Search results for: balanced anesthesia

Authors: Zane Bulderberga

Abstract:

Spatial dimension in development planning is becoming more topical in 21st century as a result of changes in population structure. Sustainable spatial development focuses on identifying and using territorial advantages to foster the harmonized development of the entire country, reducing negative effects of population concentration, increasing availability and mobility. EU and national development planning documents state polycentrism as main tool for balance spatial development, including investment concentration in growth centres. If mutual cooperation of growth centres as well as urban-rural cooperation is not fostered, then territorial differences can deepen and create unbalanced development. The aim of research: to evaluate the urban-rural interaction, elaborating spatial development scenarios in framework of Latvian regional policy. To perform the research monographic, comparison, abstract-logical method, synthesis and analysis will be used when studying the theoretical aspects of research aiming at collecting the ideas of scientists from different countries, concepts, regulations as well as to create meaningful scientific discussion. Hierarchy analysis process (AHP) will be used to state further scenarios of spatial development in Latvia. Experts from various institutions recognized urban-rural interaction and co-operation as an essential tool for the development. The most important factors for balanced spatial development in Latvia are availability of public transportation and improvement of service availability. Evaluating the three alternative scenarios, it was concluded that the urban-rural partnership will ensure a balanced development in Latvian regions.

Keywords: rural-urban interaction, rural-urban cooperation, spatial development, AHP

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Authors: Yannick Verbelen, Tim Dekegel, Ann Peeters, Klara Stinders, Niek Blondeel, Sam De Winne, An Braeken, Abdellah Touhafi

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Matching an embedded electronic application with a cantilever vibration energy harvester remains a difficult endeavour due to the large number of factors influencing the output power. In the presented work, complementary balanced energy harvester parametrization is used as a methodology for simplification of harvester integration in electronic applications. This is achieved by a dual approach consisting of an adaptation of the general parametrization methodology in conjunction with a straight forward harvester benchmarking strategy. For this purpose, the design and implementation of a suitable user friendly cantilever energy harvester benchmarking platform is discussed. Its effectiveness is demonstrated by applying the methodology to a commercially available Mide V21BL vibration energy harvester, with excitation amplitude and frequency as variables.

Keywords: vibration energy harvesting, piezoelectrics, harvester parametrization, complementary balanced energy harvesting

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Authors: Z. Kurtaslan, H. Hakan Okay, E. Can Dönmez, I. Kuçukdoğan

Abstract:

Music education aims to bring up individuals most appropriately and to advanced levels as a balanced whole physically, cognitively, affectively, and kinesthetically while making a major contribution to the physical and spiritual development of the individual. The most crucial aim of music education, an influential education medium per se, is to make music be loved; yet, among its educational aims are concepts such as affinity, friendship, goodness, philanthropy, responsibility, and respect all extremely crucial bringing up individuals as a balanced whole. One of the most essential assets of the music education is the training of making music together, solidifying musical knowledge and enabling the acquisition of cooperation. This habit requires internalization of values like responsibility, patience, cooperativeness, respect, self-control, friendship, and fairness. If musicians lack these values, the ensemble will become after some certain time a cacophony. In this qualitative research, the attitudes of music teacher candidates in orchestra/chamber music classes will be examined in terms of values.

Keywords: education, music, orchestra/chamber music, values

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Authors: Azzouzi Fadoua

Abstract:

This study focuses on the diagnosis of the dynamics of natural resources in a semi-arid mountainous weakened by natural vulnerability and anthropogenic action. This is evident in the forms of hydraulic erosion and degradation of agricultural land. The rate of this damaged land is 53%, with a strong presence of concentrated erosion; this shows that balanced and semi-balanced environments are less apparent to the Watershed, representing 47%. The results revealed the crucial role of the slopes and the density of the hydraulic networks to facilitate the transport of fine elements, at the level of the slopes with low vegetation intensity, to the lake of the dam. Something that endangers the siltation of the latter. After the study of natural and anthropogenic elements, it turned out that natural vulnerability is an integral part of the current dynamic, especially when it coincides with the overexploitation of natural resources, in this case, the exploitation of steep slopes for the cultivation of cereals and overgrazing. This causes the soil to pile up and increase the rate of runoff.

Keywords: watershed, erosion, natural vulnerability, anthropogenic

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Authors: Burra Vijitha

Abstract:

A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting.

Keywords: granisetron, palonosetron, nausea, vomiting

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Authors: Earl Joy H. Ausa, Lianna Rozl Brosas, Niema T. Floro, Jycyl Joice R. Medina, Nejie A. Millarada

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This study examines the demographic and personality profiles of pre-service teachers at Rizal Technological University, Boni Campus. The participants consisted of 212 pre-service teachers from the College of Education with majors in various subjects. The majority of respondents were female (74.88%), and the average age of participants was 22. Using the NEO PI-R framework, the study assessed the personality traits of pre-service teachers. The results showed that pre-service teachers displayed average levels of neuroticism, extraversion, openness, agreeableness, and conscientiousness. This suggests that they possess a balanced combination of traits that are conducive to effective teaching, such as moderate emotional stability, a balanced preference for social interactions, curiosity, good interpersonal skills, and a strong work ethic. The personality enhancement program could also benefit the pre-service teachers. In conclusion, this study provides valuable insights into the demographic and personality characteristics of pre-service teachers.

Keywords: personality traits, neo PI- R, pre-service teachers, five-factor theory

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Authors: Almira Sharafeeva

Abstract:

In the Soviet Union of the 1930s, motherhood was seen as a natural need of women. The masculine Bolshevik state did not see the emancipated woman as free from her maternal burden. In order to support the idea of "joyful motherhood," a medical discourse on the anesthesia of childbirth emerges. In March 1935 at the IX Congress of obstetricians and gynecologists the People's Commissar of Public Health of the RSFSR G.N. Kaminsky raised the issue of anesthesia of childbirth. It was also from that year that medical, literary and artistic editions with enviable frequency began to publish articles, studies devoted to the issue, the goal - to anesthetize all childbirths in the USSR - was proclaimed. These publications were often filled with anti-German and anti-capitalist propaganda, through which the advantages of socialism over Capitalism and Nazism were demonstrated. At congresses, in journals, and at institute meetings, doctors' discussions around obstetric anesthesia were accompanied by discussions of shortening the duration of the childbirth process, the prevention and prevention of disease, the admission of nurses to the procedure, and the proper behavior of women during the childbirth process. With the help of articles from medical periodicals of the 1930s., brochures, as well as documents from the funds of the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences of the USSR (TsGANTD SPb) and the Department of Obstetrics and Gynecology of the NKZ USSR (GARF) in this paper we will show, how the advantages of the Soviet system and the socialist way of life were constructed through the problem of childbirth pain relief, and we will also show how childbirth pain relief in the USSR was related to the foreign policy situation and how projects of labor pain relief were related to the anti-abortion policy of the state. This study also attempts to answer the question of why anesthesia of childbirth in the USSR did not become widespread and how, through this medical procedure, the Soviet authorities tried to take control of a female function (childbirth) that was not available to men. Considering this subject from the perspective of gender studies and the social history of medicine, it is productive to use the term "biopolitics. Michel Foucault and Antonio Negri, wrote that biopolitics takes under its wing the control and management of hygiene, nutrition, fertility, sexuality, contraception. The central issue of biopolitics is population reproduction. It includes strategies for intervening in collective existence in the name of life and health, ways of subjectivation by which individuals are forced to work on themselves. The Soviet state, through intervention in the reproductive lives of its citizens, sought to realize its goals of population growth, which was necessary to demonstrate the benefits of living in the Soviet Union and to train a pool of builders of socialism. The woman's body was seen as the object over which the socialist experiment of reproductive policy was being conducted.

Keywords: labor anesthesia, biopolitics of stalinism, childbirth pain relief, reproductive policy

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Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

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Authors: Jong Yeop Kim, Jong Bum Choi, Hyun Jeong Kwak, Sook Young Lee

Abstract:

Background: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to investigate remifentanil effect-site concentration (Ce) in 50% of patients (EC50) for successful insertion of i- gel, and to compare it with that for laryngeal mask airway (LMA) insertion during propofol target-controlled infusion (TCI). Methods: Forty-one female patients were randomized to the i-gel group (n=20) or the LMA group (n=21). Anesthesia induction was performed using propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and i-gel or LMA insertion was attempted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient’s response to device insertion was classified as either ‘success (no movement)’ or ‘failure (movement)’. Results: Using the Dixon’s up and down method, EC50 of remifentanil Ce for i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p=0.038). Using isotonic regression, EC50 (83% CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95% CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. Conclusion: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml), in female patients during propofol TCI without neuromuscular blockade.

Keywords: i-gel, laryngeal mask airway, propofol, remifentanil

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Authors: Matheus Borges Carneiro, Fabiane Leticia Lizarelli, José Carlos De Toledo

Abstract:

The evolution of quality management by companies was strongly enabled by, among others, ISO 9001 certification, which is considered a crucial requirement for several customers. Likewise, performance measurement provides useful insights for companies to identify the reflection of their decision-making process on their improvement. One of the most used performance measurement models is the balanced scorecard (BSC), which uses four perspectives to address a firm’s performance: financial, internal process, customer satisfaction, and learning and growth. Studies related to ISO 9001 and business performance have mostly adopted a quantitative approach to identify the standard’s causal effect on a firm’s performance. However, to verify how this influence may occur, an in-depth analysis within a qualitative approach is required. Therefore, this paper aims to verify the impact of ISO 9001:2015 on Brazilian firms’ performance based on the balanced scorecard perspective. Hence, nine certified companies located in the Southeast region of Brazil were studied through a multiple case study approach. Within this study, it was possible to identify the positive impact of ISO 9001 on firms’ overall performance, and four Critical Success Factors (CSFs) were identified as relevant on the linkage among ISO 9001 and firms’ performance: employee involvement, top management, process management, and customer focus. Due to the COVID-19 pandemic, the number of interviews was limited to the quality manager specialist, and the sample was limited since several companies were closed during the period of the study. This study presents an in-depth analysis of how the relationship between ISO 9001 certification and firms’ performance in a developing country is.

Keywords: balanced scorecard, Brazilian firms’ performance, critical success factors, ISO 9001 certification, performance measurement

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Authors: Johann Valentowitsch, Wolfgang Burr

Abstract:

In organizational research, strategies of exploration and exploitation are often considered to be contradictory. Building on the tradeoff argument, many authors have assumed that a company's market performance should be positively dependent on its strategic balance between exploration and exploitation over time. In this study, we apply this reasoning to the pharmaceutical industry. Using exploratory regression analysis we show that the long-term market performance of a pharmaceutical company is linked to both its ability to carry out exploratory projects and its ability to develop exploitative competencies. In particular, our findings demonstrate that, on average, the company's annual sales performance is higher the better the strategic alignment between exploration and exploitation is balanced. The contribution of our research is twofold. On the one hand, we provide empirical evidence for the initial tradeoff hypothesis and thus support the theoretical position of those who understand exploration and exploitation as strategic substitutes. On the other hand, our findings show that a balanced relationship between exploration and exploitation is also important in research-intensive industries, which naturally tend to place more emphasis on exploration.

Keywords: exploitation, exploration, market performance, pharmaceutical industry, strategy

Procedia PDF Downloads 193

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

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Authors: Roselyn Zaman, Mobarak Hossain

Abstract:

A new mathematical model is developed to study crack breathing behavior considering effect of angular position of unbalanced force at different crack locations. Crack breathing behavior has been determined using effectual bending angle by studying the transient change of the crack area. Different crack breathing behavior of the unbalanced shaft has been observed for different combination of angular position of unbalanced force with crack location except crack locations 0.3L and 0.8335L, where L is the total length of the shaft, where unbalanced shaft behave completely like the balanced shaft. Based on different combination of angular position of unbalanced force with crack location, the stiffness of unbalanced shaft can be divided into three regions. An unbalanced shaft is overall stiffer than a balanced shaft when angular position of unbalance force is between 90° to 270° and crack located between 0.3L and 0.8335L, and it is overall flexible when the crack located in outside this crack region. On the other hand, it is overall flexible when angular position of unbalanced force is between 0° to 90° or 270° to 360° and crack located in middle region and it is overall stiffer for outside this crack region.

Keywords: cracked shaft, crack location, shaft stiffness, unbalanced force, and unbalanced force orientation

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Authors: Masao Nakagawa, Toshiki Hirogaki, Eiichi Aoyama, Mohamed Ali Ben Abbes

Abstract:

A planetary gear set is widely used in hybrid vehicles as the power distribution system or in electric vehicles as the high reduction system, but due to its complexity with planet gears, its dynamic characteristic is not fully understood. There are many reports on two-axes driving or displacement of the planet gears under these conditions, but only few reports deal with three-axes driving. A three-axes driving condition is tested using three-axes torque measurement and focuses on the dynamic characteristic around the planet gears in this report. From experimental result, it was confirmed that the transition forces around the planet gears were balanced and the torques were also balanced around the instantaneous rotation center. The meshing frequency under these conditions was revealed to be the harmonics of two meshing frequencies; meshing frequency of the ring gear and that of the planet gears. The input power of the ring gear is distributed to the carrier and the sun gear in the dynamic sequential change of three fixed conditions; planet, star and solar modes.

Keywords: dynamic characteristic, gear, planetary gear set, torque measuring

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Authors: Elin Cahyaningsih, Dana Indra Sensuse, Wahyu Catur Wibowo, Sofiyanti Indriasari

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Bureaucracy reform program drives Indonesian government to change their management and supporting unit in order to enhance their organization performance. Information technology as one of supporting unit became one of strategic plan that organization tried to improve, because IT can automate and speed up process, reduce business process life cycle become more effective and efficient. Knowledge management system is a technology application for supporting knowledge management implementation in government which is requirement based on problem and potential functionality of each knowledge management process. Define knowledge management that suitable for each organization it is difficult, that why we should make the knowledge management system strategy as an alignment of knowledge management process in the organization. Knowledge management system is one of information system development in people perspective, because this system has high dependency in human interaction and participation. Strategic plan for developing knowledge management system can be determine using some of information system strategic methods. This research conducted to define type of strategic method of information system, stage of activity each method, the strategic method strength and weakness. The author use literature review methods for identify and classify strategic methods of information system for differentiate method type, categorize common activities, strength and weakness. Result of this research are determine and compare six strategic information system methods, there are Balanced Scorecard, Five Force Porter, SWOT analysis, Value Chain Analysis, Risk Analysis and Gap Analysis. Balanced Scorecard and Risk Analysis believe as common strategic method that usually used and have the highest excellence strength.

Keywords: knowledge management system, balanced scorecard, five force, risk analysis, gap analysis, value chain analysis, SWOT analysis

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Authors: Payal Patel

Abstract:

Textile machinery is one of the fastest evolving areas which has an application of mechanical engineering. The modular approach towards the processing right from the stage of cotton to the fabric, allows us to observe the result of each process on its input. Cost and space being the major constraints. The flyer is a component of roving machine, which is used as a part of spinning process. In the present work using the application of Hyper Works, the flyer arm has been modified which saves the material used for manufacturing the flyer. The size optimization of the flyer is carried out with the objective of reduction in weight under the constraints of standard operating conditions. The new design of the flyer is proposed and validated using the module of HyperWorks which is equally strong, but light weighted compared to the existing design. Dynamic balancing of the optimized model is carried out to align a principal inertia axis with the geometric axis of rotation. For the balanced geometry of flyer, air resistance is obtained theoretically and with Gambit and Fluent. Static analysis of the balanced geometry has been done to verify the constraint of operating condition. Comparison of weight, deflection, and factor of safety has been made for different aluminum alloys.

Keywords: flyer, size optimization, textile, weight

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Authors: Antonis Constantinides, Christos Yiallouras, Christakis Damianou

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The coaxial transformer-coupled push-pull circuitry has been used widely in HF and VHF amplifiers for many decades without significant changes in the topology of the transformers. Basic changes over the years concerned the construction and turns ratio of the transformers as has been imposed upon the newer technologies active devices demands. The balun transmission line transformers applied in push-pull amplifiers enable input/output impedance transformation, but are mainly used to convert the balanced output into unbalanced and the input unbalanced into balanced. A simple and affordable alternative solution over the traditional coaxial transformer is the coreless planar balun. A key advantage over the traditional approach lies in the high specifications repeatability; simplifying the amplifier construction requirements as the planar balun constitutes an integrated part of the PCB copper layout. This paper presents the performance analysis of a planar LDMOS MRFE6VP5600 Push-Pull amplifier that enables robust operation in Band III, DVB-T, DVB-T2 standards but functions equally well in Band II, for DRM+ new generation transmitters.

Keywords: amplifier, balun, complex impedance, LDMOS, planar-transformers

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Authors: Jayanthi Rajendran

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Experience is what makes a man perfect. Though we tend to learn many a different things in life through practice still we need to go an extra mile to gain experience which would be profitable only when it is integrated with regular practice. A clear phenomenal idea is that every teacher is a learner. The centralized idea of this paper would focus on the integrated practices carried out among the students of Jizan University which enhances learning through experiences. Integrated practices like student-directed activities, balanced curriculum, phonological based activities and use of consistent language would enlarge the vision and mission of students to earn experience through learning. Students who receive explicit instruction and guidance could practice the skills and strategies through student-directed activities such as peer tutoring and cooperative learning. The second effective practice is to use consistent language. Consistent language provides students a model for talking about the new concepts which also enables them to communicate without hindrances. Phonological awareness is an important early reading skill for all students. Students generally have phonemic awareness in their home language can often transfer that knowledge to a second language. And also a balanced curriculum requires instruction in all the elements of reading. Reading is the most effective skill when both basic and higher-order skills are included on a daily basis. Computer based reading and listening skills will empower students to understand a language in a better way. English language learners can benefit from sound reading instruction even before they are fully proficient in English as long as the instruction is comprehensible. Thus, if students have to be well equipped in learning they should foreground themselves in various integrated practices through multifarious experience for which teachers are moderators and trainers. This type of learning prepares the students for a constantly changing society which helps them to meet the competitive world around them for better employability fulfilling the vision and mission of the institution.

Keywords: consistent language, employability, phonological awareness, balanced curriculum

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Authors: Jae Ni Jang, Young Uk Kim

Abstract:

Background: Chat Generative Pre-training Transformer-3 (ChatGPT; San Francisco, California, Open Artificial Intelligence) is an artificial intelligence chatbot based on a large language model designed to generate human-like text. As the usage of ChatGPT is increasing among less knowledgeable patients, medical students, and anesthesia and pain medicine residents or trainees, we aimed to evaluate the accuracy of ChatGPT-3 responses to questions about the American Society of Anesthesiologists (ASA) classification based on patients’ underlying diseases and assess the quality of the generated responses. Methods: A total of 47 questions were submitted to ChatGPT using textual prompts. The questions were designed for ChatGPT-3 to provide answers regarding ASA classification in response to common underlying diseases frequently observed in adult patients. In addition, we created 18 questions regarding the ASA classification for pediatric patients and pregnant women. The accuracy of ChatGPT’s responses was evaluated by cross-referencing with Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, and the American Society of Anesthesiologists’ ASA Physical Status Classification System (2020). Results: Out of the 47 questions pertaining to adults, ChatGPT -3 provided correct answers for only 23, resulting in an accuracy rate of 48.9%. Furthermore, the responses provided by ChatGPT-3 regarding children and pregnant women were mostly inaccurate, as indicated by a 28% accuracy rate (5 out of 18). Conclusions: ChatGPT provided correct responses to questions relevant to the daily clinical routine of anesthesiologists in approximately half of the cases, while the remaining responses contained errors. Therefore, caution is advised when using ChatGPT to retrieve anesthesia-related information. Although ChatGPT may not yet be suitable for clinical settings, we anticipate significant improvements in ChatGPT and other large language models in the near future. Regular assessments of ChatGPT's ASA classification accuracy are essential due to the evolving nature of ChatGPT as an artificial intelligence entity. This is especially important because ChatGPT has a clinically unacceptable rate of error and hallucination, particularly in pediatric patients and pregnant women. The methodology established in this study may be used to continue evaluating ChatGPT.

Keywords: American Society of Anesthesiologists, artificial intelligence, Chat Generative Pre-training Transformer-3, ChatGPT

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Authors: Arakelian Vigen, Geng Jing, Le Baron Jean-Paul

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The paper deals with the design of parallel manipulators with balanced inertia forces and moments. The balancing of the resultant of the inertia forces of 3-RRR planar parallel manipulators is carried out through mass redistribution and centre of mass acceleration minimization. The proposed balancing technique is achieved in two steps: at first, optimal redistribution of the masses of input links is accomplished, which ensures the similarity of the end-effector trajectory and the manipulator’s common centre of mass trajectory, then, optimal trajectory planning of the end-effector by 'bang-bang' profile is reached. In such a way, the minimization of the magnitude of the acceleration of the centre of mass of the manipulator brings about a minimization of shaking force. To minimize the resultant of the inertia moments (shaking moment), the active balancing via inertia flywheel is applied. However, in this case, the active balancing is quite different from previous applications because it provides only a partial cancellation of the shaking moment due to the incomplete balancing of shaking force.

Keywords: dynamic balancing, inertia force minimization, inertia moment minimization, 3-RRR planar parallel manipulator

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Authors: Legkikh Victoria

Abstract:

The purpose of keeping bi/multilingualism is usually a way to let the child speak two/three languages at the same level. The main problem which normally appears is a mixed language or a domination of one language. The same level of two or more languages would be ideal but practically not easily reachable. So it was made an experiment with a girl with a natural multilingualism as an attempt to avoid a dominant language in the preschool age. The girl lives in Germany and the main languages for her are Italian, Russian and German but she also hears every day English. ‘One parent – one language’ strategy was used since the beginning so Italian and Russian were spoken to her since her birth, English was spoken between the parents and when she was 1,5 it was added German as a language of a nursery. In order to avoid a dominant language, she was always put in international groups with activity in different languages. Even if it was not possible to avoid an interference of languages in this case we can talk not only about natural multilingualism but also about balanced bilingualism in preschool time. The languages have been developing in parallel with different accents in a different period. Now at the age of 6 we can see natural horizontal multilingualism Russian/Italian/German/English. At the moment, her Russian/Italian bilingualism is balanced. German vocabulary is less but the language is active and English is receptive. We can also see a reciprocal interference of all the three languages (English is receptive so the simple phrases are normally said correctly but they are not enough to judge the level of language interference and it is not noticed any ‘English’ mistakes in other languages). After analysis of the state of every language, we can see as a positive and negative result of the experiment. As a positive result we can see that in the age of 6 the girl does not refuse any language, three languages are active, she differentiate languages and even if she says a word from another language she notifies that it is not a correct word, and the most important are the fact, that she does not have a preferred language. As a prove of the last statement it is to be noticed not only her self-identification as ‘half Russian and half Italian’ but also an answer to the question about her ‘mother tongue’: ‘I do not know, probably, when I have my own children I will speak one day Russian and one day Italian and sometimes German’. As a negative result, we can notice that not only a development of all the three languages are a little bit slower than it is supposed for her age but since she does not have a dominating language she also does not have a ‘perfect’ language and the interference is reciprocal. In any case, the experiment shows that it is possible to keep at least two languages without a preference in a pre-school multilingual space.

Keywords: balanced bilingualism, language interference, natural multilingualism, preschool multilingual education

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Authors: Richard Mbatu

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Implementation of the Reducing Emissions from Deforestation and forest Degradation (REDD+) program will not only lead to significant net gains in greenhouse gas reduction but also gains in biodiversity conservation. However, the looming paradigm shift in the program in the form of the proposed landscape governance approach could change this inclination. The concern lies with the fact that pursue of carbon credits by governments and private entities under the proposed landscape approach could encourage obstinate land use behaviors that are detrimental to the cause of biodiversity conservation and ecosystem services. Yet, the landscape approach could also stimulate governments to develop and implement land use management policies for climate change adaptation and mitigation. Using two potential areas of land use under the proposed landscape approach – carbon farming in grasslands and carbon farming in plantations – this paper provides a balanced analytical review of conservation challenges and opportunities for forest governance and beyond under the proposed landscape approach to REDD+. The paper argues that such a balanced view will enable policymakers and other stakeholders to better present their arguments in their efforts to shape the course of the REDD+ program in the post-Paris Agreement era.

Keywords: biodiversity conservation, REDD+, forest governance, grasslands, landscape approach, plantations

Procedia PDF Downloads 343

Authors: Mohammed Sani Abdulai

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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality

Procedia PDF Downloads 166

Authors: Hisham A. Hashem, Sameh Galal, Bassem M. Moeshed

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A 36 years old male patient presented to our unit with a history of motor-car accident from 7 months complaining of disfigurement and double vision. On examination and investigations, there was an orbital floor fracture in the left eye with inferior rectus muscle entrapment causing diplopia, dystopia and enophthalmos. Under general anesthesia, a sub-ciliary incision was performed, and the orbital floor fracture was repaired with a double layer Medpor sheet (30x50x15) with removing and freeing fibrosis that was present and freeing of the inferior rectus muscle. Remarkable improvement of the dystopia was noticed, however, there was a residual diplopia in upgaze and enophthalmos. He was then referred to a strabismologist, which upon examination found left hypotropia of 8 ΔD corrected by 8 ΔD base up prism and positive forced duction test on elevation and pseudoptosis. Under local anesthesia, a limbal incision approach with hangback 4mm recession of inferior rectus muscle was performed after identifying an inferior rectus muscle structure. Improvement was noted shortly postoperative with correction of both diplopia and pseudoptosis. Follow up after 1, 4 and 8 months was done showing a stable condition. Delayed surgery in cases of orbital floor fracture may still hold good results provided proper assessment of the case with management of each sign separately.

Keywords: diplopia, dystopia, late surgery, orbital floor fracture

Procedia PDF Downloads 212

Authors: Rania Kassir, Christophe Dos Santos, Halim Abboud, Olivier Godefroy

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The ability to communicate in at least two different languages is shared by a growing number of humans. Recently, many researchers have been studying the elderly bilingual population around the world in neuroscience, and yet, until today there’s no accurate nor universal measure or methodology used to examine bilingualism across these studies which constitute a real challenge for results generalization. This study contributes to the quest of a multidimensional bilingualism index and language proficiency literature by investigating a new bilingualism index from a reliable subjective questionnaire the Language Experience and Proficiency Questionnaire (LEAP-Q), multi-linguistic tests, and a diverse bilingual population all featured in one analysis and one index. One hundred Lebanese subjects aged between 55 and 92 years old divided into three different bilingualism subgroups (Arabic prominent, balanced, and French prominent) were recruited and underwent the LEAP-Q with a set of linguistic and cognitive tests. The analysis of the collected data led to the creation of a robust bilingualism index from speaking and oral understanding scores that underline specifically bilingualism subtype according to cutoffs scored. The practice implications of this index, particularly its use within bilingual populations, are addressed in the conclusion of this work.

Keywords: bilingualism, language dominance, bilingualism index, balanced bilingualism, Arabic first language, Lebanese, Arabic-French bilingualism

Procedia PDF Downloads 106

Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

Procedia PDF Downloads 271

Authors: Charalambos C. Cleanthous, Ryan Sain, Tabitha Black, Stephen Vera, Suzanne Milton

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A concern when administering questionnaires is whether the participant is providing information that is accurate. The results may be invalid because the person is trying to present oneself in an unrealistic positive manner referred to as ‘faking good’, or in an unrealistic negative manner known as ‘faking bad’. The Balanced Inventory of Desirable Responding (BIDR) was used to assess commercial pilots’ responses on the two subscales of the BIDR: impression management (IM) and self-deceptive enhancement (SDE) that result in high or low scores. Thus, the BIDR produces four valid profiles: IM low and SDE low, IM high and SDE low, IM low and SDE high, and IM high and SDE high. The various profiles were used to compare the respondents’ answers to crew resource management (CRM) items developed from the USA Federal Aviation Administration’s (FAA) guidelines for CRM composition and training. Of particular interest were the results on the IM subscale. The comparisons between those scoring high (lying or faking) versus those low on the IM suggest that there were significant differences regarding their views of the various dimensions of CRM. One of the more disconcerting conclusions is that the high IM scores suggest that the pilots were trying to impress rather than honestly answer the questions regarding their CRM training and practice.

Keywords: USA commercial pilots, crew resource management, faking, social desirability

Procedia PDF Downloads 233

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

Procedia PDF Downloads 76

Authors: Davoud Maleki, Neda Zamani

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The present study aims at exploring the effective accountability model of Islamic Azad University using a qualitative approach of grounded theory. The data of this study were obtained from semi-structured interviews with 25 professors and scholars in Islamic Azad University of Tehran who were selected by theoretical sampling method. In the data analysis, the stepwise method and Strauss and Corbin analytical methods (1992) were used. After identification of the main component (balanced response to stakeholders’ needs) and using it to bring the categories together, expressions and ideas representing the relationships between the main and subcomponents, and finally, the revealed components were categorized into six dimensions of the paradigm model, with the relationships among them, including causal conditions (7 components), main component (balanced response to stakeholders’ needs), strategies (5 components), environmental conditions (5 components), intervention features (4 components), and consequences (3 components). Research findings show an exploratory model for describing the relationships between causal conditions, main components, accountability strategies, environmental conditions, university environmental features, and that consequences.

Keywords: accountability, effectiveness, Islamic Azad University, grounded theory

Procedia PDF Downloads 60

Authors: Neda Azari Dodaran, Hamid Ahmadi

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Results of 405 finite element (FE) analyses were used in the present research to study the effect of the joint geometry on the ultimate strength and initial stiffness of tubular K-joints subjected to axial loading at fire-induced elevated temperatures. The FE models were validated against the data available from experimental tests. Structural behavior under different temperatures (200ºC, 400ºC, 500ºC, and 700ºC) was investigated and compared to the behavior at ambient temperature (20ºC). A parametric study was conducted to investigate the effect of dimensionless geometrical parameters (β, γ, θ, and τ) on the ultimate strength and initial stiffness. Afterwards, ultimate strength data extracted from the FE analyses were compared with the values calculated from the equations proposed by available design codes in which the ultimate strength of the joint at elevated temperatures is obtained by replacing the yield stress of the steel at ambient temperature with the corresponding value at elevated temperature. It was indicated that this method may not have acceptable accuracy for K-joints under axial loading. Hence, a design formula was developed, through nonlinear regression analyses, to determine the ultimate strength of K-joints subjected to balanced axial loads at elevated temperatures.

Keywords: axial loading, elevated temperature, parametric equation, static strength, tubular K-joint

Procedia PDF Downloads 132