Search results for: return response coefficient (RRC)

Authors: Ju-Hong Lee, Ching-Wei Liao

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An adaptive array beamformer is designed for automatically preserving the desired signals while cancelling interference and noise. Providing robustness against model mismatches and tracking possible environment changes calls for robust adaptive beamforming techniques. The design criterion yields the well-known generalized sidelobe canceller (GSC) beamformer. In practice, the knowledge of the desired steering vector can be imprecise, which often occurs due to estimation errors in the DOA of the desired signal or imperfect array calibration. In these situations, the SOI is considered as interference, and the performance of the GSC beamformer is known to degrade. This undesired behavior results in a reduction of the array output signal-to-interference plus-noise-ratio (SINR). Therefore, it is worth developing robust techniques to deal with the problem due to local scattering environments. As to the implementation of adaptive beamforming, the required computational complexity is enormous when the array beamformer is equipped with massive antenna array sensors. To alleviate this difficulty, a generalized sidelobe canceller (GSC) with partially adaptivity for less adaptive degrees of freedom and faster adaptive response has been proposed in the literature. Unfortunately, it has been shown that the conventional GSC-based adaptive beamformers are usually very sensitive to the mismatch problems due to local scattering situations. In this paper, we present an effective GSC-based beamformer against the mismatch problems mentioned above. The proposed GSC-based array beamformer adaptively estimates the actual direction of the desired signal by using the presumed steering vector and the received array data snapshots. We utilize the predefined steering vector and a presumed angle tolerance range to carry out the required estimation for obtaining an appropriate steering vector. A matrix associated with the direction vector of signal sources is first created. Then projection matrices related to the matrix are generated and are utilized to iteratively estimate the actual direction vector of the desired signal. As a result, the quiescent weight vector and the required signal blocking matrix required for performing adaptive beamforming can be easily found. By utilizing the proposed GSC-based beamformer, we find that the performance degradation due to the considered local scattering environments can be effectively mitigated. To further enhance the beamforming performance, a signal subspace projection matrix is also introduced into the proposed GSC-based beamformer. Several computer simulation examples show that the proposed GSC-based beamformer outperforms the existing robust techniques.

Keywords: adaptive antenna beamforming, local scattering, signal blocking, steering mismatch

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Authors: Emre Kara, Metehan Demir, Şura Karakuzu, Kadir Koç, Ahmet F. Geylan, Halil Aykul

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While the polymeric foam cored sandwiches have been realized for many years, recently there is a growing and outstanding interest on the use of sandwiches consisting of aluminum foam core because of their some of the distinct mechanical properties such as high bending stiffness, high load carrying and energy absorption capacities. These properties make them very useful in the transportation industry (automotive, aerospace, shipbuilding industry), where the "lightweight design" philosophy and the safety of vehicles are very important aspects. Therefore, in this study, the sandwich panels with aluminum alloy foam core and various types and thicknesses of glass fiber reinforced polymer (GFRP) skins produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique were obtained by using a commercial toughened epoxy based adhesive with two components. The aim of this contribution was the analysis of the bending response of sandwiches with various glass fiber reinforced polymer skins. The three point bending tests were performed on sandwich panels at different values of support span distance using a universal static testing machine in order to clarify the effects of the type and thickness of the GFRP skins in terms of peak load, energy efficiency and absorbed energy values. The GFRP skins were easily bonded to the aluminum alloy foam core under press machine with a very low pressure. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, collapse mechanisms and the influence of the support span length and GFRP skins. The obtained results of the experimental investigation presented that the sandwich with the skin made of thicker S-Glass fabric failed at the highest load and absorbed the highest amount of energy compared to the other sandwich specimens. The increment of the support span distance made the decrease of the peak force and absorbed energy values for each type of panels. The common collapse mechanism of the panels was obtained as core shear failure which was not affected by the skin materials and the support span distance.

Keywords: aluminum foam, collapse mechanisms, light-weight structures, transport application

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Authors: Sunaina Sunaina

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The emergence of Thailand as a modern nation was amalgamation of several minority groups. Eventually, the nation tried to mitigate these diversities in the name of nationalism in the backdrop of colonial powers presence in neighboring nations. However, the continued imposition of modern nation building processes (which is a western concept) in the post-colonial era deepen the feelings of alienation among the minority groups and leads to separatist conflicts. It is significant that whatever form these conflicts take, will impact the security of nation as well as the region of Southeast Asia. This paper tries to explore the possible factors behind the state policies adopted by the government of Thailand to manage the insurgency in Southern provinces in the south. The protracted insurgency in the South has historical roots as Pattani kingdom had glorious period whether it was trade or commerce or education and its assimilation was never accepted by the leaders of these areas. But after assimilation of southern provinces in the state, it has been the state policy as an important factor in promoting or mitigating the insurgency. Initial protests from the elite class of southern provinces inflated into a more organized and violent uprising after Second World War. It was only the decade of 1990s that a relative peace could prevail for some time. The violence reemerged in 2004 with more intensity and till today this area is suffering with violence. Period of different Prime Ministers dealt this insurgency in different ways sometimes very hard line approach had been adopted especially under Primeminstership of Thaksin Shinawatra. Recently, the peace talks which were started during the period of Yinglunck Shinawatra and were carried forward by Junta government also halted. And again, the region stays in a very volatile state. Violence in these provinces not only questions the capability of government to provide political solution to the problem, but also emerges as a major threat to the internal security of the state. The current era where global terrorism is spreading fast, such vulnerable areas may work as a new ground for its proliferation in Southeast Asia. The paper attempts to understand how Thailand’s historical experience of security determines a different approach to national unity which limits the prospects for autonomy in the South. In conjunction with this experience it is nature of national politics and leadership that influences the nature of policies on the ground in Southern Thailand. The paper also tries to bring out conflict between state sovereignty and self-determination as demanded by many in the southern provinces.

Keywords: insurgency, southern Thailand, security, nation building

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Authors: Łukasz Mazur, Kamil Domaradzki, Bartosz Kamecki, Justyna Ignaczak, Sebastian Molin, Aleksander Gil, Tomasz Brylewski

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The rising global power consumption necessitates the development of new energy storage solutions. Prospective technologies include solid oxide electrolyzer cells (SOECs), which convert surplus electrical energy into hydrogen. An electrolyzer cell consists of a porous anode, and cathode, and a dense electrolyte. Power output is increased by connecting cells into stacks using interconnects. Interconnects are currently made from high-chromium ferritic steels – for example, Crofer 22 APU – which exhibit high oxidation resistance and a thermal expansion coefficient that is similar to that of electrode materials. These materials have one disadvantage – their area-specific resistance (ASR) gradually increases due to the formation of a Cr₂O₃ scale on their surface as a result of oxidation. The chromia in the scale also reacts with the water vapor present in the reaction media, forming volatile chromium oxyhydroxides, which in turn react with electrode materials and cause their deterioration. The electrochemical efficiency of SOECs thus decreases. To mitigate this, the interconnect surface can be modified with protective-conducting coatings of spinel or other materials. The high prices of SOEC components -especially the Crofer 22 APU- have prevented their widespread adoption. More inexpensive counterparts, therefore, need to be found, and their properties need to be enhanced to make them viable. Candidates include the Nirosta 4016/1,4016 low-chromium ferritic steel with a chromium content of just 16.3 wt%. This steel's resistance to high-temperature oxidation was improved by depositing Gd₂O₃ nanoparticles on its surface via either dip coating or electrolysis. Modification with CeO₂ or Ce₀.₉Y₀.₁O₂ nanoparticles deposited by means of spray pyrolysis was also tested. These methods were selected because of their low cost and simplicity of application. The aim of this study was to investigate the oxidation kinetics of Nirosta 4016/1,4016 modified using the afore-mentioned methods and to subsequently measure the obtained samples' ASR. The samples were oxidized for 100 h in the air as well as air/H₂O and Ar/H₂/H₂O mixtures at 1073 K. Such conditions reflect those found in the anode and cathode operating space during real-life use of SOECs. Phase and chemical composition and the microstructure of oxidation products were determined using XRD and SEM-EDS. ASR was measured over the range of 623-1073 K using a four-point, two-probe DC technique. The results indicate that the applied nanoparticles improve the oxidation resistance and electrical properties of the studied layered systems. The properties of individual systems varied significantly depending on the applied reaction medium. Gd₂O₃ nanoparticles improved oxidation resistance to a greater degree than either CeO₂ or Ce₀.₉Y₀.₁O₂ nanoparticles. On the other hand, the cerium-containing nanoparticles improved electrical properties regardless of the reaction medium. The ASR values of all surface-modified steel samples were below the 0.1 Ω.cm² threshold set for interconnect materials, which was exceeded in the case of the unmodified reference sample. It can be concluded that the applied modifications increased the oxidation resistance of Nirosta 4016/1.4016 to a level that allows its use as SOEC interconnect material. Acknowledgments: Funding of Research project supported by program "Excellence initiative – research university" for the AGH University of Krakow" is gratefully acknowledged (TB).

Keywords: cerium oxide, ferritic stainless steel, gadolinium oxide, interconnect, SOEC

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: Jovie Esquivias Nicolas, Ron Aldrin Lontoc Austria, Crisabelle Belleza Bautista, Mariane Chiho Espinosa Bundalian, Owwen Kervy Del Rosario Castillo, Mary Angelyn Mercado Dela Cruz, Heinrich Theraja Recana De Luna, Chriscell Gipanao Eustaquio, Desiree Laine Lauz Gilbas, Jordan Ignacio Legaspi, Larah Denise David Madrid, Charles Linelle Malapote Mendoza, Hazel Maxine Manalad Reyes, Carl Justine Nabora Saberdo, Claire Mae Rendon Santos

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In response to the global race in discovering the next advanced sustainable material that will reduce our ecological footprint, the researchers aimed to create a masonry unit which is competent in physical edifices and other constructional facets. From different proven researches, mycelium has been concluded that when dried can be used as a robust and waterproof building material that can be grown into explicit forms, thus reducing the processing requirements. Hypothesizing inclusive measures to attest fungi’s impressive structural qualities and absorbency, the researchers projected to perform comparative analyses in creating mycelium bricks from mushroom spores of G. lucidum. Three treatments were intended to classify the most ideal concentration of clay and substrate fixings. The substrate bags fixed with 30% clay and 70% mixings indicated highest numerical frequencies in terms of full occupation of fungal mycelia. Subsequently, sorted parts of white portions from the treatment were settled in a thermoplastic mold and burnt. Three proportional concentrations of cultivated substrate and cement were also prioritized to gather results of variation focused on the weights of the bricks in the Water Absorption Test and Durability Test. Fungal inoculums with solutions of cement showed small to moderate amounts of decrease and increase in load. This proves that the treatments did not show any significant difference when it comes to strength, efficiency and absorption capacity. Each of the concentration is equally valid and could be used in supporting the worldwide demands of creating numerous bricks while also taking into consideration the recovery of our nature.

Keywords: mycelium, fungi, fungal mycelia, durability test, water absorption test

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Authors: Youlu Huang, Huanjun Jiang

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A large number of old masonry buildings built in the last century still remain in the city. It generates the problems of unsafety, obsolescence, and non-habitability. In recent years, many old buildings have been reconstructed through renovating façade, strengthening, and adding floors. However, most projects only provide a solution for a single problem. It is difficult to comprehensively solve problems of poor safety and lack of building functions. Therefore, a comprehensive functional renovation program of adding reinforced concrete frame story at the bottom via integrally lifting the building and then strengthening the building was put forward. Based on field measurement and YJK calculation software, the seismic performance of an actual three-story masonry structure in Shanghai was identified. The results show that the material strength of masonry is low, and the bearing capacity of some masonry walls could not meet the code requirements. The elastoplastic time history analysis of the structure was carried out by using SAP2000 software. The results show that under the 7 degrees rare earthquake, the seismic performance of the structure reaches 'serious damage' performance level. Based on the code requirements of the stiffness ration of the bottom frame (lateral stiffness ration of the transition masonry story and frame story), the bottom frame story was designed. The integral lifting process of the masonry building was introduced based on many engineering examples. The reinforced methods for the bottom frame structure strengthened by the steel-reinforced mesh mortar surface layer (SRMM) and base isolators, respectively, were proposed. The time history analysis of the two kinds of structures, under the frequent earthquake, the fortification earthquake, and the rare earthquake, was conducted by SAP2000 software. For the bottom frame structure, the results show that the seismic response of the masonry floor is significantly reduced after reinforced by the two methods compared to the masonry structure. The previous earthquake disaster indicated that the bottom frame is vulnerable to serious damage under a strong earthquake. The analysis results showed that under the rare earthquake, the inter-story displacement angle of the bottom frame floor meets the 1/100 limit value of the seismic code. The inter-story drift of the masonry floor for the base isolated structure under different levels of earthquakes is similar to that of structure with SRMM, while the base-isolated program is better to protect the bottom frame. Both reinforced methods could significantly improve the seismic performance of the bottom frame structure.

Keywords: old buildings, adding story, seismic strengthening, seismic performance

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Authors: Gunjan Razdan, Priyanka Sreenath, Jagannath Behera, S. K. Mishra, Sunil Mehra

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Uttar Pradesh is one of the poor performing states with high Malnutrition and Anaemia among adolescent girls resulting in high MMR, IMR and low birth weight rate. The rate of anaemia among adolescent girls has doubled in the past decade. Adolescents gain around 15-20% of their optimum height, 25-50% of the ideal adult weight and 45% of the skeletal mass by the age of 19. Poor intake of energy, protein and other nutrients is one of the factors for malnutrition and anaemia. METHODS: The cross-sectional survey using a mixed method (quantitative and qualitative) was adopted in this study. The respondents (adolescents, parents and frontline health workers) were selected randomly from 30 villages and surveyed through a semi-structured questionnaire for qualitative information and FGDs and IDIs for qualitative information. A 24 hours dietary recall method was adopted to estimate their dietary practices. A total of 1069 adolescent girls, 1067 boys, 1774 parents and 69 frontline functionaries were covered under the study. Percentages and mean were calculated for quantitative variable, and content analysis was carried out for qualitative data. RESULTS: Over 80 % of parents provided assertions that they understood the term balanced diet and strongly felt that their children were having balanced diet. However, only negligible 1.5 % of parents could correctly recount essential eight food groups and 22% could tell about four groups which was the minimum response expected to say respondents had fair knowledge on a balanced diet. Only 10 percent of parents could tell that balanced diet helps in physical and mental growth and only 2% said it has a protective role. Besides, qualitative data shows that the perception regarding balanced diet is having costly food items like nuts and fruits. The dietary intake of adolescents is very low despite the increased iron needs associated with physical growth and puberty.The consumption of green leafy vegetables (less than 35 %) and citrus fruits (less than 50%) was found to be low. CONCLUSIONS: The assertions on an understanding of term balanced diet are contradictory to the actual knowledge and practices. Knowledge on essential food groups and nutrients is crucial to inculcate healthy eating practices among adolescents. This calls for comprehensive communication efforts to improve the knowledge and dietary practices among adolescents.

Keywords: anemia, knowledge, malnutrition, perceptions

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Authors: Kaddour Fellague Mohammed

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The world has seen in recent years, significant developments affected various aspects of life and influenced the different types of institutions, thus was born a new world is a world of globalization, which dominated the scientific revolution and the tremendous technological developments, and that contributed to the re-formation of human resources in contemporary organizations, and made patterns new regulatory and at the same time raised and strongly values and new ideas, the organizations have become more flexible, and faster response to consumer and environmental conditions, and exceeded the problem of time and place in the framework of communication and human interaction and use of advanced information technology and adoption mainly mechanism in running its operations , focused on performance and based strategic thinking and approach in order to achieve its strategic goals high degrees of superiority and excellence, this new reality created an increasing need for a new type of human resources, quality aims to renew and aspire to be a strategic player in managing the organization and drafting of various strategies, think globally and act locally, to accommodate local variables in the international markets, which began organizations tend to strongly as well as the ability to work under different cultures. Human resources management of the most important management functions to focus on the human element, which is considered the most valuable resource of the Department and the most influential in productivity at all, that the management and development of human resources Tattabra a cornerstone in the majority of organizations which aims to strengthen the organizational capacity, and enable companies to attract and rehabilitation of the necessary competencies and are able to keep up with current and future challenges, human resources can contribute to and strongly in achieving the objectives and profit organization, and even expand more than contribute to the creation of new jobs to alleviate unemployment and achieve full operation, administration and human resources mean short optimal use of the human element is available and expected, where he was the efficiency and capabilities, and experience of this human element, and his enthusiasm for the work stop the efficiency and success in reaching their goals, so interested administration scientists developed the principles and foundations that help to make the most of each individual benefit in the organization through human resources management, these foundations start of the planning and selection, training and incentives and evaluation, which is not separate from each other, but are integrated with each other as a system systemic order to reach the efficient functioning of the human resources management and has been the organization as a whole in the context of development sustainable.

Keywords: configuration, training, development, human resources, operating

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Authors: A. G. Gashua, T. T. Bello, I. Alhassan, K. K. Gwiokura

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Weeds are known to interfere seriously with crop growth, thereby affecting the productivity and quality of crops. Crops are also known to compete for natural growth resources if they are not adequately spaced, also affecting the performance of the growing crop. Farmers grow cowpea in mixtures with cereals and this is known to affect its yield. For this reason, a field experiment was conducted at Yobe State College of Agriculture Gujba, Damaturu station in the 2014 and 2015 rainy seasons to determine the appropriate intra row spacing and weeding regime for optimum growth and yield of cowpea (Vigna unguiculata L.) in pure stand in Sudan Savanna ecology. The treatments consist of three levels of spacing within rows (20 cm, 30 cm and 40 cm) and four weeding regimes (none, once at 3 weeks after sowing (WAS), twice at 3 and 6WAS, thrice at 3WAS, 6WAS and 9WAS); arranged in a Randomized Complete Block Design (RCBD) and replicated three times. The variety used was the local cowpea variety (white, early and spreading) commonly grown by farmers. The growth and yield data were collected and subjected to analysis of variance using SAS software, and the significant means were ranked by Students Newman Keul’s test (SNK). The findings of this study revealed better crop performance in 2015 than in 2014 despite poor soil condition. Intra row spacing significantly influenced vegetative growth especially the number of main branches, leaves and canopy spread at 6WAS and 9WAS with the highest values obtained at wider spacing (40 cm). The values obtained in 2015 doubled those obtained in 2014 in most cases. Spacing also significantly affected the number of pods in 2015, seed weight in both years and grain yield in 2014 with the highest values obtained when the crop was spaced at 30-40 cm. Similarly, weeding regime significantly influenced almost all the growth attributes of cowpea with higher values obtained from where cowpea was weeded three times at 3-week intervals, though statistically similar results were obtained even from where cowpea was weeded twice. Weeding also affected the entire yield and yield components in 2015 with the highest values obtained with increase weeding. Based on these findings, it is recommended that spreading cowpea varieties should be grown at 40 cm (or wider spacing) within rows and be weeded twice at three-week intervals for better crop performance in related ecologies.

Keywords: intra-row spacing, local cowpea, Nigeria, weeding

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Authors: S. Pradhan, D. Pradhan, G. Tripathy

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Anti-estrogen treatment resistant is a noteworthy reason for disease relapse and mortality in estrogen receptor alpha (ERα)- positive breast cancers. Tamoxifen or estrogen withdrawal increases the dependance of breast malignancy cells on INT3 signaling. Here, we researched the contribution of Quercetin and INT3 signaling in endocrine resistant breast cancer cells. Methods: We utilized two models of endocrine therapies resistant (ETR-) breast cancer: tamoxifen-resistant (TamR) and long term estrogen-deprived (LTED) MCF7 cells. We assessed the migratory and invasive limit of these cells by Transwell assay. Expression of epithelial to mesenchymal transition (EMT) controllers and in addition INT3 receptors and targets were assessed by real-time PCR and western blot analysis. Besides, we tried in vitro anti-Quercetin monoclonal antibodies (mAbs) and gamma secretase inhibitors (GSIs) as potential EMT reversal therapeutic agents. At last, we created stable Quercetin over expessing MCF7 cells and assessed their EMT features and response to tamoxifen. Results:We found that ETR cells acquired an epithelial to mesenchymal transition (EMT) phenotype and showed expanded levels of Quercetin and INT3 targets. Interestingly, we detected higher level of INT3 however lower levels of INT31 and INT32 proposing a switch to targeting through distinctive INT3 receptors after obtaining of resistance. Anti-Quercetin monoclonal antibodies and the GSI PF03084014 were effective in obstructing the Quercetin/INT3 axis and in part inhibiting the EMT process. As a consequence of this, cell migration and invasion were weakened and the stem cell like population was considerably decreased. Genetic hushing of Quercetin and INT3 prompted proportionate impacts. Finally, stable overexpression of Quercetin was adequate to make MCF7 lethargic to tamoxifen by INT3 activation. Conclusions: ETR cells express abnormal amounts of Quercetin and INT3, whose actuation eventually drives invasive conduct. Anti-Quercetin mAbs and GSI PF03084014 lessen expression of EMT molecules decreasing cellular invasiveness. Quercetin overexpression instigates tamoxifen resistance connected to obtaining of EMT phenotype. Our discovering propose that focusing on Quercetin and/or INT3 warrants further clinical assessment as substantial therapeutic methodologies in endocrine-resistant breast cancer.

Keywords: quercetin, INT3, mesenchymal transition, MCF7 breast cancer cells

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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Authors: Saif Alomari

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The paper aims at giving physical and mathematical descriptions of how the structural parameters of a resonant tunnelling diode (RTD) affect its output characteristics. Specifically, the value of the peak voltage, peak current, peak to valley current ratio (PVCR), and the difference between peak and valley voltages and currents ΔV and ΔI. A simulation-based approach using the Non-Equilibrium Green Function (NEGF) formalism based on the Silvaco ATLAS simulator is employed to conduct a series of designed experiments. These experiments show how the doping concentration in the emitter and collector layers, their thicknesses, and the width of the barriers and the quantum well influence the above-mentioned output characteristics. Each of these parameters was systematically changed while holding others fixed in each set of experiments. Factorial experiments are outside the scope of this work and will be investigated in future. The physics involved in the operation of the device is thoroughly explained and mathematical models based on curve fitting and underlaying physical principles are deduced. The models can be used to design devices with predictable output characteristics. These models were found absent in the literature that the author acanned. Results show that the doping concentration in each region has an effect on the value of the peak voltage. It is found that increasing the carrier concentration in the collector region shifts the peak to lower values, whereas increasing it in the emitter shifts the peak to higher values. In the collector’s case, the shift is either controlled by the built-in potential resulting from the concentration gradient or the conductivity enhancement in the collector. The shift to higher voltages is found to be also related to the location of the Fermi-level. The thicknesses of these layers play a role in the location of the peak as well. It was found that increasing the thickness of each region shifts the peak to higher values until a specific characteristic length, afterwards the peak becomes independent of the thickness. Finally, it is shown that the thickness of the barriers can be optimized for a particular well width to produce the highest PVCR or the highest ΔV and ΔI. The location of the peak voltage is important in optoelectronic applications of RTDs where the operating point of the device is usually the peak voltage point. Furthermore, the PVCR, ΔV, and ΔI are of great importance for building RTD-based oscillators as they affect the frequency response and output power of the oscillator.

Keywords: peak to valley ratio, peak voltage shift, resonant tunneling diodes, structural parameters

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Authors: Luz Stella Cadavid-Rodriguez, Viviana E. Castro-Lopez

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Fish waste (FW) has a high content of potentially biodegradable components, so it is amenable to be digested anaerobically. In this line, anaerobic digestion (AD) of FW has been studied for biogas production. Nevertheless, intermediate products such as volatile fatty acids (VFA), generated during the acidogenic stage, have been scarce investigated, even though they have a high potential as a renewable source of carbon. In the literature, there are few studies about the Inoculum-Substrate (I/S) ratio on acidogenesis. On the other hand, it is well known that pH is a critical factor in the production of VFA. The optimum pH for the production of VFA seems to change depending on the substrate and can vary in a range between 5.25 and 11. Nonetheless, the literature about VFA production from protein-rich waste, such as FW, is scarce. In this context, it is necessary to deepen on the determination of the optimal operating conditions of acidogenic fermentation for VFA production from protein-rich waste. Therefore, the aim of this research was to optimize the volatile fatty acid production from artisanal fishing waste, studying the effect of pH and the I/S ratio on the acidogenic process. For this research, the inoculum used was a methanogenic sludge (MS) obtained from a UASB reactor treating wastewater of a slaughterhouse plant, and the FW was collected in the port of Tumaco (Colombia) from the local artisanal fishers. The acidogenic fermentation experiments were conducted in batch mode, in 500 mL glass bottles as anaerobic reactors, equipped with rubber stoppers provided with a valve to release biogas. The effective volume used was 300 mL. The experiments were carried out for 15 days at a mesophilic temperature of 37± 2 °C and constant agitation of 200 rpm. The effect of 3 pH levels: 5, 7, 9, coupled with five I/S ratios, corresponding to 0.20, 0.15, 0.10, 0.05, 0.00 was evaluated taking as a response variable the production of VFA. A complete randomized block design was selected for the experiments in a 5x3 factorial arrangement, with two repetitions per treatment. At the beginning and during the process, pH in the experimental reactors was adjusted to the corresponding values of 5, 7, and 9 using 1M NaOH or 1M H2SO4, as was appropriated. In addition, once the optimum I/S ratio was determined, the process was evaluated at this condition without pH control. The results indicated that pH is the main factor in the production of VFA, obtaining the highest concentration with neutral pH. By reducing the I/S ratio, as low as 0.05, it was possible to maximize VFA production. Thus, the optimum conditions found were natural pH (6.6-7.7) and I/S ratio of 0.05, with which it was possible to reach a maximum total VFA concentration of 70.3 g Ac/L, whose major components were acetic acid (35%) and butyric acid (32%). The findings showed that the acidogenic fermentation of FW is an efficient way of producing VFA and that the operating conditions can be simple and economical.

Keywords: acidogenesis, artisanal fishing waste, inoculum to substrate ratio, volatile fatty acids

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Authors: Naomi Sakamoto, Eisuke Fukuma, Mika Nashimoto, Yoshitomo Koshida

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Background: Selective localization of the metastatic lymph node with clip and removal of clipped nodes with sentinel lymph node (SLN), known as targeted axillary dissection (TAD), reduced false-negative rates (FNR) of SLN biopsy (SLNB) after neoadjuvant chemotherapy (NAC). For the patients who achieved nodal pathologic complete response (pCR), accurate staging of axilla by TAD lead to omit axillary lymph node dissection (ALND), decreasing postoperative arm morbidity without a negative effect on overall survival. This study aimed to investigate the ultrasound (US) identification rate and success removal rate of two kinds of ultrasound-visible clips placed in metastatic lymph nodes during TAD procedure. Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. A US-visible clip was placed in the suspicious lymph node under US guidance before neoadjuvant chemotherapy. Before surgery, US examination was performed to evaluate the detection rate of clipped node. During the surgery, the clipped node was removed using several localization techniques, including hook-wire localization, dye-injection, or fluorescence technique, followed by a dual-technique SLNB and resection of palpable nodes if present. For the fluorescence technique, after injection of 0.1-0.2 mL of indocyanine green dye (ICG) into the clipped node, ICG fluorescent imaging was performed using the Photodynamic Eye infrared camera (Hamamatsu Photonics k. k., Shizuoka, Japan). For the dye injection method, 0.1-0.2 mL of pyoktanin blue dye was injected into the clipped node. Results: A total of 29 patients were enrolled. Hydromark™ breast biopsy site markers (Hydromark, T3 shape; Devicor Medical Japan, Tokyo, Japan) was used in 15patients, whereas a UltraCor™ Twirl™ breast marker (Twirl; C.R. Bard, Inc, NJ, USA) was placed in 14 patients. US identified the clipped node marked with the UltraCore Twirl in 100% (14/14) and with the Hydromark in 93.3% (14/15, p = ns). Success removal of clipped node marked with the UltraCore Twirl was achieved in 100% (14/14), whereas the node marked with the Hydromark was removed in 80% (12/15) (p = ns). Conclusions: The ultrasound identification rate differed between the two types of ultrasound-visible clips, which also affected the success removal rate of clipped nodes. Labelling the positive node with a US-highly-visible clip allowed successful TAD.

Keywords: breast cancer, neoadjuvant chemotherapy, targeted axillary dissection, breast tissue marker, clip

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Authors: Sabri Serkan Gulluoglu

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The study is aimed at examining the effects of internet marketing with IPTV on human beings. Internet marketing with IPTV is emerging as an integral part of business strategies in today’s technologically advanced world and the business activities all over the world are influences with the emergence of this modern marketing tool. As the population of the Internet and on-line users’ increases, new research issues have arisen concerning the demographics and psychographics of the on-line user and the opportunities for a product or service. In recent years, we have seen a tendency of various services converging to the ubiquitous Internet Protocol based networks. Besides traditional Internet applications such as web browsing, email, file transferring, and so forth, new applications have been developed to replace old communication networks. IPTV is one of the solutions. In the future, we expect a single network, the IP network, to provide services that have been carried by different networks today. For finding some important effects of a video based technology market web site on internet, we determine to apply a questionnaire on university students. Recently some researches shows that in Turkey the age of people 20 to 24 use internet when they buy some electronic devices such as cell phones, computers, etc. In questionnaire there are ten categorized questions to evaluate the effects of IPTV when shopping. There were selected 30 students who are filling the question form after watching an IPTV channel video for 10 minutes. This sample IPTV channel is “buy.com”, it look like an e-commerce site with an integrated IPTV channel on. The questionnaire for the survey is constructed by using the Likert scale that is a bipolar scaling method used to measure either positive or negative response to a statement (Likert, R) it is a common system that is used is the surveys. By following the Likert Scale “the respondents are asked to indicate their degree of agreement with the statement or any kind of subjective or objective evaluation of the statement. Traditionally a five-point scale is used under this methodology”. For this study also the five point scale system is used and the respondents were asked to express their opinions about the given statement by picking the answer from the given 5 options: “Strongly disagree, Disagree, Neither agree Nor disagree, Agree and Strongly agree”. These points were also rates from 1-5 (Strongly disagree, Disagree, Neither disagree Nor agree, Agree, Strongly agree). On the basis of the data gathered from the questionnaire some results are drawn in order to get the figures and graphical representation of the study results that can demonstrate the outcomes of the research clearly.

Keywords: IPTV, internet marketing, online, e-commerce, video based technology

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Authors: Elif Gencturk, Ekin Yurdakul, Ahmet Y. Celik, Senol Mutlu, Kutlu O. Ulgen

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Yeast cells are generally used as a model system of eukaryotes due to their complex genetic structure, rapid growth ability in optimum conditions, easy replication and well-defined genetic system properties. Thus, yeast cells increased the knowledge of the principal pathways in humans. During fermentation, carbohydrates (hexoses and pentoses) degrade into some toxic by-products such as 5-hydroxymethylfurfural (5-HMF or HMF) and furfural. HMF influences the ethanol yield, and ethanol productivity; it interferes with microbial growth and is considered as a potent inhibitor of bioethanol production. In this study, yeast single cell behavior under HMF application was monitored by using a continuous flow single phase microfluidic platform. Microfluidic device in operation is fabricated by hot embossing and thermo-compression techniques from cyclo-olefin polymer (COP). COP is biocompatible, transparent and rigid material and it is suitable for observing fluorescence of cells considering its low auto-fluorescence characteristic. The response of yeast cells was recorded through Red Fluorescent Protein (RFP) tagged Nop56 gene product, which is an essential evolutionary-conserved nucleolar protein, and also a member of the box C/D snoRNP complexes. With the application of HMF, yeast cell proliferation continued but HMF slowed down the cell growth, and after HMF treatment the cell proliferation stopped. By the addition of fresh nutrient medium, the yeast cells recovered after 6 hours of HMF exposure. Thus, HMF application suppresses normal functioning of cell cycle but it does not cause cells to die. The monitoring of Nop56 expression phases of the individual cells shed light on the protein and ribosome synthesis cycles along with their link to growth. Further computational study revealed that the mechanisms underlying the inhibitory or inductive effects of HMF on growth are enriched in functional categories of protein degradation, protein processing, DNA repair and multidrug resistance. The present microfluidic device can successfully be used for studying the effects of inhibitory agents on growth by single cell tracking, thus capturing cell to cell variations. By metabolic engineering techniques, engineered strains can be developed, and the metabolic network of the microorganism can thus be manipulated such that chemical overproduction of target metabolite is achieved along with the maximum growth/biomass yield.  

Keywords: COP, HMF, ribosome biogenesis, thermoplastic microbioreactor, yeast

Procedia PDF Downloads 146

Authors: Maria Barbano Acevedo-Gomez, Elena Sonsoles Rodriguez-Lopez, Sofia Olivia Calvo-Moreno, Angel Basas-Garcia, Cristophe Ramirez

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5%-46.8%) and varies as it seems to depend on the intensity of exercise, movements, and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Even though the emphasis of this research is on female athletes, all women should perform pelvic floor muscle exercises as a part of their general physical exercise. Pelvic floor exercises are generally considered the first treatment against urinary incontinence. Objective: The main objective of the present study was to determine the knowledge of the pelvic floor and of the UI in elite athletes and know if they incorporate pelvic floor strengthening in their training. Methods: This was an observational study conducted on 754 elite athletes. After collecting questions about the pelvic floor, UI, and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-SF). Results: 57.3% of the athletes reflect not having knowledge of their pelvic floor, 48.3% do not know what strengthening exercises are, and around 90% have never practiced them. 78.1% (n=589) of all elite athletes do not include pelvic floor exercises in their training. Of the elite athletes surveyed, 33% had UI according to ICIQ-SF (mean age 23.75 ± 7.74 years). In response to the question 'Do you think you have or have had UI?', Only 9% of the 754 elite athletes admitted they presently had UI, and 13.3% indicated they had had UI at some time. However, 22.7% (n=171) reported they had experienced urine leakage while training. Of the athletes who indicated they did not have UI in the ICIQ-SF, 25.7% stated they did experience urine leakage during training (χ² [1] = 265.56; p < 0.001). Further, 12.3% of the athletes who considered they did not have UI and 60% of those who admitted they had had UI on some occasion stated they had suffered some urine leakage in the past 3 months (χ² [1] = 287.59; p < 0.001). Conclusions: There is a lack of knowledge about UI in sport. Through the use of validated questionnaires, we observed a UI prevalence of 33%, and 22.7% reported they experienced urine leakage while training. These figures contrast with only 9% of athletes who reported they had or had in the past had UI. This discrepancy could reflect the great lack of knowledge about UI in sports and that sometimes an athlete may consider that urine leakage is normal and a consequence of the demands of training. These data support the idea that coaches, physiotherapists, and other professionals involved in maximizing the performance of athletes should include pelvic floor muscle exercises in their training programs. Measures such as this could help to prevent UI during training and could be a starting point for future studies designed to develop adequate prevention and treatment strategies for this embarrassing problem affecting young athletes, both male and female.

Keywords: athletes, pelvic floor, performance, prevalence, sport, training, urinary incontinence

Procedia PDF Downloads 100

Authors: Natasha Perez

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This autobiographical narrative inquiry explores the relationship between religious practice, identity, language and literacy in the author’s life experience as a second-generation Cuban-American growing up in the bilingual spaces of South Florida. The author describes how the social practices around language, including the flexibility to communicate in English and Spanish simultaneously, known as translanguaging, were instrumental to developing a biliterate cosmopolitan identity, along with a greater sense of Latinidad through interactions with diverse Latinx church members. This narrative study involved cycles of writing, reading, and reflection within a three-dimensional narrative inquiry space in order to discover the ways in which language and literacy development in the relationship between the personal and the social, across time and space, as historically situated phenomena. The findings show that Catholic faith practices have always been a source and expression of Cuban-ness, a means of sustaining Cuban identity, as well as a medium for bilingual language and literacy practice in the author’s life. Despite lacking formal literacy education in Spanish, she benefitted from the Catholic Church’s response to the surge of Spanish-speaking immigrants in South Florida in the 1980s and the subsequent flexibility of language practice in church-sponsored youth groups. The faith-sharing practices of the youth group created a space to use Spanish in more sophisticated ways that served to build confidence as a bilingual speaker and expand bilingual competence. These experiences also helped the author develop a more salient identity as Cuban-American and a deeper connection to her Cuban-ness in relation to the Nicaraguan, Venezuelan, and first-generation Cuban identities of my peers. The youth group also fostered cosmopolitan identity building through interactions with pan-ethnic Spanish speakers, with Catholicism as a common language and culture that served as a uniting force. Interaction with these peers also fostered cosmopolitan understandings that deepened the author’s knowledge of the geographical boundaries, political realities, and socio-historical differences between these groups of immigrants. This narrative study opens a window onto the micro-processes and socio-cultural dynamics of language and identity development in the second generation, with the potential to deepen our understanding of the impact of religious practice on these.

Keywords: literacy, religion, identity, comopolitanism, culture, language, translanguaging

Procedia PDF Downloads 72

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Yulistiani Yulistiani, Wenny Nilamsari, Laurin Winarso, Rizkiya Rizkiya, Zamrotul Izzah, Budi Suprapti, Arif Bachtiar

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Approximately, a million new cases of TB have been found out per year, making Indonesia as the second greatest country with TBC after India. Nevertheless, until now, there are still many patients failure to conventional therapy with oral anti tuberculosis. Thus, the discovery of supplement therapy is urgently needed. Many studies showed that probiotic had the positive impact in lung diseases, diarrhea, pneumonia and it was attributed to its capability to balance the level of cytokine pro-inflammatory and anti-inflammatory. It was demonstrated in active disease the production of IFN-γ is strongly depressed and IL-10 level increases. This study aimed to investigate the effect of probiotic (multi strains) and vitamin B complex supplementation on IFN-γ and IL-10 level in patients with TB infection during intensive phase therapy. A randomized controlled trial, open labeled was conducted in TB patients with the following criteria: 1) age 18-55 years old 2) receiving oral antituberculosis during intensive therapy 3) not using probiotic, vitamin B1, B6, B12 2 weeks before enrollment 4) willing to participate in this study and signed an informed consent. While, patients with HIV, pregnant, had the history of diabetes mellitus, using corticosteroid or other immunosuppressants were excluded. IFN-γ and IL-10 levels were drawn before observation and after a month observation. The assay was performed by ELISA. There were seven patients in treated group and five patients in controlled group obtained in this study. Between groups, there was no statistical difference in comorbid, age, and disease duration. The mean level of IFN-γ after a month observation increased in treated group and controlled group, which were 31.47 ± 105.46 pg/ml and 15.09 ± 24.23 pg/ml, respectively (p> 0.005). Although, there were not statistically different, treated group showed a greater increase of IFN-γ level than that of the controlled group. IFN-γ plays an important role in immune response to Mycobacterium Tuberculosis, by activating macrofag, monosit and furthermore killing Mycobacterium Tuberculosis. Thus the level was expected to increase after supplementation with probiotic and Vitamin B complex. While the mean level of IL-10 also increased after one month observation in the treated group and controlled group (4.28 ± 12.29 pg/ml and 5.77± 6.21 pg/ml, respectively) (p>0.005). To be compared, the increased level of IL-10 in the treated group were lower than the controlled group, although it was not statistically different. IL-10 is a cytokine anti-inflammatory, thus, the level after the observation was expected to decrease. In this study, a month therapy of probiotic and vitamin B complex was not able to demonstrate the decrease of the IL-10 level. It is suggested to prolong observation up to 2 months, because, in intensive phase, the level of cytokine anti-inflammatory is very high, so the longer therapy is needed. It is indicated that supplementation therapy with probiotic and vitamin B complex to Oral Anti-Tuberculosis may have a positive effect on increasing IFN-γ level and slowing the progression of IL-10.

Keywords: TB Infection, IFN-γ, IL-10, probiotic, vitamin B complex

Procedia PDF Downloads 360

Authors: Gizaw Mamo Gebeyehu, Marianna Pap, Geza Makkai, Tibor Z. Janosi, Shima Rashidian, Tibor A. Rauch

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Sepsis poses a significant global health threat, necessitating extensive exploration of indicators tied to its pathological mechanisms and multi-organ dysfunction. While murine studies have shed light on sepsis, the intricate cellular and molecular landscape in human sepsis remains enigmatic. Exploring the influence of activated monocyte-derived exosomes in sepsis sheds light on a promising pathway for understanding the intricate cellular and molecular mechanisms involved in this condition in humans. In sepsis, exosome-borne mRNA and miRNA orchestrate immune response gene expression in recipient cells. Yet, the specifics of exosome-mediated cell-to-cell communication, especially how mRNA cargoes modulate gene expression in recipient cells, remain poorly understood. This study aims to elucidate the precise molecular pathways through which exosomal mRNA cargo, particularly MAFB, contributes to the developing sepsis-induced molecular aberrations in liver tissues, employing rigorously defined cell culture conditions. THP-1 cells were treated with LPS to induce changes in exosomal RNA profiles. Exosomes were isolated and characterized using microscopy and mass spectrometry. RNA was extracted from exosomes and sequenced. The most abundant exosomal mRNAs were subjected to GO analysis for functional annotation analysis and KEGG database analysis to identify the involved enriched pathways. PCR (Polymerase Chain Reaction), RNA sequencing, and Western blotting were involved to analyze changes in gene expression, protein levels, and signaling pathways within the liver cells( HepG2) after exposure to exosomal MAFB. This study pinpoints exosomal MAFB as a potential key regulator linked to liver cell damage during sepsis, along with associated genes (miR155HG, H3F3A, and possibly JARD2) forming a crucial molecular pathway contributing to liver cell injury, Together, these elements indicate a vital molecular pathway that plays a significant role in the emergence of liver cell injury during sepsis.. These findings suggest the importance of further research on these components for potential therapeutic interventions in managing acute liver damage in sepsis.

Keywords: sepsis, exososome, exosomal MAFB, LPS-induced THP-1 cells, RNA profiles, sepsis-triggered liver injury

Procedia PDF Downloads 44

Authors: Rebecca Greenberg, Nipa Chauhan, Rashad Rehman

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Paternalism, in its traditional form, seems largely incompatible with Western medicine. In contrast, Family-Centred Care, a partial response to historically authoritative paternalism, carries its own challenges, particularly when operationalized as family-directed care. Specifically, in neonatology, decision-making is left entirely to Substitute Decision Makers (most commonly parents). Most models of shared decision-making employ both the parents’ and medical team’s perspectives but do not recognize the inherent asymmetry of information and experience – asking parents to act like physicians to evaluate technical data and encourage physicians to refrain from strong medical opinions and proposals. They also do not fully appreciate the difficulties in adjudicating which perspective to prioritize and, moreover, how to mitigate disagreement. Introducing a mild form of paternalism can harness the unique skillset both parents and clinicians bring to shared decision-making and ultimately work towards decision-making in the best interest of the child. The notion expressed here is that within the model of shared decision-making, mild paternalism is prioritized inasmuch as optimal care is prioritized. This mild form of paternalism is known as Beneficent Paternalism and justifies our encouragement for physicians to root down in their own medical expertise to propose treatment plans informed by medical expertise, standards of care, and the parents’ values. This does not mean that we forget that paternalism was historically justified on ‘beneficent’ grounds; however, our recommendation is that a re-integration of mild paternalism is appropriate within our current Western healthcare climate. Through illustrative examples from the NICU, this paper explores the appropriateness and merits of Beneficent Paternalism and ultimately its use in promoting family-centered care, patient’s best interests and reducing moral distress. A distinctive feature of the NICU is the fact that communication regarding a patient’s treatment is exclusively done with substitute decision-makers and not the patient, i.e., the neonate themselves. This leaves the burden of responsibility entirely on substitute decision-makers and the clinical team; the patient in the NICU does not have any prior wishes, values, or beliefs that can guide decision-making on their behalf. Therefore, the wishes, values, and beliefs of the parent become the map upon which clinical proposals are made, giving extra weight to the family’s decision-making responsibility. This leads to why Family Directed Care is common in the NICU, where shared decision-making is mandatory. However, the zone of parental discretion is not as all-encompassing as it is currently considered; there are appropriate times when the clinical team should strongly root down in medical expertise and perhaps take the lead in guiding family decision-making: this is just what it means to adopt Beneficent Paternalism.

Keywords: care, ethics, expertise, NICU, paternalism

Procedia PDF Downloads 119

Authors: Patience Manjengwa-Hungwe, Carmen White

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Background: Odyssean malaria refers to malaria acquired by infected mosquito bites from malaria endemic to non-endemic regions by mechanical modes of transport, such as airplanes, water vessels, trains and vehicles. Odyssean Malaria is rare and is characterised by absence of travel history to malaria endemic areas. As not anticipated in non-endemic areas, late diagnosis and treatment lead to a high case fatality rate. On 26 September 2014, the Outbreak Response Unit at the National Institute of Communicable Diseases was notified of a suspected death from Odyssean Malaria in Johannesburg, Gauteng Province, a non-endemic area. The main objective of this investigation was to identify the etiological agent's mode and source of transmission. Methods: Epidemiological surveys were conducted with the deceased’s family and clinical details were obtained from doctors who treated the victim in Southrand, Johannesburg. Blood samples were collected prior to death and sent to the National Health Laboratory Services, Johannesburg laboratory for a full blood count, urea electrolytes, creatinine, and C-reactive protein. Environmental assessments and entomological investigations, including collection of mosquito and larvae, were conducted at the deceased’s home and surrounding areas and sent to the laboratory for analysis. Results: Epidemiological surveys revealed no travel history, no mechanical transmission through blood transfusion and no previous possible exposure of the victim to malaria mosquitoes. Laboratory findings indicated that the platelet count was low. A further smear revealed that the malaria parasite was present and malaria antigen for P. falciparum was positive. Entomological findings revealed that none of the six adult or larval mosquitoes collected on site were malaria vectors. Dumping sites found at the back of the house were identified as possible sites where mosquitoes from endemic places could possibly breed. Conclusion: Given that there was no travel history or the possibility of mechanical transmission (blood transfusion or needle), the research team concluded that it is highly probable that the infection was acquired through an infective Anopheles mosquito inadvertently translocated from a Malaria endemic area by mechanical modes of transport. We recommend that clinicians in non-endemic malaria areas be aware of this type of malaria and test for malaria in patients showing malaria-like symptoms.

Keywords: Odyssean Malaria, vector Bourne, malaria, epidemiological surveys

Procedia PDF Downloads 321

Authors: S. Arias

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New housing developments and the technological changes that this implies, adapt the styles of living of its residents, as well as new family structures and forms of work due to the particular needs of a specific group of people which involves different techniques of dealing with, organize, equip and use a particular territory. Currently, own their own space is increasingly important and the cities are faced with the challenge of providing the opportunity for such demands, as well as energy, water and waste removal necessary in the process of construction and occupation of new human settlements. Until the day of today, not has failed to give full response to these demands and needs, resulting in cities that grow without control, badly used land, avenues and congested streets. Buildings and dwellings have an important impact on the environment and on the health of the people, therefore environmental quality associated with the comfort of humans to the sustainable development of natural resources. Applied to architecture, this concept involves the incorporation of new technologies in all the constructive process of a dwelling, changing customs of developers and users, what must be a greater effort in planning energy savings and thus reducing the emissions Greenhouse Gases (GHG) depending on the geographical location where it is planned to develop. Since the techniques of occupation of the territory are not the same everywhere, must take into account that these depend on the geographical, social, political, economic and climatic-environmental circumstances of place, which in modified according to the degree of development reached. In the analysis that must be undertaken to check the degree of sustainability of the place, it is necessary to make estimates of the energy used in artificial air conditioning and lighting. In the same way is required to diagnose the availability and distribution of the water resources used for hygiene and for the cooling of artificially air-conditioned spaces, as well as the waste resulting from these technological processes. Based on the results obtained through the different stages of the analysis, it is possible to perform an energy audit in the process of proposing recommendations of sustainability in architectural spaces in search of energy saving, rational use of water and natural resources optimization. The above can be carried out through the development of a sustainable building code in develop technical recommendations to the regional characteristics of each study site. These codes would seek to build bases to promote a building regulations applicable to new human settlements looking for is generated at the same time quality, protection and safety in them. This building regulation must be consistent with other regulations both national and municipal and State, such as the laws of human settlements, urban development and zoning regulations.

Keywords: building regulations, housing, sustainability, technology

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Authors: Soran Aminiaghdam, Christian Rode, Reinhard Blickhan, Astrid Zech

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Despite considerable studies on the impact of imposed trunk posture on human walking, less is known about such locomotion while negotiating changes in ground level. The aim of this study was to investigate the behavior of the VBCOM in response to a two-fold expected perturbation, namely alterations in body posture and in ground level. To this end, the kinematic data and ground reaction forces of twelve able participants were collected. We analyzed the vertical position of the body center of mass (VBCOM) from the ground determined by the body segmental analysis method relative to the laboratory coordinate system at touchdown and toe-off instants during walking across uneven ground — characterized by perturbation contact (a 10-cm visible drop) and pre- and post-perturbation contacts — in comparison to unperturbed level contact while maintaining three postures (regular erect, ~30° and ~50° of trunk flexion from the vertical). The VBCOM was normalized to the distance between the greater trochanter marker and the lateral malleoli marker at the instant of TD. Moreover, we calculated the backward rotation during step-down as the difference of the maximum of the trunk angle in the pre-perturbation contact and the minimal trunk angle in the perturbation contact. Two-way repeated measures ANOVAs revealed contact-specific effects of posture on the VBCOM at touchdown (F = 5.96, p = 0.00). As indicated by the analysis of simple main effects, during unperturbed level and pre-perturbation contacts, no between-posture differences for the VBCOM at touchdown were found. In the perturbation contact, trunk-flexed gaits showed a significant increase of VBCOM as compared to the pre-perturbation contact. In the post-perturbation contact, the VBCOM demonstrated a significant decrease in all gait postures relative to the preceding corresponding contacts with no between-posture differences. Main effects of posture revealed that the VBCOM at toe-off significantly decreased in trunk-flexed gaits relative to the regular erect gait. For the main effect of contact, the VBCOM at toe-off demonstrated changes across perturbation and post-perturbation contacts as compared to the unperturbed level contact. Furthermore, participants exhibited a backward trunk rotation during step-down possibly to control the angular momentum of their whole body. A more pronounced backward trunk rotation (2- to 3-fold compared with level contacts) in trunk-flexed walking contributed to the observed elevated VBCOM during the step-down which may have facilitated drop negotiation. These results may shed light on the interaction between posture and locomotion in able gait, and specifically on the behavior of the body center of mass during perturbed locomotion.

Keywords: center of mass, perturbation, posture, uneven ground, walking

Procedia PDF Downloads 156

Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

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Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: Nikou Javadi, Uğur Dağlı

Abstract:

The importance of culture and tourism in the attractiveness and competitiveness of the countries is central, and many regions are evidencing their cultural assets, tangible and intangible, as a means to create comparative advantages in tourism and produce a distinctive place in response to the pressures of globalization. Culture and tourism are interlinked because of their obvious combination and growth potential. Cultural tourism is a crucial global tourism market with fast growing. Regions can develop significant relations between culture and tourism to increase their attractiveness as places to visit, live and invest, increasing their competitiveness. Accordingly, having new and creative approach to historical areas as cultural value-based destinations can improve their conditions to promote tourism. Furthermore, in 21st century, media become the most important factor affecting the development of urban cities, including public places. As a result of the digital revolution, re-imaging and re-linkage public places by media are essential to create more interactions between public spaces and users, interaction media display, and urban screens, one of the most important defined media. This interaction can transform the urban space from being neglected to be more interactive space with users, especially the pedestrians. The paper focuses on The Walled City of Famagusta. As many other historic quarters elsewhere in the world, is in a process, of decay and deterioration, and its functionally distinctive areas are severely threatened by physical, functional, locational, and image obsolescence at varying degrees. So the focus on the future development of this area through tourism promotion can be an appropriate decision for the monument enhancement of the spatial quality in Walled City of Famagusta. In this paper, it is aimed to identify the effects of these new digital factors to transform public spaces especially in historic urban areas to promote creative tourism. Accordingly, two different analysis methods are used as well as a theoretical review. The first is case study on site and the second is Close ended questionnaire, test many concepts raised in this paper. The physical analysis on site carried out in order to evaluate the walled city restoration for touristic purpose. Besides, theoretical review is done in order to provide background to the subject and cleared Factors to attract tourists.

Keywords: historical areas, media façade, sustainable tourism, Walled city of Famagusta

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

Abstract:

Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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