Search results for: early childhood caries
Commenced in January 2007
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Edition: International
Paper Count: 4022

Search results for: early childhood caries

3242 Time Bound Parallel Processing of a Disaster Management Alert System Using Random Selection of Target Audience: Bangladesh Context

Authors: Hasan Al Bashar Abul Ulayee, AKM Saifun Nabi, MD Mesbah-Ul-Awal

Abstract:

Alert system for disaster management is common now a day and can play a vital role reducing devastation and saves lives and costs. An alert in right time can save thousands of human life, help to take shelter, manage other assets including live stocks and above all, a right time alert will help to take preparation to face and early recovery of the situation. In a country like Bangladesh where populations is more than 170 million and always facing different types of natural calamities and disasters, an early right time alert is very effective and implementation of alert system is challenging. The challenge comes from the time constraint of alerting the huge number of population. The other method of existing disaster management pre alert is traditional, sequential and non-selective so efficiency is not good enough. This paper describes a way by which alert can be provided to maximum number of people within the short time bound using parallel processing as well as random selection of selective target audience.

Keywords: alert system, Bangladesh, disaster management, parallel processing, SMS

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3241 The Importance of Imaging and Functional Tests for Early Detection of Occupational Diseases in Kosovo's Miners

Authors: Krenare Shabani, Kreshnike Dedushi Hoti, Serbeze Kabashi, Jeton Shatri, Arben Rroji, Mrikë Bunjaku, Leotrim Berisha, Jona Kosova, Edmond Puca, Bleriana Shabani

Abstract:

Introduction: Workers in Kosovo's mining industry are subjected to hazardous working conditions and airborne particles, such as silica dust, which can cause silicosis and other severe respiratory illnesses. The purpose of this research is to assess the health impacts of such exposures, as well as the importance of imaging and functional testing in detecting pathological changes early on. Methodology: The study is prospective and cross-sectional and was carried out during the year 2024. 626 people (446 miners and 180 non-miners) were enrolled in the study. Subjects underwent spirometry and chest radiography. Data were analysed with SPSS24. Results: The average age of the participants is 48 years. Demographics and Smoking: Smoking was common among young miners. Radiological Changes: Radiographic abnormalities in the lungs were seen in 23.1% of miners and 10.6% of non-miners, including small irregular opacities and emphysematous changes. Lung Function: The FEV1/FVC ratio decreased with increased exposure time, indicating a decline in pulmonary function.Impact of Exposure Duration: Longer exposure duration was associated with a higher number of miners experiencing coughs and requiring medical consultations such as CT scans and biopsies. Conclusions: Medical imaging and functional testing are critical for early diagnosis of lung abnormalities in miners.Findings demonstrate a strong correlation between extended exposure to mine dust and the development of respiratory disorders, emphasising the importance of preventative measures and routine health monitoring.

Keywords: silicosis, miners, imaging, spirometry

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3240 Comparative Study of Music-Therapy Types on Anxiety in Early Stage Cancer Patients: A Randomized Clinical Trial

Authors: Farnaz Dehkhoda

Abstract:

This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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3239 A Case Report on Neonatal Conjunctivitis in Pugs

Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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3238 Fine Characterization of Glucose Modified Human Serum Albumin by Different Biophysical and Biochemical Techniques at a Range

Authors: Neelofar, Khursheed Alam, Jamal Ahmad

Abstract:

Protein modification in diabetes mellitus may lead to early glycation products (EGPs) or amadori product as well as advanced glycation end products (AGEs). Early glycation involves the reaction of glucose with N-terminal and lysyl side chain amino groups to form Schiff’s base which undergoes rearrangements to form more stable early glycation product known as Amadori product. After Amadori, the reactions become more complicated leading to the formation of advanced glycation end products (AGEs) that interact with various AGE receptors, thereby playing an important role in the long-term complications of diabetes. Millard reaction or nonenzymatic glycation reaction accelerate in diabetes due to hyperglycation and alter serum protein’s structure, their normal functions that lead micro and macro vascular complications in diabetic patients. In this study, Human Serum Albumin (HSA) with a constant concentration was incubated with different concentrations of glucose at 370C for a week. At 4th day, Amadori product was formed that was confirmed by colorimetric method NBT assay and TBA assay which both are authenticate early glycation product. Conformational changes in native as well as all samples of Amadori albumin with different concentrations of glucose were investigated by various biophysical and biochemical techniques. Main biophysical techniques hyperchromacity, quenching of fluorescence intensity, FTIR, CD and SDS-PAGE were used. Further conformational changes were observed by biochemical assays mainly HMF formation, fructoseamine, reduction of fructoseamine with NaBH4, carbonyl content estimation, lysine and arginine residues estimation, ANS binding property and thiol group estimation. This study find structural and biochemical changes in Amadori modified HSA with normal to hyperchronic range of glucose with respect to native HSA. When glucose concentration was increased from normal to chronic range biochemical and structural changes also increased. Highest alteration in secondary and tertiary structure and conformation in glycated HSA was observed at the hyperchronic concentration (75mM) of glucose. Although it has been found that Amadori modified proteins is also involved in secondary complications of diabetes as AGEs but very few studies have been done to analyze the conformational changes in Amadori modified proteins due to early glycation. Most of the studies were found on the structural changes in Amadori protein at a particular glucose concentration but no study was found to compare the biophysical and biochemical changes in HSA due to early glycation with a range of glucose concentration at a constant incubation time. So this study provide the information about the biochemical and biophysical changes occur in Amadori modified albumin at a range of glucose normal to chronic in diabetes. Although many implicates currently in use i.e. glycaemic control, insulin treatment and other chemical therapies that can control many aspects of diabetes. However, even with intensive use of current antidiabetic agents more than 50 % of diabetic patient’s type 2 suffers poor glycaemic control and 18 % develop serious complications within six years of diagnosis. Experimental evidence related to diabetes suggests that preventing the nonenzymatic glycation of relevant proteins or blocking their biological effects might beneficially influence the evolution of vascular complications in diabetic patients or quantization of amadori adduct of HSA by authentic antibodies against HSA-EGPs can be used as marker for early detection of the initiation/progression of secondary complications of diabetes. So this research work may be helpful for the same.

Keywords: diabetes mellitus, glycation, albumin, amadori, biophysical and biochemical techniques

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3237 Entertainment-Education for the Prevention & Intervention of Eating Disorders in Adolescents

Authors: Tracey Lion-Cachet

Abstract:

Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

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3236 Teaching the Meaning of the Holy Quran Using Modern Technology

Authors: Arjumand Warsy

Abstract:

Among the Muslims, the Holy Quran is taught from early childhood and generally by the age of 7-8 years the reading of the entire Quran is completed by most of the children in Muslim families. During this period excellent reciter’s are selected to teach and emphasis is laid on correct reading, pronunciation and memorization. Following these years, the parents lay emphasis on the recitation of the Quran on daily basis. During the month of Ramadan the entire Quran is read one or more times and there are considerable number of Muslims who complete the entire Quran once or more each calendar month. Many Muslims do not know Arabic and for them message in the Quran is what others tell them and often they have no idea about this Guidance sent to them. This deficiency is reflected in many ways, both among people living in Muslim or non-Muslim countries. Due to the deficiency in knowledge about Islamic teachings, the foundations of Islam are being eroded by a variety of forces. In an attempt to guard against the non-Islamic influences, every Muslim must have a clear understanding of the Islamic teachings and requirements. The best guidance can be provided by the understanding of the Holy Quran. However, we are faced with the problem that often the Quran is taught in a way that fails to develop an interest and understanding of the message from Allah. Looking at the teaching of other subjects both scientific and non-scientific, at school, college or University levels, it is obvious that the advances in teaching methodologies using electronic technology have had a major impact, where both the understanding and the interest of the students are significantly elevated. We attempted to teach the meaning of the Holy Quran to children and adults using a scientific and modern approach using slide presentation and animations. The results showed almost 100% increase in the understanding of the Quran message; all attendees claimed they developed an increased interest in the study of the Holy Quran and did not lose track or develop boredom throughout the lectures. They learnt the information and remembered it more effectively. The love for Allah and Prophet Mohammad (PBUH) increased significantly. The fear of Allah and love of Heaven developed significantly. Historical facts and the stories of the past nations became clearer and the Greatness of the Creator was strongly felt. Several of attendees wanted to become better Muslims and to spread the knowledge of Islam. In this presentation, the adopted teaching method will be first presented and demonstrated to the audience using a short Surah from the Quran, followed by discussion on the results achieved during our study. We will endeavor to convey to the audience that there is a need to adopt a more scientific approach to teach the Quran so that a greater benefit is achieved by all.

Keywords: The Holy Quran, Muslims, presentations, technology

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3235 Design for Error-Proofing Assembly: A Systematic Approach to Prevent Assembly Issues since Early Design Stages, an Industrial Case Study

Authors: Gabriela Estrada, Joaquim Lloveras

Abstract:

Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation, and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

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3234 Design for Error-Proofing Assembly: A Systematic Approach to Prevent Assembly Issues since Early Design Stages. An Industry Case Study

Authors: Gabriela Estrada, Joaquim Lloveras

Abstract:

Design for error-proofing assembly is a new DFX approach to prevent assembly issues since early design stages. Assembly issues that can happen during the life phases of a system such as: production, installation, operation and replacement phases. This prevention is possible by designing the product with poka-yoke or error-proofing characteristics. This approach guide designers to make decisions based on poka-yoke assembly design requirements. As a result of applying these requirements designers are able to create solutions to prevent assembly issues for the product in development stage. This paper integrates the needs to design products in an error proofing way into the systematic approach of design process by Pahl and Beitz. A case study is presented applying this approach.

Keywords: poka-yoke, error-proofing, assembly issues, design process, life phases of a system

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3233 Implementation of Nutritional Awareness Programme on Eating Habits of Primary School Children

Authors: Gulcin Satir, Ahmet Yildirim

Abstract:

Globally, including Turkey, health problems associated with malnutrition and nutrient deficiencies in childhood will remain major public health problems in future. Nutrition is a major environmental influence on physical and mental growth and development in early life. Many studies support the fact that nutritional knowledge makes contribution to wellbeing of children and their school performance. The purpose of this study was to examine nutritional knowledge and eating habits of primary school children and to investigate differences in these variables by socioeconomic status. A quasi-experimental one group pretest/posttest design study was conducted in five primary schools totaling 200 children aging 9-10 years in grade 4 to determine the effect of nutritional awareness programme on eating habits of primary school children. The schools were chosen according to parents’ social and demographic characteristics. The implemented nutritional awareness education programme focused on healthy lifestyle such as beneficial foods, eating habits, personal hygiene, physical activity and the programme consisted of eight lessons. The teaching approaches used included interactive teaching, role-playing, demonstration, small group discussions, questioning, and feedback. The lessons were given twice a week for four weeks totaling eight lessons. All lessons lasted 45-60 minutes and first 5 minutes of this was pre-assessment and last 5 minutes post assessment evaluation. The obtained data were analyzed for normality, and the distribution of the variables was tested by the Kolmogorov-Smirnov test. Paired t-test was used to evaluate the effectiveness of education programme and to compare the above-mentioned variables in each school separately before and after the lessons. The result of the paired t-test conducted separately for each school showed that on average after eight lessons, there was a 25-32% increase in nutritional knowledge of students regardless of the school they attend to and this rate was significant (P < 0.01). This shows that increase in nutritional awareness in these five schools having different socio-economic status was similar to each other. This study suggests that having children involved directly in lessons help to achieve nutritional awareness leading to healthy eating habits. It is concluded that nutritional awareness is a valuable tool to change eating habits. Study findings will provide information for developing nutrition education programmes for the healthy life and obesity prevention in children.

Keywords: children, nutritional awareness, obesity, socioeconomic status

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3232 The Impact of Hosting an On-Site Vocal Concert in Preschool on Music Inspiration and Learning Among Preschoolers

Authors: Meiying Liao, Poya Huang

Abstract:

The aesthetic domain is one of the six major domains in the Taiwanese preschool curriculum, encompassing visual arts, music, and dramatic play. Its primary objective is to cultivate children’s abilities in exploration and awareness, expression and creation, and response and appreciation. The purpose of this study was to explore the effects of hosting a vocal music concert on aesthetic inspiration and learning among preschoolers in a preschool setting. The primary research method employed was a case study focusing on a private preschool in Northern Taiwan that organized a school-wide event featuring two vocalists. The concert repertoires included children’s songs, folk songs, and arias performed in Mandarin, Hakka, English, German, and Italian. In addition to professional performances, preschool teachers actively participated by presenting a children’s song. A total of 5 classes, comprising approximately 150 preschoolers, along with 16 teachers and staff, participated in the event. Data collection methods included observation, interviews, and documents. Results indicated that both teachers and children thoroughly enjoyed the concert, with high levels of acceptance when the program was appropriately designed and hosted. Teachers reported that post-concert discussions with children revealed the latter’s ability to recall people, events, and elements observed during the performance, expressing their impressions of the most memorable segments. The concert effectively achieved the goals of the aesthetic domain, particularly in fostering response and appreciation. It also inspired preschoolers’ interest in music. Many teachers noted an increased desire for performance among preschoolers after exposure to the concert, with children imitating the performers and their expressions. Remarkably, one class extended this experience by incorporating it into the curriculum, autonomously organizing a high-quality concert in the music learning center. Parents also reported that preschoolers enthusiastically shared their concert experiences at home. In conclusion, despite being a single event, the positive responses from preschoolers towards the music performance suggest a meaningful impact. These experiences extended into the curriculum, as firsthand exposure to performances allowed teachers to deepen related topics, fostering a habit of autonomous learning in the designated learning centers.

Keywords: concert, early childhood music education, aesthetic education, music develpment

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3231 Afghan Refugees as Perpetui Inimici: Revisiting an Early Modern Debate on Enemy Aliens

Authors: Brian Smith

Abstract:

This paper seeks to contrast the contemporary anti-immigration rhetoric since the US pullout of Afghanistan with the debate about enemy aliens in the early modern period. In the seventeenth century, Sir Edward Coke declared that “infidels” should be seen as perpetui inimici (perpetual enemies) since their values were inimical to those of Christian states. As such, they could be perpetually excluded and denied legal standing. Even at that time, these anti-“infidel” arguments clashed with the natural law tradition of hospitality, which assumed that states had a moral responsibility to admit and care for strangers. In particular, this paper looks at the conflict between Hugo Grotius, Samuel Pufendorf, and John Locke. Grotius argues that states have a duty to admit foreigners. He goes out of his way to plan for the admittance of Jewish immigrants. In contrast, Pufendorf claimed that sovereigns had a duty exclude foreigners who would alter the constitutional character of the state. Much like Grotius, Locke argued that non-Christian peoples should be treated as friends and admitted without reservation.

Keywords: enemy aliens, perpetual enemies, hospitality, refugees

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3230 How to Empower People to Provide Good Nutrition to Children: Bengkel Gizi Terpadu (Integrated Nutrition Workshop)

Authors: Anggun Yuliana Putri, Melisa Rahmadini

Abstract:

The Ministry of National Development Planning in Indonesia has reported that more than eight million Indonesian children are still malnourished. Based on national statistics, and a recent ranking from NGO Save the Children, Indonesia is one of 15 countries making the fastest gains in cutting child malnutrition among 165 developing countries. According to a United Nations Children’s Fund, at least 7.6 million Indonesian children under the age of 5 or one out of every three suffer from stunted growth, a primary manifestation of malnutrition in early childhood, the report ranked Indonesia as having the fifth largest number of children under 5 suffering from stunted growth worldwide. Addressing the problem of malnutrition in Indonesia, Aksi Cepat Tanggap (ACT) Foundation, a humanitarian organization working with Carrefour, acts as donor and pursues several solutions to the problem, especially of malnourished children and infants in South Tangerang area, Indonesia. The objective of this study was to examine the community empowerment driven by ACT Foundation in order to maintain the good status continuity of child and toddler after the children malnutrition recovered. Research was conducted using qualitative approach through in-depth interview and observation to find out how the Bengkel Gizi Terpadu (Integrated Nutrion Workshop) programs make people empowered. Bengkel Gizi Terpadu (BGT) is divided into 3 sequences of activities, there were: integrated malnutrition rehabilitation; provision of health education to mothers of infants and young children; and family economic empowerment to head of household. Results showed that after empowerment process has been done through training and provision of knowledge to the mothers and families about the important of nutrition and health, there were 30 of 100 mothers who participated actively. Then, there were 45 of 100 heads of household who participated in business training were able to open a business on their own which provided and controlled by ACT as stakeholder in this program. The further findings revealed that BGT programs are able to form community health workers and provide employment opportunities to community. This study believes that integrated nutrition workshop program is the solution to maintain good nutrition among children in South Tangerang, through empowerment of parents and community members, via education and business training program. Both programs prepared parents with economic sustenance and necessary information, a pre-requisite to end malnutrition in children.

Keywords: community, empowerment, malnutrition, training

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3229 Swallowing Outcomes in Supraglottic Cancer Patients after Trans-Oral Robotic Surgery (TORS) Provided with Early Dysphagia Management Using Standardized Functional and Objective Measures

Authors: Hitesh Gupta, Surender Dabas

Abstract:

TORS is increasingly gaining widespread use and has been explored as minimally invasive surgery for the treatment of supraglottic cancer (SGC). Being a central critical role of Supraglottis in deglutition, swallowing outcomes post TORS remain a most important factor. Available published studies show inconsistent swallowing outcomes and are deficient in standardized outcome measures, description of swallowing recovery and rehabilitation. So, the objective of this study is to find out swallowing outcomes in SGC patients after TORS provided with early dysphagia management using standardized measures. Prospectively 16 patients were recruited in the study who underwent TORS for primary tumor of Supraglottis, involving one or more sub-sites or invading to sites other than Supraglottis at the BLK Super Specialty Hospital, New Delhi from March 2019 to June 2020. All patients were evaluated for dysphagia with subsequent swallowing rehabilitation on post operative day 3 in the hospital or at the time of discharge, whichever was earlier. Functional oral intake scale (FOIS) and penetration-aspiration score (PAS) were used as outcome measures to quantify swallowing recovery at one month and six month post operatively. Post TORS, patients achieved functional swallow in less than one month, where resection was limited to Supraglottis, while the recovery was delayed in patients with extended resection to tongue base or hypopharynx. Overall, out of Total 16 cases including all supraglottis sub-catagories, 13 (81%) could remove their NG tube (FOIS ≥5 and PAS=1 ) within 6 months. In which 8 cases(62%) achieved functional swallow in less than one month. Swallowing outcomes post TORS supraglottic laryngectomy are favorable if provided with early dysphagia management (or swallowing rehabilitation).

Keywords: dysphagia, supraglottic cancer, swallowing, TORS

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3228 Computer-Aided Exudate Diagnosis for the Screening of Diabetic Retinopathy

Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

Abstract:

Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

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3227 The Effect of Climate on Noble Houses of Siraf in the Early Islamic Centuries (Case Study: House N)

Authors: Mohadese Sukhtesaraii, Mohammad Esmail Esmaili Jelodar, Kosar Sookhtesaraii

Abstract:

Throughout history, humans have always wanted to have a shelter to live in, and this need and desire became the beginning of building and architecture. It was necessary to build a shelter and a building, dealing with the surrounding nature. The design and construction of architectural spaces are always influenced by nature, climate, and geographical location, and It is believed clearly see this influence even in the use of materials used in the construction of architectural buildings. The historical port of Siraf is located on the northern coast of the Persian Gulf in Bushehr province and 38 km from Kangan port. Geographically and climatically, Siraf is considered one of the hot and humid areas. The Zagros mountains, which continue from the Iranian plateau to the sea, end at Bandar Siraf; As a result, it creates a strip one kilometer wide by the sea. The location of Siraf in the restrictive conditions of the mountains and the sea has made it impossible to expand the city. The main goal of the current research is to investigate the climate of Siraf and the influence of the region's climate on the architecture and design of residential buildings in Siraf, known as noble houses, in the early Islamic centuries. In this research, it is looking for an answer to the question of how the climatic and geographical conditions have affected the architecture of Siraf buildings. The theoretical framework of this research can be expressed based on the influence of climate on the historical architecture of Bandar Seraf and the spatial analysis of archeology. Also, the research method will be analytical-descriptive and using field and library studies. The authors of the article believe that the architectural spaces of the early Islamic centuries of Siraf city were affected by the climate and geographical location, and the architects started building buildings by considering factors such as the sun's radiation, wind direction, and the position of the mountains and the sea. To use the regional and environmental potential for buildings.

Keywords: hose N, noble hose, islamic era, siraf, climate

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3226 Socio-Economic Inequality in Breastfeeding Patterns in India

Authors: Ankita Shukla

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The promotion and support of breastfeeding is a global priority with benefits for maternal and infant health, especially in low income and middle-income countries where the probability of child survival is still very low. In India too it has been well established that breastfeeding increases the survival of the child. However, the breastfeeding levels are quite low in the country. Examining the socio-economic inequality in breastfeeding pattern can help to the causal pathways responsible for early breastfeeding termination. This paper tries to understand the socio-economic differential in breastfeeding patterns among Indian women. Data is used from nationally representative National Family Health Survey-3. Using Cox regression modelling techniques, the analysis found that the likelihood of having small breastfeeding duration increased with increasing household wealth status similarly education also has negative effect on breastfeeding duration. The considerable gender difference is also visible in India, likelihood of stopping breastfeeding was significantly higher among female children compared with male children. To understand the cultural factors or norms responsible for the early termination of breastfeeding more in depth/qualitative studies are needed.

Keywords: breastfeeding, India, socio-economic inequality, women education

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3225 An Analytical Survey of Construction Changes: Gaps and Opportunities

Authors: Ehsan Eshtehardian, Saeed Khodaverdi

Abstract:

This paper surveys the studies on construction change and reveals some of the potential future works. A full-scale investigation of change literature, including change definitions, types, causes and effects, and change management systems, is accomplished to explore some of the coming change trends. It is tried to pick up the critical works in each section to deduct a true timeline of construction changes. The findings show that leaping from best practice guides in late 1990s and generic process models in the early 2000s to very advanced modeling environments in the mid-2000s and the early 2010s have made gaps along with opportunities for change researchers in order to develop some more easy and applicable models. Another finding is that there is a compelling similarity between the change and risk prediction models. Therefore, integrating these two concepts, specifically from proactive management point of view, may lead to a synergy and help project teams avoid rework. Also, the findings show that exploitation of cause-effect relationship models, in order to facilitate the dispute resolutions, seems to be an interesting field for future works.

Keywords: construction change, change management systems, dispute resolutions, change literature

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3224 Finite Element Modelling for the Development of a Planar Ultrasonic Dental Scaler for Prophylactic and Periodontal Care

Authors: Martin Hofmann, Diego Stutzer, Thomas Niederhauser, Juergen Burger

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Dental biofilm is the main etiologic factor for caries, periodontal and peri-implant infections. In addition to the risk of tooth loss, periodontitis is also associated with an increased risk of systemic diseases such as atherosclerotic cardiovascular disease and diabetes. For this reason, dental hygienists use ultrasonic scalers for prophylactic and periodontal care of the teeth. However, the current instruments are limited to their dimensions and operating frequencies. The innovative design of a planar ultrasonic transducer introduces a new type of dental scalers. The flat titanium-based design allows the mass to be significantly reduced compared to a conventional screw-mounted Langevin transducer, resulting in a more efficient and controllable scaler. For the development of the novel device, multi-physics finite element analysis was used to simulate and optimise various design concepts. This process was supported by prototyping and electromechanical characterisation. The feasibility and potential of a planar ultrasonic transducer have already been confirmed by our current prototypes, which achieve higher performance compared to commercial devices. Operating at the desired resonance frequency of 28 kHz with a driving voltage of 40 Vrms results in an in-plane tip oscillation with a displacement amplitude of up to 75 μm by having less than 8 % out-of-plane movement and an energy transformation factor of 1.07 μm/mA. In a further step, we will adapt the design to two additional resonance frequencies (20 and 40 kHz) to obtain information about the most suitable mode of operation. In addition to the already integrated characterization methods, we will evaluate the clinical efficiency of the different devices in an in vitro setup with an artificial biofilm pocket model.

Keywords: ultrasonic instrumentation, ultrasonic scaling, piezoelectric transducer, finite element simulation, dental biofilm, dental calculus

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3223 Comparison of Surface Hardness of Filling Material Glass Ionomer Cement Which Soaked in Alcohol Containing Mouthwash and Alcohol-Free Mouthwash

Authors: Farid Yuristiawan, Aulina R. Rahmi, Detty Iryani, Gunawan

Abstract:

Glass ionomer cement is one of the filling material that often used in the field of dentistry because it is relatively less expensive and mostly available. Surface hardness is one of the most important properties of restoration material; it is the ability of material to stand against indentation, which is directly connected to the material compressive strength and its ability to withstand abrasion. The higher surface hardness of a material means it is better to withstand abrasion. The existence of glass ionomer cement in the mouth makes it susceptible to any substance that comes into mouth, one of them is mouthwash which is a solution that used for many purposes such as antiseptic, astringent, to prevent caries, and bad breath. The presence of alcohol in mouthwash could affect the properties of glass ionomer cement, surface hardness. Objective: To determine the comparison of surface hardness of glass ionomer cement which soaked in alcohol containing mouthwash and alcohol-free mouthwash. Methods: This research is a laboratory experimental type study. There were 30 samples made from GC FUJI IX GP EXTRA and then soaked in artificial saliva for the first 24 hours inside incubator which temperature and humidity were controlled. Samples then divided into three groups. The first group will be soaked in alcohol-containing mouthwash; second group will be soaked alcohol-free mouthwash and control group will be soaked in artificial saliva for 6 hours inside incubator. Listerine is the mouthwash that was used on this research and surface hardness was examined using Vickers Hardness Tester. The result of this research shows mean value for surface hardness of the first group is 16.36 VHN, 24.04 VHN for second group, and 43.60 VHN for control group. The result one way ANOVA with post hoc Bonferroni comparing test show significant results p = 0.00. Conclusions: The data showed there were statistically significant differences of surface hardness between each group, which surface hardness of the first group is lower than the second group, and both surface hardness of the first (alcohol mouthwash) and second group (alcohol-free mouthwash) are lowered than control group (p = 0.00).

Keywords: glass ionomer cement, mouthwash, surface hardness, Vickers hardness tester

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3222 Turkey Disaster Risk Management System Project (TAFRISK)

Authors: Ahmet Parlak, Celalettin Bilgen

Abstract:

In order to create an effective early warning system, Identification of the risks, preparation and carrying out risk modeling of risk scenarios, taking into account the shortcomings of the old disaster scenarios should be used to improve the system. In the light of this, the importance of risk modeling in creating an effective early warning system is understood. In the scope of TAFRISK project risk modeling trend analysis report on risk modeling developed and a demonstration was conducted for Risk Modeling for flood and mass movements. For risk modeling R&D, studies have been conducted to determine the information, and source of the information, to be gathered, to develop algorithms and to adapt the current algorithms to Turkey’s conditions for determining the risk score in the high disaster risk areas. For each type of the disaster; Disaster Deficit Index (DDI), Local Disaster Index (LDI), Prevalent Vulnerability Index (PVI), Risk Management Index (RMI) have been developed as disaster indices taking danger, sensitivity, fragility, and vulnerability, the physical and economic damage into account in the appropriate scale of the respective type.

Keywords: disaster, hazard, risk modeling, sensor

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3221 Biosensor for Determination of Immunoglobulin A, E, G and M

Authors: Umut Kokbas, Mustafa Nisari

Abstract:

Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by activated B cells that transform into plasma cells and result in them. Antibodies are critical molecules of the immune response to fight, which help the immune system specifically recognize and destroy antigens such as bacteria, viruses, and toxins. Immunoglobulin classes differ in their biological properties, structures, targets, functions, and distributions. Five major classes of antibodies have been identified in mammals: IgA, IgD, IgE, IgG, and IgM. Evaluation of the immunoglobulin isotype can provide a useful insight into the complex humoral immune response. Evaluation and knowledge of immunoglobulin structure and classes are also important for the selection and preparation of antibodies for immunoassays and other detection applications. The immunoglobulin test measures the level of certain immunoglobulins in the blood. IgA, IgG, and IgM are usually measured together. In this way, they can provide doctors with important information, especially regarding immune deficiency diseases. Hypogammaglobulinemia (HGG) is one of the main groups of primary immunodeficiency disorders. HGG is caused by various defects in B cell lineage or function that result in low levels of immunoglobulins in the bloodstream. This affects the body's immune response, causing a wide range of clinical features, from asymptomatic diseases to severe and recurrent infections, chronic inflammation and autoimmunity Transient infant hypogammaglobulinemia (THGI), IgM deficiency (IgMD), Bruton agammaglobulinemia, IgA deficiency (SIgAD) HGG samples are a few. Most patients can continue their normal lives by taking prophylactic antibiotics. However, patients with severe infections require intravenous immune serum globulin (IVIG) therapy. The IgE level may rise to fight off parasitic infections, as well as a sign that the body is overreacting to allergens. Also, since the immune response can vary with different antigens, measuring specific antibody levels also aids in the interpretation of the immune response after immunization or vaccination. Immune deficiencies usually occur in childhood. In Immunology and Allergy clinics, apart from the classical methods, it will be more useful in terms of diagnosis and follow-up of diseases, if it is fast, reliable and especially in childhood hypogammaglobulinemia, sampling from children with a method that is more convenient and uncomplicated. The antibodies were attached to the electrode surface via the poly hydroxyethyl methacrylamide cysteine nanopolymer. It was used to evaluate the anodic peak results obtained in the electrochemical study. According to the data obtained, immunoglobulin determination can be made with a biosensor. However, in further studies, it will be useful to develop a medical diagnostic kit with biomedical engineering and to increase its sensitivity.

Keywords: biosensor, immunosensor, immunoglobulin, infection

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3220 Factors Affecting Autistic Children's Development during the Early Years in Elementary School: A Longitudinal Study in Taiwan

Authors: Huang Ying

Abstract:

The present study was to investigate factors affecting children's improvement through the first two years of elementary school on a population-based sample of children with autism in Taiwan. All the children were diagnosed with autism spectrum disorder (ASD) by clinical psychologists according to DSM-IV. Children's development was assessed by the Vineland Adaptive Behavior Scales-Chinese version (VABS-C) on the first and the third grade. Children's improvement was measured by the difference between the standardized total score of the third and the first year. In Taiwan, school-age children with special-education needs will be arranged into different classes, including normal classes (NC), resource classes (RC), and special classes (SC) by the government. Therefore, type of class was one of the independent variables. Moreover, as early intervention is considered to be crucial, the earliest age when intervention begins was collected from parents. Attention was also included in the analysis. Teachers were asked to evaluate children's attention with a 3-item Likert Scale. The frequency of paying attention to the class or the task was recorded and scores were summed up. Additionally, standardized scores of the VABS-C in the first grade were used as pretest scores representing children's developmental level at the beginning of elementary school. Multiple regression was conducted with improvement as the dependent variable. Results showed that children in special classes had smaller improvement compared to those in normal or resource classes. Attention positively predicted improvement yet the effect of earliest intervention age was not significant. Furthermore, scores in the first grade negatively predicted improvement, which indicated that children with higher developmental levels would make less progress in the following years. Results were to some degree consistent with previous findings through meta-analysis that the effectiveness of conventional intervention methods lacked sufficient evidence to support.

Keywords: attention, early intervention, elementary school, special education in Taiwan

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3219 Economics in Primary Schools – Positive Education and Well-being

Authors: Judit Nagy

Abstract:

Many scientific studies claim that financial education should start as early as possible. Children are much more capable of and willing to absorb new concepts than adults. If we introduce children to financial knowledge early, their behaviour and attitudes to this subject will change, increasing later success in this area of life. However, poor financial decisions may entail severe consequences, not only to individuals but even to the wider society. Good financial decisions and economic attitudes may contribute to economic growth and well-being. Whilst in several countries, education about financial awareness and fundamentals is available, the understanding and acquisition of complex economic knowledge and the development of children’s independent problem-solving skills are still lacking. The results suggest that teaching economic and financial knowledge through accounting and making lectures interactive by using special tools of positive education is critical to stimulating children’s interest. Eighty percent of the students in the study liked the combined and interactive lecture. Introducing this kind of knowledge to individuals is a relevant objective, even at the societal level.

Keywords: positive psychology, education innovation, primary school, gender, economics, accounting, finance, personal finance, mathematics, economic growth, well-being, sustainability

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3218 Pandemic-Related Disruption to the Home Environment and Early Vocabulary Acquisition

Authors: Matthew McArthur, Margaret Friend

Abstract:

The COVID-19 pandemic disrupted the stability of the home environment for families across the world. Potential disruptions include parent work modality (in-person vs. remote), levels of health anxiety, family routines, and caregiving. These disruptions may have interfered with the processes of early vocabulary acquisition, carrying lasting effects over the life course. Our justification for this research is as follows: First, early, stable, caregiver-child reciprocal interactions, which may have been disrupted during the pandemic, contribute to the development of the brain architecture that supports language, cognitive, and social-emotional development. Second, early vocabulary predicts several cognitive outcomes, such as numeracy, literacy, and executive function. Further, disruption in the home is associated with adverse cognitive, academic, socio-emotional, behavioral, and communication outcomes in young children. We are interested in how disruptions related to the COVID-19 pandemic are associated with vocabulary acquisition in children born during the first two waves of the pandemic. We are conducting a moderated online experiment to assess this question. Participants are 16 children (10F) ranging in age from 19 to 39 months (M=25.27) and their caregivers. All child participants were screened for language background, health history, and history of language disorders, and were typically developing. Parents completed a modified version of the COVID-19 Family Stressor Scale (CoFaSS), a published measure of COVID-19-related family stressors. Thirteen items from the original scale were replaced to better capture change in family organization and stability specifically related to disruptions in income, anxiety, family relations, and childcare. Following completion of the modified CoFaSS, children completed a Web-Based version of the Computerized Comprehension Task and the Receptive One Word Picture Vocabulary if 24 months or older or the MacArthur-Bates Communicative Development Inventory if younger than 24 months. We report our preliminary data as a partial correlation analysis controlling for age. Raw vocabulary scores on the CCT, ROWPVT-4, and MCDI were all negatively associated with pandemic-related disruptions related to anxiety (r12=-.321; r1=-.332; r9=-.509), family relations (r12=-.590*; r1=-.155; r9=-.468), and childcare (r12=-.294; r1=-.468; r9=-.177). Although the small sample size for these preliminary data limits our power to detect significance, this trend is in the predicted direction, suggesting that increased pandemic-related disruption across multiple domains is associated with lower vocabulary scores. We anticipate presenting data on a full sample of 50 monolingual English participants. A sample of 50 participants would provide sufficient statistical power to detect a moderate effect size, adhering to a nominal alpha of 0.05 and ensuring a power level of 0.80.

Keywords: COVID-19, early vocabulary, home environment, language acquisition, multiple measures

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3217 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

Abstract:

Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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3216 Products in Early Development Phases: Ecological Classification and Evaluation Using an Interval Arithmetic Based Calculation Approach

Authors: Helen L. Hein, Joachim Schwarte

Abstract:

As a pillar of sustainable development, ecology has become an important milestone in research community, especially due to global challenges like climate change. The ecological performance of products can be scientifically conducted with life cycle assessments. In the construction sector, significant amounts of CO2 emissions are assigned to the energy used for building heating purposes. Therefore, sustainable construction materials for insulating purposes are substantial, whereby aerogels have been explored intensively in the last years due to their low thermal conductivity. Therefore, the WALL-ACE project aims to develop an aerogel-based thermal insulating plaster that would achieve minor thermal conductivities. But as in the early stage of development phases, a lot of information is still missing or not yet accessible, the ecological performance of innovative products bases increasingly on uncertain data that can lead to significant deviations in the results. To be able to predict realistically how meaningful the results are and how viable the developed products may be with regard to their corresponding respective market, these deviations however have to be considered. Therefore, a classification method is presented in this study, which may allow comparing the ecological performance of modern products with already established and competitive materials. In order to achieve this, an alternative calculation method was used that allows computing with lower and upper bounds to consider all possible values without precise data. The life cycle analysis of the considered products was conducted with an interval arithmetic based calculation method. The results lead to the conclusion that the interval solutions describing the possible environmental impacts are so wide that the result usability is limited. Nevertheless, a further optimization in reducing environmental impacts of aerogels seems to be needed to become more competitive in the future.

Keywords: aerogel-based, insulating material, early development phase, interval arithmetic

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3215 Educational Challenges: Cultural Behaviours, Psychopathology and Psychological Intervention

Authors: Sandra Figueiredo, Alexandra Pereira, Ana Oliveira, Idia Brito, Ivaniltan Jones, Joana Moreira, Madalena Silva, Maria Paraíba, Milene Silva, Tânia Pinho

Abstract:

In the present society, we are facing behaviours mainly in young individuals that might be considered trends of culture or psychopathology. Both contexts are challenges for Education, Psychology and Health. This paper examines nine case studies specifically in Educational Psychology with the main goal to identify and define phenomena contexts in school culture, the psychopathology involved and to present a psychological intervention for each case. The research was conducted by university students in the period of March 2017-June 2017, in Portugal, and the childhood was focused. The case studies explored the cyberbullying; the bullying - victims and bullies’ perspectives; the obsessive compulsive disorder; perception and inclusion of children from homoparental families; inclusion of foreign students in the higher education system; blindness and the inclusion in physical curricular activities; influence of doc-reality and media in attitudes and self-esteem; and the morningness and eveningness types learning in the same school timetables. The university students were supervised during their research analysis and two methods were available for the intervention research study: the meta-analysis and the empirical study. In the second phase, the pedagogical intervention was designed for the different educational contexts in analysis, especially concerning the school environments. The evidence of literature and the empirical studies showed new trends of school’ behaviours and educational disturbances that require further research and effective (and adequate to age, gender, nationality and culture) pedagogical instruments. Respecting the instruments, on the one hand, to identify behaviors, habits or pathologies and highlight the role and training of teachers, psychologists and health professionals, on the other hand, to promote the early intervention and to enhance healthy child development and orientation of the families. To respond to both milestones, this paper present nine pedagogical techniques and measures that will be discussed on their impact concerning advances for the psychological and educational intervention, centered in the individual and in the new generations of family’ cultures.

Keywords: behaviour, culture trends, educational intervention, psychopathology, obsessive compulsive disorder, cyberbullying, bullying, homoparental families, sleep influence, blindness and sports at school, inclusion of foreign students, media influence in behaviour

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3214 Coping Strategies for Stress Used by Adolescent Girls in Riyadh, Saudi Arabia

Authors: Hafsa Raheel

Abstract:

Objectives: Secondary school girls, ages 15–19 years old were surveyed to find out the coping strategies they used when stressed. Adolescents, who are affected with stress and depression early in life, suffer from depression throughout their lives, especially if they are utilizing improper ways to cope with it. Methods: A cross-sectional school-based survey among 1028 adolescent girls was conducted among the secondary schools in Riyadh city, Kingdom of Saudi Arabia. Results: About 25% stated that they cry, 19% listen to music, 15% start eating a lot, 12% sit alone/isolate themselves, 11% pray/read the Quran, 10% get into a verbal argument or a fight. Only a few, 3% exercise, and 2% stated that they find someone to discuss and talk to. Conclusion: The majority of the adolescent girls in our survey rely on emotion-related coping mechanisms rather than problem-solving mechanisms. This can cause long-term implications in these adolescents as there is an increased probability to develop depression later on in life. Policy makers need to implement strategies for early identification of stress and depression. Talking to friends and family can serve as an effective way to cope with stress.

Keywords: adolescents, stress, Saudi Arabia, mental health

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3213 A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

Abstract:

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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