Search results for: body weight gain

Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

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Forensic DNA analysis has received much attention over the last three decades, due to its incredible usefulness in human identification. The statistical interpretation of DNA evidence is recognised as one of the most mature fields in forensic science. Peak heights in an Electropherogram (EPG) are approximately proportional to the amount of template DNA in the original sample being tested. A stutter is a minor peak in an EPG, which is not masking as an allele of a potential contributor, and considered as an artefact that is presumed to be arisen due to miscopying or slippage during the PCR. Stutter peaks are mostly analysed in terms of stutter ratio that is calculated relative to the corresponding parent allele height. Analysis of mixture profiles has always been problematic in evidence interpretation, especially with the presence of PCR artefacts like stutters. Unlike binary and semi-continuous models; continuous models assign a probability (as a continuous weight) for each possible genotype combination, and significantly enhances the use of continuous peak height information resulting in more efficient reliable interpretations. Therefore, the presence of a sound methodology to distinguish between stutters and real alleles is essential for the accuracy of the interpretation. Sensibly, any such method has to be able to focus on modelling stutter peaks. Bayesian nonparametric methods provide increased flexibility in applied statistical modelling. Mixture models are frequently employed as fundamental data analysis tools in clustering and classification of data and assume unidentified heterogeneous sources for data. In model-based clustering, each unknown source is reflected by a cluster, and the clusters are modelled using parametric models. Specifying the number of components in finite mixture models, however, is practically difficult even though the calculations are relatively simple. Infinite mixture models, in contrast, do not require the user to specify the number of components. Instead, a Dirichlet process, which is an infinite-dimensional generalization of the Dirichlet distribution, is used to deal with the problem of a number of components. Chinese restaurant process (CRP), Stick-breaking process and Pólya urn scheme are frequently used as Dirichlet priors in Bayesian mixture models. In this study, we illustrate an infinite mixture of simple linear regression models for modelling stutter ratio and introduce some modifications to overcome weaknesses associated with CRP.

Keywords: Chinese restaurant process, Dirichlet prior, infinite mixture model, PCR stutter

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Authors: C. Zimmermann, E. Lackner, M. Ebner

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Massive Open Online Courses (MOOCs) are increasingly popular learning hubs that are boasting considerable participant numbers, innovative technical features, and a multitude of instructional resources. Still, there is a high level of evidence showing that almost all MOOCs suffer from a declining frequency of participant activity and fairly low completion rates. In this paper, we would like to share the lessons learned in implementing several design patterns that have been suggested in order to foster participant activity. Our conclusions are based on experiences with the ‘Dr. Internet’ MOOC, which was created as an xMOOC to raise awareness for a more critical approach to online health information: participants had to diagnose medical case studies. There is a growing body of recommendations (based on Learning Analytics results from earlier xMOOCs) as to how the decline in participant activity can be alleviated. One promising focus in this regard is instructional design patterns, since they have a tremendous influence on the learner’s motivation, which in turn is a crucial trigger of learning processes. Since Medieval Age storytelling, micro-learning units and specific comprehensible, narrative structures were chosen to animate the audience to follow narration. Hence, MOOC participants are not likely to abandon a course or information channel when their curiosity is kept at a continuously high level. Critical aspects that warrant consideration in this regard include shorter course duration, a narrative structure with suspense peaks (according to the ‘storytelling’ approach), and a course schedule that is diversified and stimulating, yet easy to follow. All of these criteria have been observed within the design of the Dr. Internet MOOC: 1) the standard eight week course duration was shortened down to six weeks, 2) all six case studies had a special quiz format and a corresponding resolution video which was made available in the subsequent week, 3) two out of six case studies were split up in serial video sequences to be presented over the span of two weeks, and 4) the videos were generally scheduled in a less predictable sequence. However, the statistical results from the first run of the MOOC do not indicate any strong influences on the retention rate, so we conclude with some suggestions as to why this might be and what aspects need further consideration.

Keywords: case study, Dr. internet, experience, MOOCs, design patterns

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Authors: B. S. Premalatha, Mereen Rose Babu, Vaishali Prabhu

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Background: Dysphagia must be assessed, either subjectively or objectively, in order to properly address the swallowing difficulty. Providing therapeutic care to patients with dysphagia via tele mode was one approach for providing clinical services during the COVID-19 epidemic. As a result, the teleassessment of dysphagia has increased in India. Aim: This study aimed to identify challenges faced by Indian SLPs while providing teleassessment to individuals with dysphagia during the outbreak of COVID-19 from 2020 to 2021. Method: After receiving approval from the institute's institutional review board and ethics committee, the current study was carried out. The study was cross-sectional in nature and lasted from 2020 to 2021. The study enrolled participants who met the inclusion and exclusion criteria of the study. It was decided to recruit roughly 246 people based on the sample size calculations. The research was done in three stages: questionnaire development and content validation, questionnaire administration. Five speech and hearing professionals' content verified the questionnaire for faults and clarity. Participants received questionnaires via various social media platforms such as e-mail and WhatsApp, which were written in Microsoft Word and then converted to Google Forms. SPSS software was used to examine the data. Results: In light of the obstacles that Indian SLPs encounter, the study's findings were examined. Only 135 people responded. During the COVID-19 lockdowns, 38% of participants said they did not deal with dysphagia patients. After the lockout, 70.4% of SLPs kept working with dysphagia patients, while 29.6% did not. From the beginning of the oromotor examination, the main problems in completing tele evaluation of dysphagia have been highlighted. Around 37.5% of SLPs said they don't undertake the OPME online because of difficulties doing the evaluation, such as the need for repeated instructions from patients and family members and trouble visualizing structures in various positions. The majority of SLPs' online assessments were inefficient and time-consuming. A bigger percentage of SLPs stated that they will not advocate tele evaluation in dysphagia to their colleagues. SLPs' use of dysphagia assessment has decreased as a result of the epidemic. When it came to the amount of food, the majority of people proposed a small amount. Apart from placing the patient for assessment and gaining less cooperation from the family, most SLPs found that Internet speed was a source of concern and a barrier. Hearing impairment and the presence of a tracheostomy in patients with dysphagia proved to be the most difficult conditions to treat online. For patients with NPO, the majority of SLPs did not advise tele-evaluation. In the anterior region of the oral cavity, oral meal residue was more visible. The majority of SLPs reported more anterior than posterior leakage. Even while the majority of SLPs could detect aspiration by coughing, many found it difficult to discern the gurgling tone of speech after swallowing. Conclusion: The current study sheds light on the difficulties that Indian SLPs experience when assessing dysphagia via tele mode, indicating that tele-assessment of dysphagia is still to gain importance in India.

Keywords: dysphagia, teleassessment, challenges, Indian SLP

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Authors: Mohammed Ahmed, Ziba Nazarlou

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Mild steels have a limited alloying content which makes them vulnerable to excessive corrosion rates in the harsh medium. To overcome this issue, some protective coatings are used to prevent corrosion on the steel surface. The use of specialized coatings, mainly organic coatings (such as epoxies, polyurethanes, and acrylics) and inorganic coatings (such as Polysiloxanes) is the most common method of mitigating corrosion of carbon steel. Incorporating the benefits of organic and inorganic hybrid (OIH) compounds for the designing of hybrid protective coatings is still challenging for industrial applications. There are advantages of inorganic coatings have, but purely inorganic siloxane-based coatings are difficult to use on industrial applications unless they are used at extremely low thicknesses (< 1-2 microns). Hence, most industrial applications try to have a combination of Polysiloxanes with organic compounds.  A hybrid coating possesses an organic section, which transports flexibility and impact resistance, and an inorganic section, which usually helps in the decreasing of porosity and increasing thermal stability and hardness. A number of polymers including polyethylene glycol and polyvinyl pyrrolidone have been reported to inhibit the corrosion mild steel in acidic media. However, reports on the effect of polyethylene oxide (PEO) or its blends on corrosion inhibition of metals is very scarce. Different composition of OIH coatings was synthesized by using silica sol-gel, epoxy, and PEO. The effect of different coating types on the corrosion behavior of carbon steel in harsh solution has been studied by weight loss and electrochemical measurements using Gamry 1000 Interface Potentiostat. Coating structures were investigated by SEM. İt revealed a considerable reduction in corrosion rate for coated sample. Based on these results, OIH coating prepared by epoxy-silica sol gel-PEO and epoxy-silica sol-gel exhibit had a %99.5 and %98 reduction of (Corrosion rate) CR compares to baseline. Cathodic Tafel constant (βc) shows that coatings change both Tafel constants but had more effect on the cathodic process. The evolution of the Potentiostatic scan with time displays stability in potential, some of them in a high value while the other in a low value which can be attributed to the formation of an oxide film covering substrate surface. The coated samples with the group of epoxy coating have a lower potential along with the time test, while the silica group shows higher in potential with respect to time.

Keywords: electrostatic, hybrid coating, corrosion tests, silica sol gel

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Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: relational needs, values, responsibility, self-evaluation

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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Authors: Saule Balmagambetova, Zhenisgul Tlegenova, Saule Madinova

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Cardiotoxicity associated with anticancer treatment, now defined as cancer therapy-related cardiac dysfunction (CTRCD), accompanies cancer patients and negatively impacts their survivorship. Currently, a cardio-oncological service is being created in Kazakhstan based on the provisions of the European Society of Cardio-oncology (ESC) Guidelines. In the frames of a pilot project, a cohort study on CTRCD conditions was initiated at the Aktobe Cancer center. One hundred twenty-eight newly diagnosed breast cancer patients started on doxorubicin and/or trastuzumab were recruited. Echocardiography with global longitudinal strain (GLS) assessment, biomarkers panel (cardiac troponin (cTnI), brain natriuretic peptide (BNP), myeloperoxidase (MPO), galectin-3 (Gal-3), D-dimers, C-reactive protein (CRP)), and other tests were performed at baseline and every three months. Patients were stratified by the cardiovascular risks according to the ESC recommendations and allocated into the risk groups during the pre-treatment visit. Of them, 10 (7.8%) patients were assigned to the high-risk group, 48 (37.5%) to the medium-risk group, and 70 (54.7%) to the low-risk group, respectively. High-risk patients have been receiving their cardioprotective treatment from the outset. Patients were also divided by treatment - in the anthracycline-based 83 (64.8%), in trastuzumab- only 13 (10.2%), and in the mixed anthracycline/trastuzumab group 32 individuals (25%), respectively. Mild symptomatic CTRCD was revealed and treated in 2 (1.6%) participants, and a mild asymptomatic variant in 26 (20.5%). Mild asymptomatic conditions are defined as left ventricular ejection fraction (LVEF) ≥50% and further relative reduction in GLS by >15% from baseline and/or a further rise in cardiac biomarkers. The listed biomarkers were assessed longitudinally in repeated-measures linear regression models during 12 months of observation. The associations between changes in biomarkers and CTRCD and between changes in biomarkers and LVEF were evaluated. Analysis by risk groups revealed statistically significant differences in baseline LVEF scores (p 0.001), BNP (p 0.0075), and Gal-3 (p 0.0073). Treatment groups found no statistically significant differences at baseline. After 12 months of follow-up, only LVEF values showed a statistically significant difference by risk groups (p 0.0011). When assessing the temporal changes in the studied parameters for all treatment groups, there were statistically significant changes from visit to visit for LVEF (p 0.003); GLS (p 0.0001); BNP (p<0.00001); MPO (p<0.0001); and Gal-3 (p<0.0001). No moderate or strong correlations were found between the biomarkers values and LVEF, between biomarkers and GLS. Between the biomarkers themselves, a moderate, close to strong correlation was established between cTnI and D-dimer (r 0.65, p<0.05). The dose-dependent effect of anthracyclines has been confirmed: the summary dose has a moderate negative impact on GLS values: -r 0.31 for all treatment groups (p<0.05). The present study found myeloperoxidase as a promising biomarker of cardiac dysfunction in the mixed anthracycline/trastuzumab treatment group. The hazard of CTRCD increased by 24% (HR 1.21; 95% CI 1.01;1.73) per doubling in baseline MPO value (p 0.041). Increases in BNP were also associated with CTRCD (HR per doubling, 1.22; 95% CI 1.12;1.69). No cases of chemotherapy discontinuation due to cardiotoxic complications have been recorded. Further observations are needed to gain insight into the ability of biomarkers to predict CTRCD onset.

Keywords: breast cancer, chemotherapy, cardiotoxicity, Kazakhstan

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Authors: Yei Mian Adrian Yap

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This study aims to assess the Japanese and Singaporean mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular classrooms by investigating what kind of key variables influence their attitudes and teaching-efficacy. It also further investigates how they strategize to address their challenges to include their students with special needs in their regular classrooms. In order to understand the nature of teachers’ attitudes and teaching-efficacy towards the inclusive education, a mixed-method research methodology was carried out in Japan and Singapore; it involved an explanatory sequential method of employing quantitative research first before qualitative research. In the quantitative research, 189 Japanese and 183 Singaporean teachers were invited to participate in the questionnaires and out of these participants, 38 Japanese and 15 Singaporean teachers shared their views during their semi-structured interviews. Based on the empirical findings, Japanese teachers’ attitudes and teaching-efficacy were more likely to be influenced by their experiences in teaching students with special needs, knowledge about disability legislation, presence of their disabled family members and level of confidence to teach students with special needs. On the other hand, Singaporean teachers’ attitudes and teaching-efficacy were affected by gender, educational level, received trainings in special needs education, knowledge about disability legislation and level of confidence to teach students with special needs. Both country results also demonstrated that there was a positive correlation between their teaching-efficacy and attitude. Narrative findings further expanded the reasons behind these quantitative factors that shaped teachers’ attitudes and teaching-efficacy. Also, it discussed the various problems faced by Japanese and Singaporean teachers and how they identified their coping strategies to circumvent their challenges in including their students with special needs in their regular classrooms. The significance of this research manifests in necessary educational reforms in both countries especially in the context of inclusive education. These findings may not be as definitive as expected but it is believed that it could provide useful information on the current situation about teachers’ concerns towards the inclusive education. In conclusion, this research could potentially make its positive contribution to the body of literature on teachers’ attitudes and teaching-efficacy in the context of Asian developed countries. Further, these findings could posit that regular teachers’ positive attitudes and strong sense of teaching self-efficacy could directly improve the success rate of inclusion of students with special needs in the regular classrooms.

Keywords: attitudes, inclusive education, special education, teaching-efficacy

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Authors: Z. Xu

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Immersive virtual reality (VR) has gained momentum in humanitarian communication due to its utopian promises of co-presence, immediacy, and transcendence. These potential benefits have led the United Nations (UN) to tirelessly produce and distribute VR series to evoke global empathy and encourage policymakers, philanthropic business tycoons and citizens around the world to actually do something (i.e. give a donation). However, it is unclear whether or not VR can cultivate cosmopolitans with a sense of social responsibility towards the geographically, socially/culturally and morally mediated misfortune of faraway others. Drawing upon existing works on the mediation of distant suffering, this article constructs an analytical framework to articulate the issue. Applying this framework on a case study of five of the UN’s VR pieces, the article identifies three paradoxes that exist between cyber-utopian and cyber-dystopian narratives. In the “paradox of distance”, VR relies on the notions of “presence” and “storyliving” to implicitly link audiences spatially and temporally to distant suffering, creating global connectivity and reducing perceived distances between audiences and others; yet it also enables audiences to fully occupy the point of view of distant sufferers (creating too close/absolute proximity), which may cause them to feel naive self-righteousness or narcissism with their pleasures and desire, thereby destroying the “proper distance”. In the “paradox of agency”, VR simulates a superficially “real” encounter for visual intimacy, thereby establishing an “audiences–beneficiary” relationship in humanitarian communication; yet in this case the mediated hyperreality is not an authentic reality, and its simulation does not fill the gap between reality and the virtual world. In the “paradox of the hierarchies of human life”, VR enables an audience to experience virtually fundamental “freedom”, epitomizing an attitude of cultural relativism that informs a great deal of contemporary multiculturalism, providing vast possibilities for a more egalitarian representation of distant sufferers; yet it also takes the spectator’s personally empathic feelings as the focus of intervention, rather than structural inequality and political exclusion (an economic and political power relations of viewing). Thus, the audience can potentially remain trapped within the minefield of hegemonic humanitarianism. This study is significant in two respects. First, it advances the turn of digitalization in studies of media and morality in the polymedia milieu; it is motivated by the necessary call for a move beyond traditional technological environments to arrive at a more novel understanding of the asymmetry of power between the safety of spectators and the vulnerability of mediated sufferers. Second, it not only reminds humanitarian journalists and NGOs that they should not rely entirely on the richer news experience or powerful response-ability enabled by VR to gain a “moral bond” with distant sufferers, but also argues that when fully-fledged VR technology is developed, it can serve as a kind of alchemy and should not be underestimated merely as a “bugaboo” of an alarmist philosophical and fictional dystopia.

Keywords: audience, cosmopolitan, distant suffering, virtual reality, humanitarian communication

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Authors: E. C. Swart, E. Kunneke

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Background: Disparities in food security exist between communities and households across the country, reflecting continuing social and economic inequalities. The purpose of this study was to investigate the presence of food insecurity amongst UWC students. Method: Cross-sectional study recruited 200 students via email and cellphone from an ICS generated list of randomly selected students aged 18-25. Data collection took place during the first two weeks of term 3. Individual appointments were made with consenting participants and conducted in English by trained BSc Dietetics students. Data was analysed using SPSS. The hunger scale used by Stats SA (October 2010) was used. Dietary intake was assessed using a single 24hr recall. Results: Sixty-three percent of the students reported that they do experience some food insecurity whilst 14.5% reported to go hungry due to inadequate access to food. Coping mechanisms during periods of food insecurity include: Asking a friend, neighbour, family member (40%); Borrow (15%); Steal (none); Casual jobs (12%). Anthropometric status of students did not differ statistically significantly by food security status. A statistically significantly greater proportion of Xhosa speaking students reported inadequate money for food. Students residing in residences off campus appear to be least food secure in terms of money available and limiting food intake, whilst those residing at home are less food insecure. Similar proportions of students who receive bursaries or whose parents are paying reported going hungry whilst those who supports themselves never goes hungry. Mean nutrient intake during the previous 24 hours of students who reported inadequate resources to buy food, who eat less due to inadequate resources and who goes hungry only differed statistically significantly for Vitamin B (go hungry) and for fibre (money shortage). In general the nutrient intake is lower for those who reported to eat less and go hungry except for added sugar, vitamin A and folate (go hungry), and energy, fibre, iron, riboflavin and folate (eat less). For students who reported to have inadequate money to buy food, the mean nutrient intake was higher except for calcium and thiamin. The mean body mass index of this group of students was also higher even though the difference was not statistically significant. Conclusion: Hunger is present on campus however a single 24hr recall did not confirm statistically significant lower nutrient intakes for students who reported different levels of food insecurity.

Keywords: anthropometry, dietary intake, nutritional status, students

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: Debananda Mohapatra, Subramanya Badrayyana, Smrutiranjan Parida

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Carbon nano-onions (CNOs) are the spherical graphitic nanostructures composed of concentric shells of graphitic carbon can be hypothesized as the intermediate state between fullerenes and graphite. These are very important members in fullerene family also known as the multi-shelled fullerenes can be envisioned as promising supercapacitor electrode with high energy & power density as they provide easy access to ions at electrode-electrolyte interface due to their curvature. There is still very sparse report concerning on CNOs as electrode despite having an excellent electrodechemical performance record due to their unavailability and lack of convenient methods for their high yield preparation and purification. Keeping all these current pressing issues in mind, we present a facile scalable and straightforward flame synthesis method of pure and highly dispersible CNOs without contaminated by any other forms of carbon; hence, a post processing purification procedure is not necessary. To the best of our knowledge, this is the very first time; we developed an extremely simple, light weight, novel inexpensive, flexible free standing pristine CNOs electrode without using any binder element. Locally available daily used cotton wipe has been used for fabrication of such an ideal electrode by ‘dipping and drying’ process providing outstanding stretchability and mechanical flexibility with strong adhesion between CNOs and porous wipe. The specific capacitance 102 F/g, energy density 3.5 Wh/kg and power density 1224 W/kg at 20 mV/s scan rate are the highest values that ever recorded and reported so far in symmetrical two electrode cell configuration with 1M Na2SO4 electrolyte; indicating a very good synthesis conditions employed with optimum pore size in agreement with electrolyte ion size. This free standing CNOs electrode also showed an excellent cyclic performance and stability retaining 95% original capacity after 5000 charge –discharge cycles. Furthermore, this unique method not only affords binder free - freestanding electrode but also provide a general way of fabricating such multifunctional promising CNOs based nanocomposites for their potential device applications in flexible solar cells and lithium-ion batteries.

Keywords: binder-free, flame synthesis, flexible, carbon nano onion

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Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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Authors: Hamzeh Alipour, Masoumeh Bagheri, Abbasali Raz, Javad Dadgar Pakdel, Kourosh Azizi, Aboozar Soltani, Mohammad Djaefar Moemenbellah-Fard

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Background: Maggot debridement therapy is an appropriate, effective, and controlled method using sterilized larvae of Luciliasericata (L.sericata) to treat wounds. Netrin-A is an enzyme in the Laminins family which secreted from salivary gland of L.sericata with a central role in neural regeneration and angiogenesis. This study aimed to production of new recombinant Netrin-A protein of Luciliasericata larvae by baculovirus expression vector system (BEVS) in SF9. Material and methods: In the first step, gene structure was subjected to the in silico studies, which were include determination of Antibacterial activity, Prion formation risk, homology modeling, Molecular docking analysis, and Optimization of recombinant protein. In the second step, the Netrin-A gene was cloned and amplified in pTG19 vector. After digestion with BamH1 and EcoR1 restriction enzymes, it was cloned in pFastBac HTA vector. It was then transformed into DH10Bac competent cells, and the recombinant Bacmid was subsequently transfected into insect Sf9 cells. The expressed recombinant Netrin-A was thus purified in the Ni-NTA agarose. This protein evaluation was done using SDS-PAGE and western blot, respectively. Finally, its concentration was calculated with the Bradford assay method. Results: The Bacmid vector structure with Netrin-A was successfully constructed and then expressed as Netrin-A protein in the Sf9 cell lane. The molecular weight of this protein was 52 kDa with 404 amino acids. In the in silico studies, fortunately, we predicted that recombinant LSNetrin-A have Antibacterial activity and without any prion formation risk.This molecule hasa high binding affinity to the Neogenin and a lower affinity to the DCC-specific receptors. Signal peptide located between amino acids 24 and 25. The concentration of Netrin-A recombinant protein was calculated to be 48.8 μg/ml. it was confirmed that the characterized gene in our previous study codes L. sericata Netrin-A enzyme. Conclusions: Successful generation of the recombinant Netrin-A, a secreted protein in L.sericata salivary glands, and because Luciliasericata larvae are used in larval therapy. Therefore, the findings of the present study could be useful to researchers in future studies on wound healing.

Keywords: blowfly, BEVS, gene, immature insect, recombinant protein, Sf9

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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Authors: Ruthanne Tobin

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As our data-driven, cloud-based, knowledge-centric lives become ever more global, mobile, and digital, educational systems everywhere are struggling to keep pace. Schools need to prepare students to become critical-thinking, tech-savvy, life-long learners who are engaged and adaptable enough to find their unique calling in a post-industrial world of work. Recognizing that no nation can afford poor achievement or high dropout rates without jeopardizing its social and economic future, the thirty-two nations of the OECD are launching initiatives to redesign schools, generally under the banner of Personalized Learning or 21st Century Learning. Their intention is to transform education by situating students as co-enquirers and co-contributors with their teachers of what, when, and how learning happens for each individual. In this focused review of the 2007-2017 literature on personalized learning, the author sought answers to two main questions: “What are the theoretical frameworks that guide personalized learning?” and “What is the conceptual understanding of the model?” Ultimately, the review reveals that, although the research area is overly theorized and under-substantiated, it does provide a significant body of knowledge about this potentially transformative educational restructuring. For example, it addresses the following questions: a) What components comprise a PL model? b) How are teachers facilitating agency (voice & choice) in their students? c) What kinds of systems, processes and procedures are being used to guide the innovation? d) How is learning organized, monitored and assessed? e) What role do inquiry based models play? f) How do teachers integrate the three types of knowledge: Content, pedagogical and technological? g) Which kinds of forces enable, and which impede, personalizing learning? h) What is the nature of the collaboration among teachers? i) How do teachers co-regulate differentiated tasks? One finding of the review shows that while technology can dramatically expand access to information, expectations of its impact on teaching and learning are often disappointing unless the technologies are paired with excellent pedagogies in order to address students’ needs, interests and aspirations. This literature review fills a significant gap in this emerging field of research, as it serves to increase conceptual clarity that has hampered both the theorizing and the classroom implementation of a personalized learning model.

Keywords: curriculum change, educational innovation, personalized learning, school reform

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Authors: Lauren Schuldt Wilson

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Felicia Hemans’ memorializing of the unwritten lives of women and the consequent allowance for marginalized voices to remember and be remembered has been considered by many critics in terms of ekphrasis and elegy, terms which privilege the question of whether Hemans’ poeticizing can represent lost voices of history or only her poetic expression. Amy Gates, Brian Elliott, and others point out Hemans’ acknowledgement of the self-projection necessary for imaginatively filling the absences of unrecorded histories. Yet, few have examined the complex temporal positioning Hemans inscribes in these moments of self-projection and imaginative historicizing. In poems like ‘The Image in Lava,’ Hemans maps not only a lost past, but also a lost potential future onto the image of a dead infant in its mother’s arms, the discovery and consideration of which moves the imagined viewer to recover and incorporate the ‘hope’ encapsulated in the figure of the infant into a reevaluation of national time embodied by the ‘relics / Left by the pomps of old.’ By examining Hemans’ acknowledgement and response to Percy Bysshe Shelley’s ‘Ozymandias,’ this essay explores how Hemans’ depictions of imaginative historicizing open new horizons of possibility and reevaluate temporal value structures by imagining previously undiscovered or unexplored potentialities of the past. Where Shelley’s poem mocks the futility of national power and time, this essay outlines Hemans’ suggestion of alternative threads of identity and temporal meaning-making which, regardless of historical veracity, exist outside of and against the structures Shelley challenges. Counter to previous readings of Hemans’ poem as celebration of either recovered or poetically constructed maternal love, this essay argues that Hemans offers a meditation on sites of reproduction—both of personal reproductive futurity and of national reproduction of power. This meditation culminates in Hemans’ gesturing towards a method of historicism by which the imagined viewer reinvigorates the sterile, ‘shattered visage’ of national time by forming temporal identity through the imagining of trans-historical hope inscribed on the infant body of the universal, individual subject rather than the broken monument of the king.

Keywords: futurity, national temporalities, reproduction, revisionary histories

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Authors: Shau-Ping Shiu, Shu-Ling Lin

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Pregnancy lead a process of changing in the endocrine system. Either pregnancy itself or the surrounding affect such as the attitude of family to the pregnant lady can bring lots of stress. Sever stress may lead pregnant women display serious mental problem such as mood swings, impulsivity, and abnormal behavior. A method of self management of stress(SMS) has been proved that help patient of cancer in release their stress. This study were going to use SMS to help pregnant women. Methods: In this study, 42 ladies in the first to third months of pregnancy process applied to join SMS of program have divided into 21 participants in both control and experimental group by draw. 24 sessions of Yoga program were conducted once a week for 6 months for experimental group. Verbatim used to gather more feedbacks from the interview followed by each Yoga sessions. Brief symptom Rating scale also conducted pre and post experiment for 42 participations. Results: Overall score of Brief Symptom Rating Scale reduced 17.82 points and suicide drop 9 points in experimental group, compared to the control group increasing 10.24 point of overall score and suicide add 7 points. Feedback from interviews showed participations improved in emotion, physical health and stress management. They indicated having more positive emotion daily, having better gastrointestinal peristalsis movement, releasing back tention, well weight control, reducing stress and changing the quality of interpersonal relationships. Conclusion: SMS of Yoga program in this study included four key training directions which were stimulation, relaxation, awareness and pranayama lead a great improvment of stress management for pregnant lady. Throughout this Yoga program, women learned to ignite eustress, remove distress, create calmness and breath slows down. As the result, Yoga program has helped women in experiment group lower their tension, and bring the extra benifits in emotion and relationships. It support women to overcome their pregnancy. Suggestion: An unexpected result of this study showed all participants had no morning sickness since they engaged in SMS program, and no one absent from course due to the benefits of it. We strongly suggest that SMS of Yoga program can be a add of medication for women in pregnancy, however, the position of Forward in the SMS sequence has been point out pressing participant’s stomach, which can be replace to Bridge position to comfort participants.

Keywords: self-management of stress(SMS), yoga program, pregnant women, early pregnancy

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Kirill M. Dubovikov, Ekaterina S. Marchenko, Gulsharat A. Baigonakova

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NiTi alloys are widely used as implants in medicine due to their unique properties such as superelasticity, shape memory effect and biocompatibility. However, despite these properties, one of the major problems is the release of nickel after prolonged use in the human body under dynamic stress. This occurs due to oxidation and cracking of NiTi implants, which provokes nickel segregation from the matrix to the surface and release into living tissues. As we know, nickel is a toxic element and can cause cancer, allergies, etc. One of the most popular ways to solve this problem is to create a corrosion resistant coating on NiTi. There are many coatings of this type, but not all of them have good biocompatibility, which is very important for medical implants. Coatings based on calcium phosphate phases have excellent biocompatibility because Ca and P are the main constituents of the mineral part of human bone. This fact suggests that a Ca-P coating on NiTi can enhance osteogenesis and accelerate the healing process. Therefore, the aim of this study is to investigate the structure of Ca-P coating on NiTi substrate. Plasma assisted radio frequency (RF) sputtering was used to obtain this film. This method was chosen because it allows the crystallinity and morphology of the Ca-P coating to be controlled by the sputtering parameters. It allows us to obtain three different NiTi samples with Ca-P coating. XRD, AFM, SEM and EDS were used to study the composition, structure and morphology of the coating phase. Scratch tests were carried out to evaluate the adhesion of the coating to the substrate. Wettability tests were used to investigate the hydrophilicity of the different coatings and to suggest which of them had better biocompatibility. XRD showed that the coatings of all samples were hydroxyapatite, but the matrix was represented by TiNi intermetallic compounds such as B2, Ti2Ni and Ni3Ti. The SEM shows that the densest and defect-free coating has only one sample after three hours of sputtering. Wettability tests show that the sample with the densest coating has the lowest contact angle of 40.2° and the largest free surface area of 57.17 mJ/m2, which is mostly disperse. A scratch test was carried out to investigate the adhesion of the coating to the surface and it was shown that all coatings were removed by a cohesive mechanism. However, at a load of 30N, the indenter reached the substrate in two out of three samples, except for the sample with the densest coating. It was concluded that the most promising sputtering mode was the third, which consisted of three hours of deposition. This mode produced a defect-free Ca-P coating with good wettability and adhesion.

Keywords: biocompatibility, calcium phosphate coating, NiTi alloy, radio frequency sputtering.

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Authors: Suat Erel, Gozde Gur

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Background: Recently a supramalleolar type of dynamic ankle foot orthosis (DAFO) has been increasingly used to support all of the dynamic arches of the foot and redistribute the pressure under the plantar surface of the foot to reduce the muscle tone. DAFO helps to maintain balance and postural control by providing stability and proprioceptive feedback in children with disease like Cerebral Palsy, Muscular Dystrophies, Down syndrome, and congenital hypotonia. Aim: The aim of this study was to investigate the role of Dynamic ankle foot orthosis (DAFO) on temporo-spatial parameters of gait and balance in three children with hereditary spastic paraparesis (HSP). Material Method: 13, 14, and 8 years old three children with HSP were included in the study. To provide correction on weight bearing and to improve gait, DAFO was made. Lower extremity spasticity (including gastocnemius, hamstrings and hip adductor muscles) using modified Ashworth Scale (MAS) (0-5), The temporo-spatial gait parameters (walking speed, cadence, base of support, step length) and Timed Up & Go test (TUG) were evaluated. All of the assessments about gait were compared with (with DAFO and shoes) and without DAFO (with shoes only) situations. Also after six months follow up period, assessments were repeated by the same physical therapist. Results: MAS scores for lower extremity were between “2-3” for the first child, “0-2” for the second child and “1-2” for the third child. TUG scores (sec) decreased from 20.2 to 18 for case one, from 9.4 to 9 for case two and from 12,4 to 12 for case three in the condition with shoes only and also from 15,2 to 14 for case one, from 7,2 to 7,1 for case two and from 10 to 7,3 for case three in the condition with DAFO and shoes. Gait speed (m/sec) while wearing shoes only was similar but while wearing DAFO and shoes increased from 0,4 to 0,5 for case one, from 1,5 to 1,6 for case two and from 1,0 to 1,2 for case three. Base of support scores (cm) wearing shoes only decreased from 18,5 to 14 for case one, from 13 to 12 for case three and were similar as 11 for case two. While wearing DAFO and shoes, base of support decreased from 10 to 9 for case one, from 11,5 to 10 for case three and was similar as 8 for case two. Conclusion: The use of a DAFO in a patient with HSP normalized the temporo-spatial gait parameters and improved balance. Walking speed is a gold standard for evaluating gait quality. With the use of DAFO, walking speed increased in this three children with HSP. With DAFO, better TUG scores shows that functional ambulation improved. Reduction in base of support and more symmetrical step lengths with DAFO indicated better balance. These encouraging results warrant further study on wider series.

Keywords: dynamic ankle foot orthosis, gait, hereditary spastic paraparesis, balance in patient

Procedia PDF Downloads 355

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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Authors: V. Keim, J. Spachtholz, J. Hammer

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The importance of fibre reinforced plastics continually increases due to the excellent mechanical properties, low material and manufacturing costs combined with significant weight reduction. Today, components are usually designed and calculated numerically by using finite element methods (FEM) to avoid expensive laboratory tests. These programs are based on material models including material specific deformation characteristics. In this research project, material models for short glass fibre reinforced plastics are presented to simulate the visco-elasto-plastic deformation behaviour. Prior to modelling specimens of the material EMS Grivory HTV-5H1, consisting of a Polyphthalamide matrix reinforced by 50wt.-% of short glass fibres, are characterized experimentally in terms of the highly time dependent deformation behaviour of the matrix material. To minimize the experimental effort, the cyclic deformation behaviour under tensile and compressive loading (R = −1) is characterized by isothermal complex low cycle fatigue (CLCF) tests. Combining cycles under two strain amplitudes and strain rates within three orders of magnitude and relaxation intervals into one experiment the visco-elastic deformation is characterized. To identify visco-plastic deformation monotonous tensile tests either displacement controlled or strain controlled (CERT) are compared. All relevant modelling parameters for this complex superposition of simultaneously varying mechanical loadings are quantified by these experiments. Subsequently, two different material models are compared with respect to their accuracy describing the visco-elasto-plastic deformation behaviour. First, based on Chaboche an extended 12 parameter model (EVP-KV2) is used to model cyclic visco-elasto-plasticity at two time scales. The parameters of the model including a total separation of elastic and plastic deformation are obtained by computational optimization using an evolutionary algorithm based on a fitness function called genetic algorithm. Second, the 12 parameter visco-elasto-plastic material model by Launay is used. In detail, the model contains a different type of a flow function based on the definition of the visco-plastic deformation as a part of the overall deformation. The accuracy of the models is verified by corresponding experimental LCF testing.

Keywords: complex low cycle fatigue, material modelling, short glass fibre reinforced polyphthalamides, visco-elasto-plastic deformation

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Authors: Thayalan Nall, Andreas Putra

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A major offshore reclamation work is currently underway in Southeast Asia for a container terminal. The total extent of the reclamation extent is 2600m x 800m and the seabed level is around -5mRL below mean sea level. Subsoil profile below seabed comprises soft marine clays of thickness varying from 8m to 15m. To contain the dredging spoil within the reclamation area, perimeter bunds have been constructed to +2.5mRL. They include breakwaters of trapezoidal geometry, made of boulder size rock along the northern, eastern and western perimeters, with a sand bund along the southern perimeter. Breakwaters were constructed on a composite bamboo pile and raft foundation system. Bamboo clusters 8m long, with 7 individual Bamboos bundled together as one, have been installed within the footprint of the breakwater below seabed in soft marine clay. To facilitate drainage two prefabricated vertical drains (PVD) have been attached to each cluster. Once the cluster piles were installed, a bamboo raft was placed as a load transfer platform. Rafts were made up of 5 layers of bamboo mattress, and in each layer bamboos were spaced at 200mm centres. The rafts wouldn’t sink under their own weight, and hence, they were sunk by loading quarry run rock onto them. Bamboo is a building material available in abundance in Indonesia and obtained at a relatively low cost. They are commonly used as semi-rigid inclusions to improve compressibility and stability of soft soils. Although bamboo is widely used in soft soil engineering design, no local design guides are available and the designs are carried out based on local experience. In June 2015, when the 1st load of sand was pumped by a dredging vessel next to the breakwater, a 150m long section of the breakwater underwent failure and displaced the breakwater between 1.2m to 4.0m. The cause of the failure was investigated to implement remedial measures to reduce the risk of further failures. Analyses using both limit equilibrium approach and finite element modelling revealed two plausible modes of breakwater failure. This paper outlines: 1) Developed Geology and the ground model, 2) The techniques used for the installation of bamboo piles, 3) Details of the analyses including modes and mechanism of failure and 4) Design changes incorporated to reduce the risk of failure.

Keywords: bamboo piles, ground improvement, reclamation, breakwater failure

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Authors: Alexandra C. Blaga, Dan Caşcaval, Alexandra Tucaliuc, Madalina Poştaru, Anca I. Galaction

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Amino acids are valuable chemical products used in in human foods, in animal feed additives and in the pharmaceutical field. Recently, there has been a noticeable rise of amino acids utilization throughout the world to include their use as raw materials in the production of various industrial chemicals: oil gelating agents (amino acid-based surfactants) to recover effluent oil in seas and rivers and poly(amino acids), which are attracting attention for biodegradable plastics manufacture. The amino acids can be obtained by biosynthesis or from protein hydrolysis, but their separation from the obtained mixtures can be challenging. In the last decades there has been a continuous interest in developing processes that will improve the selectivity and yield of downstream processing steps. The liquid-liquid extraction of amino acids (dissociated at any pH-value of the aqueous solutions) is possible only by using the reactive extraction technique, mainly with extractants of organophosphoric acid derivatives, high molecular weight amines and crown-ethers. The purpose of this study was to analyse the separation of nine amino acids of acidic character (l-aspartic acid, l-glutamic acid), basic character (l-histidine, l-lysine, l-arginine) and neutral character (l-glycine, l-tryptophan, l-cysteine, l-alanine) by reactive extraction with di-(2-ethylhexyl)phosphoric acid (D2EHPA) dissolved in butyl acetate. The results showed that the separation yield is controlled by the pH value of the aqueous phase: the reactive extraction of amino acids with D2EHPA is possible only if the amino acids exist in aqueous solution in their cationic forms (pH of aqueous phase below the isoeletric point). The studies for individual amino acids indicated the possibility of selectively separate different groups of amino acids with similar acidic properties as a function of aqueous solution pH-value: the maximum yields are reached for a pH domain of 2–3, then strongly decreasing with the pH increase. Thus, for acidic and neutral amino acids, the extraction becomes impossible at the isolelectric point (pHi) and for basic amino acids at a pH value lower than pHi, as a result of the carboxylic group dissociation. From the results obtained for the separation from the mixture of the nine amino acids, at different pH, it can be observed that all amino acids are extracted with different yields, for a pH domain of 1.5–3. Over this interval, the extract contains only the amino acids with neutral and basic character. For pH 5–6, only the neutral amino acids are extracted and for pH > 6 the extraction becomes impossible. Using this technique, the total separation of the following amino acids groups has been performed: neutral amino acids at pH 5–5.5, basic amino acids and l-cysteine at pH 4–4.5, l-histidine at pH 3–3.5 and acidic amino acids at pH 2–2.5.

Keywords: amino acids, di-(2-ethylhexyl) phosphoric acid, reactive extraction, selective extraction

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Authors: Zeynep Yilmazer Hitit, Patrick C. Hallenbeck

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Fuel reserve requirements due to depletion of fossil fuels have increased interest in biohydrogen since the 1990’s. In fermentative hydrogen production, pure, mixed, and co-cultures can be used to produce hydrogen. Several previous studies have evaluated hydrogen production by pure cultures of Clostridium butyricum or Enterobacter aerogenes. Evaluating hydrogen production by co-culture of these microorganisms is an interestıng approach since E. aerogenes is a facultative microorganism with resistance to oxygen in contrast to the strict anaerobe C. butyricum, and therefore has the ability to maintain anaerobic conditions. It was found that using co-cultures of facultative E. aerogenes (as a reducing agent and H2 producer) and the obligate anaerobe C. butyricum for producing hydrogen increases the yield of hydrogen by about 50% compared to C. butyricum by itself. Also, using different types of microorganisms for hydrogen production eliminates the need to use expensive reducing agents. C. butyricum strain pre-cultured anaerobically at 37 0C for 15h by inoculating 100 mL of GP medium (pH 6.8) consisting of 1% glucose, 2% polypeptone, 0.2% KH2PO4, 0.05% yeast extract, 0.05% MgSO4. 7H2O and E. aerogenes strain was pre-cultured aerobically at 30 0C, 150 rpm for 9 h by inoculating 100 mL of TGY medium (pH 6.8), consisting of 0.1% glucose, 0.5% tryptone, 0.1% K2HPO4, 0.5% yeast extract. All duplicate batch experiments were conducted in 100 mL bottles with different inoculum ratios of Clostridium butyricum and Enterobater aerogenes (C:E) using 5x diluted rich media (GP) consisting of 2 g/L glucose, 4g/L polypeptone, 0.4 g/L KH2PO4, 0.1 g/L yeast extract, 0.1 MgSO4.7H2O. The range of inoculum ratio of C. butyricum to E. aerogenes were 2:1,4:1,8:1, 1:2,1:4, 1:8, 1:0, 0:1. Using glucose as a carbon source aided in the observation of microbial behavior as well as making the effect of inoculum ratio more evident. Nearly all the glucose in the medium was used to produce hydrogen, except at a 1:0 ratio of inoculum (i.e. containing only C. butyricum). Low glucose consumption leads to a higher hydrogen yield due to cumulative hydrogen production and consumption of glucose, but not as much as C:E, 8:1. The lowest hydrogen yield was achieved in 1:8 inoculum ratio of C:E, 71.9 mL, 1.007±0.01 mol H2/mol glucose and the highest cumulative hydrogen, hydrogen yield and dry cell weight were achieved in 8:1 inoculum ratio of C:E, 117.4 mL, 2.035±0.082 mol H2/mol glucose, 0.4 g/L respectively. In this study effect of inoculum ratio on dark fermentative biohydrogen production using C. butyricum and E. aerogenes was investigated. The maximum hydrogen yield of 2.035mol H2/mol glucose was obtained using 2g/L glucose, an initial pH of 6 and an inoculum ratio of C. butyricum to E. aerogenes of 8:1. Results showed that inoculum ratio is an important parameter on hydrogen production due to competition between the two microorganisms in using substrate for growth and production of by-products. The results presented here could be of great significance for further waste management studies using co-culture hydrogen production.

Keywords: biohydrogen, Clostridium butyricum, dark fermentation, Enterobacter aerogenes, inoculum ratio in biohydrogen production

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Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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Authors: Juliana Bom-Tempo

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The proposed composition occurs between images, performances, clinics and philosophies. For this enterprise we depart for what is not known beforehand, so with a question as a compass: "would it be in the creation, production and implementation of images in a performance a 'when' for the event of a poetic clinic?” In light of this, there are, in order to think a 'when' of the event of a poetic clinic, images in performances created, produced and executed in partnerships with the author of this text. Faced with this composition, we built four indicators to find spatiotemporal coordinates that would spot that "when", namely: risk zones; the mobilizations of the signs; the figuring of the flesh and an education of the affections. We dealt with the images in performances; Crútero; Flesh; Karyogamy and the risk of abortion; Egg white; Egg-mouth; Islands, threads, words ... germs; Egg-Mouth-Debris, taken as case studies, by engendering risks areas to promote individuations, which never actualize thoroughly, thus always something of pre-individual and also individuating a environment; by mobilizing the signs territorialized by the ordinary, causing them to vary the language and the words of order dictated by the everyday in other compositions of sense, other machinations; by generating a figure of flesh, disarranging the bodies, isolating them in the production of a ground force that causes the body to leak out and undo the functionalities of the organs; and, finally, by producing an education of affections, by placing the perceptions in becoming and disconnecting the visible in the production of small deserts that call for the creation of a people yet to come. The performance is processed as a problematizing of the images fixed by the ordinary, producing gestures that precipitate the individuation of images in performance, strange to the configurations that gather bodies and spaces in what we call common. Lawrence proposes to think of "people" who continually use umbrellas to protect themselves from chaos. These have the function of wrapping up the chaos in visions that create houses, forms and stabilities; they paint a sky at the bottom of the umbrella, where people march and die. A chaos, where people live and wither. Pierce the umbrella for a desire of chaos; a poet puts himself as an enemy of the convention, to be able to have an image of chaos and a little sun that burns his skin. The images in performances presented, thereby, were moving in search for the power of producing a spatio-temporal "when" putting the territories in risk areas, mobilizing the signs that format the day-to-day, opening the bodies to a disorganization and the production of an education of affections for the event of a poetic clinic.

Keywords: Experimentations , Images in Performances, Poetic Clinic, Risk

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Authors: Norbert W. Paul

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In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

Procedia PDF Downloads 262