Search results for: post WWII period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9369

Search results for: post WWII period

1809 Tracheal Stenting to Relieve Respiratory Distress in Patient with Advanced Esophageal Malignancy and Its Anaesthetic Management

Authors: Aarti Agarwal, Ajmal Khan

Abstract:

Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

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1808 Determinants of Standard Audit File for Tax Purposes Accounting Legal Obligation Compliance Costs: Empirical Study for Portuguese SMEs of Leiria District

Authors: Isa Raquel Alves Soeiro, Cristina Isabel Branco de Sá

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In Portugal, since 2008, there has been a requirement to export the Standard Audit File for Tax Purposes (SAF-T) standard file (in XML format). This file thus gathers tax-relevant information from a company relating to a specific period of taxation. There are two types of SAF-T files that serve different purposes: the SAF-T of revenues and the SAF-T of accounting, which requires taxpayers and accounting firms to invest in order to adapt the accounting programs to the legal requirements. The implementation of the SAF-T accounting file aims to facilitate the collection of relevant tax data by tax inspectors as support of taxpayers' tax returns for the analysis of accounting records or other information with tax relevance (Portaria No. 321-A/2007 of March 26 and Portaria No. 302/2016 of December 2). The main objective of this research project is to verify, through quantitative analysis, what is the cost of compliance of Small and Medium Enterprises (SME) in the district of Leiria in the introduction and implementation of the tax obligation of SAF-T - Standard Audit File for Tax Purposes of accounting. The information was collected through a questionnaire sent to a population of companies selected through the SABI Bureau Van Dijk database in 2020. Based on the responses obtained to the questionnaire, the companies were divided into two groups: Group 1 -companies who are self-employed and whose main activity is accounting services; and Group 2 -companies that do not belong to the accounting sector. In general terms, the conclusion is that there are no statistically significant differences in the costs of complying with the accounting SAF-T between the companies in Group 1 and Group 2 and that, on average, the internal costs of both groups represent the largest component of the total cost of compliance with the accounting SAF-T. The results obtained show that, in both groups, the total costs of complying with the SAF-T of accounting are regressive, which appears to be similar to international studies, although these are related to different tax obligations. Additionally, we verified that the variables volume of business, software used, number of employees, and legal form explain the differences in the costs of complying with accounting SAF-T in the Leiria district SME.

Keywords: compliance costs, SAF-T accounting, SME, Portugal

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1807 Industry Symbiosis and Waste Glass Upgrading: A Feasibility Study in Liverpool Towards Circular Economy

Authors: Han-Mei Chen, Rongxin Zhou, Taige Wang

Abstract:

Glass is widely used in everyday life, from glass bottles for beverages to architectural glass for various forms of glazing. Although the mainstream of used glass is recycled in the UK, the single-use and then recycling procedure results in a lot of waste as it incorporates intact glass with smashing, re-melting, and remanufacturing. These processes bring massive energy consumption with a huge loss of high embodied energy and economic value, compared to re-use, which’s towards a ‘zero carbon’ target. As a tourism city, Liverpool has more glass bottle consumption than most less leisure-focused cities. It’s therefore vital for Liverpool to find an upgrading approach for the single-use glass bottles with low carbon output. This project aims to assess the feasibility of industrial symbiosis and upgrading the framework of glass and to investigate the ways of achieving them. It is significant to Liverpool’s future industrial strategy since it provides an opportunity to target economic recovery for post-COVID by industry symbiosis and up-grading waste management in Liverpool to respond to the climate emergency. In addition, it will influence the local government policy for glass bottle reuse and recycling in North West England and as a good practice to be further recommended to other areas of the UK. First, a critical literature review of glass waste strategies has been conducted in the UK and worldwide industrial symbiosis practices. Second, mapping, data collection, and analysis have shown the current life cycle chain and the strong links of glass reuse and upgrading potentials via site visits to 16 local waste recycling centres. The results of this research have demonstrated the understanding of the influence of key factors on the development of a circular industrial symbiosis business model for beverage glass bottles. The current waste management procedures of the glass bottle industry, its business model, supply chain, and material flow have been reviewed. The various potential opportunities for glass bottle up-valuing have been investigated towards an industrial symbiosis in Liverpool. Finally, an up-valuing business model has been developed for an industrial symbiosis framework of glass in Liverpool. For glass bottles, there are two possibilities 1) focus on upgrading processes towards re-use rather than single-use and recycling and 2) focus on ‘smart’ re-use and recycling, leading to optimised values in other sectors to create a wider industry symbiosis for a multi-level and circular economy.

Keywords: glass bottles, industry symbiosis, smart re-use, waste upgrading

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1806 Detecting Natural Fractures and Modeling Them to Optimize Field Development Plan in Libyan Deep Sandstone Reservoir (Case Study)

Authors: Tarek Duzan

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Fractures are a fundamental property of most reservoirs. Despite their abundance, they remain difficult to detect and quantify. The most effective characterization of fractured reservoirs is accomplished by integrating geological, geophysical, and engineering data. Detection of fractures and defines their relative contribution is crucial in the early stages of exploration and later in the production of any field. Because fractures could completely change our thoughts, efforts, and planning to produce a specific field properly. From the structural point of view, all reservoirs are fractured to some point of extent. North Gialo field is thought to be a naturally fractured reservoir to some extent. Historically, natural fractured reservoirs are more complicated in terms of their exploration and production efforts, and most geologists tend to deny the presence of fractures as an effective variable. Our aim in this paper is to determine the degree of fracturing, and consequently, our evaluation and planning can be done properly and efficiently from day one. The challenging part in this field is that there is no enough data and straightforward well testing that can let us completely comfortable with the idea of fracturing; however, we cannot ignore the fractures completely. Logging images, available well testing, and limited core studies are our tools in this stage to evaluate, model, and predict possible fracture effects in this reservoir. The aims of this study are both fundamental and practical—to improve the prediction and diagnosis of natural-fracture attributes in N. Gialo hydrocarbon reservoirs and accurately simulate their influence on production. Moreover, the production of this field comes from 2-phase plan; a self depletion of oil and then gas injection period for pressure maintenance and increasing ultimate recovery factor. Therefore, well understanding of fracturing network is essential before proceeding with the targeted plan. New analytical methods will lead to more realistic characterization of fractured and faulted reservoir rocks. These methods will produce data that can enhance well test and seismic interpretations, and that can readily be used in reservoir simulators.

Keywords: natural fracture, sandstone reservoir, geological, geophysical, and engineering data

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1805 Automated, Short Cycle Production of Polymer Composite Applications with Special Regards to the Complexity and Recyclability of Composite Elements

Authors: Peter Pomlenyi, Orsolya Semperger, Gergely Hegedus

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The purpose of the project is to develop a complex composite component with visible class ‘A’ surface. It is going to integrate more functions, including continuous fiber reinforcement, foam core, injection molded ribs, and metal inserts. Therefore we are going to produce recyclable structural composite part from thermoplastic polymer in serial production with short cycle time for automotive applications. Our design of the process line is determined by the principles of Industry 4.0. Accordingly, our goal is to map in details the properties of the final product including the mechanical properties in order to replace metal elements used in automotive industry, with special regard to the effect of each manufacturing process step on the afore mentioned properties. Period of the project is 3 years, which lasts from the 1st of December 2016 to the 30th November 2019. There are four consortium members in the R&D project evopro systems engineering Ltd., Department of Polymer Engineering of the Budapest University of Technology and Economics, Research Centre for Natural Sciences of Hungarian Academy of Sciences and eCon Engineering Ltd. One of the most important result that we can obtain short cycle time (up to 2-3 min) with in-situ polymerization method, which is an innovation in the field of thermoplastic composite production. Because of the mentioned method, our fully automated production line is able to manufacture complex thermoplastic composite parts and satisfies the short cycle time required by the automotive industry. In addition to the innovative technology, we are able to design, analyze complex composite parts with finite element method, and validate our results. We are continuously collecting all the information, knowledge and experience to improve our technology and obtain even more accurate results with respect to the quality and complexity of the composite parts, the cycle time of the production, and the design and analyzing method of the composite parts.

Keywords: T-RTM technology, composite, automotive, class A surface

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1804 Detection of Autism Spectrum Disorders in Children Aged 4-6 Years by Municipal Maternal and Child Health Physicians: An Educational Intervention Study

Authors: M. Van 'T Hof, R. V. Pasma, J. T. Bailly, H. W. Hoek, W. A. Ester

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Background: The transition into primary school can be challenging for children with an autism spectrum disorder (ASD). Due to the new demands that are made to children in this period, their limitations in social functioning and school achievements may manifest and appear faster. Detection of possible ASD signals mainly takes place by parents, teachers and during obligatory municipal maternal and child health centre visits. Physicians of municipal maternal and child health centres have limited education and instruments to detect ASD. Further education on detecting ASD is needed to optimally equip these doctors for this task. Most research aims to increase the early detection of ASD in children aged 0-3 years and shows positive results. However, there is a lack of research on educational interventions to detect ASD in children aged 4-6 years by municipal maternal and child health physicians. Aim: The aim of this study is to explore the effect of the online educational intervention: Detection of ASD in children aged 4-6 years for municipal maternal and child health physicians. This educational intervention is developed within The Reach-Aut Academic Centre for Autism; Transitions in education, and will be available throughout The Netherlands. Methods: Ninety-two participants will follow the educational intervention: Detection of ASD in children aged 4-6 years for municipal maternal and child health centre physicians. The educational intervention consists of three, one and a half hour sessions, which are offered through an online interactive classroom. The focus and content of the course has been developed in collaboration with three groups of stakeholders; autism scientists, clinical practitioners (municipal maternal and child health doctors and ASD experts) and parents of children with ASD. The primary outcome measure is knowledge about ASD: signals, early detection, communication with parents and referrals. The secondary outcome measures are the number of ASD related referrals, the attitude towards the mentally ill (CAMI), perceived competency about ASD knowledge and detection skills, and satisfaction about the educational intervention. Results and Conclusion: The study started in January 2016 and data collection will end mid 2017.

Keywords: ASD, child, detection, educational intervention, physicians

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1803 Computational Fluid Dynamics Design and Analysis of Aerodynamic Drag Reduction Devices for a Mazda T3500 Truck

Authors: Basil Nkosilathi Dube, Wilson R. Nyemba, Panashe Mandevu

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In highway driving, over 50 percent of the power produced by the engine is used to overcome aerodynamic drag, which is a force that opposes a body’s motion through the air. Aerodynamic drag and thus fuel consumption increase rapidly at speeds above 90kph. It is desirable to minimize fuel consumption. Aerodynamic drag reduction in highway driving is the best approach to minimize fuel consumption and to reduce the negative impacts of greenhouse gas emissions on the natural environment. Fuel economy is the ultimate concern of automotive development. This study aims to design and analyze drag-reducing devices for a Mazda T3500 truck, namely, the cab roof and rear (trailer tail) fairings. The aerodynamic effects of adding these append devices were subsequently investigated. To accomplish this, two 3D CAD models of the Mazda truck were designed using the Design Modeler. One, with these, append devices and the other without. The models were exported to ANSYS Fluent for computational fluid dynamics analysis, no wind tunnel tests were performed. A fine mesh with more than 10 million cells was applied in the discretization of the models. The realizable k-ε turbulence model with enhanced wall treatment was used to solve the Reynold’s Averaged Navier-Stokes (RANS) equation. In order to simulate the highway driving conditions, the tests were simulated with a speed of 100 km/h. The effects of these devices were also investigated for low-speed driving. The drag coefficients for both models were obtained from the numerical calculations. By adding the cab roof and rear (trailer tail) fairings, the simulations show a significant reduction in aerodynamic drag at a higher speed. The results show that the greatest drag reduction is obtained when both devices are used. Visuals from post-processing show that the rear fairing minimized the low-pressure region at the rear of the trailer when moving at highway speed. The rear fairing achieved this by streamlining the turbulent airflow, thereby delaying airflow separation. For lower speeds, there were no significant differences in drag coefficients for both models (original and modified). The results show that these devices can be adopted for improving the aerodynamic efficiency of the Mazda T3500 truck at highway speeds.

Keywords: aerodynamic drag, computation fluid dynamics, fluent, fuel consumption

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1802 Practical Challenges of Tunable Parameters in Matlab/Simulink Code Generation

Authors: Ebrahim Shayesteh, Nikolaos Styliaras, Alin George Raducu, Ozan Sahin, Daniel Pombo VáZquez, Jonas Funkquist, Sotirios Thanopoulos

Abstract:

One of the important requirements in many code generation projects is defining some of the model parameters tunable. This helps to update the model parameters without performing the code generation again. This paper studies the concept of embedded code generation by MATLAB/Simulink coder targeting the TwinCAT Simulink system. The generated runtime modules are then tested and deployed to the TwinCAT 3 engineering environment. However, defining the parameters tunable in MATLAB/Simulink code generation targeting TwinCAT is not very straightforward. This paper focuses on this subject and reviews some of the techniques tested here to make the parameters tunable in generated runtime modules. Three techniques are proposed for this purpose, including normal tunable parameters, callback functions, and mask subsystems. Moreover, some test Simulink models are developed and used to evaluate the results of proposed approaches. A brief summary of the study results is presented in the following. First of all, the parameters defined tunable and used in defining the values of other Simulink elements (e.g., gain value of a gain block) could be changed after the code generation and this value updating will affect the values of all elements defined based on the values of the tunable parameter. For instance, if parameter K=1 is defined as a tunable parameter in the code generation process and this parameter is used to gain a gain block in Simulink, the gain value for the gain block is equal to 1 in the gain block TwinCAT environment after the code generation. But, the value of K can be changed to a new value (e.g., K=2) in TwinCAT (without doing any new code generation in MATLAB). Then, the gain value of the gain block will change to 2. Secondly, adding a callback function in the form of “pre-load function,” “post-load function,” “start function,” and will not help to make the parameters tunable without performing a new code generation. This means that any MATLAB files should be run before performing the code generation. The parameters defined/calculated in this file will be used as fixed values in the generated code. Thus, adding these files as callback functions to the Simulink model will not make these parameters flexible since the MATLAB files will not be attached to the generated code. Therefore, to change the parameters defined/calculated in these files, the code generation should be done again. However, adding these files as callback functions forces MATLAB to run them before the code generation, and there is no need to define the parameters mentioned in these files separately. Finally, using a tunable parameter in defining/calculating the values of other parameters through the mask is an efficient method to change the value of the latter parameters after the code generation. For instance, if tunable parameter K is used in calculating the value of two other parameters K1 and K2 and, after the code generation, the value of K is updated in TwinCAT environment, the value of parameters K1 and K2 will also be updated (without any new code generation).

Keywords: code generation, MATLAB, tunable parameters, TwinCAT

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1801 LYRM7-Associated Mitochondrial Complex III Deficiency with Non-Cavitating Leukoencephalopathy and Stroke-Like Episodes

Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

Abstract:

Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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1800 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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1799 Organizational Stress in Women Executives

Authors: Poornima Gupta, Sadaf Siraj

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The study examined the organizational causes of organizational stress in women executives and entrepreneurs in India. This was done so that mediation strategies could be developed to combat the organizational stress experienced by them, in order to retain the female employees as well as attract quality talent. The data for this research was collected through the self- administered survey, from the women executives across various industries working at different levels in management. The research design of the study was descriptive and cross-sectional. It was carried out through a self-administered questionnaire filled in by the women executives and entrepreneurs in the NCR region. Multistage sampling involving stratified random sampling was employed. A total of 1000 questionnaires were distributed out of which 450 were returned and after cleaning the data 404 were fit to be considered for analyses. The overall findings of the study suggested that there were various job-related factors that induce stress. Fourteen factors were identified which were a major cause of stress among the working women by applying Factor analysis. The study also assessed the demographic factors which influence the stress in women executives across various industries. The findings show that the women, no doubt, were stressed by organizational factors. The mean stress score was 153 (out of a possible score of 196) indicating high stress. There appeared to be an inverse relationship between the marital status, age, education, work experience, and stress. Married women were less stressed compared to single women employees. Similarly, female employees 29 years or younger experienced more stress at work. Women having education up to 12th standard or less were more stressed compared to graduates and post graduates. Women who had spent more than two years in the same organization perceived more stress compared to their counterparts. Family size and income, interestingly, had no significant impact on stress. The study also established that the level of stress experienced by women across industries differs considerably. Banking sector emerged as the industry where the women experienced the most stress followed by Entrepreneurs, Medical, BPO, Advertising, Government, Academics, and Manufacturing, in that order. The results contribute to the better understanding of the personal and economic factors surrounding job stress and working women. It concludes that the organizations need to be sensitive to the women’s needs. Organizations are traditionally designed around men with the rules made by the men for the men. Involvement of women in top positions, decision making, would make them feel more useful and less stressed. The invisible glass ceiling causes more stress than realized among women. Less distinction between the men and women colleagues in terms of giving responsibilities, involvement in decision making, framing policies, etc. would go a long way to reduce stress in women.

Keywords: women, stress, gender in management, women in management

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1798 Impact of Expressive Writing on Creativity

Authors: Małgorzata Osowiecka

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Negative emotions are rather seen as creativity inhibitor. On the other hand, it is worth noting that negative emotions may be good for our functioning. Negative emotions enhance cognitive resources and improve evaluative processes. Moreover maintaining a negative emotional state allow for cognitive reinterpretation of the emotional stimuli, what is good for our creativity, especially cognitive flexibility. Writing a diary or writing about difficult emotional experiences in general can be the way to not only improve psychical health, but also – enhance creative behaviors. Thanks to translating difficult emotions to the verbal level and giving them ‘a name’ or ‘a label’, we can get easier access to both emotional content of an experience and to the semantic content, without the need of speaking out loud. Expressive writing improves academic results and the efficiency of working memory. The classical method of writing about emotions consists in a long-term process of describing negative experiences. Present research demonstrate the efficiency of this process over a shorter period of time - one writing session, on school children sample. Participants performed writing task. Writing task had two different topics: emotions connected with their negative emotions (expressive writing) and content not connected with negative emotional state (writing about one’s typical day). Creativity was measured by Guilford’s Alternative Uses Task. Results have shown that writing about negative emotions results in the higher level of divergent thinking in all three parameters: fluency, flexibility and originality. After the writing task mood of expressive writing participants remained negative more than the mood of the controls. Taking an expressive action after a difficult emotional experience can support functioning, which can be observed in enhancement of divergent thinking. Writing about emotions connected with negative experience makes one more creative, than writing about something unrelated with difficult emotional moments. Research has shown that young people should not demonize negative emotions. Sometimes, properly applied, negative emotions can be the basis of creation. Preparation was supported by a The Young Scientist University grant titled ‘Dynamics of emotions in the creative process’ from The Polish Ministry of Science and Higher Education.

Keywords: creativity, divergent thinking, emotions, expressive writing

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1797 Study of the Prevalence, Associated Factors and Impact of Maternal Perinatal Depression in Women Alexandria 2022

Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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1796 Local Binary Patterns-Based Statistical Data Analysis for Accurate Soccer Match Prediction

Authors: Mohammad Ghahramani, Fahimeh Saei Manesh

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Winning a soccer game is based on thorough and deep analysis of the ongoing match. On the other hand, giant gambling companies are in vital need of such analysis to reduce their loss against their customers. In this research work, we perform deep, real-time analysis on every soccer match around the world that distinguishes our work from others by focusing on particular seasons, teams and partial analytics. Our contributions are presented in the platform called “Analyst Masters.” First, we introduce various sources of information available for soccer analysis for teams around the world that helped us record live statistical data and information from more than 50,000 soccer matches a year. Our second and main contribution is to introduce our proposed in-play performance evaluation. The third contribution is developing new features from stable soccer matches. The statistics of soccer matches and their odds before and in-play are considered in the image format versus time including the halftime. Local Binary patterns, (LBP) is then employed to extract features from the image. Our analyses reveal incredibly interesting features and rules if a soccer match has reached enough stability. For example, our “8-minute rule” implies if 'Team A' scores a goal and can maintain the result for at least 8 minutes then the match would end in their favor in a stable match. We could also make accurate predictions before the match of scoring less/more than 2.5 goals. We benefit from the Gradient Boosting Trees, GBT, to extract highly related features. Once the features are selected from this pool of data, the Decision trees decide if the match is stable. A stable match is then passed to a post-processing stage to check its properties such as betters’ and punters’ behavior and its statistical data to issue the prediction. The proposed method was trained using 140,000 soccer matches and tested on more than 100,000 samples achieving 98% accuracy to select stable matches. Our database from 240,000 matches shows that one can get over 20% betting profit per month using Analyst Masters. Such consistent profit outperforms human experts and shows the inefficiency of the betting market. Top soccer tipsters achieve 50% accuracy and 8% monthly profit in average only on regional matches. Both our collected database of more than 240,000 soccer matches from 2012 and our algorithm would greatly benefit coaches and punters to get accurate analysis.

Keywords: soccer, analytics, machine learning, database

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1795 Machine Learning Approaches to Water Usage Prediction in Kocaeli: A Comparative Study

Authors: Kasim Görenekli, Ali Gülbağ

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This study presents a comprehensive analysis of water consumption patterns in Kocaeli province, Turkey, utilizing various machine learning approaches. We analyzed data from 5,000 water subscribers across residential, commercial, and official categories over an 80-month period from January 2016 to August 2022, resulting in a total of 400,000 records. The dataset encompasses water consumption records, weather information, weekends and holidays, previous months' consumption, and the influence of the COVID-19 pandemic.We implemented and compared several machine learning models, including Linear Regression, Random Forest, Support Vector Regression (SVR), XGBoost, Artificial Neural Networks (ANN), Long Short-Term Memory (LSTM), and Gated Recurrent Units (GRU). Particle Swarm Optimization (PSO) was applied to optimize hyperparameters for all models.Our results demonstrate varying performance across subscriber types and models. For official subscribers, Random Forest achieved the highest R² of 0.699 with PSO optimization. For commercial subscribers, Linear Regression performed best with an R² of 0.730 with PSO. Residential water usage proved more challenging to predict, with XGBoost achieving the highest R² of 0.572 with PSO.The study identified key factors influencing water consumption, with previous months' consumption, meter diameter, and weather conditions being among the most significant predictors. The impact of the COVID-19 pandemic on consumption patterns was also observed, particularly in residential usage.This research provides valuable insights for effective water resource management in Kocaeli and similar regions, considering Turkey's high water loss rate and below-average per capita water supply. The comparative analysis of different machine learning approaches offers a comprehensive framework for selecting appropriate models for water consumption prediction in urban settings.

Keywords: mMachine learning, water consumption prediction, particle swarm optimization, COVID-19, water resource management

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1794 Integrating Sexual Reproductive Health and Rights in Promoting Gender Equality, Equity, and Empowerment of Women

Authors: Danielle G. Saique

Abstract:

Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.

Keywords: women development, promoting gender equality, equity, empowerment of women

Procedia PDF Downloads 476
1793 Innovation in "Low-Tech" Industries: Portuguese Footwear Industry

Authors: Antonio Marques, Graça Guedes

Abstract:

The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also analyses the strategy follow in the innovation process, as suggested by Freeman and Soete, and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. Can conclude that the Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: footwear, innovation, “low-tech” industry, Oslo manual

Procedia PDF Downloads 379
1792 Emotion Expression of the Leader and Collective Efficacy: Pride and Guilt

Authors: Hsiu-Tsu Cho

Abstract:

Collective efficacy refers to a group’s sense of its capacity to complete a task successfully or to reach objectives. Little effort has been expended on investigating the relationship between the emotion expression of a leader and collective efficacy. In this study, we examined the impact of the different emotions and emotion expression of a group leader on collective efficacy and explored whether the emotion–expressive effects differed under conditions of negative and positive emotions. A total of 240 undergraduate and graduate students recruited using Facebook and posters at a university participated in this research. The participants were separated randomly into 80 groups of four persons consisting of three participants and a confederate. They were randomly assigned to one of five conditions in a 2 (pride vs. guilt) × 2 (emotion expression of group leader vs. no emotion expression of group leader) factorial design and a control condition. Each four-person group was instructed to get the reward in a group competition of solving the five-disk Tower of Hanoi puzzle and making decisions on an investment case. We surveyed the participants by employing the emotional measure revised from previous researchers and collective efficacy questionnaire on a 5-point scale. To induce an emotion of pride (or guilt), the experimenter announced whether the group performance was good enough to have a chance of getting the reward (ranking the top or bottom 20% among all groups) after group task. The leader (confederate) could either express or not express a feeling of pride (or guilt) following the instruction according to the assigned condition. To check manipulation of emotion, we added a control condition under which the experimenter revealed no results regarding group performance in maintaining a neutral emotion. One-way ANOVAs and post hoc pairwise comparisons among the three emotion conditions (pride, guilt, and control condition) involved assigning pride and guilt scores (pride: F(1,75) = 32.41, p < .001; guilt: F(1,75) = 6.75, p < .05). The results indicated that manipulations of emotion were successful. A two-way between-measures ANOVA was conducted to examine the predictions of the main effects of emotion types and emotion expression as well as the interaction effect of these two variables on collective efficacy. The experimental findings suggest that pride did not affect collective efficacy (F(1,60) = 1.90, ns.) more than guilt did and that the group leader did not motivate collective efficacy regardless of whether he or she expressed emotion (F(1,60) = .89, ns.). However, the interaction effect of emotion types and emotion expression was statistically significant (F(1,60) = 4.27, p < .05, ω2 = .066); the effects accounted for 6.6% of the variance. Additional results revealed that, under the pride condition, the leader enhanced group efficacy when expressing emotion, whereas, under the guilt condition, an expression of emotion could reduce collective efficacy. Overall, these findings challenge the assumption that the effect of expression emotion are the same on all emotions and suggest that a leader should be cautious when expressing negative emotions toward a group to avoid reducing group effectiveness.

Keywords: collective efficacy, group leader, emotion expression, pride, guilty

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1791 Antioxidant Efficacy of Lovi (Flacourtia inermis) Peel Extract in Edible Oils during Storage

Authors: Sasini U. G. Nanayakkara, Nishala E. Wedamulla, W. A. J. P. Wijesinghe

Abstract:

Lovi (Flacourtia inermis) is an underutilized fruit crop grown in Sri Lanka with promising antioxidant properties; thus, exhibits the great potential to use as a natural antioxidant. With the concern of synthetic antioxidants, there is a growing trend towards the addition of a natural antioxidant to retard the rancidity of edible oils. Hence, in this backdrop, extract obtained from the peel of F. inermis fruit was used to retard the rancidity of selected edible oils. Free fatty acid (FFA) content and peroxide value (PV) of sunflower oil (SO) and virgin coconut oil (VCO) were measured at 3-day intervals for 21 days at 65 ± 5°C after addition of extract at 500, 1000, 2000 ppm levels and α-tocopherol at 500 ppm level was used as positive control. SO and VCO without added extract was used as the control. The extract was prepared with 70% ethanol using ultrasound-assisted extraction, and antioxidant efficacy and total phenolic content (TPC) of the extract were measured using 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging capacity and Folin-Ciocalteu method respectively. Antioxidant activity (IC50) and TPC of the extract were 227.14 ± 4.12 µgmL⁻¹ and 4.87 ± 0.01 mg GAE per gram, respectively. During the storage period, FFA content and PV of both oils were increased with time. However, SO showed comparatively high PV than that of VCO and thereby indicate the progression of lipid oxidation as PV is a good indicator of the extent of primary oxidative products formed in oils. The most effective extract concentration was 2000 ppm. After 21 days of storage, VCO (control) sample exhibited significantly (p < 0.05) high FFA (0.36%) and PV (1.93 meq kg⁻¹) than that of VCO with 1000 ppm (FFA: 0.35%; PV: 1.72 meq kg⁻¹) and 2000 ppm (FFA: 0.28%; PV: 1.19 meq kg-1) levels of extract. Thus, demonstrates the efficacy of lovi peel extract in retardation of lipid oxidation of edible oils during storage at higher concentrations of the extract addition. Moreover, FFA and PV of SO (FFA: 0.10%; PV: 12.38 meq kg⁻¹) and VCO (FFA: 0.28%; PV: 1.19 meq kg⁻¹) at 2000 ppm level of extract were significantly (p < 0.05) lower than that of positive control: SO with α-tocopherol (FFA: 0.22%, PV: 17.94 meq kg⁻¹) and VCO with α-tocopherol (FFA: 0.29%, PV: 1.39 meq kg⁻¹) after 21 days. Accordingly, lovi peel extract at 2000 ppm level was more effective than α-tocopherol in retardation of lipid oxidation of edible oils. In conclusion, lovi peel extract has strong antioxidant properties and can be used as a natural antioxidant to inhibit deteriorative oxidation of edible oils.

Keywords: antioxidant, Flacourtia inermis, peroxide value, virgin coconut oil

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1790 Evaluation of Chemoprotective Effect of NBRIQU16 against N-Methyl-N-Nitro-N-Nitrosoguanidine and NaCl-Induced Gastric Carcinomas in Wistar Rats

Authors: Lubna Azmi, Ila Shukla, Shyam Sundar Gupta, Padam Kant, C. V. Rao

Abstract:

To investigate the chemoprotective potential of NBRIQU16 chemotype isolated from Argyreia speciosa (Family: Convolvulaceae) on N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and NaCl-induced gastric carcinomas in Wistar rats. Forty-six male 6-week-old Wistar rats were divided into two groups. Thirty rats in group A were fed with a diet supplemented with 8 % NaCl for 20 weeks and simultaneously given N-methyl-N’-nitro-N-nitrosoguanidine (MNNG) in drinking water at a concentration of 100 ug/ml for the first 17 weeks. After administration of the carcinogen, 200 and 400 mg/kg of NBRIQU16 were administered orally once a day throughout the study. From week 18, these rats were given normal water. From week 21, these rats were fed with a normal diet for 15 weeks. Group B containing 16 rats was fed standard diet for thirty-five days. It served as control. Ten rats from group A were sacrificed after 20 weeks. Scarification of remaining animals was conducted after 35 weeks. Entire stomach and some part of the duodenum were incised parallel to the greater curvature, and the samples were collected. After opening the stomach location and size of tumors were recorded. The number of tumors with their locations and sizes were recorded. Expression of survivin was examined by recording the Immunohistochemistry of the specimens. The treatment with NBRIQU16 significantly reduced the nodule incidence and nodule multiplicity in the rats after MNNG administration. Surviving expression in glandular stomachs of normal rats, of rats in middle induction period, in adenocarcinomas and NBRIQU16 treated tissues adjacent to tumor were 0, 42.0 %, 79.3%, and 36.4 %, respectively. Expression of survivin was significantly different as compared to the normal rats. Histological observations of stomach tissues too correlated with the biochemical observations.These finding powerfully supports that NBRIQU16 chemopreventive effect by suppressing the tumor burden and restoring the activities of gastric cancer marker enzymes on MNNG and NaCl-induced gastric carcinomas in Wistar rats.

Keywords: Argyreia speciosa, gastric carcinoma, immunochemistry, NBRIQU16

Procedia PDF Downloads 298
1789 Assessing the Impact of Climate Change on Pulses Production in Khyber Pakhtunkhwa, Pakistan

Authors: Khuram Nawaz Sadozai, Rizwan Ahmad, Munawar Raza Kazmi, Awais Habib

Abstract:

Climate change and crop production are intrinsically associated with each other. Therefore, this research study is designed to assess the impact of climate change on pulses production in Southern districts of Khyber Pakhtunkhwa (KP) Province of Pakistan. Two pulses (i.e. chickpea and mung bean) were selected for this research study with respect to climate change. Climatic variables such as temperature, humidity and precipitation along with pulses production and area under cultivation of pulses were encompassed as the major variables of this study. Secondary data of climatic variables and crop variables for the period of thirty four years (1986-2020) were obtained from Pakistan Metrological Department and Agriculture Statistics of KP respectively. Panel data set of chickpea and mung bean crops was estimated separately. The analysis validate that both data sets were a balanced panel data. The Hausman specification test was run separately for both the panel data sets whose findings had suggested the fixed effect model can be deemed as an appropriate model for chickpea panel data, however random effect model was appropriate for estimation of the panel data of mung bean. Major findings confirm that maximum temperature is statistically significant for the chickpea yield. This implies if maximum temperature increases by 1 0C, it can enhance the chickpea yield by 0.0463 units. However, the impact of precipitation was reported insignificant. Furthermore, the humidity was statistically significant and has a positive association with chickpea yield. In case of mung bean the minimum temperature was significantly contributing in the yield of mung bean. This study concludes that temperature and humidity can significantly contribute to enhance the pulses yield. It is recommended that capacity building of pulses growers may be made to adapt the climate change strategies. Moreover, government may ensure the availability of climate change resistant varieties of pulses to encourage the pulses cultivation.

Keywords: climate change, pulses productivity, agriculture, Pakistan

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1788 Agreement between Basal Metabolic Rate Measured by Bioelectrical Impedance Analysis and Estimated by Prediction Equations in Obese Groups

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m2. Those with BMI values varying from 25.0 to 29.9 kg/m2 constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m2, 35.0-39.9 kg/m2, > 40.0 kg/m2 were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m2. Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: adult, basal metabolic rate, fao/who/unu, obesity, prediction equations

Procedia PDF Downloads 133
1787 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

Abstract:

Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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1786 Clinical Outcomes and Symptom Management in Pediatric Patients Following Eczema Action Plans: A Quality Improvement Project

Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

Abstract:

Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

Procedia PDF Downloads 135
1785 Extracellular Production of the Oncolytic Enzyme, Glutaminase Free L-Asparaginase, from Newly Isolated Streptomyces Olivaceus NEAE-119: Optimization of Culture Conditions Using Response Surface Methodology

Authors: Noura El-Ahmady El-Naggar

Abstract:

Among the antitumour drugs, bacterial enzyme L-asparaginase has been employed as the most effective chemotherapeutic agent in pediatric oncotherapy especially for acute lymphoblastic leukemia. Glutaminase free L-asparaginase producing actinomycetes were isolated from soil samples collected from Egypt. Among them, a potential culture, strain NEAE-119, was selected and identified on the basis of morphological, cultural, physiological and biochemical properties, together with 16S rDNA sequence as Streptomyces olivaceus NEAE-119 and sequencing product(1509 bp) was deposited in the GenBank database under accession number KJ200342. The optimization of different process parameters for L-asparaginase production by Streptomyces olivaceus NEAE-119 using Plackett–Burman experimental design and response surface methodology was carried out. Fifteen nutritional variables (temperature, pH, incubation time, inoculum size, inoculum age, agitation speed, dextrose, starch, L-asparagine, KNO3, yeast extract, K2HPO4, MgSO4.7H2O, NaCl and FeSO4. 7H2O) were screened using Plackett–Burman experimental design. The most positive significant independent variables affecting enzyme production (temperature, inoculum age and agitation speed) were further optimized by the central composite face-centered design -response surface methodology. As a result, a medium of the following formula is the optimum for producing an extracellular L-asparaginase in the culture filtrate of Streptomyces olivaceus NEAE-119: Dextrose 3g, starch 20g, L-asparagine 10g, KNO3 1g, K2HPO4 1g, MgSO4.7H2O 0.1g, NaCl 0.1g, pH 7, temperature 37°C, agitation speed 200 rpm/min, inoculum size 4%, v/v, inoculum age 72 h and fermentation period 5 days.

Keywords: Streptomyces olivaceus NEAE-119, glutaminase free L-asparaginase, production, Plackett-Burman design, central composite face-centered design, 16S rRNA, scanning electron microscope

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1784 Potential of Ozonation and Phytoremediation to Reduce Hydrocarbon Levels Remaining after the Pilot Scale Microbial Based Bioremediation (Land-Farming) of a Heavily Polluted Soil

Authors: Hakima Althalb

Abstract:

Petroleum contamination of sandy soils is a severe environmental problem in Libya, but relatively little work has been carried out to optimize the bioremediation of such heavily contaminated soil, particularly at a pilot scale. The purpose of this research was to determine the potential for the microbial-based bioremediation of hydrocarbon-contaminated soil obtained from an oil refinery in Libya and to assess the potential of both ozonation and phytoremediation (both applied after initial bioremediation) to reduce residual hydrocarbon levels. Plots containing 500 kg soil (triplicates) (contaminated soil diluted with clean soil 50% volume) were set up, (designated as Land Treatment Units; LTUs) containing five different nutrient levels and mixtures (Urea + NPK (nitrogen; phosphor; potassium) mixtures) to obtain C:N:P ratios 100:10:1, and monitored for 90 days. Hydrocarbon levels, microbial numbers, and toxicity (EC50 using luminescent microbial based tests) were assessed. Hydrocarbon levels in non-diluted and diluted soil ranged from 20 733-22 366 mg/kg and from 16 000-17 000 mg/kg respectively. Although all the land treatment units revealed a significant hydrocarbon reduction over time, the highest reduction in hydrocarbon levels obtained was around 60%. For example, 63% hydrocarbon removal was observed using a mixture of urea and NPK with a C:N:P ratio of 100:10:1). Soil toxicity (as assessed using luminescence based toxicity assays) reduced in line with the reduction in total petroleum hydrocarbons observed. However, as relatively high residual TPH (total petroleum hydrocarbon) levels (ranging from 6033-14166mg/kg) were still present after initial bioremediation two ‘post-treatments’ (phytoremediation and ozonation) were attempted to remove residual hydrocarbons remaining. Five locally grown (agriculturally important) plant species were tested. The germination of all plants examined was strongly inhibited (80-100%) and seedlings failed to grow well in the contaminated soil, indicating that the previously bioremediated soils were still toxic to the plants. Subsequent ozonation followed by another bioremediation of soil was more successful than phytoremediation. But even the most promising successful treatment in this study (ozonation for 6 hours at 25ppm followed by bioremediation) still only removed approximately 31% of the residual hydrocarbons. Overall, this work showed that the bioremediation of such highly contaminated soils is difficult and that a combination of treatments would be required to achieve successful remediation. Even after initial dilution and bioremediation the soils remained toxic to plant growth and were therefore not suitable for phytoremediation.

Keywords: bioremediation, petroleum hydrocarbons, ozone, phytoremediation

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1783 Insight into Localized Fertilizer Placement in Major Cereal Crops

Authors: Solomon Yokamo, Dianjun Lu, Xiaoqin Chen, Huoyan Wang

Abstract:

The current ‘high input-high output’ nutrient management model based on homogenous spreading over the entire soil surface remains a key challenge in China’s farming systems, leading to low fertilizer use efficiency and environmental pollution. Localized placement of fertilizer (LPF) to crop root zones has been proposed as a viable approach to boost crop production while protecting environmental pollution. To assess the potential benefits of LPF on three major crops—wheat, rice, and maize—a comprehensive meta-analysis was conducted, encompassing 85 field studies published from 2002-2023. We further validated the practicability and feasibility of one-time root zone N management based on LPF for the three field crops. The meta-analysis revealed that LPF significantly increased the yields of the selected crops (13.62%) and nitrogen recovery efficiency (REN) (33.09%) while reducing cumulative nitrous oxide (N₂O) emission (17.37%) and ammonia (NH₃) volatilization (60.14%) compared to the conventional surface application (CSA). Higher grain yield and REN were achieved with an optimal fertilization depth (FD) of 5-15 cm, moderate N rates, combined NPK application, one-time deep fertilization, and coarse-textured and slightly acidic soils. Field validation experiments showed that localized one-time root zone N management without topdressing increased maize (6.2%), rice (34.6%), and wheat (2.9%) yields while saving N fertilizer (3%) and also increased the net economic benefits (23.71%) compared to CSA. A soil incubation study further proved the potential of LPF to enhance the retention and availability of mineral N in the root zone over an extended period. Thus, LPF could be an important fertilizer management strategy and should be extended to other less-developed and developing regions to win the triple benefit of food security, environmental quality, and economic gains.

Keywords: grain yield, LPF, NH₃ volatilization, N₂O emission, N recovery efficiency

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1782 The Applications and Effects of the Career Courses of Taiwanese College Students with LEGO® SERIOUS PLAY®

Authors: Payling Harn

Abstract:

LEGO® SERIOUS PLAY® is a kind of facilitated workshop of thinking and problem-solving approach. Participants built symbolic and metaphorical brick models in response to tasks given by the facilitator and presented these models to other participants. LEGO® SERIOUS PLAY® applied the positive psychological mechanism of Flow and positive emotions to help participants perceiving self-experience and unknown fact and increasing the happiness of life by building bricks and narrating story. At present, LEGO® SERIOUS PLAY® is often utilized for facilitating professional identity and strategy development to assist workers in career development. The researcher desires to apply LEGO® SERIOUS PLAY® to the career courses of college students in order to promote their career ability. This study aimed to use the facilitative method of LEGO® SERIOUS PLAY® to develop the career courses of college students, then explore the effects of Taiwanese college students' positive and negative emotions, career adaptabilities, and career sense of hope by LEGO® SERIOUS PLAY® career courses. The researcher regarded strength as the core concept and use the facilitative mode of LEGO® SERIOUS PLAY® to develop the 8 weeks’ career courses, which including ‘emotion of college life’ ‘career highlights’, ‘career strengths’, ‘professional identity’, ‘business model’, ‘career coping’, ‘strength guiding principles’, ‘career visions’,’ career hope’, etc. The researcher will adopt problem-oriented teaching method to give tasks which according to the weekly theme, use the facilitative mode of LEGO® SERIOUS PLAY® to guide participants to respond tasks by building bricks. Then participants will conduct group discussions, reports, and writing reflection journals weekly. Participants will be 24 second-grade college students. They will attend LEGO® SERIOUS PLAY® career courses for 2 hours a week. The researcher used’ ‘Career Adaptability Scale’ and ‘Career Hope Scale’ to conduct pre-test and post-test. The time points of implementation testing will be one week before courses starting, one day after courses ending respectively. Then the researcher will adopt repeated measures one-way ANOVA for analyzing data. The results revealed that the participants significantly presented immediate positive effect in career adaptability and career hope. The researcher hopes to construct the mode of LEGO® SERIOUS PLAY® career courses by this study and to make a substantial contribution to the future career teaching and researches of LEGO® SERIOUS PLAY®.

Keywords: LEGO® SERIOUS PLAY®, career courses, strength, positive and negative affect, career hope

Procedia PDF Downloads 253
1781 Effect of Cognitive Rehabilitation in Pediatric Population with Acquired Brain Injury: A Pilot Study

Authors: Carolina Beltran, Carlos De Los Reyes

Abstract:

Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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1780 Integrating a Six Thinking Hats Approach Into the Prewriting Stage of Argumentative Writing In English as a Foreign Language: A Chinese Case Study of Generating Ideas in Action

Authors: Mei Lin, Chang Liu

Abstract:

Argumentative writing is the most prevalent genre in diverse writing tests. How to construct academic arguments is often regarded as a difficult task by most English as a foreign language (EFL) learners. A failure to generate enough ideas and organise them coherently and logically as well as a lack of competence in supporting their arguments with relevant evidence are frequent problems faced by EFL learners when approaching an English argumentative writing task. Overall, these problems are closely related to planning, and planning an argumentative writing at pre-writing stage plays a vital role in a good academic essay. However, how teachers can effectively guide students to generate ideas is rarely discussed in planning English argumentative writing, apart from brainstorming. Brainstorming has been a common practice used by teachers to help students generate ideas. However, some limitations of brainstorming suggest that it can help students generate many ideas, but ideas might not necessarily be coherent and logic, and could sometimes impede production. It calls for a need to explore effective instructional strategies at pre-writing stage of English argumentative writing. This paper will first examine how a Six Thinking Hats approach can be used to provide a dialogic space for EFL learners to experience and collaboratively generate ideas from multiple perspectives at pre-writing stage. Part of the findings of the impact of a twelve-week intervention (from March to July 2021) on students learning to generate ideas through engaging in group discussions of using Six Thinking Hats will then be reported. The research design is based on the sociocultural theory. The findings present evidence from a mixed-methods approach and fifty-nine participants from two first-year undergraduate natural classes in a Chinese university. Analysis of pre- and post- questionnaires suggests that participants had a positive attitude toward the Six Thinking Hats approach. It fosters their understanding of prewriting and argumentative writing, helps them to generate more ideas not only from multiple perspectives but also in a systematic way. A comparison of participants writing plans confirms an improvement in generating counterarguments and rebuttals to support their arguments. Above all, visual and transcripts data of group discussion collected from different weeks throughout the intervention enable teachers and researchers to ‘see’ the hidden process of learning to generate ideas in action.

Keywords: argumentative writing, innovative pedagogy, six thinking hats, dialogic space, prewriting, higher education

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