Search results for: evaluation tool

Authors: Selcen Nur Eri̇kci̇ Çeli̇k, Burcu İbaş Parlakyildiz, Gülay Zorer Gedi̇k

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Reducing the use of mechanical heating and cooling systems in buildings, which accounts for approximately 30-40% of total energy consumption in the world has a major impact in terms of energy conservation. Formations of buildings that have sustainable and low energy utilization, structural elements with mechanical systems should be evaluated with a holistic approach. In point of reduction of building energy consumption ratio, wall elements that are vertical building elements and have an area broadly (m2) have proposed as a regulation with a different system. In the study, designing surface heating and cooling energy with a hybrid type of modular wall system and the integration of building elements will be evaluated. The design of wall element; - Identification of certain standards in terms of architectural design and size, -Elaboration according to the area where the wall elements (interior walls, exterior walls) -Solution of the joints, -Obtaining the surface in terms of building compatible with both conceptual structural put emphasis on upper stages, these elements will be formed. The durability of the product to the various forces, stability and resistance are so much substantial that are used the establishment of ready-wall element section and the planning of structural design. All created ready-wall alternatives will be paid attention at some parameters; such as adapting to performance-cost by optimum level and size that can be easily processed and reached. The restrictions such as the size of the zoning regulations, building function, structural system, wheelbase that are imposed by building laws, should be evaluated. The building aims to intend to function according to a certain standardization system and construction of wall elements will be used. The scope of performance criteria determined on the wall elements, utilization (operation, maintenance) and renovation phase, alternative material options will be evaluated with interim materials located in the contents. Design, implementation and technical combination of modular wall elements in the use phase and installation details together with the integration of energy saving, heat-saving and useful effects on the environmental aspects will be discussed in detail. As a result, the ready-wall product with surface heating and cooling modules will be created and defined as hybrid wall and will be compared with the conventional system in terms of thermal comfort. After preliminary architectural evaluations, certain decisions for all architectural design processes (pre and post design) such as the implementation and performance in use, maintenance, renewal will be evaluated in the results.

Keywords: modular ready-wall element, hybrid, architectural design, thermal comfort, energy saving

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Authors: Jerome Joshi

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The paper presents the modelling of financial markets using the Stochastic Pi Calculus model. The Stochastic Pi Calculus model is mainly used for biological applications; however, the feature of this model promotes its use in financial markets, more prominently in high frequency trading. The trading system can be broadly classified into exchange, market makers or intermediary traders and fundamental traders. The exchange is where the action of the trade is executed, and the two types of traders act as market participants in the exchange. High frequency trading, with its complex networks and numerous market participants (intermediary and fundamental traders) poses a difficulty while modelling. It involves the participants to seek the advantage of complex trading algorithms and high execution speeds to carry out large volumes of trades. To earn profits from each trade, the trader must be at the top of the order book quite frequently by executing or processing multiple trades simultaneously. This would require highly automated systems as well as the right sentiment to outperform other traders. However, always being at the top of the book is also not best for the trader, since it was the reason for the outbreak of the ‘Hot – Potato Effect,’ which in turn demands for a better and more efficient model. The characteristics of the model should be such that it should be flexible and have diverse applications. Therefore, a model which has its application in a similar field characterized by such difficulty should be chosen. It should also be flexible in its simulation so that it can be further extended and adapted for future research as well as be equipped with certain tools so that it can be perfectly used in the field of finance. In this case, the Stochastic Pi Calculus model seems to be an ideal fit for financial applications, owing to its expertise in the field of biology. It is an extension of the original Pi Calculus model and acts as a solution and an alternative to the previously flawed algorithm, provided the application of this model is further extended. This model would focus on solving the problem which led to the ‘Flash Crash’ which is the ‘Hot –Potato Effect.’ The model consists of small sub-systems, which can be integrated to form a large system. It is designed in way such that the behavior of ‘noise traders’ is considered as a random process or noise in the system. While modelling, to get a better understanding of the problem, a broader picture is taken into consideration with the trader, the system, and the market participants. The paper goes on to explain trading in exchanges, types of traders, high frequency trading, ‘Flash Crash,’ ‘Hot-Potato Effect,’ evaluation of orders and time delay in further detail. For the future, there is a need to focus on the calibration of the module so that they would interact perfectly with other modules. This model, with its application extended, would provide a basis for researchers for further research in the field of finance and computing.

Keywords: concurrent computing, high frequency trading, financial markets, stochastic pi calculus

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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Authors: Davoud Maleki

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Today, education and investment in human capital is a long-term investment without which the economy will be stagnant Stayed. Higher education represents a type of investment in human resources by providing and improving knowledge, skills and Attitudes help economic development. Providing efficient human resources by increasing the efficiency and productivity of people and on the other hand with Expanding the boundaries of knowledge and technology and promoting technology such as the responsibility of training human resources and increasing productivity and efficiency in High specialized levels are the responsibility of universities. Therefore, the university plays an infrastructural role in economic development and growth because education by creating skills and expertise in people and improving their ability.In recent decades, Iran's higher education system has been faced with many problems, therefore, scholars have looked for it is to identify and validate the causal factors affecting the responsiveness and productivity of non-governmental universities. The data in the qualitative part is the result of semi-structured interviews with 25 senior and middle managers working in the units It was Islamic Azad University of Tehran province, which was selected by theoretical sampling method. In data analysis, stepwise method and Analytical techniques of Strauss and Corbin (1992) were used. After determining the central category (answering for the sake of the beneficiaries) and using it in order to bring the categories, expressions and ideas that express the relationships between the main categories and In the end, six main categories were identified as causal factors affecting the university's responsiveness and productivity.They are: 1- Scientism 2- Human resources 3- Creating motivation in the university 4- Development based on needs assessment 5- Teaching process and Learning 6- University quality evaluation. In order to validate the response model obtained from the qualitative stage, a questionnaire The questionnaire was prepared and the answers of 146 students of Master's degree and Doctorate of Islamic Azad University located in Tehran province were received. Quantitative data in the form of descriptive data analysis, first and second stage factor analysis using SPSS and Amos23 software were analyzed. The findings of the research indicated the relationship between the central category and the causal factors affecting the response The results of the model test in the quantitative stage confirmed the generality of the conceptual model.

Keywords: accountability, productivity, non-governmental, universities, foundation data theory

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Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: Christos E. Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Tamta Sirbilatze, Ifigenia Apostolou, Christina Kordali, Konstantina Panouria, Kostas Argyros, Georgios Mavras

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Malnutrition in hospitalized patients is related to increased morbidity and mortality. Purpose of our study was to assess nutritional status of hospitalized, elderly patients with various nutritional scores and to detect unfavorable prognostic factors, related to increased mortality and extended duration of admission. Methods: 150 patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). The following data were incorporated in analysis: Anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits and mediterranean diet (assessed by MedDiet score), cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were the mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Mann-Whitney two-sample statistics or t-test was used for group comparisons and Spearman or Pearson coefficients for testing correlation between variables. Results: Normal nutrition was assessed in 54/150 (36%), 92/150 (61.3%) and in 106/150 (70.7%) of patients, according to full MNA, MUST and sNAQ questionnaires respectively. Mortality rate was 20.7% (31/150 patients). The patients who died until 6 months after admission had lower BMI (24±4.4 vs 26±4.8, p=0.04) and albumin levels (2.9±0.7 vs 3.4±0.7, p=0.002), significantly lower full MNA (14.5±7.3 vs 20.7±6, p<0.0001) and short-form MNA scores (7.3±4.2 vs 10.5±3.4, p=0.0002) compared to non-dead one. In contrast, the aforementioned patients had higher MUST (2.5±1.8 vs 0.5±1.02, p=<0.0001) and sNAQ scores (2.9±2.4 vs 1.1±1.3, p<0.0001). Additionally, they showed significantly lower MedDiet (23.5±4.3 vs 31.1±5.6, p<0.0001) and IPAQ scores (37.2±156.2 vs 516.5±1241.7, p<0.0001) compared to remaining one. These patients had extended hospitalization [5 (0-13) days vs 0 (-1-3) days, p=0.001]. Patients who admitted due to cancer depicted higher mortality rate (10/13, 77%), compared to those who admitted due to infections (12/73, 18%), stroke (4/15, 27%) or other causes (4/49, 8%) (p<0.0001). Extension of hospitalization was negatively correlated to both full (Spearman r=-0.35, p<0.0001) and short-form MNA (Spearman r=-0.33, p<0.0001) and positively correlated to MUST (Spearman r=0.34, p<0.0001) and sNAQ (Spearman r=0.3, p=0.0002). Additionally, the extension was inversely related to MedDiet score (Spearman r=-0.35, p<0.0001), IPAQ score (Spearman r=-0.34, p<0.0001), albumin levels (Pearson r=-0.36, p<0.0001), Ht (Pearson r=-0.2, p=0.02) and Hb (Pearson r=-0.18, p=0.02). Conclusion: A great proportion of elderly, hospitalized patients are malnourished or at risk of malnutrition. All nutritional scores, physical activity and albumin are significantly related to mortality and increased hospitalization.

Keywords: dietary habits, duration of admission, malnutrition, prognostic factors for mortality

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Authors: Margarida Porfírio Tomás, Paula Pereira, José Manuel Palma Oliveira

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The decline in employment rates across sectors like industry and construction is exacerbated by an aging workforce. This has far-reaching implications for the economy, including skills gaps, labour shortages, productivity challenges due to physical limitations, and workplace safety concerns. To sustain the workforce and pension systems, technology plays a pivotal role. Robots provide valuable support to human workers, and effective human-robot interaction is essential. FORTIS, a Horizon project, aims to address these challenges by creating a comprehensive Human-Robot Interaction (HRI) solution. This solution focuses on multi-modal communication and multi-aspect interaction, with a primary goal of maintaining a human-centric approach. By meeting the needs of both human workers and robots, FORTIS aims to facilitate efficient and safe collaboration. The project encompasses three key activities: 1) A Human-Centric Approach involving data collection, annotation, understanding human behavioural cognition, and contextual human-robot information exchange. 2) A Robotic-Centric Focus addressing the unique requirements of robots during the perception and evaluation of human behaviour. 3) Ensuring Human-Robot Trustworthiness through measures such as human-robot digital twins, safety protocols, and resource allocation. Factor Social, a project partner, will analyse psycho-physiological signals that influence human factors, particularly in hazardous working conditions. The analysis will be conducted using a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. However, the adoption of novel technologies, particularly those involving human-robot interaction, often faces hurdles related to acceptance. To address this challenge, FORTIS will draw upon insights from Social Sciences and Humanities (SSH), including risk perception and technology acceptance models. Throughout its lifecycle, FORTIS will uphold a human-centric approach, leveraging SSH methodologies to inform the design and development of solutions. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No 101135707 (FORTIS).

Keywords: skills gaps, productivity challenges, workplace safety, human-robot interaction, human-centric approach, social sciences and humanities, risk perception

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Authors: Iordana Neamtu, Aurica P. Chiriac, Loredana E. Nita, Mihai Asandulesa, Elena Butnaru, Nita Tudorachi, Alina Diaconu

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In the last decade, the attention of many researchers is focused on the synthesis of innovative “intelligent” copolymer structures with great potential for different uses. This considerable scientific interest is stimulated by possibility of the significant improvements in physical, mechanical, thermal and other important specific properties of these materials. Functionalization of polymer in synthesis by designing a suitable composition with the desired properties and applications is recognized as a valuable tool. In this work is presented a comparative study of the properties of the new copolymers poly(maleic anhydride maleic-co-3,9-divinyl-2,4,8,10-tetraoxaspiro[5.5]undecane) and poly(itaconic-anhydride-co-3,9-divinyl-2,4,8,10-tetraoxaspiro[5.5]undecane) obtained by radical polymerization in dioxane, using 2,2′-azobis(2-methylpropionitrile) as free-radical initiator. The comonomers are able for generating special effects as for example network formation, biodegradability and biocompatibility, gel formation capacity, binding properties, amphiphilicity, good oxidative and thermal stability, good film formers, and temperature and pH sensitivity. Maleic anhydride (MA) and also the isostructural analog itaconic anhydride (ITA) as polyfunctional monomers are widely used in the synthesis of reactive macromolecules with linear, hyperbranched and self & assembled structures to prepare high performance engineering, bioengineering and nano engineering materials. The incorporation of spiroacetal groups in polymer structures improves the solubility and the adhesive properties, induce good oxidative and thermal stability, are formers of good fiber or films with good flexibility and tensile strength. Also, the spiroacetal rings induce interactions on ether oxygen such as hydrogen bonds or coordinate bonds with other functional groups determining bulkiness and stiffness. The synthesized copolymers are analyzed by DSC, oscillatory and rotational rheological measurements and dielectric spectroscopy with the aim of underlying the heating behavior, solution viscosity as a function of shear rate and temperature and to investigate the relaxation processes and the motion of functional groups present in side chain around the main chain or bonds of the side chain. Acknowledgments This work was financially supported by the grant of the Romanian National Authority for Scientific Research, CNCS-UEFISCDI, project number PN-II-132/2014 “Magnetic biomimetic supports as alternative strategy for bone tissue engineering and repair’’ (MAGBIOTISS).

Keywords: Poly(maleic anhydride-co-3, 9-divinyl-2, 4, 8, 10-tetraoxaspiro (5.5)undecane); Poly(itaconic anhydride-co-3, 9-divinyl-2, 4, 8, 10-tetraoxaspiro (5.5)undecane); DSC; oscillatory and rotational rheological analysis; dielectric spectroscopy

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Authors: Richard Byrne, Emma Mulliner

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Smart cities are a vision for the future that is increasingly becoming a reality. While a key concept of the smart city is the ability to capture, communicate, and process data that has long been produced through day-to-day activities of the city, much of the assessment models in place neglect this fact to focus on ‘smartness’ concepts. Although it is true technology often provides the opportunity to capture and communicate data in more effective ways, there are also human processes involved that are just as important. The growing importance with regards to the use and ownership of data in society can be seen by all with companies such as Facebook and Google increasingly coming under the microscope, however, why is the same scrutiny not applied to cities? The research area is therefore of great importance to the future of our cities here and now, while the findings will be of just as great importance to our children in the future. This research aims to understand the influence data is having on organisations operating throughout the smart cities sector and employs a mixed-method research approach in order to best answer the following question: Would a data-based evaluation model for smart cities be more appropriate than a smart-based model in assessing the development of the smart city? A fully comprehensive literature review concluded that there was a requirement for a data-driven assessment model for smart cities. This was followed by a documentary analysis to understand the root source of data integration to the smart city. A content analysis of city data platforms enquired as to the alternative approaches employed by cities throughout the UK and draws on best practice from New York to compare and contrast. Grounded in theory, the research findings to this point formulated a qualitative analysis framework comprised of: the changing environment influenced by data, the value of data in the smart city, the data ecosystem of the smart city and organisational response to the data orientated environment. The framework was applied to analyse primary data collected through the form of interviews with both public and private organisations operating throughout the smart cities sector. The work to date represents the first stage of data collection that will be built upon by a quantitative research investigation into the feasibility of data network effects in the smart city. An analysis into the benefits of data interoperability supporting services to the smart city in the areas of health and transport will conclude the research to achieve the aim of inductively forming a framework that can be applied to future smart city policy. To conclude, the research recognises the influence of technological perspectives in the development of smart cities to date and highlights this as a challenge to introduce theory applied with a planning dimension. The primary researcher has utilised their experience working in the public sector throughout the investigation to reflect upon what is perceived as a gap in practice of where we are today, to where we need to be tomorrow.

Keywords: data, planning, policy development, smart cities

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Authors: K. K. Balavenkatraman, B. Bertschi, K. Bigot, A. Grevot, A. Doelemeyer, S. D. Chibout, A. Wolf, F. Pognan, N. Manevski, O. Kretz, P. Swart, K. Litherland, J. Ashton-Chess, B. Ling, R. Wettstein, D. J. Schaefer

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Skin toxicity is poorly detected during preclinical studies, and drug-induced side effects in humans such as rashes, hyperplasia or more serious events like bullous pemphigus or toxic epidermal necrolysis represent an important hurdle for clinical development. In vitro keratinocyte-based epidermal skin models are suitable for the detection of chemical-induced irritancy, but do not recapitulate the biological complexity of full skin and fail to detect potential serious side-effects. Normal healthy skin explants may represent a valuable complementary tool, having the advantage of retaining the full skin architecture and the resident immune cell diversity. This study investigated several conditions for the maintenance of good morphological structure after several days of culture and the retention of phase II metabolism for 24 hours in skin explants in vitro. Human skin samples were collected with informed consent from patients undergoing plastic surgery and immediately transferred and processed in our laboratory by removing the underlying dermal fat. Punch biopsies of 4 mm diameter were cultured in an air-liquid interface using transwell filters. Different cultural conditions such as the effect of calcium, temperature and cultivation media were tested for a period of 14 days and explants were histologically examined after Hematoxylin and Eosin staining. Our results demonstrated that the use of Williams E Medium at 32°C maintained the physiological integrity of the skin for approximately one week. Upon prolonged incubation, the upper layers of the epidermis become thickened and some dead cells are present. Interestingly, these effects were prevented by addition of EGFR inhibitors such as Afatinib or Erlotinib. Phase II metabolism of the skin such as glucuronidation (4-methyl umbeliferone), sulfation (minoxidil), N-acetyltransferase (p-toluidene), catechol methylation (2,3-dehydroxy naphthalene), and glutathione conjugation (chlorodinitro benzene) were analyzed by using LCMS. Our results demonstrated that the human skin explants possess metabolic activity for a period of at least 24 hours for all the substrates tested. A time course for glucuronidation with 4-methyl umbeliferone was performed and a linear correlation was obtained over a period of 24 hours. Longer-term culture studies will indicate the possible evolution of such metabolic activities. In summary, these results demonstrate that human skin explants maintain a normal structure for several days in vitro and are metabolically active for at least the first 24 hours. Hence, with further characterisation, this model may be suitable for the study of drug-induced toxicity.

Keywords: human skin explant, phase II metabolism, epidermal growth factor receptor, toxicity

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Authors: Caroline Mendes, Mary McNamara, Orla Howe

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For chemotherapy, a drug delivery system should be able to specifically target cancer cells and deliver the therapeutic dose without affecting normal cells. Folate receptors (FR) can be considered key targets since they are commonly over-expressed in cancer cells and they are the molecular marker used in this study. Here, cyclodextrin (CD) has being studied as a vehicle for delivering the chemotherapeutic drug, methotrexate (MTX). CDs have the ability to form inclusion complexes, in which molecules of suitable dimensions are included within the CD cavity. In this study, β-CD has been modified using folic acid so as to specifically target the FR molecular marker. Thus, the system studied here for drug delivery consists of β-CD, folic acid and MTX (CDEnFA:MTX). Cellular uptake of folic acid is mediated with high affinity by folate receptors while the cellular uptake of antifolates, such as MTX, is mediated with high affinity by the reduced folate carriers (RFCs). This study addresses the gene (mRNA) and protein expression levels of FRs and RFCs in the cancer cell lines CaCo-2, SKOV-3, HeLa, MCF-7, A549 and the normal cell line BEAS-2B, quantified by real-time polymerase chain reaction (real-time PCR) and flow cytometry, respectively. From that, four cell lines with different levels of FRs, were chosen for cytotoxicity assays of MTX and CDEnFA:MTX using the MTT assay. Real-time PCR and flow cytometry data demonstrated that all cell lines ubiquitously express moderate levels of RFC. These experiments have also shown that levels of FR protein in CaCo-2 cells are high, while levels in SKOV-3, HeLa and MCF-7 cells are moderate. A549 and BEAS-2B cells express low levels of FR protein. FRs are highly expressed in all the cancer cell lines analysed when compared to the normal cell line BEAS-2B. The cell lines CaCo-2, MCF-7, A549 and BEAS-2B were used in the cell viability assays. 48 hours treatment with the free drug and the complex resulted in IC50 values of 93.9 µM ± 9.2 and 56.0 µM ± 4.0 for CaCo-2 for free MTX and CDEnFA:MTX respectively, 118.2 µM ± 10.8 and 97.8 µM ± 12.3 for MCF-7, 36.4 µM ± 6.9 and 75.0 µM ± 8.5 for A549 and 132.6 µM ± 12.1 and 288.1 µM ± 16.3 for BEAS-2B. These results demonstrate that MTX is more toxic towards cell lines expressing low levels of FR, such as the BEAS-2B. More importantly, these results demonstrate that the inclusion complex CDEnFA:MTX showed greater cytotoxicity than the free drug towards the high FR expressing CaCo-2 cells, indicating that it has potential to target this receptor, enhancing the specificity and the efficiency of the drug.

Keywords: cyclodextrins, cancer treatment, drug delivery, folate receptors, reduced folate carriers

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

Procedia PDF Downloads 106

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

Procedia PDF Downloads 71

Authors: Man-Yu Wong, Siyu Zhou, Zhiqiang Cao

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In quality of life, health service utilization is an important determinant of medical resource expenditures on Colorectal cancer (CRC) care, a better understanding of the increased utilization of health services is essential for optimizing the allocation of healthcare resources to services and thus for enhancing the service quality, especially for high expenditure on CRC care like Hong Kong region. In assessing the association between the health-related quality of life (HRQOL) and health service utilization in patients with colorectal neoplasm, count data models can be used, which account for over dispersion or extra zero counts. In our data, the HRQOL evaluation is a self-reported measure obtained from a questionnaire completed by the patients, misreports and variations in the data are inevitable. Besides, there are more zero counts from the observed number of clinical consultations (observed frequency of zero counts = 206) than those from a Poisson distribution with mean equal to 1.33 (expected frequency of zero counts = 156). This suggests that excess of zero counts may exist. Therefore, we study tests for detecting zero-inflation in models with measurement error in covariates. Method: Under classical measurement error model, the approximate likelihood function for zero-inflation Poisson regression model can be obtained, then Approximate Maximum Likelihood Estimation(AMLE) can be derived accordingly, which is consistent and asymptotically normally distributed. By calculating score function and Fisher information based on AMLE, a score test is proposed to detect zero-inflation effect in ZIP model with measurement error. The proposed test follows asymptotically standard normal distribution under H0, and it is consistent with the test proposed for zero-inflation effect when there is no measurement error. Results: Simulation results show that empirical power of our proposed test is the highest among existing tests for zero-inflation in ZIP model with measurement error. In real data analysis, with or without considering measurement error in covariates, existing tests, and our proposed test all imply H0 should be rejected with P-value less than 0.001, i.e., zero-inflation effect is very significant, ZIP model is superior to Poisson model for analyzing this data. However, if measurement error in covariates is not considered, only one covariate is significant; if measurement error in covariates is considered, only another covariate is significant. Moreover, the direction of coefficient estimations for these two covariates is different in ZIP regression model with or without considering measurement error. Conclusion: In our study, compared to Poisson model, ZIP model should be chosen when assessing the association between condition-specific HRQOL and health service utilization in patients with colorectal neoplasm. and models taking measurement error into account will result in statistically more reliable and precise information.

Keywords: count data, measurement error, score test, zero inflation

Procedia PDF Downloads 269

Authors: L. P. Gomes, G. F. Araújo, Y. M. L. Cordeiro, C. T. Andrade, E. M. Del Aguila, V. M. F. Paschoalin

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The application of nanoscale materials and nanostructures is an emerging area, these since materials may provide solutions to technological and environmental challenges in order to preserve the environment and natural resources. To reach this goal, the increasing demand must be accompanied by 'green' synthesis methods. Chitosan is a natural, nontoxic, biopolymer derived by the deacetylation of chitin and has great potential for a wide range of applications in the biological and biomedical areas, due to its biodegradability, biocompatibility, non-toxicity and versatile chemical and physical properties. Chitosan also presents high antimicrobial activities against a wide variety of pathogenic and spoilage microorganisms. Ultrasonication is a common tool for the preparation and processing of polymer nanoparticles. It is particularly effective in breaking up aggregates and in reducing the size and polydispersity of nanoparticles. High-intensity ultrasonication has the potential to modify chitosan molecular weight and, thus, alter or improve chitosan functional properties. The aim of this study was to evaluate the influence of sonication intensity and time on the changes of commercial chitosan characteristics, such as molecular weight and its potential antibacterial activity against Gram-negative bacteria. The nanoparticles (NPs) were produced from two commercial chitosans, of medium molecular weight (CS-MMW) and low molecular weight (CS-LMW) from Sigma-Aldrich®. These samples (2%) were solubilized in 100 mM sodium acetate pH 4.0, placed on ice and irradiated with an ultrasound SONIC ultrasonic probe (model 750 W), equipped with a 1/2" microtip during 30 min at 4°C. It was used on constant duty cycle and 40% amplitude with 1/1s intervals. The ultrasonic degradation of CS-MMW and CS-LMW were followed up by means of ζ-potential (Brookhaven Instruments, model 90Plus) and dynamic light scattering (DLS) measurements. After sonication, the concentrated samples were diluted 100 times and placed in fluorescence quartz cuvettes (Hellma 111-QS, 10 mm light path). The distributions of the colloidal particles were calculated from the DLS and ζ-potential are measurements taken for the CS-MMW and CS-LMW solutions before and after (CS-MMW30 and CS-LMW30) sonication for 30 min. Regarding the results for the chitosan sample, the major bands can be distinguished centered at Radius hydrodynamic (Rh), showed different distributions for CS-MMW (Rh=690.0 nm, ζ=26.52±2.4), CS-LMW (Rh=607.4 and 2805.4 nm, ζ=24.51±1.29), CS-MMW30 (Rh=201.5 and 1064.1 nm, ζ=24.78±2.4) and CS-LMW30 (Rh=492.5, ζ=26.12±0.85). The minimal inhibitory concentration (MIC) was determined using different chitosan samples concentrations. MIC values were determined against to E. coli (106 cells) harvested from an LB medium (Luria-Bertani BD™) after 18h growth at 37 ºC. Subsequently, the cell suspension was serially diluted in saline solution (0.8% NaCl) and plated on solid LB at 37°C for 18 h. Colony-forming units were counted. The samples showed different MICs against E. coli for CS-LMW (1.5mg), CS-MMW30 (1.5 mg/mL) and CS-LMW30 (1.0 mg/mL). The results demonstrate that the production of nanoparticles by modification of their molecular weight by ultrasonication is simple to be performed and dispense acid solvent addition. Molecular weight modifications are enough to provoke changes in the antimicrobial potential of the nanoparticles produced in this way.

Keywords: antimicrobial agent, chitosan, green production, nanoparticles

Procedia PDF Downloads 310

Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

Procedia PDF Downloads 161

Authors: Hyoshin Kim

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Most post-secondary educational institutions have offered a wide variety of professional development programs and resources in order to advance the quality of education. Such programs are designed to support faculty members by focusing on topics such as course design, behavioral learning objectives, class discussion, and evaluation methods. These are based on good intentions and might help both new and experienced educators. However, the fundamental flaw is that these ‘effective methods’ are assumed to work regardless of what we teach and whom we teach. This paper is focused on intercultural intelligence and its application to education. It presents a comprehensive literature review on context and cultural diversity in terms of beliefs, values and worldviews. What has worked well with a group of homogeneous local students may not work well with more diverse and international students. It is because students hold different notions of what is means to learn or know something. It is necessary for educators to move away from certain sets of generic teaching skills, which are based on a limited, particular view of teaching and learning. The main objective of the research is to expand our teaching strategies by incorporating what students bring to the course. There have been a growing number of resources and texts on teaching international students. Unfortunately, they tend to be based on the deficiency model, which treats diversity not as strengths, but as problems to be solved. This view is evidenced by the heavy emphasis on assimilationist approaches. For example, cultural difference is negatively evaluated, either implicitly or explicitly. Therefore the pressure is on culturally diverse students. The following questions reflect the underlying assumption of deficiencies: - How can we make them learn better? - How can we bring them into the mainstream academic culture?; and - How can they adapt to Western educational systems? Even though these questions may be well-intended, there seems to be something fundamentally wrong as the assumption of cultural superiority is embedded in this kind of thinking. This paper examines how educators can incorporate intercultural intelligence into the course design by utilizing a variety of tools such as pre-course activities, peer learning and reflective learning journals. The main goal is to explore ways to engage diverse learners in all aspects of learning. This can be achieved by activities designed to understand their prior knowledge, life experiences, and relevant cultural identities. It is crucial to link course material to students’ diverse interests thereby enhancing the relevance of course content and making learning more inclusive. Internationalization of higher education can be successful only when cultural differences are respected and celebrated as essential and positive aspects of teaching and learning.

Keywords: intercultural competence, intercultural intelligence, teaching and learning, post-secondary education

Procedia PDF Downloads 195

Authors: Nowrozy Jahan, Sharifah Syed Hassan, Daniel Reidpath

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In recent decades, Malaysia has become a dengue hyper-endemic country with the co-circulation of the four-dengue virus (DENV) serotypes. The number of symptomatic dengue cases is maintaining an increasing trend since 1995 and sharply increased in 2014. The four DENV serotypes have been co-circulating since 2000, and this pattern of cyclical dominance of sub-types contributed to the development of frequent major dengue epidemics in Malaysia. Since 2012, different Malaysian state was dominated by different serotypes. The study aims to estimate the burden of asymptomatic dengue in a healthy adult population which may act as a potential source of further symptomatic dengue infection. It also aims to identify the predominant DENV serotypes which are circulating at the community level. A longitudinal prospective community-based study was conducted in the Segamat district of Johor State, southern part of Malaysia where the number of reported dengue cases has steadily increased over the last three years (2013-2015). More specifically, the study was conducted in and around of Kampung Abdullah of Sungai Segamat sub-district which was identified as a hot spot area over the period of 2013-2015. This community-based study has been conducted by Southeast Asia Community Observatory (SEACO), an ISO-certified research platform in collaboration of the Ministry of Health Malaysia and Monash University Malaysia. It was conducted from May 2015 to May 2016. In this study, 277 apparently looking healthy respondents joined who were followed up as a cohort for four times during the one-year study period. Blood was collected to detect the serological marker of dengue at each round of follow-up. Among 277, 184 respondents (66%) joined all four rounds. Half of the study respondents were at the age-group of 45-64 years, slightly more than half of the respondents (59%) were female, and the most (69%) of them were Malay; only 35% lived in urban areas. During the baseline, the study found a very high prevalence of exposure to dengue virus; 89% of the study respondents had serological evidence of previous asymptomatic dengue infection; the majority of them did not know about it as they did not develop any symptom of dengue fever; only 13% knew as they developed symptoms. At the end of the one-year study period, 19% of respondents developed recent secondary dengue infection which was also identified by the serological marker as they did not develop any symptom (asymptomatic cases). The asymptomatic dengue incidence was higher during the rainy season compared to the dry season. All four dengue serotypes were identified in the serum of the infected respondents; among them, DENV-2 was the most prominent. Further genetic analysis is going on to identify the association of HLA-B*46 and HLA-DRB1*08 with dengue resistance. This study provides evidence for the policymakers to be aware of asymptomatic dengue infection, to develop a useful tool for raising awareness about asymptomatic dengue infection among the general population, to monitor the community participation to strengthen the individual and community level dengue prevention and control measures when neither there is vaccine nor particular treatment for dengue.

Keywords: asymptomatic, dengue, health adults, prospective study

Procedia PDF Downloads 113

Authors: A. T. Perez Fontenla, S. Sgobba, A. Bartkowska, Y. Askar, M. Dalemir Celuch, A. Newborough, M. Karppinen, H. Haalien, S. Deleval, S. Larcher, C. Charvet, L. Bruno, R. Trant

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The present study investigates the corrosion behavior of copper (Cu) based conducts predominantly brazed with Sil-Fos (self-fluxing copper-based filler with silver and phosphorus) within various cooling circuits of demineralized water across different particle accelerator components at CERN. The study covers a range of sample service time, from a few months to fifty years, and includes various accelerator components such as quadrupoles, dipoles, and bending magnets. The investigation comprises the established sample extraction procedure, examination methodology including non-destructive testing, evaluation of the corrosion phenomena, and identification of commonalities across the studied components as well as analysis of the environmental influence. The systematic analysis included computed microtomography (CT) of the joints that revealed distributed defects across all brazing interfaces. Some defects appeared to result from areas not wetted by the filler during the brazing operation, displaying round shapes, while others exhibited irregular contours and radial alignment, indicative of a network or interconnection. The subsequent dry cutting performed facilitated access to the conduct's inner surface and the brazed joints for further inspection through light and electron microscopy (SEM) and chemical analysis via Energy Dispersive X-ray spectroscopy (EDS). Brazing analysis away from affected areas identified the expected phases for a Sil-Fos alloy. In contrast, the affected locations displayed micrometric cavities propagating into the material, along with selective corrosion of the bulk Cu initiated at the conductor-braze interface. Corrosion product analysis highlighted the consistent presence of sulfur (up to 6 % in weight), whose origin and role in the corrosion initiation and extension is being further investigated. The importance of this study is paramount as it plays a crucial role in comprehending the underlying factors contributing to recently identified water leaks and evaluating the extent of the issue. Its primary objective is to provide essential insights for the repair of impacted brazed joints when accessibility permits. Moreover, the study seeks to contribute to the improvement of design and manufacturing practices for future components, ultimately enhancing the overall reliability and performance of magnet systems within CERN accelerator facilities.

Keywords: accelerator facilities, brazed copper conducts, demineralized water, magnets

Procedia PDF Downloads 34

Authors: U. Thisara G. Perera, C. M. Kanchana N. K. Chandrasekara

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Dengue is an epidemic which is spread by Aedes Egyptai and Aedes Albopictus mosquitoes. The cases of dengue show a dramatic growth rate of the epidemic in urban and semi urban areas spatially in tropical and sub-tropical regions of the world. Incidence of dengue has become a prominent reason for hospitalization and deaths in Asian countries, including Sri Lanka. During the last decade the dengue epidemic began to spread from urban to semi-urban and then to rural settings of the country. The highest number of dengue infected patients was recorded in Sri Lanka in the year 2016 and the highest number of patients was identified in Colombo district. Together with the commercial, industrial, and other supporting services, the district suffers from rapid urbanization and high population density. Thus, drainage and waste disposal patterns of the people in this area exert an additional pressure to the environment. The district is situated in the wet zone and thus low lying lands constitute the largest portion of the district. This situation additionally facilitates mosquito breeding sites. Therefore, the purpose of the present study was to assess the spatial and temporal distribution patterns of dengue epidemic in Kolonnawa MOH area (Medical Officer of Health) in the district of Colombo. The study was carried out using 615 recorded dengue cases in Kollonnawa MOH area during the south east monsoon season from May to September 2016. The Moran’s I and Kernel density estimation were used as analytical methods. The analysis of data was accomplished through the integrated use of ArcGIS 10.1 software packages along with Microsoft Excel analytical tool. Field observation was also carried out for verification purposes during the study period. Results of the Moran’s I index indicates that the spatial distribution of dengue cases showed a cluster distribution pattern across the area. Kernel density estimation emphasis that dengue cases are high where the population has gathered, especially in areas comprising housing schemes. Results of the Kernel Density estimation further discloses that hot spots of dengue epidemic are located in the western half of the Kolonnawa MOH area, which is close to the Colombo municipal boundary and there is a significant relationship with high population density and unplanned urban land use practices. Results of the field observation confirm that the drainage systems in these areas function poorly and careless waste disposal methods of the people further encourage mosquito breeding sites. This situation has evolved harmfully from a public health issue to a social problem, which ultimately impacts on the economy and social lives of the country.

Keywords: Dengue epidemic, health hazards, Kernel density, Moran’s I, Sri Lanka

Procedia PDF Downloads 287

Authors: Ginpreet Kaur, Mohammad Yasir Usmani, Mohammed Kamil Khan

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Diabetes mellitus is a disease with a high global burden and results in significant morbidity and mortality. In India, the number of people suffering with diabetes is expected to rise from 19 to 57 million in 2025. At present, interest in herbal remedies is growing to reduce the side effects associated with conventional dosage form like oral hypoglycemic agents and insulin for the treatment of diabetes mellitus. Our aim was to investigate the antidiabetic activities of combinatorial extract of N. sativa & C. cassia in Streptozotocin induced type-I Diabetic Rats. Thus, the present study was undertaken to screen postprandial glucose excursion potential through α- glucosidase inhibitory activity (In Vitro) and effect of combinatorial extract of N. sativa & C. cassia in Streptozotocin induced type-I Diabetic Rats (In Vivo). In addition changes in body weight, plasma glucose, lipid profile and kidney profile were also determined. The IC50 values for both extract and Acarbose was calculated by extrapolation method. Combinatorial extract of N. sativa & C. cassia at different dosages (100 and 200 mg/kg orally) and Metformin (50 mg/kg orally) as the standard drug was administered for 28 days and then biochemical estimation, body weights and OGTT (Oral glucose tolerance test) were determined. Histopathological studies were also performed on kidney and pancreatic tissue. In In-Vitro the combinatorial extract shows much more inhibiting effect than the individual extracts. The results reveals that combinatorial extract of N. sativa & C. cassia has shown significant decrease in plasma glucose (p<0.0001), total cholesterol and LDL levels when compared with the STZ group The decreasing level of BUN and creatinine revealed the protection of N. sativa & C. cassia extracts against nephropathy associated with diabetes. Combination of N. sativa & C. cassia significantly improved glucose tolerance to exogenously administered glucose (2 g/kg) after 60, 90 and 120 min interval on OGTT in high dose streptozotocin induced diabetic rats compared with the untreated control group. Histopathological studies shown that treatment with N. sativa & C. cassia extract alone and in combination restored pancreatic tissue integrity and was able to regenerate the STZ damaged pancreatic β cells. Thus, the present study reveals that combination of N. sativa & C. cassia extract has significant α- glucosidase inhibitory activity and thus has great potential as a new source for diabetes treatment.

Keywords: lipid levels, OGTT, diabetes, herbs, glucosidase

Procedia PDF Downloads 416

Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska

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The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.

Keywords: tourist caves, radon concentration, exposure, Bulgaria

Procedia PDF Downloads 172

Authors: Takamitsu Kodama, Eiji Kawamoto

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Introduction: Ultrasound in emergency room has advantages of safer, faster, repeatable and noninvasive. Especially focused Point-Of-Care Ultrasound (POCUS) is used daily for prompt and accurate diagnoses, for quickly identifying critical and life-threatening conditions. That is why ultrasound has demonstrated its usefulness in emergency medicine. The true value of ultrasound has been once again recognized in recent years. It is thought that all resident physicians working at emergency room should perform an ultrasound scan to interpret signs and symptoms of deteriorating patients in the emergency room. However, a practical education on ultrasound is still in development. To resolve this issue, we established a new educational program using high-fidelity simulators and evaluated the efficacy of this course. Methods: Educational program includes didactic lectures and skill stations in half-day course. Instructor gives a lecture on POCUS such as Rapid Ultrasound in Shock (RUSH) and/or Focused Assessment Transthoracic Echo (FATE) protocol at the beginning of the course. Then, attendees are provided for training of scanning with cooperation of normal simulated patients. In the end, attendees learn how to apply focused POCUS skills at clinical situation using high-fidelity simulators such as SonoSim® (SonoSim, Inc) and SimMan® 3G (Laerdal Medical). Evaluation was conducted through surveillance questionnaires to 19 attendees after two pilot courses. The questionnaires were focused on understanding course concept and satisfaction. Results: All attendees answered the questionnaires. With respect to the degree of understanding, 12 attendees (number of valid responses: 13) scored four or more points out of five points. High-fidelity simulators, especially SonoSim® was highly appreciated to enhance learning how to handle ultrasound at an actual practice site by 11 attendees (number of valid responses: 12). All attendees encouraged colleagues to take this course because the high level of satisfaction was achieved. Discussion: Newly introduced educational course using high-fidelity simulators realizes the circle of learning to deepen the understanding on focused POCUS by gradual stages. SonoSim® can faithfully reproduce scan images with pathologic findings of ultrasound and provide experimental learning for a growth number of beginners such as resident physicians. In addition, valuable education can be provided if it is used combined with SimMan® 3G. Conclusions: Newly introduced educational course using high-fidelity simulators is supposed to be effective and helps in providing better education compared with conventional courses for emergency physicians.

Keywords: point-of-care ultrasound, high-fidelity simulators, education, circle of learning

Procedia PDF Downloads 266

Authors: Jenn Gallup, Onur Kocaoz, Onder Islek

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In their pursuit of postsecondary transitions, individuals with disabilities tend to experience, academic, behavioral, and emotional challenges to a greater extent than their typically developing peers. These challenges result in lower rates of graduation, employment, independent living, and participation in college than their peers without disabilities. The lack of friendships and support systems has had a negative impact on those with a disability transitioning to postsecondary settings to include, employment, independent living, and university settings. Establishing friendships and support systems early on is an indicator of potential success and persistence in postsecondary education, employment, and independent living for typically developing college students. It is evident that a deficit in friendships and supports is a key deficit also for individuals with disabilities. To address the specific needs of this group, a mentor program was developed for a transition program held at the university for youth aged 18-21. Pre-service teachers enrolled in the special education program engaged with youth in the transition program in a variety of activities on campus. The mentorship program had two purposes: to assist young adults with disabilities who were transitioning to a workforce setting to help increase social skills, self-advocacy, supports and friendships, and confidence; and to give their peers without disabilities who were enrolled in a secondary special education course as a pre-service teacher the experience of interacting with and forming friendships with peers who had a disability for the purposes of career development. Additionally, according to researchers mobile technology has created a virtual world of equality and opportunity for a large segment of the population that was once marginalized due to physical and cognitive impairments. All of the participants had access to smart phones; therefore, technology was explored during this study to determine if it could be used as a compensatory tool to allow the young adults with disabilities to do things that otherwise would have been difficult because of their disabilities. Additionally, all participants were asked to incorporate technology such as smart phones to communicate beyond the activities, collaborate using virtual platform games which would support and promote social skills, soft-skills, socialization, and relationships. The findings of this study confirmed that a peer mentorship program that harnessed the power of technology supported outcomes specific to young adults with and without disabilities. Mobile technology and virtual game-based platforms, were identified as a significant contributor to personal, academic, and career growth for both groups. The technology encouraged friendships, provided an avenue for rich social interactions, and increased soft-skills. Results will be shared along with the development of the program and potential implications to the field.

Keywords: career outcomes, mentorship, soft-skills, technology, transition

Procedia PDF Downloads 145

Authors: A. M. Byrne, E. Bonfiglio, C. Rigby, N. Edelstyn

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Introduction: Neuromarketing employs numerous methodologies when investigating products and advertisement effectiveness. Electroencephalography (EEG), a non-invasive measure of electrical activity from the brain, is commonly used in neuromarketing. EEG data can be considered using time-frequency (TF) analysis, where changes in the frequency of brainwaves are calculated to infer participant’s mental states, or event-related potential (ERP) analysis, where changes in amplitude are observed in direct response to a stimulus. This presentation discusses the findings of a systematic review of EEG measures in neuromarketing. A systematic review summarises evidence on a research question, using explicit measures to identify, select, and critically appraise relevant research papers. Thissystematic review identifies which EEG measures are the most robust predictor of customer preference and purchase intention. Methods: Search terms identified174 papers that used EEG in combination with marketing-related stimuli. Publications were excluded if they were written in a language other than English or were not published as journal articles (e.g., book chapters). The review investigated which TF effect (e.g., theta-band power) and ERP component (e.g., N400) most consistently reflected preference and purchase intention. Machine-learning prediction was also investigated, along with the use of EEG combined with physiological measures such as eye-tracking. Results: Frontal alpha asymmetry was the most reliable TF signal, where an increase in activity over the left side of the frontal lobe indexed a positive response to marketing stimuli, while an increase in activity over the right side indexed a negative response. The late positive potential, a positive amplitude increase around 600 ms after stimulus presentation, was the most reliable ERP component, reflecting the conscious emotional evaluation of marketing stimuli. However, each measure showed mixed results when related to preference and purchase behaviour. Predictive accuracy was greatly improved through machine-learning algorithms such as deep neural networks, especially when combined with eye-tracking or facial expression analyses. Discussion: This systematic review provides a novel catalogue of the most effective use of each EEG measure commonly used in neuromarketing. Exciting findings to emerge are the identification of the frontal alpha asymmetry and late positive potential as markers of preferential responses to marketing stimuli. Predictive accuracy using machine-learning algorithms achieved predictive accuracies as high as 97%, and future research should therefore focus on machine-learning prediction when using EEG measures in neuromarketing.

Keywords: EEG, ERP, neuromarketing, machine-learning, systematic review, time-frequency

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Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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Authors: Kimuel Suyat, Francis Aldrine Uy, John Paul Carreon

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The Philippines, composed of many islands, is connected with approximately 8030 bridges. Continuous evaluation of the structural condition of these bridges is needed to safeguard the safety of the general public. With most bridges reaching its design life, retrofitting and replacement may be needed. Concerned government agencies allocate huge costs for periodic monitoring and maintenance of these structures. The rising volume of traffic and aging of these infrastructures is challenging structural engineers to give rise for structural health monitoring techniques. Numerous techniques are already proposed and some are now being employed in other countries. Vibration Analysis is one way. The natural frequency and vibration of a bridge are design criteria in ensuring the stability, safety and economy of the structure. Its natural frequency must not be so high so as not to cause discomfort and not so low that the structure is so stiff causing it to be both costly and heavy. It is well known that the stiffer the member is, the more load it attracts. The frequency must not also match the vibration caused by the traffic loads. If this happens, a resonance occurs. Vibration that matches a systems frequency will generate excitation and when this exceeds the member’s limit, a structural failure will happen. This study presents a method for calculating dynamic fragility through the use of vibration-based monitoring system. Dynamic fragility is the probability that a structural system exceeds a limit state when subjected to dynamic loads. The bridge is modeled in SAP2000 based from the available construction drawings provided by the Department of Public Works and Highways. It was verified and adjusted based from the actual condition of the bridge. The bridge design specifications are also checked using nondestructive tests. The approach used in this method properly accounts the uncertainty of observed values and code-based structural assumptions. The vibration response of the structure due to actual loads is monitored using installed sensors on the bridge. From the determinacy of these dynamic characteristic of a system, threshold criteria can be established and fragility curves can be estimated. This study conducted in relation with the research project between Department of Science and Technology, Mapúa Institute of Technology, and the Department of Public Works and Highways also known as Mapúa-DOST Smart Bridge Project deploys Structural Health Monitoring Sensors at Zamora Bridge. The bridge is selected in coordination with the Department of Public Works and Highways. The structural plans for the bridge are also readily available.

Keywords: structural health monitoring, dynamic characteristic, threshold criteria, traffic loads

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Authors: Medina Kadiri

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Nigeria has an extensive coastline of 853 km long between latitude 4°10′ to 6°20′ N and longitude 2°45′ to 8°35′ E and situated in the Gulf of Guinea within the Guinea Current Large Marine Ecosystem. There is a substantial coastal community relying on this region for their livelihood of fishing, aquaculture, mariculture for various sea foods either for consumption or economic sustenance or both. Socio-economic study was conducted, using questionnaires and interview, to investigate the health symptoms of harmful algae experienced by these communities on consumption of sea foods. Eighteen symptoms were recorded. Of the respondents who experienced symptoms after consumption of sea foods, overall, more people (33.5%) experienced vomiting as a symptom, followed by nausea (14.03%) and then diarrhea (13.57%). Others were headache (9.95%), mouth tingling (8.6%) and tiredness (7.24%).The least were muscle pain, rashes, confusion, chills, burning sensation, breathing difficulty and balance difficulty which represented 0.45% each and the rest (dizziness, digestive tract tumors, itching, memory loss, & stomach pain) were less than 3% each. In terms of frequency, the most frequent symptom was diarrhea with 87.5% occurrence, closely followed by vomiting with 81.3%. Tiredness was 75% while nausea was 62.5% and headache 50%. Others such as dizziness, itching, memory loss, mouth tingling and stomach pain had about 40% occurrence or less. The least occurring symptoms were muscle pain, rashes, confusion, chills and balance difficulty and burning sensation occurring only once i.e 6.3%. Breathing difficulty was last but one with 12.5%. Visible symptom from seafood and the particular seafood consumed that prompted the visible symptoms, shows that 3.5% of the entire respondents who ate crab experienced various symptoms ranging from vomiting (2.4%), itching (0.5%) and headache (0.4%). For periwinkle, vomiting had 1.7%, while 1.2% represented diarrhea and nausea symptom comprised 0.8% of all the respondents who ate periwinkle. Some respondents who consumed fish shows that 0.4% of the respondents had Itching. From the respondents who preferred to consume shrimps/crayfish and crab, shrimps/crayfish, crab and periwinkle, the most common illness was tiredness (1.2%), while 0.5% had experienced diarrhea and many others. However, for most respondents who claimed to have no preference for any seafood, with 55.7% affirming this with vomiting being the highest (6.1%), followed closely by mouth tingling/ burning sensation (5.8%). Examining the seasonal influence on visible symptoms revealed that vomiting occurred more in the month of January with 5.5%, while headache and itching were predominant in October with (2.8%). Nausea has 3.1% in January than any season of the year, 2.6% of the entire respondents opined to have experience diarrhea in October than in any other season of the year. Regular evaluation of harmful algal poisoning symptoms is recommended for coastal communities.

Keywords: coastal, harmful algae, human poisoning symptoms, Nigeria, phycotoxins

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Authors: G. Bravo, D. Lopez, A. Iriarte

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Several organizations and governments have created a demand for information about the environmental impacts of agricultural products. Today, the export oriented fruit sector in Chile is being challenged to quantify and reduce their environmental impacts. Chile is the largest southern hemisphere producer and exporter of sweet cherry fruit. Chilean sweet cherry production reached a volume of 80,000 tons in 2012. The main destination market for the Chilean cherry in 2012 was Asia (including Hong Kong and China), taking in 69% of exported volume. Another important market was the United States with 16% participation, followed by Latin America (7%) and Europe (6%). Concerning geographical distribution, the Chilean conventional cherry production is focused in the center-south area, between the regions of Maule and O’Higgins; both regions represent 81% of the planted surface. The Life Cycle Assessment (LCA) is widely accepted as one of the major methodologies for assessing environmental impacts of products or services. The LCA identifies the material, energy, material, and waste flows of a product or service, and their impact on the environment. There are scant studies that examine the impacts of sweet cherry cultivation, such as acidification and eutrophication. Within this context, the main objective of this study is to evaluate, using the LCA, the acidification and eutrophication impacts of sweet cherry production in Chile. The additional objective is to identify the agricultural inputs that contributed significantly to the impacts of this fruit. The system under study included all the life cycle stages from the cradle to the farm gate (harvested sweet cherry). The data of sweet cherry production correspond to nationwide representative practices and are based on technical-economic studies and field information obtained in several face-to-face interviews. The study takes into account the following agricultural inputs: fertilizers, pesticides, diesel consumption for agricultural operations, machinery and electricity for irrigation. The results indicated that the mineral fertilizers are the most important contributors to the acidification and eutrophication impacts of the sheet cherry cultivation. Improvement options are suggested for the hotspot in order to reduce the environmental impacts. The results allow planning and promoting low impacts procedures across fruit companies, as well as policymakers, and other stakeholders on the subject. In this context, this study is one of the first assessments of the environmental impacts of sweet cherry production. New field data or evaluation of other life cycle stages could further improve the knowledge on the impacts of this fruit. This study may contribute to environmental information in other countries where there is similar agricultural production for sweet cherry.

Keywords: acidification, eutrophication, life cycle assessment, sweet cherry production

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