Search results for: Clinical Application

Authors: Liana Melissa E. de la Rosa, Jayson P. Ada

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This exploratory study was conducted to determine the sociology of the Facebook. Specifically, it aimed to know the socio-demographic profile of the respondents in terms of age, sex, year level and monthly allowance; find out the common usage of Facebook to the respondents; identify the features of Facebook that are commonly used by the respondents; understand the benefits and risks of using the Facebook; determine how frequent the respondents use the Facebook; and find out if there is a significant relationship between socio-demographic profile of the respondents and their Facebook usage. This study used the exploratory research design and correlational design employing research survey questionnaire as its main data gathering instrument. Students of the University of Eastern Philippines were selected as the respondents of this study through quota sampling. Ten (10) students were randomly selected from each college of the university. Based on the findings of this study, the following conclusion were drawn: The majority of the respondents are aged 18 and 21 old, female, are third year students, and have monthly allowance of P 2,000 above. On the respondents’ usage of Facebook, the majority of use the Facebook on a daily basis for one to two (1-2) hours everyday. And most users used Facebook by renting a computer in an internet cafe. On the use of Facebook, most users have created their profiles mainly to connect with people and gain new friends. The most commonly used features of Facebook, are: photos application, like button, wall, notification, friend, chat, network, groups and “like” pages status updates, messages and inbox and events. While the other Facebook features that are seldom used by the respondents are games, news feed, user name, video sharing and notes. And the least used Facebook features are questions, poke feature, credits and the market place. The respondents stated that the major benefit that the Facebook has given to its users is its ability to keep in touch with family members or friends while the main risk identified is that the users can become addicted to the Internet. On the tests of relationships between the respondents’ use of Facebook and the four (4) socio-demographic profile variables: age, sex, year level, and month allowance, were found to be not significantly related to the respondents’ use of the Facebook. While the variable found to be significantly related was gender.

Keywords: Facebook, sociology, social networking, exploratory study

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Authors: Paolo Ragazzi, Olivier Peillon, Paul Fauris, Mathias Simon, Raul Navarro, Juan Carlos Martin, Oriol Casasayas, Laura Pacheco, Albert Perez-Bellmunt

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Introduction: The use of stretching techniques in the sports world is frequent and widely used for its many effects. One of the main benefits is the gain in flexibility, range of motion and facilitation of the sporting performance. Recently the use of Roller-Foam (RF) has spread in sports practice both at elite and recreational level for its benefits being similar to those observed in stretching. The objective of the following study is to compare the results of the Roller-Foam with the proprioceptive neuromuscular facilitation stretching (PNF) (one of the stretchings with more evidence) on the hamstring muscles. Study design: The design of the study is a single-blind, randomized controlled trial and the participants are 40 healthy volunteers. Intervention: The subjects are distributed randomly in one of the following groups; stretching (PNF) intervention group: 4 repetitions of PNF stretching (5seconds of contraction, 5 second of relaxation, 20 second stretch), Roller-Foam intervention group: 2 minutes of Roller-Foam was realized on the hamstring muscles. Main outcome measures: hamstring muscles flexibility was assessed at the beginning, during (30’’ of intervention) and the end of the session by using the Modified Sit and Reach test (MSR). Results: The baseline results data given in both groups are comparable to each other. The PNF group obtained an increase in flexibility of 3,1 cm at 30 seconds (first series) and of 5,1 cm at 2 minutes (the last of all series). The RF group obtained a 0,6 cm difference at 30 seconds and 2,4 cm after 2 minutes of application of roller foam. The results were statistically significant when comparing intragroups but not intergroups. Conclusions: Despite the fact that the use of roller foam is spreading in the sports and rehabilitation field, the results of the present study suggest that the gain of flexibility on the hamstrings is greater if PNF type stretches are used instead of RF. These results may be due to the fact that the use of roller foam intervened more in the fascial tissue, while the stretches intervene more in the myotendinous unit. Future studies are needed, increasing the sample number and diversifying the types of stretching.

Keywords: hamstring muscle, stretching, neuromuscular facilitation stretching, roller foam

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Authors: I. N. Nwafia, U. C. Ozumba, M. E. Ohanu, S. O. Ebede

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Antibiotic resistance is increasing globally and has become a major health challenge. Extended-spectrum beta-lactamase is clinically important because the ESBL gene are mostly plasmid encoded and these plasmids frequently carry genes encoding resistance to other classes of antimicrobials thereby limiting antibiotic options in the treatment of infections caused by these organisms. The specific objectives of this study were to determine the prevalence of ESBLs production in Escherichia coli, to determine the antibiotic susceptibility pattern of ESBLs producing Escherichia coli, to detect TEM, SHV and CTX-M genes and the risk factors to acquisition of ESBL producing Escherichia coli. The protocol of the study was approved by Health Research and Ethics committee of the University of Nigeria Teaching Hospital (UNTH), Enugu. It was a descriptive cross-sectional study that involved all hospitalized patients in UNTH from whose specimens Escherichia coli was isolated during the period of the study. The samples analysed were urine, wound swabs, blood and cerebrospinal fluid. These samples were cultured in 5% sheep Blood agar and MacConkey agar (Oxoid Laboratories, Cambridge UK) and incubated at 35-370C for 24 hours. Escherichia coli was identified with standard biochemical tests and confirmed using API 20E auxanogram (bioMerieux, Marcy 1'Etoile, France). The antibiotic susceptibility testing was done by disc diffusion method and interpreted according to the Clinical and Laboratory Standard Institute guideline. ESBL production was confirmed using ESBL Epsilometer test strips (Liofilchem srl, Italy). The ESBL bla genes were detected with polymerase chain reaction, after extraction of DNA with plasmid mini-prep kit (Jena Bioscience, Jena, Germany). Data analysis was with appropriate descriptive and inferential statistics. One hundred and six isolates (53.00%) out of the 200 were from urine, followed by isolates from different swabs specimens 53(26.50%) and the least number of the isolates 4(2.00) were from blood (P value = 0.096). Seventy (35.00%) out of the 200 isolates, were confirmed positive for ESBL production. Forty-two (60.00%) of the isolates were from female patients while 28(40.00%) were from male patients (P value = 0.13). Sixty-eight (97.14%) of the isolates were susceptible to imipenem while all of the isolates were resistant to ampicillin, chloramphenicol and tetracycline. From the 70 positive isolates the ESBL genes detected with polymerase chain reaction were blaCTX-M (n=26; 37.14%), blaTEM (n=7; 10.00%), blaSHV (n=2; 2.86%), blaCTX-M/TEM (n=7; 10.0%), blaCTX-M/SHV (n=14; 20.0%) and blaCTX-M/TEM/SHV (n=10; 14.29%). There was no gene detected in 4(5.71%) of the isolates. The most associated risk factors to infections caused by ESBL producing Escherichia coli was previous antibiotics use for the past 3 months followed by admission in the intensive care unit, recent surgery, and urinary catheterization. In conclusion, ESBLs was detected in 4 of every 10 Escherichia coli with the predominant gene detected being CTX-M. This knowledge will enable appropriate measures towards improvement of patient health care, antibiotic stewardship, research and infection control in the hospital.

Keywords: antimicrobial, Escherichia coli, extended spectrum beta lactamase, resistance

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Authors: Laura Roe

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This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.

Keywords: addiction, poly-substance use, temporality, timelessness

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Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Menuka Maharjan

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In the name of food security, agriculture intensification through conventional farming is being implemented in Nepal. Government focus on increasing agriculture production completely ignores soil as well human health. This leads to create serious soil degradation, i.e., reduction of soil fertility and microbial activity and health hazard in the country. On this note, organic farming is sustainable agriculture approach which can address challenge of sustaining food security while protecting the environment. This creates a win-win situation both for people and the environment. However, people have limited knowledge on significance of organic farming for environment conservation and food security especially developing countries like Nepal. Thus, the objective of the study was to assess the impacts of organic farming on soil fertility and microbial activity compared to conventional farming and forest in Chitwan, Nepal. Total soil organic carbon (C) was highest in organic farming (24 mg C g⁻¹ soil) followed by conventional farming (15 mg C g⁻¹ soil) and forest (9 mg C g⁻¹ soil) in the topsoil layer (0-10 cm depth). A similar trend was found for total nitrogen (N) content in all three land uses with organic farming soil possessing the highest total N content in both 0-10 cm and 10-20 cm depth. Microbial biomass C and N were also highest under organic farming, especially in the topsoil layer (350 and 46 mg g⁻¹ soil, respectively). Similarly, microbial biomass phosphorus (P) was higher (3.6 and 1.0 mg P kg⁻¹ at 0-10 and 10-20 cm depth, respectively) in organic farming compared to conventional farming and forest at both depths. However, conventional farming and forest soils had similar microbial biomass (C, N, and P) content. After conversion of forest, the P stock significantly increased by 373% and 170% in soil under organic farming at 0-10 and 10-20 cm depth, respectively. In conventional farming, the P stock increased by 64% and 36% at 0-10 cm and 10-20 cm depth, respectively, compared to forest. Overall, organic farming practices, i.e., crop rotation, residue input and farmyard manure application, significantly alters soil fertility and microbial activity. Organic farming system is emerging as a sustainable land use system which can address the issues of food security and environment conservation by increasing sustainable agriculture production and carbon sequestration, respectively, supporting to achieve goals of sustainable development.

Keywords: organic farming, soil fertility, micobial biomas, food security

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Authors: Mariia Karizhenskaia, Tanvi Nandani, Ali Tafazoli Moghadam

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Hospice palliative care (HPC) is one of the most complicated philosophies of care in which physical, social/cultural, and spiritual aspects of human life are intermingled with an undeniably significant role in every aspect. Among these dimensions of care, culture possesses an outstanding position in the process and goal determination of HPC. This study shows the importance of cultural elements in the establishment of effective and optimized structures of HPC in the Canadian healthcare environment. Our systematic search included Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 1998 to 2023 to identify recent national literature connecting culture and palliative care delivery. The most frequently presented feature among the articles is the role of culture in the efficiency of the HPC. It has been shown frequently that including the culturespecific parameters of each nation in this system of care is vital for its success. On the other hand, ignorance about the exclusive cultural trends in a specific location has been accompanied by significant failure rates. Accordingly, implementing a culture-wise adaptable approach is mandatory for multicultural societies. The following outcome of research studies in this field underscores the importance of culture-oriented education for healthcare staff. Thus, all the practitioners involved in HPC will recognize the importance of traditions, religions, and social habits for processing the care requirements. Cultural competency training is a telling sample of the establishment of this strategy in health care that has come to the aid of HPC in recent years. Another complexity of the culturized HPC nowadays is the long-standing issue of racialization. Systematic and subconscious deprivation of minorities has always been an adversity of advanced levels of care. The last part of the constellation of our research outcomes is comprised of the ethical considerations of culturally driven HPC. This part is the most sophisticated aspect of our topic because almost all the analyses, arguments, and justifications are subjective. While there was no standard measure for ethical elements in clinical studies with palliative interventions, many research teams endorsed applying ethical principles for all the involved patients. Notably, interpretations and projections of ethics differ in varying cultural backgrounds. Therefore, healthcare providers should always be aware of the most respectable methodologies of HPC on a case-by-case basis. Cultural training programs have been utilized as one of the main tactics to improve the ability of healthcare providers to address the cultural needs and preferences of diverse patients and families. In this way, most of the involved health care practitioners will be equipped with cultural competence. Considerations for ethical and racial specifications of the clients of this service will boost the effectiveness and fruitfulness of the HPC. Canadian society is a colorful compilation of multiple nationalities; accordingly, healthcare clients are diverse, and this divergence is also translated into HPC patients. This fact justifies the importance of studying all the cultural aspects of HPC to provide optimal care on this enormous land.

Keywords: cultural competence, end-of-life care, hospice, palliative care

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Authors: Mohammad Mahdi Hajiali

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Many of construction projects estimated in Iran have been influenced by the limitations of financial resources. As for Iran, a country that is developing, and to follow this development-oriented approach which many numbers of projects each year run in, if we can reduce the cost of projects by applying a method we will help greatly to minimize the cost of major construction projects and therefore projects will finish faster and more efficiently. One of the components of transportation infrastructure are roads that are considered to have a considerable share of the country budget. In addition, major budget of the related ministry is spending to repair, improve and maintain roads. Value Engineering is a simple and powerful methodology over the past six decades that has been successful in reducing the cost of many projects. Specific solution for using value engineering in the stage of project implementation is called value engineering change proposal (VECP). It was tried in this research to apply VECP in one of the road-building projects in Iran in order to enhance the value of this kind of projects and reduce their cost. In this case study after applying VECP, an idea was raised. It was about use of concrete pavement instead of hot mixed asphalt (HMA) and also using fiber in order to improve concrete pavement performance. VE group team made a decision that for choosing the best alternatives, get expert’s opinions in pavement systems and use Fuzzy TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) for ranking opinions of the experts. Finally, Jointed Plain Concrete Pavement (JPCP) was selected. Group also experimented concrete samples with available fibers in Iran and the results of experiments showed a significant increment in concrete specifications such as flexural strength. In the end, it was shown that by using of fiber-reinforced concrete pavement instead of asphalt pavement, we can achieve a significant saving in cost, time and also increment in quality, durability, and longevity.

Keywords: road-building projects, value engineering change proposal (VECP), Jointed Plain Concrete Pavement (JPCP), Fuzzy TOPSIS, fiber-reinforced concrete

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Authors: T. J. B. van Niekerk, J. Viviers, E. J. Cilliers

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Substantial efforts were made in South Africa, stemming from a historic political change in 1994, to remedy the inequality and injustice, resulting from a dispensation where spatial patterns were largely based on racial segregation. Spatially distorted patterns predominantly originated from colonialism in the beginning of the twentieth century, ensuing a physical imprint on South African cities relating to architecture, urban layout and planning, frequently reflecting European norms and standards. As a consequence of physical and land use barriers, and well-established dual cities, attempts to address spatial injustices, apart from limited occurrences in metropolitan areas, gravely failed. Interception of incessant segregated growth, combined with urban sprawl is becoming increasingly evident. Intervention is a prerequisite to duly address the impact of colonial planning and its legacy still prevalent in most urban areas. During 1998, the National Department of Transport prepared the “Moving South Africa” strategy; presenting the Corridor Densification Option Model for the first time, as it was deemed more fitting to the existing South African urban tenure patterns than more familiar planning approaches. Urban planners are progressively contemplating the Corridor Densification Option Model and its attributes, besides its transportation emphasis, as an alternative approach to address spatial imbalances and to attain the physical integration of contemporary urban forms. In attaining a clearer understanding of the Corridor Densification Option Model, its rationale was analysed in greater detail. This research further investigated the provisional applications of the model in spatially segregated cities and illustrated that viable options are present to effectively employ it. Research revealed that the application of the model will, however, be dependent on the occurrence of specific characteristics in spatially segregated cities to warrant augmentation thereof.

Keywords: corridor densification option model, spatially segregated settlements, integration, urban restructuring

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Authors: G. Disciglio, G. Gatta, F. Lops, A. Libutti, A. Tarantino, E. Tarantino

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The experimental trial was carried out in open field at Foggia district (Apulia Region, Southern Italy), during the spring-summer season 2014, in order to evaluate the effect of four biostimulant products (RadiconÒ, Viormon plusÒ, LysodinÒ and SiaptonÒ 10L), compared with a control (no biostimulant), on the infestation of processing tomato crop (cv Dres) by the chlorophyll-lacking root parasite Phelipanche ramosa. Biostimulants consist in different categories of products (microbial inoculants, humic and fulvic acids, hydrolyzed proteins and aminoacids, seaweed extracts) which play various roles in plant growing, including the improvement of crop resistance and quali-quantitative characteristics of yield. The experimental trial was arranged according to a complete randomized block design with five treatments, each of one replicated three times. The processing tomato seedlings were transplanted on 5 May 2014. Throughout the crop cycle, P. ramosa infestation was assessed according to the number of emerged shoots (branched plants) counted in each plot, at 66, 78 and 92 day after transplanting. The tomato fruits were harvested at full-stage of maturity on 8 August 2014. From each plot, the marketable yield was measured and the quali-quantitative yield parameters (mean weight, dry matter content, colour coordinate, colour index and soluble solids content of the fruits) were determined. The whole dataset was tested according to the basic assumptions for the analysis of variance (ANOVA) and the differences between the means were determined using Tukey’s tests at the 5% probability level. The results of the study showed that none of the applied biostimulants provided a whole control of Phelipanche, although some positive effects were obtained from their application. To this respect, the RadiconÒ appeared to be the most effective in reducing the infestation of this root-parasite in tomato crop. This treatment also gave the higher tomato yield.

Keywords: biostimulant, control methods, Phelipanche ramosa, tomato crop

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Authors: Thifhuriwi Emmanuel Madzunye, Patricia Harpur, Ephias Ruhode

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A review of the pertinent literature identified a gap concerning the hindrances and opportunities accompanying the implementation of real-time online learning systems (RTOLs) in rural areas. Whilst RTOLs present a possible solution to teaching and learning issues in rural areas, little is known about the implementation of digital strategies among schools in isolated communities. This study explores associated guidelines that have the potential to inform decision-making where Internet-based education could improve educational opportunities. A systematic literature review has the potential to consolidate and focus on disparate literature served to collect interlinked data from specific sources in a structured manner. During qualitative data analysis (QDA) of selected publications via the application of a QDA tool - ATLAS.ti, the following overarching themes emerged: digital divide, educational strategy, human factors, and support. Furthermore, findings from data collection and literature review suggest that signiant factors include a lack of digital knowledge, infrastructure shortcomings such as a lack of computers, poor internet connectivity, and handicapped real-time online may limit students’ progress. The study recommends that timeous consideration should be given to the influence of the digital divide. Additionally, the evolution of educational strategy that adopts digital approaches, a focus on training of role-players and stakeholders concerning human factors, and the seeking of governmental funding and support are essential to the implementation and success of RTOLs.

Keywords: communication, digital divide, digital skills, distance, educational strategy, government, ICT, infrastructures, learners, limpopo, lukalo, network, online learning systems, political-unrest, real-time, real-time online learning, real-time online learning system, pass-rate, resources, rural area, school, support, teachers, teaching and learning and training

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Authors: Mohammed Seyam, Faridah Othman, Ahmed El-Shafie

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The early warning of high stream flow events (HSF) and floods is an important aspect in the management of surface water and rivers systems. This process can be performed using either process-based models or data driven-based models such as artificial intelligence (AI) techniques. The main goal of this study is to develop efficient AI-based model for predicting the real-time hourly stream flow (Q) and apply it as early warning tool of HSF and floods in the downstream area of the Selangor River basin, taken here as a paradigm of humid tropical rivers in Southeast Asia. The performance of AI-based models has been improved through the integration of the lag time (Lt) estimation in the modelling process. A total of 8753 patterns of Q, water level, and rainfall hourly records representing one-year period (2011) were utilized in the modelling process. Six hydrological scenarios have been arranged through hypothetical cases of input variables to investigate how the changes in RF intensity in upstream stations can lead formation of floods. The initial SF was changed for each scenario in order to include wide range of hydrological situations in this study. The performance evaluation of the developed AI-based model shows that high correlation coefficient (R) between the observed and predicted Q is achieved. The AI-based model has been successfully employed in early warning throughout the advance detection of the hydrological conditions that could lead to formations of floods and HSF, where represented by three levels of severity (i.e., alert, warning, and danger). Based on the results of the scenarios, reaching the danger level in the downstream area required high RF intensity in at least two upstream areas. According to results of applications, it can be concluded that AI-based models are beneficial tools to the local authorities for flood control and awareness.

Keywords: floods, stream flow, hydrological modelling, hydrology, artificial intelligence

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Authors: Huey-Yeu Yan, Ching-Ying Lee, Hung-Ru Lin

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Background: Physical assessment is a vital clinical nursing competence. The gap between conventional teaching method and the way e-generation students’ preferred could be bridged owing to the support of Internet technology, i.e. interacting with online media to manage learning works. Nursing instructors in the wake of new learning pattern of the e-generation students are challenged to actively adjust and make teaching contents and methods more versatile. Objective: The objective of this research is to explore the effects on teaching and learning with live webcast-assisted on a specific topic, Physical Assessment technique, on a designated group of young nursing majors. It’s hoped that, with a way of nursing instructing, more versatile learning resources may be provided to facilitate self-directed learning. Design: This research adopts a cross-sectional descriptive survey. The instructor demonstrated physical assessment techniques and operation procedures via live webcast broadcasted online to all students. It increased both the off-time interaction between teacher and students concerning teaching materials. Methods: A convenient sampling was used to recruit a total of 52 nursing-majors at a certain university. The nursing majors took two-hour classes of Physical Assessment per week for 18 weeks (36 hrs. in total). The instruction covered four units with live webcasting and then conducted an online anonymous survey of learning outcomes by questionnaire. The research instrument was the online questionnaire, covering three major domains—online media used, learning outcome evaluation and evaluation result. The data analysis was conducted via IBM SPSS Statistics Version 2.0. The descriptive statistics was undertaken to describe the analysis of basic data and learning outcomes. Statistical methods such as descriptive statistics, t-test, ANOVA, and Pearson’s correlation were employed in verification. Results: Results indicated the following five major findings. (1) learning motivation, about four fifth of the participants agreed the online instruction resources are very helpful in improving learning motivation and raising the learning interest. (2) learning needs, about four fifth of participants agreed it was helpful to plan self-directed practice after the instruction, and meet their needs of repetitive learning and/or practice at their leisure time. (3) learning effectiveness, about two third agreed it was helpful to reduce pre-exam anxiety, and improve their test scores. (4) course objects, about three fourth agreed that it was helpful to achieve the goal of ‘executing the complete Physical Assessment procedures with proper skills’. (5) finally, learning reflection, about all of participants agreed this experience of online instructing, learning, and practicing is beneficial to them, they recommend instructor to share with other nursing majors, and they will recommend it to fellow students too. Conclusions: Live webcasting is a low-cost, convenient, efficient and interactive resource to facilitate nursing majors’ motivation of learning, need of self-directed learning and practice, outcome of learning. When live webcasting is integrated into nursing teaching, it provides an opportunity of self-directed learning to promote learning effectiveness, as such to fulfill the teaching objective.

Keywords: innovative teaching, learning effectiveness, live webcasting, physical assessment technique

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Authors: Mohammed Alharbi, Clare Wood, Vasileios Samaras

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Sustainability leadership is a controversial topic, particularly in the engineering context. The theoretical and practical technical focus of the engineering profession impacts our lives. Technologically, engineers significantly contribute to our modern civilization. Industrial revolutions are among the top engineering accomplishments that have contributed to the flourishing of our life. However, engineers have not always received the credit they deserve; instead, they have been blamed for the advent of various global issues, among them the global warming phenomena that are believed to be a result of the industrial revolutions. Global challenges demand engineers demonstrate more than their technical skills for effective contribution to a sustainable future. As a result, engineering leadership has emerged as a new research field. Sustainable manufacturing is a cornerstone for sustainable development. Investigating the change to more sustainable manufacturing practices is a significant issue for all, and even more in the field of engineering leadership. Engineers dominate the manufacturing industry; however, one of the main criticism of engineers is the lack of leadership skills. The literature on engineering leadership has not highlighted enough the engineers' leadership ability in leading sustainable manufacturing. Since we are at the cusp of a new industrial revolution -Industry 4.0, it is vital to investigate the ability of engineers to lead the industry towards a sustainable future. The primary purpose of this paper is to evaluate engineers' sustainability leadership competencies utilizing The Cambridge University Behavioral Competency Model. However, the practical application of the Cambridge model is limited due to the absence of a reliable measurement tool. Therefore, this study developed a valid and reliable survey instrument tool compatible with the Cambridge model as a secondary objective. More than 300 Saudi engineers from the manufacturing industry responded to an online questionnaire collected through the Qualtrics platform and analyzed using SPSS software. The findings provide a contemporary understanding of engineers' mindset related to sustainability leadership. The output of this research study could be valuable in designing effective engineering leadership programs in academia or industry, particularly for enhancing a sustainable manufacturing environment.

Keywords: engineer, leadership, manufacturing, sustainability

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Authors: Esther Friedlander, Philip Friedlander

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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

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Authors: Nurul Aliaa Idris, David A. Collings

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Phi thickenings are specialized secondary cell wall thickenings that are found in the cortex of the roots in a wide range of plant species, including orchids. The role of phi thickenings in the root is still under debate through research have linked environmental conditions, particularly abiotic stresses such as water stress, heavy metal stress and salinity to their induction in the roots. It has also been suggested that phi thickenings may act as a barrier to regulate solute uptake, act as a physical barrier against fungal hyphal penetration due to its resemblance to the Casparian strip and play a mechanical role to support cortical cells. We have investigated phi thickening function in epiphytic orchids of the genus Miltoniopsis through induction experiment against factors such as soil compaction and water stress. The permeability of the phi thickenings in Miltoniopsis was tested through uptake experiments using the fluorescent tracer dyes Calcofluor white, Lucifer yellow and Propidium iodide then viewed with wide-field or confocal microscopy. To test whether phi thickening may prevent fungal colonization in the root cell, fungal re-infection experiment was conducted by inoculating isolated symbiotic fungus to sterile in vitro Miltoniopsis explants. As the movement of fluorescent tracers through the apoplast was not blocked by phi thickenings, and as phi thickenings developed in the roots of sterile cultures in the absence of fungus and did not prevent fungal colonization of cortical cells, the phi thickenings in Miltoniopsis do not function as a barrier. Phi thickenings were found to be absent in roots grown on agar and remained absent when plants were transplanted to moist soil. However, phi thickenings were induced when plants were transplanted to well-drained media, and by the application of water stress in all soils tested. It is likely that phi thickenings stabilize the root cortex during dehydration. Nevertheless, the varied induction responses present in different plant species suggest that the phi thickenings may play several adaptive roles, instead of just one, depending on species.

Keywords: abiotic stress, Miltoniopsis, orchid, phi thickening

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Authors: Victor Manuel Alcántara Alza

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The way in which the application of the deep cryogenic treatment DCT(-196°C) affects, applied with subsequent aging, was investigated, regarding the mechanical properties of hardness, toughness and microstructure, applied to martensitic stainless steels, with the aim of establishing a different methodology compared to the traditional DCT cryogenic treatment with subsequent tempering. For this experimental study, a muffle furnace was used, first subjecting the specimens to deep cryogenization in a liquid Nitrogen bath/4h, after being previously austenitized at the following temperatures: 1020-1030-1040-1050 (°C) / 1 hour; and then tempered in oil. A first group of cryogenic samples were subjected to subsequent aging at 150°C, with immersion times: 2.5 -5- 10 - 20 - 50 – 100 (h). The next group was subjected to subsequent tempering at temperatures: 480-500-510-520-530-540 (°C)/ 2h. The hardness tests were carried out under standards, using a Universal Durometer, and the readings were made on the HRC scale. The Impact Resistance tests were carried out in a Charpy machine following the ASTM E 23 – 93ª standard. Measurements were taken in joules. Microscopy was performed at the optical level using a 1000X microscope. It was found: For the entire aging interval, the samples austenitized at 1050°C present greater hardness than austenitized at 1040°C, with the maximum peak aged being at 30h. In all cases, the aged samples exceed the hardness of the tempered samples, even in their minimum values. In post-tempered samples, the tempering temperature hardly have effect on the impact strength of material. In the Cryogenic Treatment: DCT + subsequent aging, the maximum hardness value (58.7 HRC) is linked to an impact toughness value (54J) obtained with aging time of 39h, which is considered an optimal condition. The higher hardness of steel after the DCT treatment is attributed to the transformation of retained austenite into martensite. The microstructure is composed mainly of lath martensite; and the original grain size of the austenite can be appreciated. The choice of the combination: Hardness-toughness, is subject to the required service conditions of steel.

Keywords: deep cryogenic treatment; aged precipitation; martensitic steels;, mechanical properties; martensitic steels, hardness, carbides precipitaion

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Authors: Thomas Louis, Irina Primac, Florent Morfoisse, Tania Durre, Silvia Blacher, Agnes Noel

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In vitro and in vivo lymphangiogenesis assays are essential for the identification of potential lymphangiogenic agents and the screening of pharmacological inhibitors. In the present study, we analyse three biological models: in vitro lymphatic endothelial cell spheroids, in vivo ear sponge assay, and in vivo lymph node colonisation by tumour cells. These assays provide suitable 3D models to test pro- and anti-lymphangiogenic factors or drugs. 3D images were acquired by confocal laser scanning and light sheet fluorescence microscopy. Virtual scan microscopy followed by 3D reconstruction by image aligning methods was also used to obtain 3D images of whole large sponge and ganglion samples. 3D reconstruction, image segmentation, skeletonisation, and other image processing algorithms are described. Fixed and time-lapse imaging techniques are used to analyse lymphatic endothelial cell spheroids behaviour. The study of cell spatial distribution in spheroid models enables to detect interactions between cells and to identify invasion hierarchy and guidance patterns. Global measurements such as volume, length, and density of lymphatic vessels are measured in both in vivo models. Branching density and tortuosity evaluation are also proposed to determine structure complexity. Those properties combined with vessel spatial distribution are evaluated in order to determine lymphangiogenesis extent. Lymphatic endothelial cell invasion and lymphangiogenesis were evaluated under various experimental conditions. The comparison of these conditions enables to identify lymphangiogenic agents and to better comprehend their roles in the lymphangiogenesis process. The proposed methodology is validated by its application on the three presented models.

Keywords: 3D image segmentation, 3D image skeletonisation, cell invasion, confocal microscopy, ear sponges, light sheet microscopy, lymph nodes, lymphangiogenesis, spheroids

Procedia PDF Downloads 360

Authors: Abubakar Bello Usman, Alhassan Muhammad Gani, Kolo Ibrahim

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The use of botanical raw materials to produce pharmaceuticals, herbal remedies, teas, spirits, cosmetics, sweets, dietary supplements, special industrial compounds and crude materials constitute an important global resource in terms of healthcare and economy. In Nigeria and other developing countries, the indigenous knowledge on the uses of plants lies with the older generation and the traditional healers. However, these custodians are decreasing in number due to death and other unforeseen occurrences. An Ethno-botanical survey was carried out to obtain information on the ethno medical values of wide range of plants used by the people of Gombe State, North-Eastern Nigeria, in the practice of healing and cure of typhoid (enteric) fever. Oral interviews were conducted so as to consider those with low literacy level who are involved in the practice of traditional medicine and thirty four (34) informants availed themselves for the interview and were consulted. All relevant information obtained from the respondents was recorded. A recent and valid nomenclature, along with local names, family names, part of the plant(s) used, methods of preparation and administration and fifty four (54) plant species belonging to 27 families as well as 7 unidentified species that are commonly used by the people of the state in ethnomedical treatment of the ailment were tabulated. Those interviewed included traditional practitioners, local herb sellers, traditional rulers, hunters, farmers and patients. Specific questions were asked and information supplied by informants was promptly documented. Results showed that the people of Gombe State are knowledgeable on herbal medicine in the treatment of diseases and ailments. Furthermore, the aqueous leaf extracts of Senna siamea, the plant species with the highest PPK (percentage of people who have knowledge about the use of a species for treating typhoid fever) in this ethnobotanical survey, was tested for its activity against clinical isolates of Salmonella typhi using the agar well diffusion method. The aqueous extracts showed some activity (zones of inhibition 11, 9, 7.5, 3.5, 1.3 mm) at 2000, 1800, 1600, 1400, 1200 µg/ml concentrations respectively. Preliminary phytochemical studies of the aqueous leaf extracts of the plant revealed the presence of secondary metabolites such as alkaloids, saponins, tannins, flavonoids and cardiac glycosides. Though a large number of traditionally used plants for the treatment of enteric fever were identified, further scientific validation of the traditional claims of anti-typhoid properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-typhoid drugs, as well as in the conservation of this rich diversity of medicinal plants.

Keywords: antimicrobial activities, ethnobotany, gombe state, north-eastern Nigeria, phytochemical screening, senna siamea, typhoid fever

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Authors: Kwan Hee Han

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External environment of enterprise is rapidly changing majorly by global competition, cost reduction pressures, and new technology. In these situations, production scheduling function plays a critical role to meet customer requirements and to attain the goal of operational efficiency. It deals with short-term decision making in the production process of the whole supply chain. The major task of production scheduling is to seek a balance between customer orders and limited resources. In manufacturing companies, this task is so difficult because it should efficiently utilize resource capacity under the careful consideration of many interacting constraints. At present, many computerized software solutions have been utilized in many enterprises to generate a realistic production schedule to overcome the complexity of schedule generation. However, most production scheduling systems do not provide sufficient information about the validity of the generated schedule except limited statistics. Process mining only recently emerged as a sub-discipline of both data mining and business process management. Process mining techniques enable the useful analysis of a wide variety of processes such as process discovery, conformance checking, and bottleneck analysis. In this study, the performance of generated production schedule is evaluated by mining event log data of production scheduling software system by using the process mining techniques since every software system generates event logs for the further use such as security investigation, auditing and error bugging. An application of process mining approach is proposed for the validation of the goodness of production schedule generated by scheduling software systems in this study. By using process mining techniques, major evaluation criteria such as utilization of workstation, existence of bottleneck workstations, critical process route patterns, and work load balance of each machine over time are measured, and finally, the goodness of production schedule is evaluated. By using the proposed process mining approach for evaluating the performance of generated production schedule, the quality of production schedule of manufacturing enterprises can be improved.

Keywords: data mining, event log, process mining, production scheduling

Procedia PDF Downloads 266

Authors: Tania Viju, Bimal P., Naseer M. A.

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This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

Procedia PDF Downloads 125

Authors: Albert P. Ekanem, Austin I. Obiekezie, Elizabeth X. Ntia

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Introduction: Some African plants and bile from animals have shown efficacies in the treatment and control of diseases in farmed fish. The background of the study is based on the fact the African rain forest is blessed with the abundance of medicinal plants that should be investigated for their use in the treatment of diseases. The significance of the study is informed by the fact that chemical-based substances accumulate in the tissues of food fish, thereby reducing the food values of such products and moreover, the continuous use of chemotherapeutics in the aquatic environments tends to degrade the affected environment. Methodology: Plants and animal products were extracted, purified and applied under in vitro and in vivo conditions to the affected organisms. Effective plants and bills were analyzed for biologically active substances responsible for the activities by both qualitative and HPLC methods. Results: Extracts of Carica papaya and Mucuna pruriens were effective in the treatment of Ichthyophthiriasis in goldfish (Carassius auratus auratus) with high host tolerance. Similarly, ectoparasitic monogeneans were effectively dislodged from the gills and skin of goldfish by the application of extracts of Piper guineense at therapeutic concentrations. Artemesia annua with known antimalarial activities in human was also effective against fish monogenean parasites of Clarias gariepinus in a concentration-related manner without detriments to the host. Effective antibacterial activities against Aeromonas and Pseudomonas diseases of the African catfish (Heterobranchus longifilis) were demonstrated in some plants such as Phylanthus amarus, Allium sativum, A. annua, and Citrus lemon. Bile from some animals (fish, goat, chicken, cow, and pig) showed great antibacterial activities against some gastrointestinal bacterial pathogens of fish. Conclusions: African plants and some animal bile have shown potential promise in the treatment of diseases in fish and other aquatic animals. The use of chemical-based substances for control of diseases in the aquatic environments should be restricted.

Keywords: control, diseases, fish, treatment

Procedia PDF Downloads 442

Authors: Léa Chawki, Émilie Cappe

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Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

Procedia PDF Downloads 81

Authors: Eyasu Markos Woldesemayat, Paolo Vincenzo Genovese

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In recent years with an increase in the concentration of Green House Gases (GHG), Climate Change (CC) externalities are mounting, regardless of governments, are scrambling to implement mitigation and adaptation measures. With multiple social, economic and environmental benefits, Green Infrastructure (GI) has evolved as a highly valuable policy tool to promote sustainable development and smart growth by meeting multiple objectives towards quality of life. However, despite the wide range of benefits, it's uptake in African cities such as Addis Ababa is very low due to several constraining factors. This study, through content analysis and key informant interviews, examined barriers for the uptake of GI among spatial planners in Addis Ababa. Added to this, the study has revealed that the spatial planners had insufficient knowledge about GI planning principles such as multi-functionality, integration, and connectivity, and multiscale. The practice of implementing these holistic principles in urban spatial planning is phenomenally nonexistent. The findings also revealed 20 barriers categorized under four themes, i.e., institutional, socio-cultural, resource, and cognitive barriers. Similarly, it was identified that institutional barriers (0.756), socio-cultural barriers (0.730), cognitive barriers (0.700) and resource barriers (0.642), respectively, are the foremost impending factors for the promotion of GI in Addis Ababa. It was realized that resource barriers were the least constraining factor for enshrining the GI uptake in the city. Strategies to hasten the adoption of GI in the city mainly focus on improving political will, harmonization sectorial plans, improve spatial planning and implementation practice, prioritization of GI in all planning activities, enforcement of environmental laws, introducing collaborative GI governance, creating strong and stable institutions and raising awareness on the need to conserve environment and CC externalities through education and outreach mechanisms.

Keywords: Addis Ababa, climate change, green infrastructure, spatial planning, spatial planners

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Authors: Innocent Uzougbo Onwuegbuzie

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Healthcare delivery in low-income markets is fraught with numerous challenges, including limited access to essential medical resources, inadequate healthcare infrastructure, and a significant shortage of trained healthcare professionals. These constraints lead to suboptimal health outcomes and a higher incidence of preventable diseases. This paper explores the application of Wireless Sensor Networks (WSNs) as a transformative solution to enhance healthcare delivery in these underserved regions. WSNs, comprising spatially distributed sensor nodes that collect and transmit health-related data, present opportunities to address critical healthcare needs. Leveraging WSN technology facilitates real-time health monitoring and remote diagnostics, enabling continuous patient observation and early detection of medical issues, especially in areas with limited healthcare facilities and professionals. The implementation of WSNs can enhance the overall efficiency of healthcare systems by enabling timely interventions, reducing the strain on healthcare facilities, and optimizing resource allocation. This paper highlights the potential benefits of WSNs in low-income markets, such as cost-effectiveness, increased accessibility, and data-driven decision-making. However, deploying WSNs involves significant challenges, including technical barriers like limited internet connectivity and power supply, alongside concerns about data privacy and security. Moreover, robust infrastructure and adequate training for local healthcare providers are essential for successful implementation. It further examines future directions for WSNs, emphasizing innovation, scalable solutions, and public-private partnerships. By addressing these challenges and harnessing the potential of WSNs, it is possible to revolutionize healthcare delivery and improve health outcomes in low-income markets.

Keywords: wireless sensor networks (WSNs), healthcare delivery, low-Income markets, remote patient monitoring, health data security

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Authors: S. Malebary, W. Xu

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Antennas are important components that enable transmitting and receiving signals in mid-air (wireless). The radiation pattern of omni-directional (i.e., dipole) antennas, reflects the variation of power radiated by an antenna as a function of direction when transmitting. As the performance of the antenna is the same in transmitting and receiving, it also reflects the sensitivity of the antenna in different directions when receiving. The main observation when dealing with omni-directional antennas, regardless the application, is they equally radiate power in all directions in reference to Equivalent Isotropically Radiated Power (EIRP). Disseminating radio frequency signals in an omni-directional manner form a doughnut-shape-field with a cone in the middle of the elevation plane (when mounted vertically). In this paper, we investigate the existence of this physical phenomena namely silence cone zone (the zone where radiated power is nulled). First, we overview antenna types and properties that have the major impact on the shape of the electromagnetic field. Then we model various off the shelf dipoles in Matlab based on antennas’ features (dimensions, gain, operating frequency, … etc.) and compare the resulting radiation patterns. After that, we validate the existence of the null zone in Omni-directional antennas by conducting experiments and generating waveforms (using USRP1 and USRP2) at various frequencies using different types of antennas and gains in indoor/outdoor. We capture the generated waveforms around antennas' null zone in the reactive, near, and far field with a spectrum analyzer mounted on a drone, using various off the shelf antennas. We analyze the captured signals in RF-Explorer and plot the impact on received power and signal amplitude inside and around the null zone. Finally, it is concluded from evaluation and measurements the existence of null zones in Omni-directional antennas which we plan on extending this work in the near future to investigate the usability of the null zone for various applications such as localization and path finding.

Keywords: antennas, amplitude, field regions, frequency, FSPL, omni-directional, radiation pattern, RSSI, silence zone cone

Procedia PDF Downloads 291

Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

Procedia PDF Downloads 57

Authors: S. B. R. Slagmulder

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Monitoring inspiratory effort and dynamic lung stress in patients on pressure support ventilation in the ICU is important for protecting against self inflicted lung injury (P-SILI) and diaphragm dysfunction. Strategies to address the detrimental effects of respiratory drive and effort can lead to improved patient outcomes. Two non-invasive estimation methods, occlusion pressure (Pocc) and P0.1, have been proposed for achieving lung and diaphragm protective ventilation. However, their relationship and interpretation in neuro ICU patients is not well understood. P0.1 is the airway pressure measured during a 100-millisecond occlusion of the inspiratory port. It reflects the neural drive from the respiratory centers to the diaphragm and respiratory muscles, indicating the patient's respiratory drive during the initiation of each breath. Occlusion pressure, measured during a brief inspiratory pause against a closed airway, provides information about the inspiratory muscles' strength and the system's total resistance and compliance. Research Objective: Understanding the relationship between Pocc and P0.1 in brain-injured patients can provide insights into the interpretation of these values in pressure support ventilation. This knowledge can contribute to determining extubation readiness and optimizing ventilation strategies to improve patient outcomes. The central goal is to asses a study protocol for determining the relationship between Pocc and P0.1 in brain-injured patients on pressure support ventilation and their ability to predict successful extubation. Additionally, comparing these values between brain-damaged and non-brain-damaged patients may provide valuable insights. Key Areas of Inquiry: 1. How do Pocc and P0.1 values correlate within brain injury patients undergoing pressure support ventilation? 2. To what extent can Pocc and P0.1 values serve as predictive indicators for successful extubation in patients with brain injuries? 3. What differentiates the Pocc and P0.1 values between patients with brain injuries and those without? Methodology: P0.1 and occlusion pressures are standard measurements for pressure support ventilation patients, taken by attending doctors as per protocol. We utilize electronic patient records for existing data. Unpaired T-test will be conducted to compare P0.1 and Pocc values between both study groups. Associations between P0.1 and Pocc and other study variables, such as extubation, will be explored with simple regression and correlation analysis. Depending on how the data evolve, subgroup analysis will be performed for patients with and without extubation failure. Results: While it is anticipated that neuro patients may exhibit high respiratory drive, the linkage between such elevation, quantified by P0.1, and successful extubation remains unknown The analysis will focus on determining the ability of these values to predict successful extubation and their potential impact on ventilation strategies. Conclusion: Further research is pending to fully understand the potential of these indices and their impact on mechanical ventilation in different patient populations and clinical scenarios. Understanding these relationships can aid in determining extubation readiness and tailoring ventilation strategies to improve patient outcomes in this specific patient population. Additionally, it is vital to account for the influence of sedatives, neurological scores, and BMI on respiratory drive and occlusion pressures to ensure a comprehensive analysis.

Keywords: brain damage, diaphragm dysfunction, occlusion pressure, p0.1, respiratory drive

Procedia PDF Downloads 53

Authors: Sukhila Krishnan, Smita Mohanty, Sanjay K. Nayak

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Polylactide (PLA) and thermoplastic starch (TPS) are the most promising bio-based materials presently available on the market. Polylactic acid is one of the versatile biodegradable polyester showing wide range of applications in various fields and starch is a biopolymer which is renewable, cheap as well as extensively available. The usual increase in the cost of petroleum-based commodities in the next decades opens bright future for these materials. Their biodegradability and compostability was an added advantage in applications that are difficult to recycle. Currently, thermoplastic starch (TPS) has been used as a substitute for synthetic plastic in several commercial products. But, TPS shows some limitations mainly due to its brittle and hydrophilic nature, which has to be resolved to widen its application.The objective of the work we report here was to initiate chemical modifications on TPS and to build up a process to control its chemical structure using a solution process which can reduce its water sensitive properties and then blended it with PLA to improve compatibility between PLA and TPS. The method involves in cleavage of starch amylose and amylopectin chain backbone to plasticize with glycerol and water in batch mixer and then the prepared TPS was reacted in solution with diisocyanates i.e, 4,4'-Methylenediphenyl Diisocyanate (MDI).This diisocyanate was used before with great success for the chemical modification of TPS surface. The method utilized here will form an urethane-linkages between reactive isocyanate groups (–NCO) and hydroxyl groups (-OH) of starch as well as of glycerol. New polymer synthesised shows a reduced crystallinity, less hydrophilic and enhanced compatibility with other polymers. The TPS was prepared by Haake Rheomix 600 batch mixer with roller rotors operating at 50 rpm. The produced material is then refluxed for 5hrs with MDI in toluene with constant stirring. Finally, the modified TPS was melt blended with PLA in different compositions. Blends obtained shows an improved mechanical properties. These materials produced are characterized by Fourier Transform Infrared Spectra (FTIR), DSC, X-Ray diffraction and mechanical tests.

Keywords: polylactic acid, thermoplastic starch, Methylenediphenyl Diisocyanate, Polylactide (PLA)

Procedia PDF Downloads 371

Authors: D Kokt, TF Dreyer

Abstract:

The main objective of the study was to design a mentoring programme aimed at developing the soft skills of mentors. The mentors are all employed by a multinational corporation. The company had a mentoring plan in place that it did not yield the required results, especially related to the development of soft skills. This prompted the researchers to conduct an extensive literature review followed by a mixed methods approach to ascertain the best practices in developing the soft skills of mentors. The outcomes of the study led to the development of a structured mentoring programme using 25 modules to be completed by mentors. The design incorporated a blended modular approach using both face-to-face teaching and teaching supported by Information Communication Technology (ICT). Blended learning was ideal as the ICT component helped to minimise instructor-mentor physical contact as part of the health measures during the Covid-19 pandemic. The blended learning approach also allowed instructors and mentors an online or offline mode, so that mentors could have more time for creative and cooperative exercises. A range of delivery methodologies were spread out across the different modules to ensure mentor engagement and accelerate mentor development. This included: concept development through in-person instructor-led training sessions, concept development through virtual instructor-led training sessions, simulations and case studies, e-learning, role plays and interactive learning using mentoring toolkits; and experiential learning through application. The mentor development journey included formal modular competency assessments. All modules contained post-competency assessment consisting of 10 questions (comprising of a combination of explanatory questions and multiple-choice questions) to ensure understanding and deal with identified competency gaps. The minimum pass mark for all modular competency assessments was 80%. Mentors were allowed retake the assessment if they scored less than 80%, until they demonstrated understanding at the required level.

Keywords: mentor, mentee, soft skills, mentor development, blended learning, modular approach

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