human bone morphogenetic protein 2 (rhBMP-2) mediated dental pulp stem cells (DPSCs) and nano-hydroxyapatite/collagen/poly(L-lactide)(nHAC/PLA) to reconstruct critical-size alveolar bone defects in New Zealand rabbit. Methods: Autologous DPSCs were isolated from rabbit dental pulp tissue and expanded ex vivo to enrich DPSCs numbers, and then their attachment and differentiation capability were evaluated when cultured on the culture plate or nHAC/PLA. The alveolar bone defects were treated with nHAC/PLA, nHAC/PLA+rhBMP-2, nHAC/PLA+DPSCs, nHAC/PLA+DPSCs+rhBMP-2, and autogenous bone (AB) obtained from iliac bone or were left untreated as a control. X-ray and a polychrome sequential fluorescent labeling were performed post-operatively and the animals were sacrificed 12 weeks after operation for histological observation and histomorphometric analysis. Results: Our results showed that DPSCs expressed STRO-1 and vementin, and favoured osteogenesis and adipogenesis in conditioned media. DPSCs attached and spread well, and retained their osteogenic phenotypes on nHAC/PLA. The rhBMP-2 could significantly increase protein content, alkaline phosphatase (ALP) activity/protein, osteocalcin (OCN) content, and mineral formation of DPSCs cultured on nHAC/PLA. The X-ray graph, the fluorescent, histological observation and histomorphometric analysis showed that the nHAC/PLA+DPSCs+rhBMP-2 tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than nHAC/PLA, nHAC/PLA+rhBMP-2 and nHAC/PLA+DPSCs, or even autologous bone. Implanted DPSCs contribution to new bone were detected through transfected eGFP genes. Conclutions: Our findings indicated that stem cells existed in adult rabbit dental pulp tissue. The rhBMP-2 promoted osteogenic capability of DPSCs as a potential cell source for periodontal bone regeneration. The nHAC/PLA could serve as a good scaffold for autologous DPSCs seeding, proliferation and differentiation. The tissue-engineered bone complex with nHAC/PLA, rhBMP-2, and autologous DPSCs might be a better alternative to autologous bone for the clinical reconstruction of periodontal bone defects.Keywords: nano-hydroxyapatite/collagen/poly (L-lactide), dental pulp stem cell, recombinant human bone morphogenetic protein, bone tissue engineering, alveolar bone
Procedia PDF Downloads 402904 Interdisciplinary Evaluations of Children with Autism Spectrum Disorder in a Telehealth Arena
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
Procedia PDF Downloads 210903 Teaching Material, Books, Publications versus the Practice: Myths and Truths about Installation and Use of Downhole Safety Valve
Authors: Robson da Cunha Santos, Caio Cezar R. Bonifacio, Diego Mureb Quesada, Gerson Gomes Cunha
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The paper is related to the safety of oil wells and environmental preservation on the planet, because they require great attention and commitment from oil companies and people who work with these equipments. This must occur from drilling the well until it is abandoned in order to safeguard the environment and prevent possible damage. The project had as main objective the constitution resulting from comparatives made among books, articles and publications with information gathered in technical visits to operational bases of Petrobras. After the visits, the information from methods of utilization and present managements, which were not available before, became available to the general audience. As a result, it is observed a huge flux of incorrect and out-of-date information that comprehends not only bibliographic archives, but also academic resources and materials. During the gathering of more in-depth information on the manufacturing, assembling, and use aspects of DHSVs, several issues that were previously known as correct, customary issues were discovered to be uncertain and outdated. Information of great importance resulted in affirmations about subjects as the depth of the valve installation that was before installed to 30 meters from the seabed (mud line). Despite this, the installation should vary in conformity to the ideal depth to escape from area with the biggest tendency to hydrates formation according to the temperature and pressure. Regarding to valves with nitrogen chamber, in accordance with books, they have their utilization linked to water line ≥ 700 meters, but in Brazilian exploratory fields, their use occurs from 600 meters of water line. The valves used in Brazilian fields are able to be inserted to the production column and self-equalizing, but the use of screwed valve in the column of production and equalizing is predominant. Although these valves are more expensive to acquire, they are more reliable, efficient, with a bigger shelf life and they do not cause restriction to the fluid flux. It follows that based on researches and theoretical information confronted to usual forms used in fields, the present project is important and relevant. This project will be used as source of actualization and information equalization that connects academic environment and real situations in exploratory situations and also taking into consideration the enrichment of precise and easy to understand information to future researches and academic upgrading.Keywords: down hole safety valve, security devices, installation, oil-wells
Procedia PDF Downloads 273902 Sample Preparation and Coring of Highly Friable and Heterogeneous Bonded Geomaterials
Authors: Mohammad Khoshini, Arman Khoshghalb, Meghdad Payan, Nasser Khalili
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Most of the Earth’s crust surface rocks are technically categorized as weak rocks or weakly bonded geomaterials. Deeply weathered, weakly cemented, friable and easily erodible, they demonstrate complex material behaviour and understanding the overlooked mechanical behaviour of such materials is of particular importance in geotechnical engineering practice. Weakly bonded geomaterials are so susceptible to surface shear and moisture that conventional methods of core drilling fail to extract high-quality undisturbed samples out of them. Moreover, most of these geomaterials are of high heterogeneity rendering less reliable and feasible material characterization. In order to compensate for the unpredictability of the material response, either numerous experiments are needed to be conducted or large factors of safety must be implemented in the design process. However, none of these approaches is sustainable. In this study, a method for dry core drilling of such materials is introduced to take high-quality undisturbed core samples. By freezing the material at certain moisture content, a secondary structure is developed throughout the material which helps the whole structure to remain intact during the core drilling process. Moreover, to address the heterogeneity issue, the natural material was reconstructed artificially to obtain a homogeneous material with very high similarity to the natural one in both micro and macro-mechanical perspectives. The method is verified for both micro and macro scale. In terms of micro-scale analysis, using Scanning Electron Microscopy (SEM), pore spaces and inter-particle bonds were investigated and compared between natural and artificial materials. X-Ray Diffraction, XRD, analyses are also performed to control the chemical composition. At the macro scale, several uniaxial compressive strength tests, as well as triaxial tests, were performed to verify the similar mechanical response of the materials. A high level of agreement is observed between micro and macro results of natural and artificially bonded geomaterials. The proposed methods can play an important role to cut down the costs of experimental programs for material characterization and also to promote the accuracy of the numerical modellings based on the experimental results.Keywords: Artificial geomaterial, core drilling, macro-mechanical behavior, micro-scale, sample preparation, SEM photography, weakly bonded geomaterials
Procedia PDF Downloads 216901 Improving Student Retention: Enhancing the First Year Experience through Group Work, Research and Presentation Workshops
Authors: Eric Bates
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Higher education is recognised as being of critical importance in Ireland and has been linked as a vital factor to national well-being. Statistics show that Ireland has one of the highest rates of higher education participation in Europe. However, student retention and progression, especially in Institutes of Technology, is becoming an issue as rates on non-completion rise. Both within Ireland and across Europe student retention is seen as a key performance indicator for higher education and with these increasing rates the Irish higher education system needs to be flexible and adapt to the situation it now faces. The author is a Programme Chair on a Level 6 full time undergraduate programme and experience to date has shown that the first year undergraduate students take some time to identify themselves as a group within the setting of a higher education institute. Despite being part of a distinct class on a specific programme some individuals can feel isolated as he or she take the first step into higher education. Such feelings can contribute to students eventually dropping out. This paper reports on an ongoing initiative that aims to accelerate the bonding experience of a distinct group of first year undergraduates on a programme which has a high rate of non-completion. This research sought to engage the students in dynamic interactions with their peers to quickly evolve a group sense of coherence. Two separate modules – a Research Module and a Communications module - delivered by the researcher were linked across two semesters. Students were allocated into random groups and each group was given a topic to be researched. There were six topics – essentially the six sub-headings on the DIT Graduate Attribute Statement. The research took place in a computer lab and students also used the library. The output from this was a document that formed part of the submission for the Research Module. In the second semester the groups then had to make a presentation of their findings where each student spoke for a minimum amount of time. Presentation workshops formed part of that module and students were given the opportunity to practice their presentation skills. These presentations were video recorded to enable feedback to be given. Although this was a small scale study preliminary results found a strong sense of coherence among this particular cohort and feedback from the students was very positive. Other findings indicate that spreading the initiative across two semesters may have been an inhibitor. Future challenges include spreading such Initiatives College wide and indeed sector wide.Keywords: first year experience, student retention, group work, presentation workshops
Procedia PDF Downloads 229900 Immunomodulatory Role of Heat Killed Mycobacterium indicus pranii against Cervical Cancer
Authors: Priyanka Bhowmik, Subrata Majumdar, Debprasad Chattopadhyay
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Background: Cervical cancer is the third major cause of cancer in women and the second most frequent cause of cancer related deaths causing 300,000 deaths annually worldwide. Evasion of immune response by Human Papilloma Virus (HPV), the key contributing factor behind cancer and pre-cancerous lesions of the uterine cervix, makes immunotherapy a necessity to treat this disease. Objective: A Heat killed fraction of Mycobacterium indicus pranii (MIP), a non-pathogenic Mycobacterium has been shown to exhibit cytotoxic effects on different cancer cells, including human cervical carcinoma cell line HeLa. However, the underlying mechanisms remain unknown. The aim of this study is to decipher the mechanism of MIP induced HeLa cell death. Methods: The cytotoxicity of Mycobacterium indicus pranii against HeLa cells was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was detected by annexin V and Propidium iodide (PI) staining. The assessment of reactive oxygen species (ROS) generation and cell cycle analysis were measured by flow cytometry. The expression of apoptosis associated genes was analyzed by real time PCR. Result: MIP could inhibit the proliferation of HeLa cell in a time and dose dependent manner but caused minor damage to normal cells. The induction of apoptosis was confirmed by the cell surface presentation of phosphatidyl serine, DNA fragmentation, and mitochondrial damage. MIP caused very early (as early as 30 minutes) transcriptional activation of p53, followed by a higher activation (32 fold) at 24 hours suggesting prime importance of p53 in MIP-induced apoptosis in HeLa cell. The up regulation of p53 dependent pro-apoptotic genes Bax, Bak, PUMA, and Noxa followed a lag phase that was required for the transcriptional p53 program. MIP also caused the transcriptional up regulation of Toll like receptor 2 and 4 after 30 minutes of MIP treatment suggesting recognition of MIP by toll like receptors. Moreover, MIP caused the inhibition of expression of HPV anti apoptotic gene E6, which is known to interfere with p53/PUMA/Bax apoptotic cascade. This inhibition might have played a role in transcriptional up regulation of PUMA and subsequently apoptosis. ROS was generated transiently which was concomitant with the highest transcription activation of p53 suggesting a plausible feedback loop network of p53 and ROS in the apoptosis of HeLa cells. Scavenger of ROS, such as N-acetyl-L-cysteine, decreased apoptosis suggesting ROS is an important effector of MIP induced apoptosis. Conclusion: Taken together, MIP possesses full potential to be a novel therapeutic agent in the clinical treatment of cervical cancer.Keywords: cancer, mycobacterium, immunity, immunotherapy.
Procedia PDF Downloads 249899 Anti-Apoptotic Effect of Pueraria tuberosa in Rats with Streptozotocin Induced Diabetic Nephropathy
Authors: Rashmi Shukla, Yamini Bhusan Tripathi
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Diabetic nephropathy (DN) is characterized as diabetic kidney disease which involves many pathways e.g. hyperactivated protein kinase c (PKC), polyol pathway, excess production of advanced glycation end product (AGEs) & free radical accumulation etc. All of them results to hypoxia followed by apoptosis of podocytes, glomerulosclerosis, extracellular matrix (ECM) accumulation and fibrosis resulting to irreversible changes in kidney. This is continuously rising worldwide and there are not enough specific drugs, to retard its progress. Due to increasing side effects of allopathic drugs, interest in herbal remedies is growing. Earlier, we have reported that PTY-2 (a phytomedicine, derived from Pueraria tuberosa Linn.) inhibits the accumulation of extracellular matrix (ECM) through activation of MMP-9. Present study exhibited the therapeutic potential of Pueraria tuberosa in the prevention of podocytes apoptosis and modulation of nephrin expression in streptozotocin (STZ) induced DN rats. DN rats were produced by maintaining persistent hyperglycemia for 8 weeks by intra-peritoneal injection of 55 mg/kg streptozotocin (STZ). These rats were randomly divided in 2 groups, i.e. DN control, and DN+ water extract of Pueraria tuberosa (PTW). One group of age-matched normal rats served as non-diabetic control (group-1), The STZ induced DN rats (group-2) and DN+PTW treated rats (group-3). The PTW was orally administered (0.3g/kg) daily to group-2 rats and drug vector (1 ml of 10% tween 20) in control rats. The treatments were continued for 20 days and blood and urine samples were collected. Rats were then sacrificed to investigate the expression Bcl2, Bax and nephroprotective protein i.e. nephrin in kidney glomerulus. The effect of PTW was evaluated, we have found that the PTW significantly(p < .001) reversed the raised serum urea, serum creatinine, urine protein and improved the creatinine clearance in STZ induce diabetic nephropathy in rats and also significantly(p < .001) prevented the rise in urine albumin excretion. The Western blot analysis of kidney tissue homogenate showed increased expression of Bcl2 in PTW treated rats. The RT-PCR showed the increased expression and accumulation of nephrin mRNA. The confocal photomicrographs also supported the reduction of Bax and a simultaneous increase in Bcl2 and nephrin in glomerular podocytes. Hence, our finding suggests that the nephroprotective role of PTW is mediated via restoration of nephrin thus prevents the podocytes apoptosis and ameliorates diabetic nephropathy. The clinical trial of PTW would prove to be a potential food supplement/ drug of alternative medicine for patients with diabetic nephropathy in early stage.Keywords: Pueraria tuberosa, diabetic nephropathy, anti-apoptosis, nephrin
Procedia PDF Downloads 219898 The Significance of Childhood in Shaping Family Microsystems from the Perspective of Biographical Learning: Narratives of Adults
Authors: Kornelia Kordiak
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The research is based on a biographical approach and serves as a foundation for understanding individual human destinies through the analysis of the context of life experiences. It focuses on the significance of childhood in shaping family micro-worlds from the perspective of biographical learning. In this case, the family micro-world is interpreted as a complex of beliefs and judgments about elements of the ‘total universe’ based on the individual's experiences. The main aim of the research is to understand the importance of childhood in shaping family micro-worlds from the perspective of reflection on biographical learning. Additionally, it contributes to a deeper understanding of the familial experiences of the studied individuals who form these family micro-worlds and the course of the biographical learning process in the subjects. Biographical research aligns with an interpretative paradigm, where individuals are treated as active interpreters of the world, giving meaning to their experiences and actions based on their own values and beliefs. The research methods used in the project—narrative interview method and analysis of personal documents—enable obtaining a multidimensional perspective on the phenomenon under study. Narrative interviews serve as the main data collection method, allowing researchers to delve into various life contexts of individuals. Analysis of these narratives identifies key moments and life patterns, as well as discovers the significance of childhood in shaping family micro-worlds. Moreover, analysis of personal documents such as diaries or photographs enriches the understanding of the studied phenomena by providing additional contexts and perspectives. The research will be conducted in three phases: preparatory, main, and final. The anticipated schedule includes preparation of research tools, selection of research sample, conducting narrative interviews and analysis of personal documents, as well as analysis and interpretation of collected research material. The narrative interview method and document analysis will be utilized to capture various contexts and interpretations of childhood experiences and family relations. The research will contribute to a better understanding of family dynamics and individual developmental processes. It will allow for the identification and understanding of mechanisms of biographical learning and their significance in shaping identity and family relations. Analysis of adult narratives will enable the identification of factors determining patterns of behavior and attitudes in adult life, which may have significant implications for pedagogical practice.Keywords: childhood, adulthood, biographical learning, narrative interview, analysis of personal documents, family micro-worlds
Procedia PDF Downloads 31897 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators
Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes
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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.Keywords: gender, men with disabilities, perpetration of violence, victimization
Procedia PDF Downloads 323