Search results for: hand surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4764

Search results for: hand surgery

3984 Regression of Hand Kinematics from Surface Electromyography Data Using an Long Short-Term Memory-Transformer Model

Authors: Anita Sadat Sadati Rostami, Reza Almasi Ghaleh

Abstract:

Surface electromyography (sEMG) offers important insights into muscle activation and has applications in fields including rehabilitation and human-computer interaction. The purpose of this work is to predict the degree of activation of two joints in the index finger using an LSTM-Transformer architecture trained on sEMG data from the Ninapro DB8 dataset. We apply advanced preprocessing techniques, such as multi-band filtering and customizable rectification methods, to enhance the encoding of sEMG data into features that are beneficial for regression tasks. The processed data is converted into spike patterns and simulated using Leaky Integrate-and-Fire (LIF) neuron models, allowing for neuromorphic-inspired processing. Our findings demonstrate that adjusting filtering parameters and neuron dynamics and employing the LSTM-Transformer model improves joint angle prediction performance. This study contributes to the ongoing development of deep learning frameworks for sEMG analysis, which could lead to improvements in motor control systems.

Keywords: surface electromyography, LSTM-transformer, spiking neural networks, hand kinematics, leaky integrate-and-fire neuron, band-pass filtering, muscle activity decoding

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3983 Signals Monitored During Anaesthesia

Authors: Launcelot McGrath, Xiaoxiao Liu, Colin Flanagan

Abstract:

It is widely recognised that a comprehensive understanding of physiological data is a vital aid to the anaesthesiologist in monitoring and maintaining the well-being of a patient undergoing surgery. Bio signal analysis is one of the most important topics that researchers have tried to develop over the last century to understand numerous human diseases. There are tremendous biological signals during anaesthesia, and not all of them are important, which to choose to observe is a significant decision. It is important that the anaesthesiologist understand both the signals themselves, and the limitations introduced by the processes of acquisition. In this article, we provide an all-sided overview of different types of biological signals as well as the mechanisms applied to acquire them.

Keywords: general biosignals, anaesthesia, biological, electroencephalogram

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3982 Reasons behind Accounting Information Tools Adopted by Portuguese Third Sector Organizations: Institutional Theory versus Rational Choice Theory

Authors: Eurico Lima Basto, Ofélia Pinto, Anabela Silva, Amélia Ferreira-Da-Silva

Abstract:

The purpose if this study is two-fold: on the one hand, to identify the accounting information systems implemented in third sector organizations, as well as its components, its tools and the decisions and control purposes they serve; on the other hand, and by confronting these two theories - institutional theory versus rational choice – we intent to go further by understanding the reasons behind the adoption of the aforementioned tools. Data has been collected from third sector organizations operating in Portugal. Our sample includes all juridical types of organizations such as foundations, cooperative, associations or private institutions of social solidarity. The questionnaire contained sixteen close-ended questions and four open-questions. Results confirm the theoretical perspective of institutionalism. Most third sector organizations operating in Portugal implemented only traditional accounting tools like standard accounting statements, cost accounting, budgeting. Moreover, there is clear evidence that the decisions about the implementation of these tools were coercive oriented. With this study it is intended to contribute to a better understanding of the context of third sector organizations in Portugal, in particular the role that accounting plays in this sector, with a special focus on management accounting tools, and the factors that influence their use and the degree of their usefulness in the process of decision making.

Keywords: third sector, accounting tools, institutional theory, Portugal, descriptive research

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3981 Morpho-Genetic Assessment of Guava (Psidium guajava L.) Genetic Resources in Pakistan

Authors: Asim Mehmood, Abdul Karim, Muhammad J. Jaskani, Faisal S. Awan, Muhammad W. Sajid

Abstract:

Guava (Psidium guajava L.) is an important commercial fruit crop of Pakistan. It is an allogamous crop having 25-40% cross pollination which on the one hand leads to clonal degradation and on the other hand can add variations to generated new cultivars. Morpho-genetic characterization of 37 guava accessions was carried out for study of the genetic diversity among guava accessions located in province Punjab, Pakistan. For morphological analysis, 17 morphological traits were studied, and strong positive correlation was found among the 7 morphological traits which included thickness of outer flesh in relation to core diameter, fruit length, fruit width, fruit juiciness, fruit size, fruit sweetness and number of seeds. For genetic characterization, 18 microsatellites were used, and the sizes of reproducible and scorable bands ranged from 150 to 320 bp. These 18 primer pairs amplified a total of 85 alleles in P. guajava, with an average total number of 4.7 alleles per locus and no more than two displayed bands (nuclear SSR loci). The phylogenetic tree based on the morphological and genetic traits showed the diversity of these 37 guava genotypes into two major groups. These results indicated that Pakistani guava is quite diverse and a more detail study is needed to define the level of genetic variability.

Keywords: Psidium guajava L, genetic diversity, SSR markers, polymorphism, dendrogram

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3980 Victimization in Schizophrenia: A Cross-Sectional Prospective Study

Authors: Mehmet Budak, Mehmet Fatih Ustundag

Abstract:

Objectives: In this research, we studied the extent of exposure to physical violence and committing violence in patients diagnosed with schizophrenia in comparison to a control group consisting of patients with psychiatric diseases other than psychotic and mood disorders. Method: Between August 2019 and October 2019, a total of 100 hospitalized patients diagnosed with schizophrenia (clinically in remission, Brief Psychiatric Rate Scale < 30) were sequentially studied while undergoing inpatient treatment at Erenkoy Mental Health Training and Research Hospital. From the outpatient clinic, 50 patients with psychiatric disorders other than psychotic disorders or mood disorders were consecutively included as a control group. All participants were evaluated by the sociodemographic data that also questions the history of violence, physical examination, bilateral comparative hand, and forearm anterior-posterior and lateral radiography. Results: While 59% of patients with schizophrenia and 28% of the control group stated that they were exposed to physical violence at least once in a lifetime (p < 0,001); a defensive wound or fracture was detected in 29% of patients with schizophrenia and 2% of the control group (p < 0.001). On the other hand, 61% of patients diagnosed with schizophrenia, and 32% of the control group expressed that they committed physical violence at least once in a lifetime (p: 0.001). A self-destructive wound or fracture was detected in 53% of the patients with schizophrenia and 24% of the control group (p: 0,001). In the schizophrenia group, the rate of committing physical violence is higher in those with substance use compared to those without substance use (p:0.049). Also, wounds and bone fractures (boxer’s fracture) resulting from self-injury are more common in schizophrenia patients with substance use (p:0,002). In the schizophrenia group, defensive wounds and parry fractures (which are located in the hand, forearm, and arm usually occur as a result of a trial to shield the face against an aggressive attack and are known to be the indicators of interpersonal violence) are higher in those with substance use compared to those who do not (p:0,007). Conclusion: This study shows that exposure to physical violence and the rate of violence is higher in patients with schizophrenia compared to the control group. It is observed that schizophrenia patients who are stigmatized as being aggressive are more exposed to violence. Substance use in schizophrenia patients increases both exposure to physical violence and the use of physical violence. Physical examination and anamnesis that question violence are important tools to reveal the exposure to violence in patients. Furthermore, some specific bone fractures and wounds could be used to detect victimization even after plenty of time passes.

Keywords: fracture, physical violence, schizophrenia, substance use

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3979 The Quality of Public Space in Mexico City: Current State and Trends

Authors: Mildred Moreno Villanueva

Abstract:

Public space is essential to strengthen the social and urban fabric and the social cohesion; there lies the importance of its study. Hence, the aim of this paper is to analyze the quality of public space in the XXI century in both quantitative and qualitative terms. In this article, the concept of public space includes open spaces such as parks, public squares and walking areas. To make this analysis we take Mexico City as the case study. It has a population of nearly 9 million inhabitants and it is composed of sixteen boroughs. For this analysis, we consider both, existing public spaces and the government intervention for building and improvement of new and existent public spaces. Results show that on the one hand, quantitatively there is not an equitable distribution of public spaces because of both, the growth of the city itself, as well as for the absence of political will to create public spaces. Another factor is the evolution of this city, which has been growing merely in a 'patched pattern', where public space has played no role at all with a total absence of urban design. On the other hand, qualitatively, even the boroughs with the most public spaces have not shown interest in making these spaces qualitatively inclusive and open to the general population aiming for integration. Therefore, urban projects that privatize public space seem to be the rule, rather than a rehabilitation effort of the existent public spaces. Hence, state intervention should reinforce its role as an agent of social change acting in the benefit of the majority of the inhabitants with the promotion of more inclusive public spaces.

Keywords: exclusion, inclusion, Mexico City, public space

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3978 The Balance between the Two Characters of the Night: A Study on the Nightscape of Pei Ho Street and Yen Chow Street West in Sham Shui Po

Authors: Lei Danyang, Lu Jialiang

Abstract:

As nightlife is getting richer in urban area, urban nightscape has become an increasingly important part of the urban landscape. Understanding urban nightscape from the perspec­tive of pedestrian perception is very important to improve the livability and walkability of a city. The purpose of this study is to analyze the nightscapes of two different urban forms. The research methods are literature investigation and field investigation. From analyzing the lighting, sensory ex­perience, and night activities, this research studies the two streets, Pei Ho Street and Yen Chow Street West in Sham Shui Po. Results revealed that the two streets are on the two extremes of the two characters of the night and a better balance needs to be found between them. Because of the different land usage and stakeholders, the two streets should play different roles in the nightscape, so their balance points are also different. On the one hand, Pei Ho Street, which has a strong commercial atmos­phere, should not only retain its vitality and diversity but also ensure its function of relaxation at night; on the other hand, in Yen Chow Street West, it is necessary to develop its potential of reconnecting people with the darkness of the night while ensur­ing its safety. These findings may not only provide policymak­ers with information to help them improve the nightscape and livability of the Sham Shui Po area but also help bridge the gap between research and design. In the future, more attention should be paid to pedestrian preference and nightscape perception of vulnerable groups.

Keywords: Hong Kong, pedestrian perception, Sham Shui Po, urban form, urban nightscape

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3977 The Practice of Low Flow Anesthesia to Reduce Carbon Footprints Sustainability Project

Authors: Ahmed Eid, Amita Gupta

Abstract:

Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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3976 Design and Development of Multi-Functional Intelligent Robot Arm Gripper

Authors: W. T. Asheber, L. Chyi-Yeu

Abstract:

An intelligent robot arm is expected to recognize the desired object, grasp it with appropriate force without dropping or damaging it, and also manipulate and deliver the object to the desired destination safely. This paper presents an intelligent multi-finger robot arm gripper design along with vision, proximity, and tactile sensor for efficient grasping and manipulation tasks. The generic design of the gripper makes it convenient for improved parts manipulation, multi-tasking and ease for components assembly. The proposed design emulates the human’s hand fingers structure using linkages and direct drive through power screw like transmission. The actuation and transmission mechanism is designed in such a way that it has non-back-drivable capability, which makes the fingers hold their position when even unpowered. The structural elements are optimized for a finest performance in motion and force transmissivity of the gripper fingers. The actuation mechanisms is designed specially to drive each finger and also rotate two of the fingers about the palm to form appropriate configuration to grasp various size and shape objects. The gripper has an automatic tool set fixture incorporated into its palm, which will reduce time wastage and do assembling in one go. It is equipped with camera-in-hand integrated into its palm; subsequently an image based visual-servoing control scheme is employed.

Keywords: gripper, intelligent gripper, transmissivity, vision sensor

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3975 Finite Element Analysis of Piezolaminated Structures with Both Geometric and Electroelastic Material Nonlinearities

Authors: Shun-Qi Zhang, Shu-Yang Zhang, Min Chen, , Jing Bai

Abstract:

Piezoelectric laminated smart structures can be subjected to the strong driving electric field, which may result in large displacements and rotations. In one hand, piezoelectric materials usually behave very significant material nonlinear effects under strong electric fields. On the other hand, thin-walled structures undergoing large displacements and rotations exist nonnegligible geometric nonlinearity. In order to give a precise prediction of piezo laminated smart structures under the large electric field, this paper develops a finite element (FE) model accounting for material nonlinearity (piezoelectric part) and geometric nonlinearity based on the first order shear deformation (FSOD) hypothesis. The proposed FE model is first validated by both experimental and numerical examples from the literature. Afterwards, it is applied to simulate for plate and shell structures with multiple piezoelectric patches under the strong applied electric field. From the simulation results, it shows that large discrepancies occur between linear and nonlinear predictions for piezoelectric laminated structures driving at the strong electric field. Therefore, both material and geometric nonlinearities should be taken into account for piezoelectric structures under strong electric.

Keywords: piezoelectric smart structures, finite element analysis, geometric nonlinearity, electroelastic material nonlinearities

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3974 The Composer’s Hand: An Analysis of Arvo Pärt’s String Orchestral Work, Psalom

Authors: Mark K. Johnson

Abstract:

Arvo Pärt has composed over 80 text-based compositions based on nine different languages. But prior to 2015, it was not publicly known what texts the composer used in composing a number of his non-vocal works, nor the language of those texts. Because of this lack of information, few if any musical scholars have illustrated in any detail how textual structure applies to any of Pärt’s instrumental compositions. However, in early 2015, the Arvo Pärt Centre in Estonia published In Principio, a compendium of the texts Pärt has used to derive many of the parameters of his text-based compositions. This paper provides the first detailed analysis of the relationship between structural aspects of the Church Slavonic Eastern Orthodox text of Psalm 112 and the musical parameters that Pärt used when composing the string orchestral work Psalom. It demonstrates that Pärt’s text-based compositions are carefully crafted works, and that evidence of the presence of the ‘invisible’ hand of the composer can be found within every aspect of the underpinning structures, at the more elaborate middle ground level, and even within surface aspects of these works. Based on the analysis of Psalom, it is evident that the text Pärt selected for Psalom informed many of his decisions regarding the musical structures, parameters and processes that he deployed in composing this non-vocal text-based work. Many of these composerly decisions in relation to these various aspects cannot be fathomed without access to, and an understanding of, the text associated with the work.

Keywords: Arvo Pärt, minimalism, psalom, text-based process music

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3973 Analysis of State Documents on Environmental Awareness Aspects in Kazakhstan

Authors: Y. A. Kumar

Abstract:

Environmental awareness issues in Kazakhstan are one of the most undermined topics both among the public community and in terms of state rhetoric. In the context of official state documents, so far only two official environmental codes and national programs called Zhasyl Kazakhstan were introduced in the country in 2021. While on the one hand the Environmental Code was introduced with the purpose to modernize, frame and enlist main legislative aspects on various sectors of environmental law in Kazakhstan, on the other hand, the Zhasyl Kazakhstan Program has been implemented as a state program to address with numerous environmental projects various environmental issues ranging from air pollution to waste management as well as aspects related to ecological education and low environmental awareness matters. In this regard, the main goal of this paper is to analyze critically the main content of both of these documents with a particular focus on sections related to environmental awareness-raising aspects. For that, this paper applied a subjective-based content analysis in order to identify interesting insights on regulatory legal aspects, future research streams, and uncovering of improved legislative frameworks in the context of an environmental awareness issue. Apart from that, five open-ended questions were sent out to the Ministry of Ecology, Geology and Natural Resources to obtain primary data on the state’s view in regards to current previous, recent and future aspects of environmental awareness issues in the country.

Keywords: Kazakhstan, environmental awareness, environmental code, Zhasyl Kazakhstan, content analysis

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3972 Evaluation of the Cities Specific Characteristics in the Formation of the Safavid Period Mints

Authors: Mahmood Seyyed, Akram Salehi Heykoei, Hamidreza Safakish Kashani

Abstract:

Among the remaining resource of the past, coins considered as an authentic documents among the most important documentary sources. The coins were minted in a place that called mint. The number and position of the mints in each period reflects the amount of economic power, political security and business growth, which was always fluctuated its position with changing the political and economic condition. Considering that, trade has more growth during the Safavid period than previous ones, the mint also has been in greater importance. It seems the one hand, the growth of economic in Safavid period has a direct link with the number and places of the mints at that time and in the other hand, the mints have been formed in some places because of the specific characteristic of cities and regions. Increasing the number of mints in the north of the country due to the growth of silk trade and in the west and northwest due to the political and commercial relation with Ottoman Empire, also the characteristics such as existence of mines, located in the Silk Road and communication ways, all are the results of this investigation. Accordingly, in this article researcher tries to examine the characteristics that give priority to a city for having mint. With considering that in the various historical periods, the mints were based in the most important cities in terms of political and social, at that time, this article examines the cities specific characteristics in the formation of the mints in Safavid period.

Keywords: documentary sources, coins, mint, city, Safavid

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3971 Risk Propagation in Electricity Markets: Measuring the Asymmetric Transmission of Downside and Upside Risks in Energy Prices

Authors: Montserrat Guillen, Stephania Mosquera-Lopez, Jorge Uribe

Abstract:

An empirical study of market risk transmission between electricity prices in the Nord Pool interconnected market is done. Crucially, it is differentiated between risk propagation in the two tails of the price variation distribution. Thus, the downside risk from upside risk spillovers is distinguished. The results found document an asymmetric nature of risk and risk propagation in the two tails of the electricity price log variations. Risk spillovers following price increments in the market are transmitted to a larger extent than those after price reductions. Also, asymmetries related to both, the size of the transaction area and related to whether a given area behaves as a net-exporter or net-importer of electricity, are documented. For instance, on the one hand, the bigger the area of the transaction, the smaller the size of the volatility shocks that it receives. On the other hand, exporters of electricity, alongside countries with a significant dependence on renewable sources, tend to be net-transmitters of volatility to the rest of the system. Additionally, insights on the predictive power of positive and negative semivariances for future market volatility are provided. It is shown that depending on the forecasting horizon, downside and upside shocks to the market are featured by a distinctive persistence, and that upside volatility impacts more on net-importers of electricity, while the opposite holds for net-exporters.

Keywords: electricity prices, realized volatility, semivariances, volatility spillovers

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3970 Investigating Self-Confidence Influence on English as a Foreign Language Student English Language Proficiency Level

Authors: Ali A. Alshahrani

Abstract:

This study aims to identify Saudi English as a Foreign Language (EFL) students' perspectives towards using the English language in their studies. The study explores students' self-confident and its association with students' actual performance in English courses in their different academic programs. A multimodal methodology was used to fulfill the research purpose and answer the research questions. A 25-item survey questionnaire and final examination grades were used to collect data. Two hundred forty-one students agreed to participate in the study. They completed the questionnaire and agreed to release their final grades to be a part of the collected data. The data were coded and analyzed by SPSS software. The findings indicated a significant difference in students' performance in English courses between participants' academic programs on the one hand. Students' self-confidence in their English language skills, on the other hand, was not significantly different between participants' academic programs. Data analysis also revealed no correlational relationship between students' self-confidence level and their language skills and their performance. The study raises more questions about other vital factors such as course instructors' views of the materials, faculty members of the target department, family belief in the usefulness of the program, potential employers. These views and beliefs shape the student's preparation process and, therefore, should be explored further.

Keywords: English language intensive program, language proficiency, performance, self-confidence

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3969 Development of a Core Set of Clinical Indicators to Measure Quality of Care for Thyroid Cancer: A Modified-Delphi Approach

Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

Abstract:

BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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3968 Improving the Management of Delirium of Surgical Inpatients

Authors: Shammael Selorfia

Abstract:

The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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3967 Spontaneous Eruption of Impacted Teeth While Awaiting Surgical Intervention

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

Abstract:

Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

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3966 'Freud and Jung: Dissenting Friends'; An Analysis of the Foundations of the Psychoanalytical Theory in Theirs Letters

Authors: Laurence Doremus

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Freud as the builder of psychoanalysis as a discipline had created the science with Carl Gustav Jung (1875-1961), a psychiatry specialist from Zurich who was very important in the Freudian theory. The knowledge about the foundation of psychoanalysis is often focused on the influence of the works from Breuer or Charcot in the Freudian praxis, at least at the beginning of his career, and Jung's influence is often under-estimated. The paper focuses on the importance of the Jungian contributions in Freud's theories at the beginning of the creation of the discipline in the 1910s. We often meet Jungian schools on the first hand and Freudian schools, on the other hand in the academic field, but the Freudian field has to admit the importance of the Jungian theories in Freudian science. And also, the dialectical energy which appears in the letters exchanged between both of the fathers of psychoanalysis is important to understand the foundations of Freud Theory. That's why the paper will analyze in detail the correspondence between them in an epistemological and historical approach. Effectively the letters were translated and published (in French but also in English and other languages) lately in history and are still not well knew by the researchers in the psychoanalytical field. We well explain how Freud was helped by Jung despite his desire to build the theory. We analyze how the second topic named 'unconscious, preconscious, and conscious', is the result of the first topic that Jung built with Freud. The paper is a contribution to the knowledge we should have about the intense friendship between the two protagonists.

Keywords: Carl Gustav Jung, correspondence, Freud's letters, psychoanalytic theory

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3965 Research on Urban Design Method of Ancient City Guided by Catalyst Theory

Authors: Wang Zhiwei, Wang Weiwu

Abstract:

The process of urbanization in China has entered a critical period of transformation from urban expansion and construction to delicate urban design, thus forming a new direction in the field of urban design. So far, catalyst theory has become a prominent guiding strategy in urban planning and design. In this paper, under the background of urban renewal, catalyst theory is taken as the guiding ideology to explore the method of urban design in shouxian county. Firstly, this study briefly introduces and analyzes the catalyst theory. Through field investigation, it is found that the city has a large number of idle Spaces, such as abandoned factories and schools. In the design, the idle Spaces in the county town are utilized and interlinked in space, and functional interaction is carried out from the pattern of the county town. On the one hand, the results showed that the catalyst theory can enhance the vitality of the linear street space with a small amount of monomer construction. On the other hand, the city can also increase the cultural and economic sites of the city without damaging the historical relics and the sense of alterations of the ancient city, to improve the quality of life and quality of life of citizens. The city micro-transformation represented by catalyst theory can help ancient cities like shouxian to realize the activation of the old city and realize the gradual development.

Keywords: catalytic theory, urban design, China's ancient city, Renaissance

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3964 The Lead Poisoning of Beethoven and Handel

Authors: Michael Stevens

Abstract:

David Hunter, a musicologist, has suggested that both Beethoven and Handel had chronic lead poisoning from the wine that they drank. These two eminent musical composers had some striking similarities. Beethoven had alcohol dependency and preferred wine, to which lead had been added to improve the taste. Handel was obese due to an eating disorder that included drinking tainted wine after large meals. They both had paresthesia of their extremities that they interpreted as rheumatism. This is a common sensory symptom from chronic lead poisoning. Their differences are marked in that Beethoven was profoundly deaf by the end of his life, whereas Handel had remarkably good hearing. Handel had paresis of three fingers of his right hand, whereas Beethoven lacked any motor symptoms. Beethoven reported recurrent abdominal pain suggestive of lead colic, whereas it can only be inferred that this symptom was present in Handel. Lead poisoning is likely in Handel because his paralysis was consistent with radial nerve involvement in the dominant hand. In addition, it was cured by hot baths, which have been shown to reduce total body lead content by exchanging with iron and calcium ions in water. Although lead produces predominantly motor symptoms in classic or subacute lead poisoning, and sensory symptoms in chronic lead poisoning, lead poisoning causes a variety of symptoms that depending on duration and level of exposure, are extremely variable from person to person. It therefore seems likely that Handel had lead poisoning, but extremely likely that Beethoven did because of the confirmatory finding of high levels of lead deep in his skull bone, which is a good measure of total body burden.

Keywords: beethoven, handel, lead, poisoning

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3963 Requirements Management in Agile

Authors: Ravneet Kaur

Abstract:

The concept of Agile Requirements Engineering and Management is not new. However, the struggle to figure out how traditional Requirements Management Process fits within an Agile framework remains complex. This paper talks about a process that can merge the organization’s traditional Requirements Management Process nicely into the Agile Software Development Process. This process provides Traceability of the Product Backlog to the external documents on one hand and User Stories on the other hand. It also gives sufficient evidence that the system will deliver the right functionality with good quality in the form of various statistics and reports. In the nutshell, by overlaying a process on top of Agile, without disturbing the Agility, we are able to get synergic benefits in terms of productivity, profitability, its reporting, and end to end visibility to all Stakeholders. The framework can be used for just-in-time requirements definition or to build a repository of requirements for future use. The goal is to make sure that the business (specifically, the product owner) can clearly articulate what needs to be built and define what is of high quality. To accomplish this, the requirements cycle follows a Scrum-like process that mirrors the development cycle but stays two to three steps ahead. The goal is to create a process by which requirements can be thoroughly vetted, organized, and communicated in a manner that is iterative, timely, and quality-focused. Agile is quickly becoming the most popular way of developing software because it fosters continuous improvement, time-boxed development cycles, and more quickly delivering value to the end users. That value will be driven to a large extent by the quality and clarity of requirements that feed the software development process. An agile, lean, and timely approach to requirements as the starting point will help to ensure that the process is optimized.

Keywords: requirements management, Agile

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3962 The Effect of a Probiotic Diet on htauE14 in a Rodent Model of Alzheimer’s Disease

Authors: C. Flynn, Q. Yuan, C. Reinhardt

Abstract:

Alzheimer’s Disease (AD) is a progressive neurodegenerative disorder affecting broad areas of the cerebral cortex and hippocampus. More than 95% of AD cases are representative of sporadic AD, where both genetic and environmental risk factors play a role. The main pathological features of AD include the widespread deposition of amyloid-beta and neurofibrillary tau tangles in the brain. The earliest brain pathology related to AD has been defined as hyperphosphorylated soluble tau in the noradrenergic locus coeruleus (LC) neurons, characterized by Braak. However, the cause of this pathology and the ultimate progression of AD is not understood. Increasing research points to a connection between the gut microbiota and the brain, and mounting evidence has shown that there is a bidirectional interaction between the two, known as the gut-brain axis. This axis can allow for bidirectional movement of neuroinflammatory cytokines and pathogenic misfolded proteins, as seen in AD. Prebiotics and probiotics have been shown to have a beneficial effect on gut health and can strengthen the gut-barrier as well as the blood-brain barrier, preventing the spread of these pathogens across the gut-brain axis. Our laboratory has recently established a pretangle tau rat model, in which we selectively express pseudo-phosphorylated human tau (htauE14) in the LC neurons of TH-Cre rats. LC htauE14 produced pathological changes in rats resembling those of the preclinical AD pathology (reduced olfactory discrimination and LC degeneration). In this work, we will investigate the effects of pre/probiotic ingestion on AD behavioral deficits, blood inflammation/cytokines, and various brain markers in our experimental rat model of AD. Rats will be infused with an adeno-associated viral vector containing a human tau gene pseudophosphorylated at 14 sites (common in LC pretangles) into 2-3 month TH-Cre rats. Fecal and blood samples will be taken at pre-surgery, and various post-surgery time points. A collection of behavioral tests will be performed, and immunohistochemistry/western blotting techniques will be used to observe various biomarkers. This work aims to elucidate the relationship between gut health and AD progression by strengthening gut-brain relationship and aims to observe the overall effect on tau formation and tau pathology in AD brains.

Keywords: alzheimer’s disease, aging, gut microbiome, neurodegeneration

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3961 Evaluation Criteria for Performance of Knitted Terry Fabrics and Building Elements of Fashion: A Critical Review

Authors: Harpinder Kaur, Amit Madahar

Abstract:

The terry fabric is one of the fastest growing and challenging sub-sectors of the textile industry. Terry fabrics are produced using ground weft, ground warp, and pile yarns. The terry fabrics not only finds applications in towels but also in home textile products, sauna dressing- gowns, slippers, jackets, garments, apparels, outerwears, overcoats, sweatshirts, children’s clothes, and hygiene products for babies, beachwear, sleepwear, gloves, scarfs, shawls, etc. In some cases, these wide ranges of applications not only demand a high degree of absorption but also necessitate the due consideration for the handle properties of the fabrics. These fabrics are required to be accessed for their performance in terms of absorbency and comfort characteristics. Since material (yarns, colors, fabrics, fashion, patrons, accessories and fittings) are the core elements of structure of fashion, hence textile and fashion go hand in hand. This paper throws some light on the performance evaluation of terry fabrics. Here, characteristics/features that are required to be achieved for satisfactory performance of the terry fabrics with reference to fashion are discussed. The terry fabrics are being modified over the years in terms of the raw material requirements such as 100% cotton or blends or cotton with other fibers in order to obtain better performance as well as their structural parameters including stitch length and stitch density etc.

Keywords: absorbency, comfort, cotton, performance, terry fabrics, fashion

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3960 Study of Pressure and Air Mass Flow Effect on Output Power of PEM Fuel Cell Powertrains in Vehicles and Airplanes- A Simulation-based Approach

Authors: Mahdiye Khorasani, Arjun Vijay, Ali Mashayekh, Christian Trapp

Abstract:

The performance of Proton Exchange Membrane Fuel Cell (PEMFC) is highly dependent on the pressure and mass flow of media (Hydrogen and air) throughout the cells and the stack. Higher pressure, on the one hand, results in higher output power of the stack but, on the other hand, increases the electrical power demand of the compressor. In this work, a simulation model of a PEMFC system for vehicle and airplane applications is developed. With this new model, the effect of different pressures and air mass flow rates are investigated to discover the optimum operating point in a PEMFC system, and innovative operation strategies are implemented to optimize reactants flow while minimizing electrical power demand of the compressor for optimum performance. Additionally, a fuel cell system test bench is set up, which contains not only all the auxiliary components for conditioning the gases, reactants, and flows but also a dynamic titling table for testing different orientations of the stack to simulate the flight conditions during take-off and landing and off-road-vehicle scenarios. The results of simulation will be tested and validated on the test bench for future works.

Keywords: air mass flow effect, optimization of operation, pressure effect, PEMFC system, PEMFC system simulation

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3959 Signals Monitored During Anaesthesia

Authors: Launcelot McGrath

Abstract:

A comprehensive understanding of physiological data is a vital aid to the anaesthesiologist in monitoring and maintaining the well-being of a patient undergoing surgery. Bio signal analysis is one of the most important topics that researchers have tried to develop over the last century to understand numerous human diseases. Understanding which biological signals are most important during anaesthesia is critically important. It is important that the anaesthesiologist understand both the signals themselves and the limitations introduced by the processes of acquisition. In this article, we provide an overview of different types of biological signals as well as the mechanisms applied to acquire them.

Keywords: biological signals, signal acquisition, anaesthesiology, patient monitoring

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3958 Therapeutic Effects of Toll Like Receptor 9 Ligand CpG-ODN on Radiation Injury

Authors: Jianming Cai

Abstract:

Exposure to ionizing radiation causes severe damage to human body and an safe and effective radioprotector is urgently required for alleviating radiation damage. In 2008, flagellin, an agonist of TLR5, was found to exert radioprotective effects on radiation injury through activating NF-kB signaling pathway. From then, the radioprotective effects of TLR ligands has shed new lights on radiation protection. CpG-ODN is an unmethylated oligonucleotide which activates TLR9 signaling pathway. In this study, we demonstrated that CpG-ODN has therapeutic effects on radiation injuries induced by γ ray and 12C6+ heavy ion particles. Our data showed that CpG-ODN increased the survival rate of mice after whole body irradiation and increased the number of leukocytes as well as the bone marrow cells. CpG-ODN also alleviated radiation damage on intestinal crypt through regulating apoptosis signaling pathway including bcl2, bax, and caspase 3 etc. By using a radiation-induced pulmonary fibrosis model, we found that CpG-ODN could alleviate structural damage, within 20 week after whole–thorax 15Gy irradiation. In this model, Th1/Th2 imbalance induced by irradiation was also reversed by CpG-ODN. We also found that TGFβ-Smad signaling pathway was regulated by CpG-ODN, which accounts for the therapeutic effects of CpG-ODN in radiation-induced pulmonary injury. On another hand, for high LET radiation protection, we investigated protective effects of CpG-ODN against 12C6+ heavy ion irradiation and found that after CpG-ODN treatment, the apoptosis and cell cycle arrest induced by 12C6+ irradiation was reduced. CpG-ODN also reduced the expression of Bax and caspase 3, while increased the level of bcl2. Then we detected the effect of CpG-ODN on heavy ion induced immune dysfunction. Our data showed that CpG-ODN increased the survival rate of mice and also the leukocytes after 12C6+ irradiation. Besides, the structural damage of immune organ such as thymus and spleen was also alleviated by CpG-ODN treatment. In conclusion, we found that TLR9 ligand, CpG-ODN reduced radiation injuries in response to γ ray and 12C6+ heavy ion irradiation. On one hand, CpG-ODN inhibited the activation of apoptosis induced by radiation through regulating bcl2, bax and caspase 3. On another hand, through activating TLR9, CpG-ODN recruit MyD88-IRAK-TRAF6 complex, activating TAK1, IRF5 and NF-kB pathway, and thus alleviates radiation damage. This study provides novel insights into protection and therapy of radiation damages.

Keywords: TLR9, CpG-ODN, radiation injury, high LET radiation

Procedia PDF Downloads 480
3957 IT-Based Global Healthcare Delivery System: An Alternative Global Healthcare Delivery System

Authors: Arvind Aggarwal

Abstract:

We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

Procedia PDF Downloads 179
3956 A Study of the Resistance of Protective Glove Materials to Metalworking Fluids

Authors: Nguyen-Tri Phuong, Triki Ennouri, Gauvin Chantal, Tuduri Ludovic, Vu-Khanh Toan

Abstract:

Hand injuries due to mechanical hazards such as cuts and punctures are major risks and concerns for several occupational groups, particularly for workers in the metal manufacturing sector and mechanical automotive services. Personal protective equipment such as gloves or clothing is necessary for many professionals to protect against a variety of occupational hazards, which arise daily in their work environments. In many working places such as metal manufacturing or automotive services, mechanical hazards often occur together with industrial contaminants, particularly metalworking fluids (MWFs). The presence of these contaminants could modify the properties of gloves made from polymeric materials and thus increase the risk of hand injuries for workers. The focus of this study is to determine the swelling characteristics and the resistance of six polymer membranes when they are contaminated with several industrial metalworking fluids. These polymer membranes, commonly used in protective gloves, are nitrile, neoprene, vinyl, butyl, polyurethane and latex rubbers. Changes swelling index were continuously followed during the contamination procedure to compare the performance of each polymer under different conditions. The modification of the samples surface, tensile properties during the contamination process was also investigated. The effect of temperature on mechanical properties and morphology of material was also examined.

Keywords: metalworking fluid, swelling behavior, protective glove materials, elastomers

Procedia PDF Downloads 393
3955 Sailing/Anchoring: Home-making and Aspirations of Non-Majority Female Migrants in Shenzhen, China

Authors: Meiyun Meng

Abstract:

Urban China is now undergoing social transformation based on its rapid economic growth, developing its individualism and feminism. This paper approaches emergent relationships between female individuals’ everyday lives and urban China through internal migration, home-making practices and life-course perspectives. Focusing on Shenzhen, it explores how ten highly educated female migrants pursue aspirations of accommodating ‘non-majority’ identities, such as lesbians, divorced, or childless women, in urban China. Based on life stories and home video tours, this paper finds how these women develop non-majority lifestyles to negotiate their aspirations. On the one hand, they ‘sail’ away from past/present situations where collectivist and hetero-patriarchal norms marginalised their non-majority identities. On the other hand, they ‘anchor’ in places where ‘new’ socio-cultural contexts allow female individuals to pursue alternative opportunities and preferential lifestyles. This paper provides fresh insights to interpret the social transformation in urban China, under the collectivist culture and hetero-patriarchal norms, through the lens of individual everyday home-making practices.

Keywords: home-making practices, internal migration, highly educated women, shenzhen, transforming urban China

Procedia PDF Downloads 91