Search results for: family quality of life scale
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21487

Search results for: family quality of life scale

13297 Mobi-DiQ: A Pervasive Sensing System for Delirium Risk Assessment in Intensive Care Unit

Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

Abstract:

Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

Procedia PDF Downloads 79
13296 An Enhanced Approach in Validating Analytical Methods Using Tolerance-Based Design of Experiments (DoE)

Authors: Gule Teri

Abstract:

The effective validation of analytical methods forms a crucial component of pharmaceutical manufacturing. However, traditional validation techniques can occasionally fail to fully account for inherent variations within datasets, which may result in inconsistent outcomes. This deficiency in validation accuracy is particularly noticeable when quantifying low concentrations of active pharmaceutical ingredients (APIs), excipients, or impurities, introducing a risk to the reliability of the results and, subsequently, the safety and effectiveness of the pharmaceutical products. In response to this challenge, we introduce an enhanced, tolerance-based Design of Experiments (DoE) approach for the validation of analytical methods. This approach distinctly measures variability with reference to tolerance or design margins, enhancing the precision and trustworthiness of the results. This method provides a systematic, statistically grounded validation technique that improves the truthfulness of results. It offers an essential tool for industry professionals aiming to guarantee the accuracy of their measurements, particularly for low-concentration components. By incorporating this innovative method, pharmaceutical manufacturers can substantially advance their validation processes, subsequently improving the overall quality and safety of their products. This paper delves deeper into the development, application, and advantages of this tolerance-based DoE approach and demonstrates its effectiveness using High-Performance Liquid Chromatography (HPLC) data for verification. This paper also discusses the potential implications and future applications of this method in enhancing pharmaceutical manufacturing practices and outcomes.

Keywords: tolerance-based design, design of experiments, analytical method validation, quality control, biopharmaceutical manufacturing

Procedia PDF Downloads 61
13295 Rhizospheric Oxygen Release of Hydroponically Grown Wetland Macrophytes as Passive Source for Cathodic Reduction in Microbial Fuel Cell

Authors: Chabungbam Niranjit Khuman, Makarand Madhao Ghangrekar, Arunabha Mitra

Abstract:

The cost of aeration is one of the limiting factors in the upscaling of microbial fuel cells (MFC) for field-scale applications. Wetland macrophytes have the ability to release oxygen into the water to maintain aerobic conditions in their root zone. In this experiment, the efficacy of rhizospheric oxygen release of wetland macrophytes as a source of oxygen in the cathodic chamber of MFC was conducted. The experiment was conducted in an MFC consisting of a three-liter anodic chamber made of ceramic cylinder and a 27 L cathodic chamber. Untreated carbon felts were used as electrodes (i.e., anode and cathode) and connected to an external load of 100 Ω using stainless steel wire. Wetland macrophytes (Canna indica) were grown in the cathodic chamber of the MFC in a hydroponic fashion using a styrofoam sheet (termed as macrophytes assisted-microbial fuel cell, M-MFC). The catholyte (i.e., water) in the M-MFC had negligible contact with atmospheric air due to the styrofoam sheet used for maintaining the hydroponic condition. There was no mixing of the catholyte in the M-MFC. Sucrose based synthetic wastewater having chemical oxygen demand (COD) of 3000 mg/L was fed into the anodic chamber of the MFC in fed-batch mode with a liquid retention time of four days. The C. indica thrived well throughout the duration of the experiment without much care. The average dissolved oxygen (DO) concentration and pH value in the M-MFC were 3.25 mg/L and 7.07, respectively, in the catholyte. Since the catholyte was not in contact with air, the DO in the catholyte might be considered as solely liberated from the rhizospheric oxygen release of C. indica. The maximum COD removal efficiency of M-MFC observed during the experiment was 76.9%. The inadequacy of terminal electron acceptor in the cathodic chamber in M-MFC might have hampered the electron transfer, which in turn, led to slower specific microbial activity, thereby resulting in lower COD removal efficiency than the traditional MFC with aerated catholyte. The average operating voltage (OV) and open-circuit voltage (OCV) of 294 mV and 594 mV, respectively, were observed in M-MFC. The maximum power density observed during polarization was 381 mW/m³, and the maximum sustainable power density observed during the experiment was 397 mW/m³ in M-MFC. The maximum normalized energy recovery and coulombic efficiency of 38.09 Wh/m³ and 1.27%, respectively, were observed. Therefore, it was evidenced that rhizospheric oxygen release of wetland macrophytes (C. indica) was capable of sustaining the cathodic reaction in MFC for field-scale applications.

Keywords: hydroponic, microbial fuel cell, rhizospheric oxygen release, wetland macrophytes

Procedia PDF Downloads 119
13294 Immobilized Iron Oxide Nanoparticles for Stem Cell Reconstruction in Magnetic Particle Imaging

Authors: Kolja Them, Johannes Salamon, Harald Ittrich, Michael Kaul, Tobias Knopp

Abstract:

Superparamagnetic iron oxide nanoparticles (SPIONs) are nanoscale magnets which can be biologically functionalized for biomedical applications. Stem cell therapies to repair damaged tissue, magnetic fluid hyperthermia for cancer therapy and targeted drug delivery based on SPIONs are prominent examples where the visualization of a preferably low concentrated SPION distribution is essential. In 2005 a new method for tomographic SPION imaging has been introduced. The method named magnetic particle imaging (MPI) takes advantage of the nanoparticles magnetization change caused by an oscillating, external magnetic field and allows to directly image the time-dependent nanoparticle distribution. The SPION magnetization can be changed by the electron spin dynamics as well as by a mechanical rotation of the nanoparticle. In this work different calibration methods in MPI are investigated for image reconstruction of magnetically labeled stem cells. It is shown that a calibration using rotationally immobilized SPIONs provides a higher quality of stem cell images with fewer artifacts than a calibration using mobile SPIONs. The enhancement of the image quality and the reduction of artifacts enables the localization and identification of a smaller number of magnetically labeled stem cells. This is important for future medical applications where low concentrations of functionalized SPIONs interacting with biological matter have to be localized.

Keywords: biomedical imaging, iron oxide nanoparticles, magnetic particle imaging, stem cell imaging

Procedia PDF Downloads 448
13293 Quality of Care for the Maternal Complications at Selected Primary and Secondary Health Facilities of Bangladesh: Lessons Learned from a Formative Research

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

Abstract:

After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

Procedia PDF Downloads 215
13292 Biodiversity and Biotechnology: Some Considerations about the International Regulation of Agriculture and the International Legal System on Access to Genetic Resources

Authors: Leandro Moura da Silva

Abstract:

The international community has strived to create legal mechanisms to protect their biodiversity, but this can represent, sometimes, particularly in the case of regulatory regime on access to genetic resources, an excessive nationalism which transforms itself into a significant obstacle to scientific progress causing damages to the country and to local farmers. Although it has been poorly publicized in the media, the international legal system was marked, in 2014, by the entry into force of the Nagoya Protocol, which regulates the access and benefit sharing of genetic resources of the States Party to that legal instrument. However, it’s not reasonable to think of regulating access to genetic resources without reflecting on the links of this important subject with other related issues, such as family farming and agribusiness, food safety, food security, intellectual property rights (on seeds, genetic material, new plant varieties, etc.), environmental sustainability, biodiversity, and biosafety.

Keywords: international law, regulation on agriculture, agronomy techniques, sustainability, genetic resources and new crop varieties, CBD, Nagoya Protocol, ITPGRFA

Procedia PDF Downloads 491
13291 Internal Capital Market Efficiency Study Based on Improved Cash Flow Sensitivity Coefficient - Take Tomorrow Group as an Example

Authors: Peng Lu, Liu Ting

Abstract:

Because of the difficulty of financing from the external capital market, the reorganization and merger of private enterprises have formed a family group, seeking the help of the internal capital market to alleviate the capital demand. However, the inefficiency of the internal capital market can damage the effect it should have played, and even hinder the development of enterprises. This paper takes the "Tomorrow Group" as the research object to carry on the case analysis. After using the improved cash flow sensitivity coefficient to measure the efficiency of the internal capital market of Tomorrow Group, the inefficiency phenomenon is found. Then the analysis reveals that the reasons for its inefficiency include that the pyramidal equity structure is conducive to control, the separation of cash flow rights and control rights, the concentration of equity leads to poor balance, the abandonment of real industries and information asymmetry.

Keywords: tomorrow group, internal capital market, related-party transactions, Baotou tomorrow technology Co., LTD

Procedia PDF Downloads 120
13290 Asymmetric Synthesis and Biological Study of Suberosanes

Authors: Mohammad Kousara, Françoise Dumas, Rama Ibrahim, Joëlle Dubois, Joël Raingeaud

Abstract:

Suberosanes are a small group of marine natural sesquiterpenes discovered since 1996 by Boyd, Sheu and Qi from three gorgonians. Their skeleton was previously found in quadranes produced by the terrestrial fungus Aspergillus terreus. Up to date, eleven suberosanes are described from which (-)-suberosanone and (-)-suberosenol A are reaching the picomolar cytotoxicity level on human solid tumors cell lines. Due to their impressive cytotoxic properties and their limited availability, we undertook an asymmetric synthesis of the most active members of this family in order to get insight into their absolute configurations and their biological properties. The challenge of their synthesis is the regio- and stereoselective elaboration of the compact bridged tricyclic skeleton with up to five all adjacent asymmetric centers, including a central quaternary carbon one. Our strategy is based on an aza-ene-synthesis key step which is regio-and stereo-controlled by the choice of a chiral amine enantiomer. it approach is concise and flexible, the enantiopur ABC tricyclic intermediate that have been synthesized being the common precursor of suberosanes.

Keywords: suberosanes, asymmetric synthesis, sesquiterpenes, quadranes

Procedia PDF Downloads 74
13289 Educational Video Capsules for Fostering Teachers Creativity

Authors: Martha Salinas, Valkyria Bernal

Abstract:

Creativity is a possible response to the profound social, economic, and global changes society is living and education is the source to develop this kind of capacity. However, institutional pressures often prevent teachers from engaging in creative teaching practices and make innovation not the main curricular focus when building learning scenarios and experiences. This study proposes and validates the use of a prototype of Educative Video – Capsules from the perspective of teacher training, presenting the different stages of design, the content plan, as well as the influences of its components and characteristics from the perspective of creativity. The paper presents literature findings of the factors that influence the innovative behavior of teachers, the beliefs of teachers about creativity and its nature, as well as the creative pedagogies that have generated better results. The results show that the disposition of teachers towards creative pedagogies improves significantly with the use of a tool that is based on the principles of microlearning and is developed in a non-academic, autonomous, and non-imposed family environment as traditional teacher training processes usually occur.

Keywords: educational innovation, resistance to innovation, creativity, creative pedagogy

Procedia PDF Downloads 139
13288 July 15 Coup Attempt and the Use of New Communication Technologies

Authors: Yasemin Gulsen Yilmaz, Suleyman Hakan Yilmaz, Muhammet Erbay

Abstract:

The new communication technologies have gradually improved its efficiency in all fields of life and made its presence irreplaceable. These technologies which appear in every aspect of life differently showed itself during the failed coup attempt in Turkey too. The evening of July 15, 2016, have already taken its place in the Turkish political history. In the evening of July 15, Turkish nation confronted to a coup attempted by a group within the Turkish Armed Forces. That evening, the scene of the confrontation between the coup attempters and the resisting civilians were watched minute-by-minute by the people using the new communication technologies. Pro-coup soldiers and the resisting groups that came face to face in the streets of metropolitan cities, made their in-group communications by using new media tools very actively. New media turned into the most important weapon both for coup plotters and for those who resisted. In the morning of next day, whoever used these tools better had the upper hand. The civilians were successful in protecting democracy not only by resisting against tanks and bullets but also by following the internet, organising in social media, sharing information-photos on the net and telling large masses their experiences through these technologies. In this study, we focused on and analysed the use of new media both by coup soldiers and resisting civilians during the failed coup attempt in July 15. Within the scope of this study, coup attempt news that took place in printed media within one week were examined; the information about the use of new media tools during the night of failed coup were compiled; and it was determined how, to what extend and what for these tools were used and how effective they were.

Keywords: communication, July 15, new media, media

Procedia PDF Downloads 231
13287 Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History

Authors: E. H. Szeto, E. Ammendola, J. V. Tabares, A. Starkey, J. Hay, J. G. McClung, C. J. Bryan

Abstract:

Introduction: Suicide is a leading cause of death globally, which accounts for more deaths annually than war, acquired immunodeficiency syndrome, homicides, and car accidents, while an estimated 140 million individuals have significant suicide ideation (SI) each year in the United States. Typical risk factors such as hopelessness, depression, and psychiatric disorders can predict suicide ideation but cannot distinguish between those who ideate from those who attempt suicide (SA). The Fluid Vulnerability Theory of suicide posits that a person’s activation of the suicidal mode is predicated on one’s predisposition, triggers, baseline/acute risk, and protective factors. The current study compares self-conscious cognitive-affective states (including guilt, shame, anger towards the self, and suicidal beliefs) among patients based on the endorsement of recent SI (i.e., past two weeks; acute risk) and lifetime SA (i.e., baseline risk). Method: A total of 2,722 individuals in an outpatient primary care setting were included in this cross-sectional, observational study; data for 2,584 were valid and retained for analysis. The Differential Emotions Scale measuring guilt, shame, and self-anger and the Suicide Cognitions Scale measuring suicide cognitions were administered. Results: A total of 2,222 individuals reported no recent SI or lifetime SA (Group 1), 161 reported recent SI only (Group 2), 145 reported lifetime SA only (Group 3), 56 reported both recent SI and lifetime SA (Group 4). The Kruskal-Wallis test showed that guilt, shame, self-anger, and suicide cognitions were the highest for Group 4 (both recent SI and lifetime SA), followed by Group 2 (recent SI-only), then Group 3 (lifetime SA-only), and lastly, Group 1 (no recent SI or lifetime SA). Conclusion: The results on recent SI-only versus lifetime SA-only contribute to the literature on the Fluid Vulnerability Theory of suicide by capturing SI and SA in two different time periods, which signify the acute risks and chronic baseline risks of the suicidal mode, respectively. It is also shown that: (a) people with a lifetime SA reported more severe symptoms than those without, (b) people with recent SI reported more severe symptoms than those without, and (c) people with both recent SI and lifetime SA were the most severely distressed. Future studies may replicate the findings here with other pertinent risk factors such as thwarted belongingness, perceived burdensomeness, and acquired capability, the last of which is consistently linked to attempting among ideators.

Keywords: suicide, guilt, shame, self-anger, suicide cognitions, suicide ideation, suicide attempt

Procedia PDF Downloads 149
13286 Assessment of Drinking Water Quality in Relation to Arsenic Contamination in Drinking Water in Liberia: Achieving the Sustainable Development Goal of Ensuring Clean Water and Sanitation

Authors: Victor Emery David Jr., Jiang Wenchao, Daniel Mmereki, Yasinta John

Abstract:

The fundamentals of public health are access to safe and clean drinking water. The presence of arsenic and other contaminants in drinking water leads to the potential risk to public health and the environment particularly in most developing countries where there’s inadequate access to safe and clean water and adequate sanitation. Liberia has taken steps to improve its drinking water status so as to achieve the Sustainable Development Goals (SDGs) target of ensuring clean water and effective sanitation but there is still a lot to be done. The Sustainable Development Goals are a United Nation initiative also known as transforming our world: The 2030 agenda for sustainable development. It contains seventeen goals with 169 targets to be met by respective countries. Liberia is situated within in the gold belt region where there exist the presence of arsenic and other contaminants in the underground water due to mining and other related activities. While there are limited or no epidemiological studies conducted in Liberia to confirm illness or death as a result of arsenic contamination in Liberia, it remains a public health concern. This paper assesses the drinking water quality, the presence of arsenic in groundwater/drinking water in Liberia, and proposes strategies for mitigating contaminants in drinking water and suggests options for improvement with regards to achieving the Sustainable Development Goals of ensuring clean water and effective sanitation in Liberia by 2030.

Keywords: arsenic, action plan, contaminants, environment, groundwater, sustainable development goals (SDGs), Monrovia, Liberia, public health, drinking water

Procedia PDF Downloads 245
13285 Identification of Factors and Impacts on the Success of Implementing Extended Enterprise Resource Planning: Case Study of Manufacturing Industries in East Java, Indonesia

Authors: Zeplin Jiwa Husada Tarigan, Sautma Ronni Basana, Widjojo Suprapto

Abstract:

The ERP is integrating all data from various departments within the company into one data base. One department inputs the data and many other departments can access and use the data through the connected information system. As many manufacturing companies in Indonesia implement the ERP technology, many adjustments are to be made to align with the business process in the companies, especially the management policy and the competitive advantages. For companies that are successful in the initial implementation, they still have to maintain the process so that the initial success can develop along with the changing of business processes of the company. For companies which have already implemented the ERP successfully, they are still in need to maintain the system so that it can match up with the business development and changes. The continued success of the extended ERP implementation aims to achieve efficient and effective performance for the company. This research is distributing 100 questionnaires to manufacturing companies in East Java, Indonesia, which have implemented and have going live ERP for over five years. There are 90 returned questionnaires with ten disqualified questionnaires because they are from companies that implement ERP less than five years. There are only 80 questionnaires used as the data, with the response rate of 80%. Based on the data results and analysis with PLS (Partial Least Square), it is obtained that the organization commitment brings impacts to the user’s effectiveness and provides the adequate IT infrastructure. The user’s effectiveness brings impacts to the adequate IT infrastructure. The information quality of the company increases the implementation of the extended ERP in manufacturing companies in East Java, Indonesia.

Keywords: organization commitment, adequate IT infrastructure, information quality, extended ERP implementation

Procedia PDF Downloads 152
13284 An Assessment of Self-Perceived Health after the Death of a Spouse among the Elderly

Authors: Shu-Hsi Ho

Abstract:

The problems of aging and number of widowed peers gradually rise in Taiwan. It is worth to concern the related issues for elderly after the death of a spouse. Hence, this study is to examine the impact of spousal death on the surviving spouse’s self-perceived health and mental health for the elderly in Taiwan. A cross section data design and ordered logistic regression models are applied to investigate whether marriage is associated significantly to self-perceived health and mental health for the widowed older Taiwanese. The results indicate that widowed marriage shows significant negative effects on self-perceived health and mental health regardless of widows or widowers. Among them, widows might be more likely to show worse mental health than widowers. The belief confirms that marriage provides effective sources to promote self-perceived health and mental health, particularly for females. In addition, since the social welfare system is not perfect in Taiwan, the findings also suggest that family and social support reveal strongly association with the self-perceived health and mental health for the widows and widowers elderly.

Keywords: logistic regression models, self-perceived health, widow, widower

Procedia PDF Downloads 445
13283 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

Abstract:

Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

Procedia PDF Downloads 352
13282 Thermal Contact Resistance of Nanoscale Rough Surfaces

Authors: Ravi Prasher

Abstract:

In nanostructured material thermal transport is dominated by contact resistance. Theoretical models describing thermal transport at interfaces assume perfectly flat surface whereas in reality surfaces can be rough with roughness ranging from sub-nanoscale dimension to micron scale. Here we introduce a model which includes both nanoscale contact mechanics and nanoscale heat transfer for rough nanoscale surfaces. This comprehensive model accounts for the effect of phonon acoustic mismatch, mechanical properties, chemical properties and randomness of the rough surface.

Keywords: adhesion and contact resistance, Kaptiza resistance of rough surfaces, nanoscale thermal transport

Procedia PDF Downloads 355
13281 The Response of Mammal Populations to Abrupt Changes in Fire Regimes in Montane Landscapes of South-Eastern Australia

Authors: Jeremy Johnson, Craig Nitschke, Luke Kelly

Abstract:

Fire regimes, climate and topographic gradients interact to influence ecosystem structure and function across fire-prone, montane landscapes worldwide. Biota have developed a range of adaptations to historic fire regime thresholds, which allow them to persist in these environments. In south-eastern Australia, a signal of fire regime changes is emerging across these landscapes, and anthropogenic climate change is likely to be one of the main drivers of an increase in burnt area and more frequent wildfire over the last 25 years. This shift has the potential to modify vegetation structure and composition at broad scales, which may lead to landscape patterns to which biota are not adapted, increasing the likelihood of local extirpation of some mammal species. This study aimed to address concerns related to the influence of abrupt changes in fire regimes on mammal populations in montane landscapes. It first examined the impact of climate, topography, and vegetation on fire patterns and then explored the consequences of these changes on mammal populations and their habitats. Field studies were undertaken across diverse vegetation, fire severity and fire frequency gradients, utilising camera trapping and passive acoustic monitoring methodologies and the collection of fine-scale vegetation data. Results show that drought is a primary contributor to fire regime shifts at the landscape scale, while topographic factors have a variable influence on wildfire occurrence at finer scales. Frequent, high severity wildfire influenced forest structure and composition at broad spatial scales, and at fine scales, it reduced occurrence of hollow-bearing trees and promoted coarse woody debris. Mammals responded differently to shifts in forest structure and composition depending on their habitat requirements. This study highlights the complex interplay between fire regimes, environmental gradients, and biotic adaptations across temporal and spatial scales. It emphasizes the importance of understanding complex interactions to effectively manage fire-prone ecosystems in the face of climate change.

Keywords: fire, ecology, biodiversity, landscape ecology

Procedia PDF Downloads 52
13280 An Exploratory Study in Nursing Education: Factors Influencing Nursing Students’ Acceptance of Mobile Learning

Authors: R. Abdulrahman, A. Eardley, A. Soliman

Abstract:

The proliferation in the development of mobile learning (m-learning) has played a vital role in the rapidly growing electronic learning market. This relatively new technology can help to encourage the development of in learning and to aid knowledge transfer a number of areas, by familiarizing students with innovative information and communications technologies (ICT). M-learning plays a substantial role in the deployment of learning methods for nursing students by using the Internet and portable devices to access learning resources ‘anytime and anywhere’. However, acceptance of m-learning by students is critical to the successful use of m-learning systems. Thus, there is a need to study the factors that influence student’s intention to use m-learning. This paper addresses this issue. It outlines the outcomes of a study that evaluates the unified theory of acceptance and use of technology (UTAUT) model as applied to the subject of user acceptance in relation to m-learning activity in nurse education. The model integrates the significant components across eight prominent user acceptance models. Therefore, a standard measure is introduced with core determinants of user behavioural intention. The research model extends the UTAUT in the context of m-learning acceptance by modifying and adding individual innovativeness (II) and quality of service (QoS) to the original structure of UTAUT. The paper goes on to add the factors of previous experience (of using mobile devices in similar applications) and the nursing students’ readiness (to use the technology) to influence their behavioural intentions to use m-learning. This study uses a technique called ‘convenience sampling’ which involves student volunteers as participants in order to collect numerical data. A quantitative method of data collection was selected and involves an online survey using a questionnaire form. This form contains 33 questions to measure the six constructs, using a 5-point Likert scale. A total of 42 respondents participated, all from the Nursing Institute at the Armed Forces Hospital in Saudi Arabia. The gathered data were then tested using a research model that employs the structural equation modelling (SEM), including confirmatory factor analysis (CFA). The results of the CFA show that the UTAUT model has the ability to predict student behavioural intention and to adapt m-learning activity to the specific learning activities. It also demonstrates satisfactory, dependable and valid scales of the model constructs. This suggests further analysis to confirm the model as a valuable instrument in order to evaluate the user acceptance of m-learning activity.

Keywords: mobile learning, nursing institute students’ acceptance of m-learning activity in Saudi Arabia, unified theory of acceptance and use of technology model (UTAUT), structural equation modelling (SEM)

Procedia PDF Downloads 174
13279 Investigating the Environmental Impact of Tourists Activities on Yankari Resort and Safari

Authors: Eldah Ephraim Buba, Sanusi Abubakar Sadiq

Abstract:

Habitat can be degraded by tourism leisure activities for example wildlife viewing can bring abrupt stress for animals and alter their natural behaviors when tourist come too close and wildlife watching have degradation effects on the habitats as they often are accompanied by the noise and commotion created by tourist as they chase wild animals. It is observed that Jos Wild Life Park is usually congested during on-peak periods which causes littering and contamination of the environment by tourist which may lead to changes in the soil nutrient. The issue of unauthorized feeding of animals by a tourist in which the food might be dangerous and harmful to their health and making them be so aggressive is also observed. The aim of the study is to investigate the environmental impact of tourists’ activities in Jos Wild Life Park, Nigeria. The study used survey questionnaires to both tourists and the staff of the wildlife park. One hundred questionnaires were self-administered to randomly selected tourists as the visit the park and some staff. The average mean score of the response was used to show agreement or disagreement. Major findings show the negative impact of tourist’s activities to the environment as air pollution, overcrowding, and congestion, solid littering of the environment, distress to animals and alteration of the ecosystem. Furthermore, the study found the positive impact of tourists activities on the environment to be income generation through tourists activities and infrastructural development. It is recommended that the impact of tourism should be minimized through admitting the right carrying capacity and impact assessment.

Keywords: environmental, impact, investigation, tourists, activities

Procedia PDF Downloads 343
13278 Carbon Skimming: Towards an Application to Summarise and Compare Embodied Carbon to Aid Early-Stage Decision Making

Authors: Rivindu Nethmin Bandara Menik Hitihamy Mudiyanselage, Matthias Hank Haeusler, Ben Doherty

Abstract:

Investors and clients in the Architectural, Engineering and Construction industry find it difficult to understand complex datasets and reports with little to no graphic representation. The stakeholders examined in this paper include designers, design clients and end-users. Communicating embodied carbon information graphically and concisely can aid with decision support early in a building's life cycle. It is essential to create a common visualisation approach as the level of knowledge about embodied carbon varies between stakeholders. The tool, designed in conjunction with Bates Smart, condenses Tally Life Cycle Assessment data to a carbon hot-spotting visualisation, highlighting the sections with the highest amounts of embodied carbon. This allows stakeholders at every stage of a given project to have a better understanding of the carbon implications with minimal effort. It further allows stakeholders to differentiate building elements by their carbon values, which enables the evaluation of the cost-effectiveness of the selected materials at an early stage. To examine and build a decision-support tool, an action-design research methodology of cycles of iterations was used along with precedents of embodied carbon visualising tools. Accordingly, the importance of visualisation and Building Information Modelling are also explored to understand the best format for relaying these results.

Keywords: embodied carbon, visualisation, summarisation, data filtering, early-stage decision-making, materiality

Procedia PDF Downloads 70
13277 High-Rises and Urban Design: The Reasons for Unsuccessful Placemaking with Residential High-Rises in England

Authors: E. Kalcheva, A. Taki, Y. Hadi

Abstract:

High-rises and placemaking is an understudied combination which receives more and more interest with the proliferation of this typology in many British cities. The reason for studying three major cities in England: London, Birmingham and Manchester, is to learn from the latest advances in urban design in well-developed and prominent urban environment. The analysis of several high-rise sites reveals the weaknesses in urban design of contemporary British cities and presents an opportunity to study from the implemented examples. Therefore, the purpose of this research is to analyze design approaches towards creating a sustainable and varied urban environment when high-rises are involved. The research questions raised by the study are: what is the quality of high-rises and their surroundings; what facilities and features are deployed in the research area; what is the role of the high-rise buildings in the placemaking process; what urban design principles are applicable in this context. The methodology utilizes observation of the researched area by structured questions, developed by the author to evaluate the outdoor qualities of the high-rise surroundings. In this context, the paper argues that the quality of the public realm around the high-rises is quite low, missing basic but vital elements such as plazas, public art, and seating, along with landscaping and pocket parks. There is lack of coherence, the rhythm of the streets is often disrupted, and even though the high-rises are very aesthetically appealing, they fail to create a sense of place on their own. The implications of the study are that future planning can take into consideration the critique in this article and provide more opportunities for urban design interventions around high-rise buildings in the British cities.

Keywords: high-rises, placemaking, urban design, townscape

Procedia PDF Downloads 312
13276 A Preliminary Research on Constituted Rules of Settlement Housing Alterations of Chinese New Village in Malaysia: A Study of Ampang New Village, Selangor

Authors: Song Hung Chi, Lee Chun Benn

Abstract:

Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

Procedia PDF Downloads 309
13275 Individualism/Collectivism and Extended Theory of Planned Behavior

Authors: Ela Ari, Aysi̇ma Findikoglu

Abstract:

Consumers’ switching GSM operators’ has been an important research issue since the rise of their competitive offers. Recent research has looked at consumer switching behavior through the theory of planned behavior, but not yet extended the theory with identity, psycho-social and cultural influences within the service context. This research explores an extended version of the theory of planned behavior including social and financial risks and brand loyalty. Moreover, the role of individualism and collectivism at the individual level is investigated in a collectivistic culture that moves toward to individualism due to changing family relationships, use of technology and education. Our preliminary analysis showed that financial risk and vertical individualism prove to be a significant determinant of intention to switch. The study also investigates social risk and intention, subjective norm, perceived behavioral control relationship. The effect of individualism and collectivism and attitudes relationship has been also examined within a service industry. Implications for marketing managers and scholars are also discussed.

Keywords: attitude, individualism, intention, subjective norm

Procedia PDF Downloads 438
13274 Tolerance of Some Warm Season Turfgrasses to Compaction under Shade and Sunlight Conditions of Riyadh, Saudi Arabia

Authors: Mohammed A. Al-Yafrsi, Fahed A. Al-Mana

Abstract:

A study was conducted to evaluate the compaction-tolerance ability of some warm season turfgrasses under shade and sunlight conditions in Riyadh, Saudi Arabia. Hybrid bermudagrass (Cynodon dactylon): 'Tifway' and 'Tifsport', seashore paspalum (Paspalum vaginatum) and its cultivar 'Sea Isle 2000' were used. The study area was divided into two sections where one was exposed to sunlight and the other one was maintained under shade using green plastic grille (shade 70%). Turfgrasses were planted by sods in beds containing a mixture of sand, silt, and peat moss (4: 1: 1, v/v). The soil compaction was applied using a locally-made cylindrical roll (weighing 250 kg), passing four times over the growing turfgrasses for 3 days/week. The results revealed that compaction treatment led to a decrease in grass height, and it was the lowest (4.0 cm) for paspalum 'Sea Isle 2000' in February. At the shaded area, paspalum turfgrasses retained its high quality degree (4.0) in April, May, and June. In the sunlight area, the grass quality degree was the greatest (4.0) in 'Sea Isle 2000' and the lowest (3.0) in 'Tifsport'. Paspalum turfgrasses gave higher color degree (4) than bermuda grasses (2.5) in April, May, and June. The compaction also led to a decline in leaf area, fresh and dry weights of all grown turfgrasses. The grass density was high for paspalum turfgrasses indicating that their resistance to compaction was greater than bermudagrasses. It can be concluded that the best compaction and shade tolerant turfgrasses are 'Sea Isle 2000' and seashore paspalum.

Keywords: hybrid bermudagrass, seashore paspalum, soil compaction, shade area, sunlight condition

Procedia PDF Downloads 108
13273 Simulation and Experimental Study on Dual Dense Medium Fluidization Features of Air Dense Medium Fluidized Bed

Authors: Cheng Sheng, Yuemin Zhao, Chenlong Duan

Abstract:

Air dense medium fluidized bed is a typical application of fluidization techniques for coal particle separation in arid areas, where it is costly to implement wet coal preparation technologies. In the last three decades, air dense medium fluidized bed, as an efficient dry coal separation technique, has been studied in many aspects, including energy and mass transfer, hydrodynamics, bubbling behaviors, etc. Despite numerous researches have been published, the fluidization features, especially dual dense medium fluidization features have been rarely reported. In dual dense medium fluidized beds, different combinations of different dense mediums play a significant role in fluidization quality variation, thus influencing coal separation efficiency. Moreover, to what extent different dense mediums mix and to what extent the two-component particulate mixture affects the fluidization performance and quality have been in suspense. The proposed work attempts to reveal underlying mechanisms of generation and evolution of two-component particulate mixture in the fluidization process. Based on computational fluid dynamics methods and discrete particle modelling, movement and evolution of dual dense mediums in air dense medium fluidized bed have been simulated. Dual dense medium fluidization experiments have been conducted. Electrical capacitance tomography was employed to investigate the distribution of two-component mixture in experiments. Underlying mechanisms involving two-component particulate fluidization are projected to be demonstrated with the analysis and comparison of simulation and experimental results.

Keywords: air dense medium fluidized bed, particle separation, computational fluid dynamics, discrete particle modelling

Procedia PDF Downloads 368
13272 The Concept of Universal Design in the Independent City Life of Disabled Individuals

Authors: Berfu Guley Goren, Ayse Lale Berkoz

Abstract:

The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

Procedia PDF Downloads 287
13271 Active Packaging Films Based on Chitosan Incorporated with Thyme Essential Oil and Cross Linkers and Its Effect on the Quality Shelf Life of Food

Authors: Aiman Zehra, Sajad Mohd Wani

Abstract:

Packaging has a vital role as it contains and protects the food that moves from the supply chain to the consumer. Chitosan (CH) has been extensively used in food packaging applications among the plentiful natural macromolecules, including all the polysaccharide class, owing to its easy film-forming capacity, biodegradability, better oxygen and water vapour barrier ability and good mechanical strength. Compared to synthetic films, the films produced from chitosan present poor barrier and mechanical properties. To overcome its deficient qualities, a number of modification procedures are required to enhance the mechanical and physical properties. Various additives such as plasticizers (e.g., glycerol and sorbitol), crosslinkers (e.g.,CaCl₂, ZnO), fillers (nanoclay), and antimicrobial agents (e.g. thyme essential oil) have been used to improve the mechanical, thermal, morphological, antimicrobial properties and emulsifying agents for the stability and elasticity of chitosan-based biodegradable films. Different novel biocomposite films based on chitosan incorporated with thyme essential oil and different additives (ZnO, CaCl₂, NC, and PEG) were successfully prepared and used as packaging material for carrot candy. The chitosan film incorporated with crosslinkers was capable of forming a protective barrier on the surface of the candy to maintain moisture content, water activity, TSS, total sugars, and titratable acidity. ZnO +PEG +NC +CaCl₂ remarkably promotes a synergistic effect on the barrier properties of the film. The combined use of ZnO +PEG +NC +CaCl₂ in CH-TO films was more effective in preventing the moisture gain in candies. The lowest a𝓌 (0.624) was also observed for the candies stored in treatment. The color values L*, a*, b* of the candies were also retained in the film containing all the additives during the 6th month of storage. The value for L*, a*, and b* observed for T was 42.72, 9.89, and 10.84, respectively. The candies packaged in film retained TSS and acidity. The packaging film significantly p≤0.05 conserved sensory qualities and inhibited microbial activity during storage. Carrot candy was found microbiologically safe for human consumption even after six months of storage in all the packaging materials.

Keywords: chitosan, biodegradable films, antimicrobial activity, thyme essential oil, crosslinkers

Procedia PDF Downloads 83
13270 Production of Functional Crackers Enriched with Olive (Olea europaea L.) Leaf Extract

Authors: Rosa Palmeri, Julieta I. Monteleone, Antonio C. Barbera, Carmelo Maucieri, Aldo Todaro, Virgilio Giannone, Giovanni Spagna

Abstract:

In recent years, considerable interest has been shown in the functional properties of foods, and a relevant role has been played by phenolic compounds, able to scavenge free radicals. A more sustainable agriculture has to emerge to guarantee food supply over the next years. Wheat, corn, and rice are the most common cereals cultivated, but also other cereal species, such as barley can be appreciated for their peculiarities. Barley (Hordeum vulgare L.) is a C3 winter cereal that shows high resistance at drought and salt stresses. There are growing interests in barley as ingredient for the production of functional foods due to its high content of phenolic compounds and Beta-glucans. In this respect, the possibility of separating specific functional fractions from food industry by-products looks very promising. Olive leaves represent a quantitatively significant by-product of olive grove farming, and are an interesting source of phenolic compounds. In particular, oleuropein, which provide important nutritional benefits, is the main phenolic compound in olive leaves and ranges from 17% to 23% depending upon the cultivar and growing season period. Together with oleuropein and its derivatives (e.g. dimethyloleuropein, oleuropein diglucoside), olive leaves further contain tyrosol, hydroxytyrosol, and a series of secondary metabolities structurally related to them: verbascoside, ligstroside, hydroxytyrosol glucoside, tyrosol glucoside, oleuroside, oleoside-11-methyl ester, and nuzhenide. Several flavonoids, flavonoid glycosides, and phenolic acids have also described in olive leaves. The aim of this work was the production of functional food with higher content of polyphenols and the evaluation of their shelf life. Organic durum wheat and barley grains contain higher levels of phenolic compounds were used for the production of crackers. Olive leaf extract (OLE) was obtained from cv. ‘Biancolilla’ by aqueous extraction method. Two baked goods trials were performed with both organic durum wheat and barley flours, adding olive leaf extract. Control crackers, made as comparison, were produced with the same formulation replacing OLE with water. Total phenolic compound, moisture content, activity water, and textural properties at different time of storage were determined to evaluate the shelf-life of the products. Our the preliminary results showed that the enriched crackers showed higher phenolic content and antioxidant activity than control. Alternative uses of olive leaf extracts for crackers production could represent a good candidate for the addition of functional ingredients because bakery items are daily consumed, and have long shelf-life.

Keywords: barley, functional foods, olive leaf, polyphenols, shelf life

Procedia PDF Downloads 289
13269 Opinions of Pre-Service Teachers on Online Language Teaching: COVID-19 Pandemic Perspective

Authors: Neha J. Nandaniya

Abstract:

In the present research paper researcher put focuses on the opinions of pre-service teachers have been taken regarding online language teaching, which was held during the COVID-19 pandemic and is still going on. The researcher developed a three-point rating scale in Google Forms to find out the views of trainees on online language learning, in which 167 B. Ed. trainees having language content and method gave their responses. After scoring the responses obtained by the investigator, the chi-square value was calculated, and the findings were concluded. The major finding of the study is language learning is not as effective as offline teaching mode.

Keywords: online language teaching, ICT competency, B. Ed. trainees, COVID-19 pandemic

Procedia PDF Downloads 70
13268 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

Procedia PDF Downloads 98