Search results for: Chang Dong Sheng
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 949

Search results for: Chang Dong Sheng

139 The Effect of Post-Acute Stroke Inpatient Rehabilitation under per Diem Payment: A Pilot Study

Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

Abstract:

Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

Procedia PDF Downloads 309
138 Efficient Residual Road Condition Segmentation Network Based on Reconstructed Images

Authors: Xiang Shijie, Zhou Dong, Tian Dan

Abstract:

This paper focuses on the application of real-time semantic segmentation technology in complex road condition recognition, aiming to address the critical issue of how to improve segmentation accuracy while ensuring real-time performance. Semantic segmentation technology has broad application prospects in fields such as autonomous vehicle navigation and remote sensing image recognition. However, current real-time semantic segmentation networks face significant technical challenges and optimization gaps in balancing speed and accuracy. To tackle this problem, this paper conducts an in-depth study and proposes an innovative Guided Image Reconstruction Module. By resampling high-resolution images into a set of low-resolution images, this module effectively reduces computational complexity, allowing the network to more efficiently extract features within limited resources, thereby improving the performance of real-time segmentation tasks. In addition, a dual-branch network structure is designed in this paper to fully leverage the advantages of different feature layers. A novel Hybrid Attention Mechanism is also introduced, which can dynamically capture multi-scale contextual information and effectively enhance the focus on important features, thus improving the segmentation accuracy of the network in complex road condition. Compared with traditional methods, the proposed model achieves a better balance between accuracy and real-time performance and demonstrates competitive results in road condition segmentation tasks, showcasing its superiority. Experimental results show that this method not only significantly improves segmentation accuracy while maintaining real-time performance, but also remains stable across diverse and complex road conditions, making it highly applicable in practical scenarios. By incorporating the Guided Image Reconstruction Module, dual-branch structure, and Hybrid Attention Mechanism, this paper presents a novel approach to real-time semantic segmentation tasks, which is expected to further advance the development of this field.

Keywords: hybrid attention mechanism, image reconstruction, real-time, road status recognition

Procedia PDF Downloads 16
137 Initiation of Paraptosis-Like PCD Pathway in Hepatocellular Carcinoma Cell Line by Hep88 mAb through the Binding of Mortalin (HSPA9) and Alpha-Enolase

Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

Abstract:

Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

Procedia PDF Downloads 356
136 Factors Influencing Milk Yield, Quality, and Revenue of Dairy Farms in Southern Vietnam

Authors: Ngoc-Hieu Vu

Abstract:

Dairy production in Vietnam is a relatively new agricultural activity and milk production increased remarkably in recent years. Smallholders are still the main drivers for this development, especially in the southern part of the country. However, information on the farming practices is very limited. Therefore, this study aimed to determine factors influencing milk yield and quality (milk fat, total solids, solids-not-fat, total number of bacteria, and somatic cell count) and revenue of dairy farms in Southern Vietnam. The collection of data was at the farm level; individual animal records were unavailable. The 539 studied farms were located in the provinces Lam Dong (N=111 farms), Binh Duong (N=69 farms), Long An (N=174 farms), and Ho Chi Minh city (N=185 farms). The dataset included 9221 monthly test-day records of the farms from January 2013 to May 2015. Seasons were defined as rainy and dry. Farms sizes were classified as small (< 10 milking cows), medium (10 to 19 milking cows) and large (≥ 20 milking cows). The model for each trait contained year-season and farm region-farm size as subclass fixed effects, and individual farm and residual as random effects. Results showed that year-season, region, and farm size were determining sources of variation affecting all studied traits. Milk yield was higher in dry than in rainy seasons (P < 0.05), while it tended to increase from years 2013 to 2015. Large farms had higher yields (445.6 kg/cow) than small (396.7 kg/cow) and medium (428.0 kg/cow) farms (P < 0.05). Small farms, in contrast, were superior to large farms in terms of milk fat, total solids, solids-not-fat, total number of bacteria, and somatic cell count than large farms (P < 0.05). Revenue per cow was higher in large compared with medium and small farms. In conclusion, large farms achieved higher milk yields and revenues per cow, while small farms were superior in milk quality. Overall, milk yields were low and better training, financial support and marketing opportunities for farmers are needed to improve dairy production and increase farm revenues in Southern Vietnam.

Keywords: farm size, milk yield and quality, season, Southern Vietnam

Procedia PDF Downloads 356
135 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

Procedia PDF Downloads 130
134 Instant Data-Driven Robotics Fabrication of Light-Transmitting Ceramics: A Responsive Computational Modeling Workflow

Authors: Shunyi Yang, Jingjing Yan, Siyu Dong, Xiangguo Cui

Abstract:

Current architectural façade design practices incorporate various daylighting and solar radiation analysis methods. These emphasize the impact of geometry on façade design. There is scope to extend this knowledge into methods that address material translucency, porosity, and form. Such approaches can also achieve these conditions through adaptive robotic manufacturing approaches that exploit material dynamics within the design, and alleviate fabrication waste from molds, ultimately accelerating the autonomous manufacturing system. Besides analyzing the environmental solar radiant in building facade design, there is also a vacancy research area of how lighting effects can be precisely controlled by engaging the instant real-time data-driven robot control and manipulating the material properties. Ceramics carries a wide range of transmittance and deformation potentials for robotics control with the research of its material property. This paper presents one semi-autonomous system that engages with real-time data-driven robotics control, hardware kit design, environmental building studies, human interaction, and exploratory research and experiments. Our objectives are to investigate the relationship between different clay bodies or ceramics’ physio-material properties and their transmittance; to explore the feedback system of instant lighting data in robotic fabrication to achieve precise lighting effect; to design the sufficient end effector and robot behaviors for different stages of deformation. We experiment with architectural clay, as the material of the façade that is potentially translucent at a certain stage can respond to light. Studying the relationship between form, material properties, and porosity can help create different interior and exterior light effects and provide façade solutions for specific architectural functions. The key idea is to maximize the utilization of in-progress robotics fabrication and ceramics materiality to create a highly integrated autonomous system for lighting facade design and manufacture.

Keywords: light transmittance, data-driven fabrication, computational design, computer vision, gamification for manufacturing

Procedia PDF Downloads 114
133 Improvement of the Geometric of Dental Bridge Framework through Automatic Program

Authors: Rong-Yang Lai, Jia-Yu Wu, Chih-Han Chang, Yung-Chung Chen

Abstract:

The dental bridge is one of the clinical methods of the treatment for missing teeth. The dental bridge is generally designed for two layers, containing the inner layer of the framework(zirconia) and the outer layer of the porcelain-fused to framework restorations. The design of a conventional bridge is generally based on the antagonist tooth profile so that the framework evenly indented by an equal thickness from outer contour. All-ceramic dental bridge made of zirconia have well demonstrated remarkable potential to withstand a higher physiological occlusal load in posterior region, but it was found that there is still the risk of all-ceramic bridge failure in five years. Thus, how to reduce the incidence of failure is still a problem to be solved. Therefore, the objective of this study is to develop mechanical designs for all-ceramic dental bridges framework by reducing the stress and enhancing fracture resistance under given loading conditions by finite element method. In this study, dental design software is used to design dental bridge based on tooth CT images. After building model, Bi-directional Evolutionary Structural Optimization (BESO) Method algorithm implemented in finite element software was employed to analyze results of finite element software and determine the distribution of the materials in dental bridge; BESO searches the optimum distribution of two different materials, namely porcelain and zirconia. According to the previous calculation of the stress value of each element, when the element stress value is higher than the threshold value, the element would be replaced by the framework material; besides, the difference of maximum stress peak value is less than 0.1%, calculation is complete. After completing the design of dental bridge, the stress distribution of the whole structure is changed. BESO reduces the peak values of principle stress of 10% in outer-layer porcelain and avoids producing tensile stress failure.

Keywords: dental bridge, finite element analysis, framework, automatic program

Procedia PDF Downloads 279
132 Satisfaction of Distance Education University Students with the Use of Audio Media as a Medium of Instruction: The Case of Mountains of the Moon University in Uganda

Authors: Mark Kaahwa, Chang Zhu, Moses Muhumuza

Abstract:

This study investigates the satisfaction of distance education university students (DEUS) with the use of audio media as a medium of instruction. Studying students’ satisfaction is vital because it shows whether learners are comfortable with a certain instructional strategy or not. Although previous studies have investigated the use of audio media, the satisfaction of students with an instructional strategy that combines radio teaching and podcasts as an independent teaching strategy has not been fully investigated. In this study, all lectures were delivered through the radio and students had no direct contact with their instructors. No modules or any other material in form of text were given to the students. They instead, revised the taught content by listening to podcasts saved on their mobile electronic gadgets. Prior to data collection, DEUS received orientation through workshops on how to use audio media in distance education. To achieve objectives of the study, a survey, naturalistic observations and face-to-face interviews were used to collect data from a sample of 211 undergraduate and graduate students. Findings indicate that there was no statistically significant difference in the levels of satisfaction between male and female students. The results from post hoc analysis show that there is a statistically significant difference in the levels of satisfaction regarding the use of audio media between diploma and graduate students. Diploma students are more satisfied compared to their graduate counterparts. T-test results reveal that there was no statistically significant difference in the general satisfaction with audio media between rural and urban-based students. And ANOVA results indicate that there is no statistically significant difference in the levels of satisfaction with the use of audio media across age groups. Furthermore, results from observations and interviews reveal that DEUS found learning using audio media a pleasurable medium of instruction. This is an indication that audio media can be considered as an instructional strategy on its own merit.

Keywords: audio media, distance education, distance education university students, medium of instruction, satisfaction

Procedia PDF Downloads 113
131 Resistances among Sexual Offenders on Specific Stage of Change

Authors: Chang Li Yu

Abstract:

Resistances commonly happened during sexual offenders treatment program (SOTP), and removing resistances was one of the treatment goals on it. Studies concerning treatment effectiveness relied on pre- and post-treatment evaluations, however, no significant difference on resistance revealed after treatment, and the above consequences generally contributed to the low motivation for change instead. Therefore, the aim of this study was to investigate the resistance across each stage of change among sexual offenders (SO). The present study recruited prisoned SO in Taiwan, excluding those with literacy difficulties; finally, 272 participants were included. Of all participants completed revised version of URICA (University of Rhode Island Change Assessment) and resistance scale specifically for SO. The former included four stages of change: pre-contemplation (PC), contemplation (C), action (A), and maintain (M); the later composed eight types of resistance: system blaming, victims blaming, problems with treatment alliance, social justification, hopelessness, isolation, psychological reactance, and passive reactance. Both of the instruments were with well reliability and validity. Descriptive statistics and ANOVA were performed. All of 272 participants, age under 25 were 18(6.6%), 25-39 were 133(48.9%), 40-54 were 102(37.5%), and age over 55 were 19(7.0%); college level and above were 53(19.5%), high school level were 110(40.4%), and under high school level were 109(40.1%); first offended were 117(43.0%), and recidivist were 23(8.5%). Further deleting data with missing values and invalid questionnaires, SO with stage of change on PC were 43(18.9%), C were 109(47.8%), A were 70(30.7%), and on M were 6(2.6%). One-way ANOVA showed significant differences on every kind of resistances, excepting isolation and passive reactance. Post-hoc analysis showed that SO with different stages had their main resistance. There are two contributions to the present study. First, this study provided a clinical and theoretical measurement of evaluation that was never used in the past. Second, this study used an evidence-based methodology to prove a clinical perspective differed from the past, suggesting that resistances to treatment on SO appear the whole therapeutic process, when SO progress into the next stage of change, clinicians have to deal with their main resistance for working through the therapy.

Keywords: resistance, sexual offenders treatment program (SOTP), motivation for change, prisoned sexual offender

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130 The Effectiveness of Using Dramatic Conventions as the Teaching Strategy on Self-Efficacy for Children With Autism Spectrum Disorder

Authors: Tso Sheng-Yang, Wang Tien-Ni

Abstract:

Introduction and Purpose: Previous researchers have documented children with ASD (Autism Spectrum Disorders) prefer to escaping internal privates and external privates when they face tough conditions they can’t control or they don’t like.Especially, when children with ASD need to learn challenging tasks, such us Chinese language, their inappropriate behaviors will occur apparently. Recently, researchers apply positive behavior support strategies for children with ASD to enhance their self-efficacy and therefore to reduce their adverse behaviors. Thus, the purpose of this research was to design a series of lecture based on art therapy and to evaluate its effectiveness on the child’s self-efficacy. Method: This research was the single-case design study that recruited a high school boy with ASD. Whole research can be separated into three conditions. First, baseline condition, before the class started and ended, the researcher collected participant’s competencies of self-efficacy every session. In intervention condition, the research used dramatic conventions to teach the child in Chinese language twice a week.When the data was stable across three documents, the period entered to the maintenance condition. In maintenance condition, the researcher only collected the score of self-efficacynot to do other interventions five times a month to represent the effectiveness of maintenance.The time and frequency of data collection among three conditions are identical. Concerning art therapy, the common approach, e.g., music, drama, or painting is to use art medium as independent variable. Due to visual cues of art medium, the ASD can be easily to gain joint attention with teachers. Besides, the ASD have difficulties in understanding abstract objectives Thus, using the drama convention is helpful for the ASD to construct the environment and understand the context of Classical Chinese. By real operation, it can improve the ASD to understand the context and construct prior knowledge. Result: Bassd on the 10-points Likert scale and research, we product following results. (a) In baseline condition, the average score of self-efficacyis 1.12 points, rangedfrom 1 to 2 points, and the level change is 0 point. (b)In intervention condition, the average score of self-efficacy is 7.66 points rangedfrom 7 to 9 points, and the level change is 1 point. (c)In maintenance condition, the average score of self-efficacy is 6.66 points rangedfrom 6 to 7 points, and the level change is 1 point. Concerning immediacy of change, between baseline and intervention conditions, the difference is 5 points. No overlaps were found between these two conditions. Conclusion: According to the result, we find that it is effective that using dramatic conventions a s teaching strategies to teach children with ASD. The result presents the score of self-efficacyimmediately enhances when the dramatic conventions commences. Thus, we suggest the teacher can use this approach and adjust, based on the student’s trait, to teach the ASD on difficult task.

Keywords: dramatic conventions, autism spectrum disorder, slef-efficacy, teaching strategy

Procedia PDF Downloads 82
129 Comparison of Cardiovascular and Metabolic Responses Following In-Water and On-Land Jump in Postmenopausal Women

Authors: Kuei-Yu Chien, Nai-Wen Kan, Wan-Chun Wu, Guo-Dong Ma, Shu-Chen Chen

Abstract:

Purpose: The purpose of this study was to investigate the responses of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), rating of perceived exertion (RPE) and lactate following continued high-intensity interval exercise in water and on land. The results of studies can be an exercise program design reference for health care and fitness professionals. Method: A total of 20 volunteer postmenopausal women was included in this study. The inclusion criteria were: duration of menopause > 1 year; and sedentary lifestyle, defined as engaging in moderate-intensity exercise less than three times per week, or less than 20 minutes per day. Participants need to visit experimental place three times. The first time visiting, body composition was performed and participant filled out the questionnaire. Participants were assigned randomly to the exercise environment (water or land) in second and third time visiting. Water exercise testing was under water of trochanter level. In continuing jump testing, each movement consisted 10-second maximum volunteer jump for two sets. 50% heart rate reserve dynamic resting (walking or running) for one minute was within each set. SBP, DBP, HR, RPE of whole body/thigh (RPEW/RPET) and lactate were performed at pre and post testing. HR, RPEW, and RPET were monitored after 1, 2, and 10 min of exercise testing. SBP and DBP were performed after 10 and 30 min of exercise testing. Results: The responses of SBP and DBP after exercise testing in water were higher than those on land. Lactate levels after exercise testing in water were lower than those on land. The responses of RPET were lower than those on land post exercise 1 and 2 minutes. The heart rate recovery in water was faster than those on land at post exercise 5 minutes. Conclusion: This study showed water interval jump exercise induces higher cardiovascular responses with lower RPE responses and lactate levels than on-land jumps exercise in postmenopausal women. Fatigue is one of the major reasons to obstruct exercise behavior. Jump exercise could enhance cardiorespiratory fitness, the lower-extremity power, strength, and bone mass. There are several health benefits to the middle to older adults. This study showed that water interval jumping could be more relaxed and not tried to reach the same land-based cardiorespiratory exercise intensity.

Keywords: interval exercise, power, recovery, fatigue

Procedia PDF Downloads 406
128 Legal Judgment Prediction through Indictments via Data Visualization in Chinese

Authors: Kuo-Chun Chien, Chia-Hui Chang, Ren-Der Sun

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Legal Judgment Prediction (LJP) is a subtask for legal AI. Its main purpose is to use the facts of a case to predict the judgment result. In Taiwan's criminal procedure, when prosecutors complete the investigation of the case, they will decide whether to prosecute the suspect and which article of criminal law should be used based on the facts and evidence of the case. In this study, we collected 305,240 indictments from the public inquiry system of the procuratorate of the Ministry of Justice, which included 169 charges and 317 articles from 21 laws. We take the crime facts in the indictments as the main input to jointly learn the prediction model for law source, article, and charge simultaneously based on the pre-trained Bert model. For single article cases where the frequency of the charge and article are greater than 50, the prediction performance of law sources, articles, and charges reach 97.66, 92.22, and 60.52 macro-f1, respectively. To understand the big performance gap between articles and charges, we used a bipartite graph to visualize the relationship between the articles and charges, and found that the reason for the poor prediction performance was actually due to the wording precision. Some charges use the simplest words, while others may include the perpetrator or the result to make the charges more specific. For example, Article 284 of the Criminal Law may be indicted as “negligent injury”, "negligent death”, "business injury", "driving business injury", or "non-driving business injury". As another example, Article 10 of the Drug Hazard Control Regulations can be charged as “Drug Control Regulations” or “Drug Hazard Control Regulations”. In order to solve the above problems and more accurately predict the article and charge, we plan to include the article content or charge names in the input, and use the sentence-pair classification method for question-answer problems in the BERT model to improve the performance. We will also consider a sequence-to-sequence approach to charge prediction.

Keywords: legal judgment prediction, deep learning, natural language processing, BERT, data visualization

Procedia PDF Downloads 118
127 Ambulatory Care Utilization of Individuals with Cerebral Palsy in Taiwan- A Country with Universal Coverage and No Gatekeeper Regulation

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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126 Benefits of Whole-Body Vibration Training on Lower-Extremity Muscle Strength and Balance Control in Middle-Aged and Older Adults

Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Jenn-Woei Hsieh, Ching-Yu Tseng

Abstract:

This study aimed to determine the effects of whole-body vibration (WBV) training on lower-extremity muscle strength and balance control performance among community-dwelling middle-aged and older adults in the United States. Twenty-nine participants without any contraindication of performing WBV exercise completed all the study procedures. Participants were randomly assigned to do body weight exercise with either an individualized vibration frequency and amplitude, a fixed vibration frequency and amplitude, or no vibration. Isokinetic knee extensor power, limits of stability, and sit-to-stand tests were performed at the baseline and after 8 weeks of training. Neither the individualized frequency-amplitude WBV training protocol nor the fixed frequency-amplitude WBV training protocol improved isokinetic knee extensor power. The limits of stability endpoint excursion score for the individualized frequency-amplitude group increased by 8.8 (12.9%; p = 0.025) after training. No significant differences were observed in fixed and control group. The maximum excursion score for the individualized frequency-amplitude group at baseline increased by 9.2 (11.5%; p = 0.006) after training. The average weight transfer time score significantly decreased by 0.21 s in the fixed group. The participants in the individualized group showed a significant increase (3.2%) in weight rising index score after 8 weeks of WBV training. These results suggest that 8 weeks of WBV training improved limit of stability and sit-to-stand performance. Future studies need to determine whether WBV training improves other factors that can influence posture control.

Keywords: whole-body vibration training, muscle strength, balance control, middle-aged and older adults

Procedia PDF Downloads 222
125 A Digital Twin Approach to Support Real-time Situational Awareness and Intelligent Cyber-physical Control in Energy Smart Buildings

Authors: Haowen Xu, Xiaobing Liu, Jin Dong, Jianming Lian

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Emerging smart buildings often employ cyberinfrastructure, cyber-physical systems, and Internet of Things (IoT) technologies to increase the automation and responsiveness of building operations for better energy efficiency and lower carbon emission. These operations include the control of Heating, Ventilation, and Air Conditioning (HVAC) and lighting systems, which are often considered a major source of energy consumption in both commercial and residential buildings. Developing energy-saving control models for optimizing HVAC operations usually requires the collection of high-quality instrumental data from iterations of in-situ building experiments, which can be time-consuming and labor-intensive. This abstract describes a digital twin approach to automate building energy experiments for optimizing HVAC operations through the design and development of an adaptive web-based platform. The platform is created to enable (a) automated data acquisition from a variety of IoT-connected HVAC instruments, (b) real-time situational awareness through domain-based visualizations, (c) adaption of HVAC optimization algorithms based on experimental data, (d) sharing of experimental data and model predictive controls through web services, and (e) cyber-physical control of individual instruments in the HVAC system using outputs from different optimization algorithms. Through the digital twin approach, we aim to replicate a real-world building and its HVAC systems in an online computing environment to automate the development of building-specific model predictive controls and collaborative experiments in buildings located in different climate zones in the United States. We present two case studies to demonstrate our platform’s capability for real-time situational awareness and cyber-physical control of the HVAC in the flexible research platforms within the Oak Ridge National Laboratory (ORNL) main campus. Our platform is developed using adaptive and flexible architecture design, rendering the platform generalizable and extendable to support HVAC optimization experiments in different types of buildings across the nation.

Keywords: energy-saving buildings, digital twins, HVAC, cyber-physical system, BIM

Procedia PDF Downloads 102
124 Prenatal Exposure to Organophosphate Pesticide and Fetal Growth

Authors: Yi-Shuan ShaoShao, Yen-An Tsai, Chia-Huang Chang, Kai-Wei Liao, Ming-Song Tsai, Mei-Lien Chen

Abstract:

Organophosphate pesticides (OPs) is an environmental hormone with proven endocrine-disrupting effects that may affect the growth and development in human. A large amount of organophosphate pesticides (OPs) is used throughout Taiwan, and human may be exposed through dietary intake or residential use. During pregnancy, OPs can be transferred to the blood stream reaching the fetus through the placenta. The aim of this study was to explore the association between maternal OPs exposure levels and fetal developments and birth outcomes. A birth cohort was follow-up. Maternal urine sample were collected at the first, second, and third gestational trimester. Fetal growth characteristics were measured by ultrasonic scan and birth outcomes were assessed by pediatrician. Urinary metabolite of organophosphate pesticides were assessed using gas chromatography-mass spectrometry. The analytes included dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphates (DMDTP), diethylphosphate (DEP), diethylthiophosphate (DETP), and diethyldithiophosphate (DEDTP). We found that all of urine samples in each trimester were detected at least one metabolite for dialkyl phosphate (DAP). The detection rate range of OP urinary metabolites were from the lowest 22% DEDTP to the highest 100% DMP and DMTP. And to compared geometric means (GM) of urinary metabolites with three trimesters, that third trimester had the highest concentration for DMPs, DEPs, and DAPs in pregnant women were 368.01, 169.85 and 543.75 nmol/g creatinine, respectively. We observed that DAPs concentration in first and second trimester were significantly negative association with head circumference. DMPs in first trimester was significantly negative association with thoracic circumference (p=0.05) by spearman correlation. Our results support associations with prenatal OPs exposure with fetal head circumference and thoracic circumference. It provided that maternal OPs exposure might affect birth outcomes. Thus, prenatal exposure to OPs and health risk worthy of attention and concern.

Keywords: DAPs, birth outcomes, organophosphate pesticides, prenatal

Procedia PDF Downloads 338
123 Application of Zeolite Nanoparticles in Biomedical Optics

Authors: Vladimir Hovhannisyan, Chen Yuan Dong

Abstract:

Recently nanoparticles (NPs) have been introduced in biomedicine as effective agents for cancer-targeted drug delivery and noninvasive tissue imaging. The most important requirements to these agents are their non-toxicity, biocompatibility and stability. In view of these criteria, the zeolite (ZL) nanoparticles (NPs) may be considered as perfect candidates for biomedical applications. ZLs are crystalline aluminosilicates consisting of oxygen-sharing SiO4 and AlO4 tetrahedral groups united by common vertices in three-dimensional framework and containing pores with diameters from 0.3 to 1.2 nm. Generally, the behavior and physical properties of ZLs are studied by SEM, X-ray spectroscopy, and AFM, whereas optical spectroscopic and microscopic approaches are not effective enough, because of strong scattering in common ZL bulk materials and powders. The light scattering can be reduced by using of ZL NPs. ZL NPs have large external surface area, high dispersibility in both aqueous and organic solutions, high photo- and thermal stability, and exceptional ability to adsorb various molecules and atoms in their nanopores. In this report, using multiphoton microscopy and nonlinear spectroscopy, we investigate nonlinear optical properties of clinoptilolite type of ZL micro- and nanoparticles with average diameters of 2200 nm and 240 nm, correspondingly. Multiphoton imaging is achieved using a laser scanning microscope system (LSM 510 META, Zeiss, Germany) coupled to a femtosecond titanium:sapphire laser (repetition rate- 80 MHz, pulse duration-120 fs, radiation wavelength- 720-820 nm) (Tsunami, Spectra-Physics, CA). Two Zeiss, Plan-Neofluar objectives (air immersion 20×∕NA 0.5 and water immersion 40×∕NA 1.2) are used for imaging. For the detection of the nonlinear response, we use two detection channels with 380-400 nm and 435-700 nm spectral bandwidths. We demonstrate that ZL micro- and nanoparticles can produce nonlinear optical response under the near-infrared femtosecond laser excitation. The interaction of hypericine, chlorin e6 and other dyes with ZL NPs and their photodynamic activity is investigated. Particularly, multiphoton imaging shows that individual ZL NPs particles adsorb Zn-tetraporphyrin molecules, but do not adsorb fluorescein molecules. In addition, nonlinear spectral properties of ZL NPs in native biotissues are studied. Nonlinear microscopy and spectroscopy may open new perspectives in the research and application of ZL NP in biomedicine, and the results may help to introduce novel approaches into the clinical environment.

Keywords: multiphoton microscopy, nanoparticles, nonlinear optics, zeolite

Procedia PDF Downloads 409
122 Comparative Study of sLASER and PRESS Techniques in Magnetic Resonance Spectroscopy of Normal Brain

Authors: Shin Ku Kim, Yun Ah Oh, Eun Hee Seo, Chang Min Dae, Yun Jung Bae

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Objectives: The commonly used PRESS technique in magnetic resonance spectroscopy (MRS) has a limitation of incomplete water suppression. The recently developed sLASER technique is known for its improved effectiveness in suppressing water signal. However, no prior study has compared both sequences in a normal human brain. In this study, we firstly aimed to compare the performances of both techniques in brain MRS. Materials and methods: From January 2023 to July 2023, thirty healthy participants (mean age 38 years, 17 male, 13 female) without underlying neurological diseases were enrolled in this study. All participants underwent single-voxel MRS using both PRESS and sLASER techniques on 3T MRI. Two regions-of-interest were allocated in the left medial thalamus and left parietal white matter (WM) by a single reader. The SpectroView Analysis (SW5, Philips, Netherlands) provided automatic measurements, including signal-to-noise ratio (SNR) and peak_height of water, N-acetylaspartate (NAA)-water/Choline (Cho)-water/Creatine (Cr)-water ratios, and NAA-Cr/Cho-Cr ratios. The measurements from PRESS and sLASER techniques were compared using paired T-tests and Bland-Altman methods, and the variability was assessed using coefficients of variation (CV). Results: SNR and peak_heights of the water were significantly lower with sLASER compared to PRESS (left medial thalamus, sLASER SNR/peak_height 2092±475/328±85 vs. PRESS 2811±549/440±105); left parietal WM, 5422±1016/872±196 vs. 7152±1305/1150±278; all, P<0.001, respectively). Accordingly, NAA-water/Cho-water/Cr-water ratios and NAA-Cr/Cho-Cr ratios were significantly higher with sLASER than with PRESS (all, P< 0.001, respectively). The variabilities of NAA-water/Cho-water/Cr-water ratios and Cho-Cr ratio in the left medial thalamus were lower with sLASER than with PRESS (CV, sLASER vs. PRESS, 19.9 vs. 58.1/19.8 vs. 54.7/20.5 vs. 43.9 and 11.5 vs. 16.2) Conclusion: The sLASER technique demonstrated enhanced background water suppression, resulting in increased signals and reduced variability in brain metabolite measurements of MRS. Therefore, sLASER could offer a more precise and stable method for identifying brain metabolites.

Keywords: Magnetic resonance spectroscopy, Brain, sLASER, PRESS

Procedia PDF Downloads 41
121 Submarine Topography and Beach Survey of Gang-Neung Port in South Korea, Using Multi-Beam Echo Sounder and Shipborne Mobile Light Detection and Ranging System

Authors: Won Hyuck Kim, Chang Hwan Kim, Hyun Wook Kim, Myoung Hoon Lee, Chan Hong Park, Hyeon Yeong Park

Abstract:

We conducted submarine topography & beach survey from December 2015 and January 2016 using multi-beam echo sounder EM3001(Kongsberg corporation) & Shipborne Mobile LiDAR System. Our survey area were the Anmok beach in Gangneung, South Korea. We made Shipborne Mobile LiDAR System for these survey. Shipborne Mobile LiDAR System includes LiDAR (RIEGL LMS-420i), IMU ((Inertial Measurement Unit, MAGUS Inertial+) and RTKGNSS (Real Time Kinematic Global Navigation Satellite System, LEIAC GS 15 GS25) for beach's measurement, LiDAR's motion compensation & precise position. Shipborne Mobile LiDAR System scans beach on the movable vessel using the laser. We mounted Shipborne Mobile LiDAR System on the top of the vessel. Before beach survey, we conducted eight circles IMU calibration survey for stabilizing heading of IMU. This exploration should be as close as possible to the beach. But our vessel could not come closer to the beach because of latency objects in the water. At the same time, we conduct submarine topography survey using multi-beam echo sounder EM3001. A multi-beam echo sounder is a device observing and recording the submarine topography using sound wave. We mounted multi-beam echo sounder on left side of the vessel. We were equipped with a motion sensor, DGNSS (Differential Global Navigation Satellite System), and SV (Sound velocity) sensor for the vessel's motion compensation, vessel's position, and the velocity of sound of seawater. Shipborne Mobile LiDAR System was able to reduce the consuming time of beach survey rather than previous conventional methods of beach survey.

Keywords: Anmok, beach survey, Shipborne Mobile LiDAR System, submarine topography

Procedia PDF Downloads 422
120 Intrathecal: Not Intravenous Administration of Evans Blue Reduces Pain Behavior in Neuropathic Rats

Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

Abstract:

Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P<0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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119 Water-Controlled Fracturing with Fuzzy-Ball Fluid in Tight Gas Reservoirs of Deep Coal Measures in Sulige

Authors: Xiangchun Wang, Lihui Zheng, Maozong Gan, Peng Zhang, Tong Wu, An Chang

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The deep coal measure tight gas reservoir in Sulige is usually reformed by fracturing, because the reservoir thickness is small, the water layers can be easily communicated during fracturing, which will lead to water production of gas wells and lower production of gas wells. Therefore, it is necessary to control water during fracturing in deep coal measure tight gas reservoir. Using fuzzy-ball fluid to control water fracturing can not only increase the output but also reduce the water output. The fuzzy-ball fluid was prepared indoors to carry out evaluation experiments. The fuzzy ball fluid was mixed in equal volume with the pre-fluid and formation water to test its compatibility. The core displacement device was used to test the gas and water breaking through the matrix and fractured cores blocked by fuzzy-ball fluid. The breakthrough pressure of the plunger tests its water blocking performance. The experimental results show that there is no precipitation after the fuzzy-ball fluid is mixed with the pad fluid and the formation water, respectively. The breakthrough pressure gradients of gas and water after the fuzzy-ball fluid plugged the cracks were 0.02MPa/cm and 0.04MPa/cm, respectively, and the breakthrough pressure gradients of gas and water after the matrix was plugged were 0.03MPa/cm and 0.2MPa/cm, respectively, which meet the requirements of field operation. Two wells A and B in the Sulige Gas Field were used on site to implement water control fracturing. After the pre-fluid was injected into the two wells, 50m3 of fuzzy-ball fluid was pumped to plug the water. The construction went smoothly. After water control and fracturing, the average daily output in 161 days was increased by 13.71% and 6.99% compared with that of adjacent wells in the same layer. The adjacent wells were bubbled for 3 times and 63 times respectively, while there was no effusion in A and B construction wells. The results show that fuzzy-ball fluid is a water plugging material suitable for water control fracturing in tight gas wells, and its water control mechanism can also provide a new idea for the development of water control fracturing materials.

Keywords: coal seam, deep layer, fracking, fuzzy-ball fluid, reservoir reconstruction

Procedia PDF Downloads 223
118 A Bayesian Approach for Analyzing Academic Article Structure

Authors: Jia-Lien Hsu, Chiung-Wen Chang

Abstract:

Research articles may follow a simple and succinct structure of organizational patterns, called move. For example, considering extended abstracts, we observe that an extended abstract usually consists of five moves, including Background, Aim, Method, Results, and Conclusion. As another example, when publishing articles in PubMed, authors are encouraged to provide a structured abstract, which is an abstract with distinct and labeled sections (e.g., Introduction, Methods, Results, Discussions) for rapid comprehension. This paper introduces a method for computational analysis of move structures (i.e., Background-Purpose-Method-Result-Conclusion) in abstracts and introductions of research documents, instead of manually time-consuming and labor-intensive analysis process. In our approach, sentences in a given abstract and introduction are automatically analyzed and labeled with a specific move (i.e., B-P-M-R-C in this paper) to reveal various rhetorical status. As a result, it is expected that the automatic analytical tool for move structures will facilitate non-native speakers or novice writers to be aware of appropriate move structures and internalize relevant knowledge to improve their writing. In this paper, we propose a Bayesian approach to determine move tags for research articles. The approach consists of two phases, training phase and testing phase. In the training phase, we build a Bayesian model based on a couple of given initial patterns and the corpus, a subset of CiteSeerX. In the beginning, the priori probability of Bayesian model solely relies on initial patterns. Subsequently, with respect to the corpus, we process each document one by one: extract features, determine tags, and update the Bayesian model iteratively. In the testing phase, we compare our results with tags which are manually assigned by the experts. In our experiments, the promising accuracy of the proposed approach reaches 56%.

Keywords: academic English writing, assisted writing, move tag analysis, Bayesian approach

Procedia PDF Downloads 329
117 Power Performance Improvement of 500W Vertical Axis Wind Turbine with Salient Design Parameters

Authors: Young-Tae Lee, Hee-Chang Lim

Abstract:

This paper presents the performance characteristics of Darrieus-type vertical axis wind turbine (VAWT) with NACA airfoil blades. The performance of Darrieus-type VAWT can be characterized by torque and power. There are various parameters affecting the performance such as chord length, helical angle, pitch angle and rotor diameter. To estimate the optimum shape of Darrieustype wind turbine in accordance with various design parameters, we examined aerodynamic characteristics and separated flow occurring in the vicinity of blade, interaction between flow and blade, and torque and power characteristics derived from it. For flow analysis, flow variations were investigated based on the unsteady RANS (Reynolds-averaged Navier-Stokes) equation. Sliding mesh algorithm was employed in order to consider rotational effect of blade. To obtain more realistic results we conducted experiment and numerical analysis at the same time for three-dimensional shape. In addition, several parameters (chord length, rotor diameter, pitch angle, and helical angle) were considered to find out optimum shape design and characteristics of interaction with ambient flow. Since the NACA airfoil used in this study showed significant changes in magnitude of lift and drag depending on an angle of attack, the rotor with low drag, long cord length and short diameter shows high power coefficient in low tip speed ratio (TSR) range. On the contrary, in high TSR range, drag becomes high. Hence, the short-chord and long-diameter rotor produces high power coefficient. When a pitch angle at which airfoil directs toward inside equals to -2° and helical angle equals to 0°, Darrieus-type VAWT generates maximum power.

Keywords: darrieus wind turbine, VAWT, NACA airfoil, performance

Procedia PDF Downloads 364
116 Self-Healing Hydrogel Triggered by Magnetic Microspheres to Control Glutathione Release for Cartilage Repair

Authors: I-Yun Cheng, Min-Yu Chiang, Shwu-Jen Chang, San-Yuan Chen

Abstract:

Osteoarthritis (OA) is among the most challenging joint diseases, and as far as we know, there is currently no exact and effective cure for it because it has low self-repair ability due to lack of blood vessels and low cell density in articular cartilage. So far, there have been several methods developed to treat cartilage disorder. The most common method is to treat the high molecular weight of hyaluronic acid (HA) injection, but it will degrade after a period of time, so the patients need to inject HA repeatedly. In recent years, self-healing hydrogel has drawn considerable attention because it can recover its initial mechanical properties after damaged and further increase the lifetime of the hydrogel. Here, we aim to develop a self-healable composite hydrogel combined with magnetic microspheres to trigger glutathione(GSH) release for promoting cartilage repair. We use HA-cyclodextrin (CD) as host polymer and poly(acrylic acid)-ferrocene (pAA-Fc) as guest polymer to form the self-healable HA-pAA hydrogel by host and guest interaction where various graft amount of pAA-Fc (pAA:Fc= 1:2, 1:1.5, 1:1, 2:1, 4:1) was conducted to develop different mechanical strength hydrogel. The rheology analysis showed that the 4:1 of pAA-Fc has higher mechanical strength than other formulations. On the other hand, iron oxide nanoparticle, poly(lactic-co-glycolic acid) (PLGA) and polyethyleneimine (PEI) were used to synthesize porous magnetic microspheres via double emulsification water-in-oil-in-water (W/O/W) to increase GSH loading which acted as a reductant to control the hydrogel crosslink density and promote hydrogel self-healing. The results show that the porous magnetic microspheres can be loaded with 70% of GSH and sustained release about 50% of GSH after 24 hours. More importantly, the HA-pAA composite hydrogel can self-heal rapidly within 24 hours when suffering external force destruction by releasing GSH from the magnetic microspheres. Therefore, the developed the HA-pAA composite hydrogel combined with GSH-loaded magnetic microspheres can be in-vivo guided to damaged OA surface for inducing the cartilage repair by controlling the crosslinking of self-healing hydrogel via GSH release.

Keywords: articular cartilage, magnetic microsphere, osteoarthritis, self-healing hydrogel

Procedia PDF Downloads 127
115 Accepting the Illness and Moving toward Normality: Providing Continuous Care to a Patient by Utilizing Community Mental Health Nursing Skills

Authors: Szu-Yi Chang, Jiin-Ru Rong

Abstract:

This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

Procedia PDF Downloads 273
114 Electromyography Analysis during Walking and Seated Stepping in the Elderly

Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

Abstract:

The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

Procedia PDF Downloads 216
113 The Retinoprotective Effects and Mechanisms of Fungal Ingredient 3,4-Dihydroxybenzalacetone through Inhibition of Retinal Müller and Microglial Activation

Authors: Yu-Wen Cheng, Jau-Der Ho, Liang-Huan Wu, Fan-Li Lin, Li-Huei Chen, Hung-Ming Chang, Yueh-Hsiung Kuo, George Hsiao

Abstract:

Retina glial activation and neuroinflammation have been confirmed to cause devastating responses in retinodegenerative diseases. The expression and activation of matrix metalloproteinase (MMP)-9 and inducible nitric oxide synthase (iNOS) could be exerted as the crucial pathological factors in glaucoma- and blue light-induced retinal injuries. The present study aimed to investigate the retinoprotective effects and mechanisms of fungal ingredient 3,4-dihydroxybenzalacetone (DBL) isolated from Phellinus linteus in the retinal glial activation and retinodegenerative animal models. According to the cellular studies, DBL significantly and concentration-dependently abrogated MMP-9 activation and expression in TNFα-stimulated retinal Müller (rMC-1) cells. We found the inhibitory activities of DBL were strongly through the STAT- and ERK-dependent pathways. Furthermore, DBL dramatically attenuated MMP-9 activation in the stimulated Müller cells exposed to conditioned media from LPS-stimulated microglia BV-2 cells. On the other hand, DBL strongly suppressed LPS-induced production of NO and ROS and expression of iNOS in microglia BV-2 cells. Consistently, the phosphorylation of STAT was substantially blocked by DBL in LPS-stimulated microglia BV-2 cells. In the evaluation of retinoprotective functions, the high IOP-induced scotopic electroretinographic (ERG) deficit and blue light-induced abnormal pupillary light response (PLR) were assessed. The deficit scotopic ERG responses markedly recovered by DBL in a rat model of glaucoma-like ischemia/reperfusion (I/R)-injury. DBL also reduced the aqueous gelatinolytic activity and retinal MMP-9 expression in high IOP-injured conditions. Additionally, DBL could restore the abnormal PLR and reduce retinal MMP-9 activation. In summary, DBL could ameliorate retinal neuroinflammation and MMP-9 activation by predominantly inhibiting STAT3 activation in the retinal Müller cells and microglia, which exhibits therapeutic potential for glaucoma and other retinal degenerative diseases.

Keywords: glaucoma, blue light, DBL, retinal Müller cell, MMP-9, STAT, Microglia, iNOS, ERG, PLR

Procedia PDF Downloads 135
112 The Quantitative Analysis of the Influence of the Superficial Abrasion on the Lifetime of the Frog Rail

Authors: Dong Jiang

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Turnout is the essential equipment on the railway, which also belongs to one of the strongest demanded infrastructural facilities of railway on account of the more seriously frog rail failures. In cooperation with Germany Company (DB Systemtechnik AG), our research team focuses on the quantitative analysis about the frog rails to predict their lifetimes. Moreover, the suggestions for the timely and effective maintenances are made to improve the economy of the frog rails. The lifetime of the frog rail depends strongly on the internal damage of the running surface until the breakages occur. On the basis of Hertzian theory of the contact mechanics, the dynamic loads of the running surface are calculated in form of the contact pressures on the running surface and the equivalent tensile stress inside the running surface. According to material mechanics, the strength of the frog rail is determined quantitatively in form of the Stress-cycle (S-N) curve. Under the interaction between the dynamic loads and the strength, the internal damage of the running surface is calculated by means of the linear damage hypothesis of the Miner’s rule. The emergence of the first Breakage on the running surface is to be defined as the failure criterion that the damage degree equals 1.0. From the microscopic perspective, the running surface of the frog rail is divided into numerous segments for the detailed analysis. The internal damage of the segment grows slowly in the beginning and disproportionately quickly in the end until the emergence of the breakage. From the macroscopic perspective, the internal damage of the running surface develops simply always linear along the lifetime. With this linear growth of the internal damages, the lifetime of the frog rail could be predicted simply through the immediate introduction of the slope of the linearity. However, the superficial abrasion plays an essential role in the results of the internal damages from the both perspectives. The influences of the superficial abrasion on the lifetime are described in form of the abrasion rate. It has two contradictory effects. On the one hand, the insufficient abrasion rate causes the concentration of the damage accumulation on the same position below the running surface to accelerate the rail failure. On the other hand, the excessive abrasion rate advances the disappearance of the head hardened surface of the frog rail to result in the untimely breakage on the surface. Thus, the relationship between the abrasion rate and the lifetime is subdivided into an initial phase of the increased lifetime and a subsequent phase of the more rapid decreasing lifetime with the continuous growth of the abrasion rate. Through the compensation of these two effects, the critical abrasion rate is discussed to reach the optimal lifetime.

Keywords: breakage, critical abrasion rate, frog rail, internal damage, optimal lifetime

Procedia PDF Downloads 214
111 The Application of Animal Welfare Certification System for Farm Animal in South Korea

Authors: Ahlyum Mun, Ji-Young Moon, Moon-Seok Yoon, Dong-Jin Baek, Doo-Seok Seo, Oun-Kyong Moon

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There is a growing public concern over the standards of farm animal welfare, with higher standards of food safety. In addition, the recent low incidence of Avian Influenza in laying hens among certificated farms is receiving attention. In this study, we introduce animal welfare systems covering the rearing, transport and slaughter of farm animals in South Korea. The concepts of animal welfare farm certification are based on ensuring the five freedoms of animal. The animal welfare is also achieved by observing the condition of environment including shelter and resting area, feeding and water and the care for the animal health. The certification of farm animal welfare is handled by the Animal Protection & Welfare Division of Animal and Plant Quarantine Agency (APQA). Following the full amendment of Animal Protection Law in 2011, animal welfare farm certification program has been implemented since 2012. The certification system has expanded to cover laying hen, swine, broiler, beef cattle and dairy cow, goat and duck farms. Livestock farmers who want to be certified must apply for certification at the APQA. Upon receipt of the application, the APQA notifies the applicant of the detailed schedule of the on-site examination after reviewing the document and conducts the on-site inspection according to the evaluation criteria of the welfare standard. If the on-site audit results meet the certification criteria, APQA issues a certificate. The production process of certified farms is inspected at least once a year for follow-up management. As of 2017, a total of 145 farms have been certified (95 laying hen farms, 12 swine farms, 30 broiler farms and 8 dairy cow farms). In addition, animal welfare transportation vehicles and slaughterhouses have been designated since 2013 and currently 6 slaughterhouses have been certified. Animal Protection Law has been amended so that animal welfare certification marks can be affixed only to livestock products produced by animal welfare farms, transported through animal welfare vehicles and slaughtered at animal welfare slaughterhouses. The whole process including rearing–transportation- slaughtering completes the farm animal welfare system. APQA established its second 5-year animal welfare plan (2014-2019) that includes setting a minimum standard of animal welfare applicable to all livestock farms, transportation vehicles and slaughterhouses. In accordance with this plan, we will promote the farm animal welfare policy in order to truly advance the Korean livestock industry.

Keywords: animal welfare, farm animal, certification system, South Korea

Procedia PDF Downloads 394
110 Quality Assurances for an On-Board Imaging System of a Linear Accelerator: Five Months Data Analysis

Authors: Liyun Chang, Cheng-Hsiang Tsai

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To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

Procedia PDF Downloads 294