Search results for: deviation.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1065

Search results for: deviation.

75 An Unusual Case of Wrist Pain: Idiopathic Avascular Necrosis of the Scaphoid, Preiser’s Disease

Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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74 Influence of Counter-Face Roughness on the Friction of Bionic Microstructures

Authors: Haytam Kasem

Abstract:

The problem of quick and easy reversible attachment has become of great importance in different fields of technology. For the reason, during the last decade, a new emerging field of adhesion science has been developed. Essentially inspired by some animals and insects, which during their natural evolution have developed fantastic biological attachment systems allowing them to adhere and run on walls and ceilings of uneven surfaces. Potential applications of engineering bio-inspired solutions include climbing robots, handling systems for wafers in nanofabrication facilities, and mobile sensor platforms, to name a few. However, despite the efforts provided to apply bio-inspired patterned adhesive-surfaces to the biomedical field, they are still in the early stages compared with their conventional uses in other industries mentioned above. In fact, there are some critical issues that still need to be addressed for the wide usage of the bio-inspired patterned surfaces as advanced biomedical platforms. For example, surface durability and long-term stability of surfaces with high adhesive capacity should be improved, but also the friction and adhesion capacities of these bio-inspired microstructures when contacting rough surfaces. One of the well-known prototypes for bio-inspired attachment systems is biomimetic wall-shaped hierarchical microstructure for gecko-like attachments. Although physical background of these attachment systems is widely understood, the influence of counter-face roughness and its relationship with the friction force generated when sliding against wall-shaped hierarchical microstructure have yet to be fully analyzed and understood. To elucidate the effect of the counter-face roughness on the friction of biomimetic wall-shaped hierarchical microstructure we have replicated the isotropic topography of 12 different surfaces using replicas made of the same epoxy material. The different counter-faces were fully characterized under 3D optical profilometer to measure roughness parameters. The friction forces generated by spatula-shaped microstructure in contact with the tested counter-faces were measured on a home-made tribometer and compared with the friction forces generated by the spatulae in contact with a smooth reference. It was found that classical roughness parameters, such as average roughness Ra and others, could not be utilized to explain topography-related variation in friction force. This has led us to the development of an integrated roughness parameter obtained by combining different parameters which are the mean asperity radius of curvature (R), the asperity density (η), the deviation of asperities high (σ) and the mean asperities angle (SDQ). This new integrated parameter is capable of explaining the variation of results of friction measurements. Based on the experimental results, we developed and validated an analytical model to predict the variation of the friction force as a function of roughness parameters of the counter-face and the applied normal load, as well.

Keywords: friction, bio-mimetic micro-structure, counter-face roughness, analytical model

Procedia PDF Downloads 238
73 Bisphenol-A Concentrations in Urine and Drinking Water Samples of Adults Living in Ankara

Authors: Hasan Atakan Sengul, Nergis Canturk, Bahar Erbas

Abstract:

Drinking water is indispensable for life. With increasing awareness of communities, the content of drinking water and tap water has been a matter of curiosity. The presence of Bisphenol-A is the top one when content curiosity is concerned. The most used chemical worldwide for production of polycarbonate plastics and epoxy resins is Bisphenol-A. People are exposed to Bisphenol-A chemical, which disrupts the endocrine system, almost every day. Each year it is manufactured an average of 5.4 billion kilograms of Bisphenol-A. Linear formula of Bisphenol-A is (CH₃)₂C(C₆H₄OH)₂, its molecular weight is 228.29 and CAS number is 80-05-7. Bisphenol-A is known to be used in the manufacturing of plastics, along with various chemicals. Bisphenol-A, an industrial chemical, is used in the raw materials of packaging mate-rials in the monomers of polycarbonate and epoxy resins. The pass through the nutrients of Bisphenol-A substance happens by packaging. This substance contaminates with nutrition and penetrates into body by consuming. International researches show that BPA is transported through body fluids, leading to hormonal disorders in animals. Experimental studies on animals report that BPA exposure also affects the gender of the newborn and its time to reach adolescence. The extent to what similar endocrine disrupting effects are on humans is a debate topic in many researches. In our country, detailed studies on BPA have not been done. However, it is observed that 'BPA-free' phrases are beginning to appear on plastic packaging such as baby products and water carboys. Accordingly, this situation increases the interest of the society about the subject; yet it causes information pollution. In our country, all national and international studies on exposure to BPA have been examined and Ankara province has been designated as testing region. To assess the effects of plastic use in daily habits of people and the plastic amounts removed out of the body, the results of the survey conducted with volunteers who live in Ankara has been analyzed with Sciex appliance by means of LC-MS/MS in the laboratory and the amount of exposure and BPA removal have been detected by comparing the results elicited before. The results have been compared with similar studies done in international arena and the relation between them has been exhibited. Consequently, there has been found no linear correlation between the amount of BPA in drinking water and the amount of BPA in urine. This has also revealed that environmental exposure and the habits of daily plastic use have also direct effects a human body. When the amount of BPA in drinking water is considered; minimum 0.028 µg/L, maximum 1.136 µg/L, mean 0.29194 µg/L and SD(standard deviation)= 0.199 have been detected. When the amount of BPA in urine is considered; minimum 0.028 µg/L, maximum 0.48 µg/L, mean 0.19181 µg/L and SD= 0.099 have been detected. In conclusion, there has been found no linear correlation between the amount of BPA in drinking water and the amount of BPA in urine (r= -0.151). The p value of the comparison between drinking water’s and urine’s BPA amounts is 0.004 which shows that there is a significant change and the amounts of BPA in urine is dependent on the amounts in drinking waters (p < 0.05). This has revealed that environmental exposure and daily plastic habits have also direct effects on the human body.

Keywords: analyze of bisphenol-A, BPA, BPA in drinking water, BPA in urine

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72 Precise Determination of the Residual Stress Gradient in Composite Laminates Using a Configurable Numerical-Experimental Coupling Based on the Incremental Hole Drilling Method

Authors: A. S. Ibrahim Mamane, S. Giljean, M.-J. Pac, G. L’Hostis

Abstract:

Fiber reinforced composite laminates are particularly subject to residual stresses due to their heterogeneity and the complex chemical, mechanical and thermal mechanisms that occur during their processing. Residual stresses are now well known to cause damage accumulation, shape instability, and behavior disturbance in composite parts. Many works exist in the literature on techniques for minimizing residual stresses in thermosetting and thermoplastic composites mainly. To study in-depth the influence of processing mechanisms on the formation of residual stresses and to minimize them by establishing a reliable correlation, it is essential to be able to measure very precisely the profile of residual stresses in the composite. Residual stresses are important data to consider when sizing composite parts and predicting their behavior. The incremental hole drilling is very effective in measuring the gradient of residual stresses in composite laminates. This method is semi-destructive and consists of drilling incrementally a hole through the thickness of the material and measuring relaxation strains around the hole for each increment using three strain gauges. These strains are then converted into residual stresses using a matrix of coefficients. These coefficients, called calibration coefficients, depending on the diameter of the hole and the dimensions of the gauges used. The reliability of the incremental hole drilling depends on the accuracy with which the calibration coefficients are determined. These coefficients are calculated using a finite element model. The samples’ features and the experimental conditions must be considered in the simulation. Any mismatch can lead to inadequate calibration coefficients, thus introducing errors on residual stresses. Several calibration coefficient correction methods exist for isotropic material, but there is a lack of information on this subject concerning composite laminates. In this work, a Python program was developed to automatically generate the adequate finite element model. This model allowed us to perform a parametric study to assess the influence of experimental errors on the calibration coefficients. The results highlighted the sensitivity of the calibration coefficients to the considered errors and gave an order of magnitude of the precisions required on the experimental device to have reliable measurements. On the basis of these results, improvements were proposed on the experimental device. Furthermore, a numerical method was proposed to correct the calibration coefficients for different types of materials, including thick composite parts for which the analytical approach is too complex. This method consists of taking into account the experimental errors in the simulation. Accurate measurement of the experimental errors (such as eccentricity of the hole, angular deviation of the gauges from their theoretical position, or errors on increment depth) is therefore necessary. The aim is to determine more precisely the residual stresses and to expand the validity domain of the incremental hole drilling technique.

Keywords: fiber reinforced composites, finite element simulation, incremental hole drilling method, numerical correction of the calibration coefficients, residual stresses

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71 Exploring Nature and Pattern of Mentoring Practices: A Study on Mentees' Perspectives

Authors: Nahid Parween Anwar, Sadia Muzaffar Bhutta, Takbir Ali

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Mentoring is a structured activity which is designed to facilitate engagement between mentor and mentee to enhance mentee’s professional capability as an effective teacher. Both mentor and mentee are important elements of the ‘mentoring equation’ and play important roles in nourishing this dynamic, collaborative and reciprocal relationship. Cluster-Based Mentoring Programme (CBMP) provides an indigenous example of a project which focused on development of primary school teachers in selected clusters with a particular focus on their classroom practice. A study was designed to examine the efficacy of CBMP as part of Strengthening Teacher Education in Pakistan (STEP) project. This paper presents results of one of the components of this study. As part of the larger study, a cross-sectional survey was employed to explore nature and patterns of mentoring process from mentees’ perspectives in the selected districts of Sindh and Balochistan. This paper focuses on the results of the study related to the question: What are mentees’ perceptions of their mentors’ support for enhancing their classroom practice during mentoring process? Data were collected from mentees (n=1148) using a 5-point scale -‘Mentoring for Effective Primary Teaching’ (MEPT). MEPT focuses on seven factors of mentoring: personal attributes, pedagogical knowledge, modelling, feedback, system requirement, development and use of material, and gender equality. Data were analysed using SPSS 20. Mentees perceptions of mentoring practice of their mentors were summarized using mean and standard deviation. Results showed that mean scale scores on mentees’ perceptions of their mentors’ practices fell between 3.58 (system requirement) and 4.55 (personal attributes). Mentees’ perceives personal attribute of the mentor as the most significant factor (M=4.55) towards streamlining mentoring process by building good relationship between mentor and mentees. Furthermore, mentees have shared positive views about their mentors efforts towards promoting gender impartiality (M=4.54) during workshop and follow up visit. Contrary to this, mentees felt that more could have been done by their mentors in sharing knowledge about system requirement (e.g. school policies, national curriculum). Furthermore, some of the aspects in high scoring factors were highlighted by the mentees as areas for further improvement (e.g. assistance in timetabling, written feedback, encouragement to develop learning corners). Mentees’ perceptions of their mentors’ practices may assist in determining mentoring needs. The results may prove useful for the professional development programme for the mentors and mentees for specific mentoring programme in order to enhance practices in primary classrooms in Pakistan. Results would contribute into the body of much-needed knowledge from developing context.

Keywords: cluster-based mentoring programme, mentoring for effective primary teaching (MEPT), professional development, survey

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70 Synthesis, Computational Studies, Antioxidant and Anti-Inflammatory Bio-Evaluation of 2,5-Disubstituted- 1,3,4-Oxadiazole Derivatives

Authors: Sibghat Mansoor Rana, Muhammad Islam, Hamid Saeed, Hummera Rafique, Muhammad Majid, Muhammad Tahir Aqeel, Fariha Imtiaz, Zaman Ashraf

Abstract:

The 1,3,4-oxadiazole derivatives Ox-6a-f have been synthesized by incorporating flur- biprofen moiety with the aim to explore the potential of target molecules to decrease the oxidative stress. The title compounds Ox-6a-f were prepared by simple reactions in which a flurbiprofen –COOH group was esterified with methanol in an acid-catalyzed medium, which was then reacted with hydrazine to afford the corresponding hydrazide. The acid hydrazide was then cyclized into 1,3,4-oxadiazole-2-thiol by reacting with CS2 in the presence of KOH. The title compounds Ox-6a-f were synthesized by the reaction of an –SH group with various alkyl/aryl chlorides, which involves an S-alkylation reaction. The structures of the synthesized Ox-6a-f derivatives were ascer- tained by spectroscopic data. The in silico molecular docking was performed against target proteins cyclooxygenase-2 COX-2 (PDBID 5KIR) and cyclooxygenase-1 COX-1 (PDBID 6Y3C) to determine the binding affinity of the synthesized compounds with these structures. It has been inferred that most of the synthesized compounds bind well with an active binding site of 5KIR compared to 6Y3C, and especially compound Ox-6f showed excellent binding affinity (7.70 kcal/mol) among all synthesized compounds Ox-6a-f. The molecular dynamic (MD) simulation has also been performed to check the stability of docking complexes of ligands with COX-2 by determining their root mean square deviation and root mean square fluctuation. Little fluctuation was observed in case of Ox-6f, which forms the most stable complex with COX-2. The comprehensive antioxidant potential of the synthesized compounds has been evaluated by determining their free radical scavenging activity, including DPPH, OH, nitric oxide (NO), and iron chelation assay. The derivative Ox-6f showed promising results with 80.23% radical scavenging potential at a dose of 100 μg/mL while ascorbic acid exhibited 87.72% inhibition at the same dose. The anti-inflammatory activity of the final products has also been performed, and inflammatory markers were assayed, such as a thiobarbituric acid-reducing substance, nitric oxide, interleukin-6 (IL-6), and COX-2. The derivatives Ox-6d and Ox-6f displayed higher anti-inflammatory activity, exhibiting 70.56% and 74.16% activity, respectively. The results were compared with standard ibuprofen, which showed 84.31% activity at the same dose, 200 μg/mL. The anti-inflammatory potential has been performed by following the carrageen-induced hind paw edema model, and results showed that derivative Ox-6f exhibited 79.83% reduction in edema volume compared to standard ibuprofen, which reduced 84.31% edema volume. As dry lab and wet lab results confirm each other, it has been deduced that derivative Ox-6f may serve as the lead structure to design potent compounds to address oxidative stress.

Keywords: synthetic chemistry, pharmaceutical chemistry, oxadiazole derivatives, anti-inflammatory, anti-cancer compounds

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69 Autonomic Nervous System and CTRA Gene Expression among Healthy Young Adults in Japan

Authors: Yoshino Murakami, Takeshi Hashimoto, Steve Cole

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The autonomic nervous system (ANS), particularly the sympathetic (SNS) and parasympathetic (PNS) branches, plays a vital role in modulating immune function and physiological homeostasis. In recent years, the Conserved Transcriptional Response to Adversity (CTRA) has emerged as a key marker of the body's response to chronic stress. This gene expression profile is characterized by SNS-mediated upregulation of pro-inflammatory genes (such as IL1B and TNF) and downregulation of antiviral response genes (e.g., IFI and MX families). CTRA has been observed in individuals exposed to prolonged stressors like loneliness, social isolation, and bereavement. Some research suggests that PNS activity, as indicated by heart rate variability (HRV), may help counteract the CTRA. However, previous PNS-CTRA studies have focused on Western populations, raising questions about the generalizability of these findings across different cultural and ethnic backgrounds. This study aimed to examine the relationship between HRV and CTRA gene expression in young, healthy adults in Japan. We hypothesized that HRV would be inversely related to CTRA gene expression, similar to patterns observed in previous Western studies. A total of 49 participants aged 20 to 39 were recruited, and after data exclusions, 26 participants' HRV and CTRA data were analyzed. HRV was measured using an electrocardiogram (ECG), and two time-domain indices were utilized: the root mean square of successive differences (RMSSD) and the standard deviation of NN intervals (SDNN). Blood samples were collected for gene expression analysis, focusing on a standard set of 47 CTRA indicator gene transcripts. it findings revealed a significant inverse relationship between HRV and CTRA gene expression, with higher HRV correlating with reduced pro-inflammatory gene activity and increased antiviral response. These results are consistent with findings from Western populations and demonstrate that the relationship between ANS function and immune response generalizes to an East Asian population. The study highlights the importance of HRV as a biomarker for psychophysiological health, reflecting the body's ability to buffer stress and maintain immune balance. These findings have implications for understanding how physiological systems interact across different cultures and ethnicities. Given the influence of chronic stress in promoting inflammation and disease risk, interventions aimed at improving HRV, such as mindfulness-based practices or physical exercise, could provide significant health benefits. Future research should focus on larger sample sizes and experimental interventions to better understand the causal pathways linking HRV to CTRA gene expression, and determine whether improving HRV may help mitigate the harmful effects of stress on health by reducing inflammation.

Keywords: autonomic nervous activity, neuroendocrine system, inflammation, Japan

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68 Experimental Study of Energy Absorption Efficiency (EAE) of Warp-Knitted Spacer Fabric Reinforced Foam (WKSFRF) Under Low-Velocity Impact

Authors: Amirhossein Dodankeh, Hadi Dabiryan, Saeed Hamze

Abstract:

Using fabrics to reinforce composites considerably leads to improved mechanical properties, including resistance to the impact load and the energy absorption of composites. Warp-knitted spacer fabrics (WKSF) are fabrics consisting of two layers of warp-knitted fabric connected by pile yarns. These connections create a space between the layers filled by pile yarns and give the fabric a three-dimensional shape. Today because of the unique properties of spacer fabrics, they are widely used in the transportation, construction, and sports industries. Polyurethane (PU) foams are commonly used as energy absorbers, but WKSF has much better properties in moisture transfer, compressive properties, and lower heat resistance than PU foam. It seems that the use of warp-knitted spacer fabric reinforced PU foam (WKSFRF) can lead to the production and use of composite, which has better properties in terms of energy absorption from the foam, its mold formation is enhanced, and its mechanical properties have been improved. In this paper, the energy absorption efficiency (EAE) of WKSFRF under low-velocity impact is investigated experimentally. The contribution of the effect of each of the structural parameters of the WKSF on the absorption of impact energy has also been investigated. For this purpose, WKSF with different structures such as two different thicknesses, small and large mesh sizes, and position of the meshes facing each other and not facing each other were produced. Then 6 types of composite samples with different structural parameters were fabricated. The physical properties of samples like weight per unit area and fiber volume fraction of composite were measured for 3 samples of any type of composites. Low-velocity impact with an initial energy of 5 J was carried out on 3 samples of any type of composite. The output of the low-velocity impact test is acceleration-time (A-T) graph with a lot deviation point, in order to achieve the appropriate results, these points were removed using the FILTFILT function of MATLAB R2018a. Using Newtonian laws of physics force-displacement (F-D) graph was drawn from an A-T graph. We know that the amount of energy absorbed is equal to the area under the F-D curve. Determination shows the maximum energy absorption is 2.858 J which is related to the samples reinforced with fabric with large mesh, high thickness, and not facing of the meshes relative to each other. An index called energy absorption efficiency was defined, which means absorption energy of any kind of our composite divided by its fiber volume fraction. With using this index, the best EAE between the samples is 21.6 that occurs in the sample with large mesh, high thickness, and meshes facing each other. Also, the EAE of this sample is 15.6% better than the average EAE of other composite samples. Generally, the energy absorption on average has been increased 21.2% by increasing the thickness, 9.5% by increasing the size of the meshes from small to big, and 47.3% by changing the position of the meshes from facing to non-facing.

Keywords: composites, energy absorption efficiency, foam, geometrical parameters, low-velocity impact, warp-knitted spacer fabric

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67 The Duty of Sea Carrier to Transship the Cargo in Case of Vessel Breakdown

Authors: Mojtaba Eshraghi Arani

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Concluding the contract for carriage of cargo with the shipper (through bill of lading or charterparty), the carrier must transport the cargo from loading port to the port of discharge and deliver it to the consignee. Unless otherwise agreed in the contract, the carrier must avoid from any deviation, transfer of cargo to another vessel or unreasonable stoppage of carriage in-transit. However, the vessel might break down in-transit for any reason and becomes unable to continue its voyage to the port of discharge. This is a frequent incident in the carriage of goods by sea which leads to important dispute between the carrier/owner and the shipper/charterer (hereinafter called “cargo interests”). It is a generally accepted rule that in such event, the carrier/owner must repair the vessel after which it will continue its voyage to the destination port. The dispute will arise in the case that temporary repair of the vessel cannot be done in the short or reasonable term. There are two options for the contract parties in such a case: First, the carrier/owner is entitled to repair the vessel while having the cargo onboard or discharged in the port of refugee, and the cargo interests must wait till the breakdown is rectified at any time, whenever. Second, the carrier/owner will be responsible to charter another vessel and transfer the entirety of cargo to the substitute vessel. In fact, the main question revolves around the duty of carrier/owner to perform transfer of cargo to another vessel. Such operation which is called “trans-shipment” or “transhipment” (in terms of the oil industry it is usually called “ship-to-ship” or “STS”) needs to be done carefully and with due diligence. In fact, the transshipment operation for various cargoes might be different as each cargo requires its own suitable equipment for transfer to another vessel, so this operation is often costly. Moreover, there is a considerable risk of collision between two vessels in particular in bulk carriers. Bulk cargo is also exposed to the shortage and partial loss in the process of transshipment especially during bad weather. Concerning tankers which carry oil and petrochemical products, transshipment, is most probably followed by sea pollution. On the grounds of the above consequences, the owners are afraid of being held responsible for such operation and are reluctant to perform in the relevant disputes. The main argument raised by them is that no regulation has recognized such duty upon their shoulders so any such operation must be done under the auspices of the cargo interests and all costs must be reimbursed by themselves. Unfortunately, not only the international conventions including Hague rules, Hague-Visby Rules, Hamburg rules and Rotterdam rules but also most domestic laws are silent in this regard. The doctrine has yet to analyse the issue and no legal researches was found out in this regard. A qualitative method with the concept of interpretation of data collection has been used in this paper. The source of the data is the analysis of regulations and cases. It is argued in this article that the paramount rule in the maritime law is “the accomplishment of the voyage” by the carrier/owner in view of which, if the voyage can only be finished by transshipment, then the carrier/owner will be responsible to carry out this operation. The duty of carrier/owner to apply “due diligence” will strengthen this reasoning. Any and all costs and expenses will also be on the account pf the owner/carrier, unless the incident is attributable to any cause arising from the cargo interests’ negligence.

Keywords: cargo, STS, transshipment, vessel, voyage

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66 A development of Innovator Teachers Training Curriculum to Create Instructional Innovation According to Active Learning Approach to Enhance learning Achievement of Private School in Phayao Province

Authors: Palita Sooksamran, Katcharin Mahawong

Abstract:

This research aims to offer the development of innovator teachers training curriculum to create instructional innovation according to active learning approach to enhance learning achievement. The research and development process is carried out in 3 steps: Step 1 The study of the needs necessary to develop a training curriculum: the inquiry was conducted by a sample of teachers in private schools in Phayao province that provide basic education at the level of education. Using a questionnaire of 176 people, the sample was defined using a table of random numbers and stratified samples, using the school as a random layer. Step 2 Training curriculum development: the tools used are developed training curriculum and curriculum assessments, with nine experts checking the appropriateness of the draft curriculum. The statistic used in data analysis is the average ( ) and standard deviation (S.D.) Step 3 study on effectiveness of training curriculum: one group pretest/posttest design applied in this study. The sample consisted of 35 teachers from private schools in Phayao province. The participants volunteered to attend on their own. The results of the research showed that: 1.The essential demand index needed with the list of essential needs in descending order is the choice and create of multimedia media, videos, application for learning management at the highest level ,Developed of multimedia, video and applications for learning management and selection of innovative learning management techniques and methods of solve the problem Learning , respectively. 2. The components of the training curriculum include principles, aims, scope of content, training activities, learning materials and resources, supervision evaluation. The scope of the curriculum consists of basic knowledge about learning management innovation, active learning, lesson plan design, learning materials and resources, learning measurement and evaluation, implementation of lesson plans into classroom and supervision and motoring. The results of the evaluation of quality of the draft training curriculum at the highest level. The Experts suggestion is that the purpose of the course should be used words that convey the results. 3. The effectiveness of training curriculum 1) Cognitive outcomes of the teachers in creating innovative learning management was at a high level of relative gain score. 2) The assessment results of learning management ability according to the active learning approach to enhance learning achievement by assessing from 2 education supervisor as a whole were very high , 3) Quality of innovation learning management based on active learning approach to enhance learning achievement of the teachers, 7 instructional Innovations were evaluated as outstanding works and 26 instructional Innovations passed the standard 4) Overall learning achievement of students who learned from 35 the sample teachers was at a high level of relative gain score 5) teachers' satisfaction towards the training curriculum was at the highest level.

Keywords: training curriculum, innovator teachers, active learning approach, learning achievement

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65 Prevalence and Risk Factors of Musculoskeletal Disorders among School Teachers in Mangalore: A Cross Sectional Study

Authors: Junaid Hamid Bhat

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Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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64 A Column Generation Based Algorithm for Airline Cabin Crew Rostering Problem

Authors: Nan Xu

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In airlines, the crew scheduling problem is usually decomposed into two stages: crew pairing and crew rostering. In the crew pairing stage, pairings are generated such that each flight is covered by exactly one pairing and the overall cost is minimized. In the crew rostering stage, the pairings generated in the crew pairing stage are combined with off days, training and other breaks to create individual work schedules. The paper focuses on cabin crew rostering problem, which is challenging due to the extremely large size and the complex working rules involved. In our approach, the objective of rostering consists of two major components. The first is to minimize the number of unassigned pairings and the second is to ensure the fairness to crew members. There are two measures of fairness to crew members, the number of overnight duties and the total fly-hour over a given period. Pairings should be assigned to each crew member so that their actual overnight duties and fly hours are as close to the expected average as possible. Deviations from the expected average are penalized in the objective function. Since several small deviations are preferred than a large deviation, the penalization is quadratic. Our model of the airline crew rostering problem is based on column generation. The problem is decomposed into a master problem and subproblems. The mater problem is modeled as a set partition problem and exactly one roster for each crew is picked up such that the pairings are covered. The restricted linear master problem (RLMP) is considered. The current subproblem tries to find columns with negative reduced costs and add them to the RLMP for the next iteration. When no column with negative reduced cost can be found or a stop criteria is met, the procedure ends. The subproblem is to generate feasible crew rosters for each crew member. A separate acyclic weighted graph is constructed for each crew member and the subproblem is modeled as resource constrained shortest path problems in the graph. Labeling algorithm is used to solve it. Since the penalization is quadratic, a method to deal with non-additive shortest path problem using labeling algorithm is proposed and corresponding domination condition is defined. The major contribution of our model is: 1) We propose a method to deal with non-additive shortest path problem; 2) Operation to allow relaxing some soft rules is allowed in our algorithm, which can improve the coverage rate; 3) Multi-thread techniques are used to improve the efficiency of the algorithm when generating Line-of-Work for crew members. Here a column generation based algorithm for the airline cabin crew rostering problem is proposed. The objective is to assign a personalized roster to crew member which minimize the number of unassigned pairings and ensure the fairness to crew members. The algorithm we propose in this paper has been put into production in a major airline in China and numerical experiments show that it has a good performance.

Keywords: aircrew rostering, aircrew scheduling, column generation, SPPRC

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63 Investigating the Neural Heterogeneity of Developmental Dyscalculia

Authors: Fengjuan Wang, Azilawati Jamaludin

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Developmental Dyscalculia (DD) is defined as a particular learning difficulty with continuous challenges in learning requisite math skills that cannot be explained by intellectual disability or educational deprivation. Recent studies have increasingly recognized that DD is a heterogeneous, instead of monolithic, learning disorder with not only cognitive and behavioral deficits but so too neural dysfunction. In recent years, neuroimaging studies employed group comparison to explore the neural underpinnings of DD, which contradicted the heterogenous nature of DD and may obfuscate critical individual differences. This research aimed to investigate the neural heterogeneity of DD using case studies with functional near-infrared spectroscopy (fNIRS). A total of 54 aged 6-7 years old of children participated in this study, comprising two comprehensive cognitive assessments, an 8-minute resting state, and an 8-minute one-digit addition task. Nine children met the criteria of DD and scored at or below 85 (i.e., the 16th percentile) on the Mathematics or Math Fluency subtest of the Wechsler Individual Achievement Test, Third Edition (WIAT-III) (both subtest scores were 90 and below). The remaining 45 children formed the typically developing (TD) group. Resting-state data and brain activation in the inferior frontal gyrus (IFG), superior frontal gyrus (SFG), and intraparietal sulcus (IPS) were collected for comparison between each case and the TD group. Graph theory was used to analyze the brain network under the resting state. This theory represents the brain network as a set of nodes--brain regions—and edges—pairwise interactions across areas to reveal the architectural organizations of the nervous network. Next, a single-case methodology developed by Crawford et al. in 2010 was used to compare each case’s brain network indicators and brain activation against 45 TD children’s average data. Results showed that three out of the nine DD children displayed significant deviation from TD children’s brain indicators. Case 1 had inefficient nodal network properties. Case 2 showed inefficient brain network properties and weaker activation in the IFG and IPS areas. Case 3 displayed inefficient brain network properties with no differences in activation patterns. As a rise above, the present study was able to distill differences in architectural organizations and brain activation of DD vis-à-vis TD children using fNIRS and single-case methodology. Although DD is regarded as a heterogeneous learning difficulty, it is noted that all three cases showed lower nodal efficiency in the brain network, which may be one of the neural sources of DD. Importantly, although the current “brain norm” established for the 45 children is tentative, the results from this study provide insights not only for future work in “developmental brain norm” with reliable brain indicators but so too the viability of single-case methodology, which could be used to detect differential brain indicators of DD children for early detection and interventions.

Keywords: brain activation, brain network, case study, developmental dyscalculia, functional near-infrared spectroscopy, graph theory, neural heterogeneity

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62 Risk Assessment Tools Applied to Deep Vein Thrombosis Patients Treated with Warfarin

Authors: Kylie Mueller, Nijole Bernaitis, Shailendra Anoopkumar-Dukie

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Background: Vitamin K antagonists particularly warfarin is the most frequently used oral medication for deep vein thrombosis (DVT) treatment and prophylaxis. Time in therapeutic range (TITR) of the international normalised ratio (INR) is widely accepted as a measure to assess the quality of warfarin therapy. Multiple factors can affect warfarin control and the subsequent adverse outcomes including thromboembolic and bleeding events. Predictor models have been developed to assess potential contributing factors and measure the individual risk of these adverse events. These predictive models have been validated in atrial fibrillation (AF) patients, however, there is a lack of literature on whether these can be successfully applied to other warfarin users including DVT patients. Therefore, the aim of the study was to assess the ability of these risk models (HAS BLED and CHADS2) to predict haemorrhagic and ischaemic incidences in DVT patients treated with warfarin. Methods: A retrospective analysis of DVT patients receiving warfarin management by a private pathology clinic was conducted. Data was collected from November 2007 to September 2014 and included demographics, medical and drug history, INR targets and test results. Patients receiving continuous warfarin therapy with an INR reference range between 2.0 and 3.0 were included in the study with mean TITR calculated using the Rosendaal method. Bleeding and thromboembolic events were recorded and reported as incidences per patient. The haemorrhagic risk model HAS BLED and ischaemic risk model CHADS2 were applied to the data. Patients were then stratified into either the low, moderate, or high-risk categories. The analysis was conducted to determine if a correlation existed between risk assessment tool and patient outcomes. Data was analysed using GraphPad Instat Version 3 with a p value of <0.05 considered to be statistically significant. Patient characteristics were reported as mean and standard deviation for continuous data and categorical data reported as number and percentage. Results: Of the 533 patients included in the study, there were 268 (50.2%) female and 265 (49.8%) male patients with a mean age of 62.5 years (±16.4). The overall mean TITR was 78.3% (±12.7) with an overall haemorrhagic incidence of 0.41 events per patient. For the HAS BLED model, there was a haemorrhagic incidence of 0.08, 0.53, and 0.54 per patient in the low, moderate and high-risk categories respectively showing a statistically significant increase in incidence with increasing risk category. The CHADS2 model showed an increase in ischaemic events according to risk category with no ischaemic events in the low category, and an ischaemic incidence of 0.03 in the moderate category and 0.47 high-risk categories. Conclusion: An increasing haemorrhagic incidence correlated to an increase in the HAS BLED risk score in DVT patients treated with warfarin. Furthermore, a greater incidence of ischaemic events occurred in patients with an increase in CHADS2 category. In an Australian population of DVT patients, the HAS BLED and CHADS2 accurately predicts incidences of haemorrhage and ischaemic events respectively.

Keywords: anticoagulant agent, deep vein thrombosis, risk assessment, warfarin

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61 Social Economic Factors Associated with the Nutritional Status of Children In Western Uganda

Authors: Baguma Daniel Kajura

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The study explores socio-economic factors, health related and individual factors that influence the breastfeeding habits of mothers and their effect on the nutritional status of their infants in the Rwenzori region of Western Uganda. A cross-sectional research design was adopted, and it involved the use of self-administered questionnaires, interview guides, and focused group discussion guides to assess the extent to which socio-demographic factors associated with breastfeeding practices influence child malnutrition. Using this design, data was collected from 276 mother-paired infants out of the selected 318 mother-paired infants over a period of ten days. Using a sample size formula by Kish Leslie for cross-sectional studies N= Zα2 P (1- P) / δ2, where N= sample size estimate of paired mother paired infants. P= assumed true population prevalence of mother–paired infants with malnutrition cases, P = 29.3%. 1-P = the probability of mother-paired infants not having malnutrition, so 1-P = 70.7% Zα = Standard normal deviation at 95% confidence interval corresponding to 1.96.δ = Absolute error between the estimated and true population prevalence of malnutrition of 5%. The calculated sample size N = 1.96 × 1.96 (0.293 × 0.707) /0,052= 318 mother paired infants. Demographic and socio-economic data for all mothers were entered into Microsoft Excel software and then exported to STATA 14 (StataCorp, 2015). Anthropometric measurements were taken for all children by the researcher and the trained assistants who physically weighed the children. The use of immunization card was used to attain the age of the child. The bivariate logistic regression analysis was used to assess the relationship between socio-demographic factors associated with breastfeeding practices and child malnutrition. The multivariable regression analysis was used to draw a conclusion on whether or not there are any true relationships between the socio-demographic factors associated with breastfeeding practices as independent variables and child stunting and underweight as dependent variables in relation to breastfeeding practices. Descriptive statistics on background characteristics of the mothers were generated and presented in frequency distribution tables. Frequencies and means were computed, and the results were presented using tables, then, we determined the distribution of stunting and underweight among infants by the socioeconomic and demographic factors. Findings reveal that children of mothers who used milk substitutes besides breastfeeding are over two times more likely to be stunted compared to those whose mothers exclusively breastfed them. Feeding children with milk substitutes instead of breastmilk predisposes them to both stunting and underweight. Children of mothers between 18 and 34 years of age are less likely to be underweight, as were those who were breastfed over ten times a day. The study further reveals that 55% of the children were underweight, and 49% were stunted. Of the underweight children, an equal number (58/151) were either mildly or moderately underweight (38%), and 23% (35/151) were severely underweight. Empowering community outreach programs by increasing knowledge and increased access to services on integrated management of child malnutrition is crucial to curbing child malnutrition in rural areas.

Keywords: infant and young child feeding, breastfeeding, child malnutrition, maternal health

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60 Sexual Behaviour and Psychological Well-Being of a Group of African Adolescent Males in Alice, Eastern Cape

Authors: Jabulani Gilford Kheswa, Thembelihle Lobi

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From a cultural perspective, expression of hegemonic masculinity in South Africa continues to escalate among adolescent males who grow up in communities lacking in role models and recreational facilities. However, when the schools are constructive, and peer influence is positive, adolescent male can potentially express character strengths and lead a meaningful life. Drawing from Bronfenbrenner’s Ecological Model and Keyes and Ryff’s six dimensions of psychological well-being and mental health, such youth may exemplify positive self-esteem, problem- focused coping strategies, condom self-efficacy, good leadership skills, enhanced motivation and a positive emotional state, which buffer against risky sexual behaviors. This paper was aimed at investigating the relationships between adolescent males’ sexual behavior and psychological well-being. This study employed a quantitative research to collect data from 54 Xhosa-speaking adolescent males from one school high school in Fort Beaufort, Eastern Cape, South Africa. These learners were from grade nine, ten and eleven with their ages ranging from 14 to 20. Prior the research commenced, the school principal and caregivers of the learners who participated in the study, gave their informed consent. Self- administered closed-ended questionnaire with Section A (that is, biographical information) and Section B with each question rated on the 5–point Likert scale was used. The advantages of questionnaires include a high response rate as they require less time and offer anonymity because participants’ names are not identified. The SPSS version 18 was used for statistical data analysis. The mean age was 16.83 with a standard deviation of 1.611. 44.4% of the participants were from grade 9, 33.3% from grade 10 and 22.2% from grade 11. The Chronbach alpha of 0.79 was yielded, with respect to self- esteem of adolescent males. In this study, 76.9% reported to attend church services whilst 23% indicated not to attend church services. A further 96.2% of adolescent males indicated to have good relations with guardians while only 3.8% had poorer relations. A large proportion of adolescent males (72.9%) indicated to high-quality friendship as opposed to 27.1% who reported being receiving negative guidance from peers. Other findings revealed that 81.1% of the participants’ parents do not drink alcohol, and they cope at school as 79.6% reported protective factors as attributable towards non-engagement to risky sexual practices. As a result, 81.4% of participants reported not to participate in criminal activities although 85% of the participants indicated that in their school there are drugs. It could be speculated from this study that adolescent males whose caregivers are authoritative, find purpose in life and are most likely to be socially and academically competent. This paper leads to further research interest into mental health, coping strategies and sexual decision-making skills of the youth in South Africa.

Keywords: church, mental health, school, sexual behaviour

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59 In-Flight Aircraft Performance Model Enhancement Using Adaptive Lookup Tables

Authors: Georges Ghazi, Magali Gelhaye, Ruxandra Botez

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Over the years, the Flight Management System (FMS) has experienced a continuous improvement of its many features, to the point of becoming the pilot’s primary interface for flight planning operation on the airplane. With the assistance of the FMS, the concept of distance and time has been completely revolutionized, providing the crew members with the determination of the optimized route (or flight plan) from the departure airport to the arrival airport. To accomplish this function, the FMS needs an accurate Aircraft Performance Model (APM) of the aircraft. In general, APMs that equipped most modern FMSs are established before the entry into service of an individual aircraft, and results from the combination of a set of ordinary differential equations and a set of performance databases. Unfortunately, an aircraft in service is constantly exposed to dynamic loads that degrade its flight characteristics. These degradations endow two main origins: airframe deterioration (control surfaces rigging, seals missing or damaged, etc.) and engine performance degradation (fuel consumption increase for a given thrust). Thus, after several years of service, the performance databases and the APM associated to a specific aircraft are no longer representative enough of the actual aircraft performance. It is important to monitor the trend of the performance deterioration and correct the uncertainties of the aircraft model in order to improve the accuracy the flight management system predictions. The basis of this research lies in the new ability to continuously update an Aircraft Performance Model (APM) during flight using an adaptive lookup table technique. This methodology was developed and applied to the well-known Cessna Citation X business aircraft. For the purpose of this study, a level D Research Aircraft Flight Simulator (RAFS) was used as a test aircraft. According to Federal Aviation Administration the level D is the highest certification level for the flight dynamics modeling. Basically, using data available in the Flight Crew Operating Manual (FCOM), a first APM describing the variation of the engine fan speed and aircraft fuel flow w.r.t flight conditions was derived. This model was next improved using the proposed methodology. To do that, several cruise flights were performed using the RAFS. An algorithm was developed to frequently sample the aircraft sensors measurements during the flight and compare the model prediction with the actual measurements. Based on these comparisons, a correction was performed on the actual APM in order to minimize the error between the predicted data and the measured data. In this way, as the aircraft flies, the APM will be continuously enhanced, making the FMS more and more precise and the prediction of trajectories more realistic and more reliable. The results obtained are very encouraging. Indeed, using the tables initialized with the FCOM data, only a few iterations were needed to reduce the fuel flow prediction error from an average relative error of 12% to 0.3%. Similarly, the FCOM prediction regarding the engine fan speed was reduced from a maximum error deviation of 5.0% to 0.2% after only ten flights.

Keywords: aircraft performance, cruise, trajectory optimization, adaptive lookup tables, Cessna Citation X

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58 Flux-Gate vs. Anisotropic Magneto Resistance Magnetic Sensors Characteristics in Closed-Loop Operation

Authors: Neoclis Hadjigeorgiou, Spyridon Angelopoulos, Evangelos V. Hristoforou, Paul P. Sotiriadis

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The increasing demand for accurate and reliable magnetic measurements over the past decades has paved the way for the development of different types of magnetic sensing systems as well as of more advanced measurement techniques. Anisotropic Magneto Resistance (AMR) sensors have emerged as a promising solution for applications requiring high resolution, providing an ideal balance between performance and cost. However, certain issues of AMR sensors such as non-linear response and measurement noise are rarely discussed in the relevant literature. In this work, an analog closed loop compensation system is proposed, developed and tested as a means to eliminate the non-linearity of AMR response, reduce the 1/f noise and enhance the sensitivity of magnetic sensor. Additional performance aspects, such as cross-axis and hysteresis effects are also examined. This system was analyzed using an analytical model and a P-Spice model, considering both the sensor itself as well as the accompanying electronic circuitry. In addition, a commercial closed loop architecture Flux-Gate sensor (calibrated and certified), has been used for comparison purposes. Three different experimental setups have been constructed for the purposes of this work, each one utilized for DC magnetic field measurements, AC magnetic field measurements and Noise density measurements respectively. The DC magnetic field measurements have been conducted in laboratory environment employing a cubic Helmholtz coil setup in order to calibrate and characterize the system under consideration. A high-accuracy DC power supply has been used for providing the operating current to the Helmholtz coils. The results were recorded by a multichannel voltmeter The AC magnetic field measurements have been conducted in laboratory environment employing a cubic Helmholtz coil setup in order to examine the effective bandwidth not only of the proposed system but also for the Flux-Gate sensor. A voltage controlled current source driven by a function generator has been utilized for the Helmholtz coil excitation. The result was observed by the oscilloscope. The third experimental apparatus incorporated an AC magnetic shielding construction composed of several layers of electric steel that had been demagnetized prior to the experimental process. Each sensor was placed alone and the response was captured by the oscilloscope. The preliminary experimental results indicate that closed loop AMR response presented a maximum deviation of 0.36% with respect to the ideal linear response, while the corresponding values for the open loop AMR system and the Fluxgate sensor reached 2% and 0.01% respectively. Moreover, the noise density of the proposed close loop AMR sensor system remained almost as low as the noise density of the AMR sensor itself, yet considerably higher than that of the Flux-Gate sensor. All relevant numerical data are presented in the paper.

Keywords: AMR sensor, chopper, closed loop, electronic noise, magnetic noise, memory effects, flux-gate sensor, linearity improvement, sensitivity improvement

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57 Symptom Burden and Quality of Life in Advanced Lung Cancer Patients

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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56 The Quantitative SWOT-Analysis of Service Blood Activity of Kazakhstan

Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

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55 Cross-Country Mitigation Policies and Cross Border Emission Taxes

Authors: Massimo Ferrari, Maria Sole Pagliari

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Pollution is a classic example of economic externality: agents who produce it do not face direct costs from emissions. Therefore, there are no direct economic incentives for reducing pollution. One way to address this market failure would be directly taxing emissions. However, because emissions are global, governments might as well find it optimal to wait let foreign countries to tax emissions so that they can enjoy the benefits of lower pollution without facing its direct costs. In this paper, we first document the empirical relation between pollution and economic output with static and dynamic regression methods. We show that there is a negative relation between aggregate output and the stock of pollution (measured as the stock of CO₂ emissions). This relationship is also highly non-linear, increasing at an exponential rate. In the second part of the paper, we develop and estimate a two-country, two-sector model for the US and the euro area. With this model, we aim at analyzing how the public sector should respond to higher emissions and what are the direct costs that these policies might have. In the model, there are two types of firms, brown firms (which produce a polluting technology) and green firms. Brown firms also produce an externality, CO₂ emissions, which has detrimental effects on aggregate output. As brown firms do not face direct costs from polluting, they do not have incentives to reduce emissions. Notably, emissions in our model are global: the stock of CO₂ in the economy affects all countries, independently from where it is produced. This simplified economy captures the main trade-off between emissions and production, generating a classic market failure. According to our results, the current level of emission reduces output by between 0.4 and 0.75%. Notably, these estimates lay in the upper bound of the distribution of those delivered by studies in the early 2000s. To address market failure, governments should step in introducing taxes on emissions. With the tax, brown firms pay a cost for polluting hence facing the incentive to move to green technologies. Governments, however, might also adopt a beggar-thy-neighbour strategy. Reducing emissions is costly, as moves production away from the 'optimal' production mix of brown and green technology. Because emissions are global, a government could just wait for the other country to tackle climate change, ripping the benefits without facing any costs. We study how this strategic game unfolds and show three important results: first, cooperation is first-best optimal from a global prospective; second, countries face incentives to deviate from the cooperating equilibria; third, tariffs on imported brown goods (the only retaliation policy in case of deviation from the cooperation equilibrium) are ineffective because the exchange rate would move to compensate. We finally study monetary policy under when costs for climate change rise and show that the monetary authority should react stronger to deviations of inflation from its target.

Keywords: climate change, general equilibrium, optimal taxation, monetary policy

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54 Adopting a New Policy in Maritime Law for Protecting Ship Mortgagees Against Maritime Liens

Authors: Mojtaba Eshraghi Arani

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Ship financing is the vital element in the development of shipping industry because while the ship constitutes the owners’ main asset, she is considered a reliable security in the financiers’ viewpoint as well. However, it is most probable that a financier who has accepted a ship as security will face many creditors who are privileged and rank before him for collecting, out of the ship, the money that they are owed. In fact, according to the current rule of maritime law, which was established by “Convention Internationale pour l’Unification de Certaines Règles Relatives aux Privilèges et Hypothèques Maritimes, Brussels, 10 April 1926”, the mortgages, hypotheques, and other charges on vessels rank after several secured claims referred to as “maritime liens”. Such maritime liens are an exhaustive list of claims including but not limited to “expenses incurred in the common interest of the creditors to preserve the vessel or to procure its sale and the distribution of the proceeds of sale”, “tonnage dues, light or harbour dues, and other public taxes and charges of the same character”, “claims arising out of the contract of engagement of the master, crew and other persons hired on board”, “remuneration for assistance and salvage”, “the contribution of the vessel in general average”, “indemnities for collision or other damage caused to works forming part of harbours, docks, etc,” “indemnities for personal injury to passengers or crew or for loss of or damage to cargo”, “claims resulting form contracts entered into or acts done by the master”. The same rule survived with only some minor change in the categories of maritime liens in the substitute conventions 1967 and 1993. The status que in maritime law have always been considered as a major obstacle to the development of shipping market and has inevitably led to increase in the interest rates and other related costs of ship financing. It seems that the national and international policy makers have yet to change their mind being worried about the deviation from the old marine traditions. However, it is crystal clear that the continuation of status que will harm, to a great extent, the shipowners and, consequently, the international merchants as a whole. It is argued in this article that the raison d'être for many categories of maritime liens cease to exist anymore, in view of which, the international community has to recognize only a minimum category of maritime liens which are created in the common interests of all creditors; to this effect, only two category of “compensation due for the salvage of ship” and “extraordinary expenses indispensable for the preservation of the ship” can be declared as taking priority over the mortgagee rights, in anology with the Geneva Convention on the International Recognition of Rights in Aircrafts (1948). A qualitative method with the concept of interpretation of data collection has been used in this manuscript. The source of the data is the analysis of international conventions and domestic laws.

Keywords: ship finance, mortgage, maritime liens, brussels convenion, geneva convention 1948

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53 The Effects of Adding Vibrotactile Feedback to Upper Limb Performance during Dual-Tasking and Response to Misleading Visual Feedback

Authors: Sigal Portnoy, Jason Friedman, Eitan Raveh

Abstract:

Introduction: Sensory substitution is possible due to the capacity of our brain to adapt to information transmitted by a synthetic receptor via an alternative sensory system. Practical sensory substitution systems are being developed in order to increase the functionality of individuals with sensory loss, e.g. amputees. For upper limb prosthetic-users the loss of tactile feedback compels them to allocate visual attention to their prosthesis. The effect of adding vibrotactile feedback (VTF) to the applied force has been studied, however its effect on the allocation if visual attention during dual-tasking and the response during misleading visual feedback have not been studied. We hypothesized that VTF will improve the performance and reduce visual attention during dual-task assignments in healthy individuals using a robotic hand and improve the performance in a standardized functional test, despite the presence of misleading visual feedback. Methods: For the dual-task paradigm, twenty healthy subjects were instructed to toggle two keyboard arrow keys with the left hand to retain a moving virtual car on a road on a screen. During the game, instructions for various activities, e.g. mix the sugar in the glass with a spoon, appeared on the screen. The subject performed these tasks with a robotic hand, attached to the right hand. The robotic hand was controlled by the activity of the flexors and extensors of the right wrist, recorded using surface EMG electrodes. Pressure sensors were attached at the tips of the robotic hand and induced VTF using vibrotactile actuators attached to the right arm of the subject. An eye-tracking system tracked to visual attention of the subject during the trials. The trials were repeated twice, with and without the VTF. Additionally, the subjects performed the modified box and blocks, hidden from eyesight, in a motion laboratory. A virtual presentation of a misleading visual feedback was be presented on a screen so that twice during the trial, the virtual block fell while the physical block was still held by the subject. Results: This is an ongoing study, which current results are detailed below. We are continuing these trials with transradial myoelectric prosthesis-users. In the healthy group, the VTF did not reduce the visual attention or improve performance during dual-tasking for the tasks that were typed transfer-to-target, e.g. place the eraser on the shelf. An improvement was observed for other tasks. For example, the average±standard deviation of time to complete the sugar-mixing task was 13.7±17.2s and 19.3±9.1s with and without the VTF, respectively. Also, the number of gaze shifts from the screen to the hand during this task were 15.5±23.7 and 20.0±11.6, with and without the VTF, respectively. The response of the subjects to the misleading visual feedback did not differ between the two conditions, i.e. with and without VTF. Conclusions: Our interim results suggest that the performance of certain activities of daily living may be improved by VTF. The substitution of visual sensory input by tactile feedback might require a long training period so that brain plasticity can occur and allow adaptation to the new condition.

Keywords: prosthetics, rehabilitation, sensory substitution, upper limb amputation

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52 Sensory Integration for Standing Postural Control Among Children and Adolescents with Autistic Spectrum Disorder Compared with Typically Developing Children and Adolescents

Authors: Eglal Y. Ali, Smita Rao, Anat Lubetzky, Wen Ling

Abstract:

Background: Postural abnormalities, rigidity, clumsiness, and frequent falls are common among children with autism spectrum disorders (ASD). The central nervous system’s ability to process all reliable sensory inputs (weighting) and disregard potentially perturbing sensory input (reweighting) is critical for successfully maintaining standing postural control. This study examined how sensory inputs (visual and somatosensory) are weighted and reweighted to maintain standing postural control in children with ASD compared with typically developing (TD) children. Subjects: Forty (20 (TD) and 20 ASD) children and adolescents participated in this study. The groups were matched for age, weight, and height. Participants had normal somatosensory (no somatosensory hypersensitivity), visual, and vestibular perception. Participants with ASD were categorized with severity level 1 according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and Social Responsiveness Scale. Methods: Using one force platform, the center of pressure (COP) was measured during quiet standing for 30 seconds, 3 times first standing on stable surface with eyes open (Condition 1), followed by randomization of the following 3 conditions: Condition 2 standing on stable surface with eyes closed, (visual input perturbed); Condition 3 standing on compliant foam surface with eyes open, (somatosensory input perturbed); and Condition 4 standing on compliant foam surface with eyes closed, (both visual and somatosensory inputs perturbed). Standing postural control was measured by three outcome measures: COP sway area, COP anterior-posterior (AP), and mediolateral (ML) path length (PL). A repeated measure mixed model Analysis of Variance was conducted to determine whether there was a significant difference between the two groups in the mean of the three outcome measures across the four conditions. Results: According to all three outcome measures, both groups showed a gradual increase in postural sway from condition 1 to condition 4. However, TD participants showed a larger postural sway than those with ASD. There was a significant main effect of condition on three outcome measures (p< 0.05). Only the COP AP PL showed a significant main effect of the group (p<0.05) and a significant group by condition interaction (p<0.05). In COP AP PL, TD participants showed a significant difference between condition 2 and the baseline (p<0.05), whereas the ASD group did not. This suggests that the ASD group did not weight visual input as much as the TD group. A significant difference between conditions for the ASD group was seen only when participants stood on foam regardless of the visual condition, suggesting that the ASD group relied more on the somatosensory inputs to maintain the standing postural control. Furthermore, the ASD group exhibited significantly smaller postural sway compared with TD participants during standing on the stable surface, whereas the postural sway of the ASD group was close to that of the TD group on foam. Conclusion: These results suggest that participants with high functioning ASD (level 1, no somatosensory hypersensitivity in ankles and feet) over-rely on somatosensory inputs and use a stiffening strategy for standing postural control. This deviation in the reweighting mechanism might explain the postural abnormalities mentioned above among children with ASD.

Keywords: autism spectrum disorders, postural sway, sensory weighting and reweighting, standing postural control

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51 Sensory Weighting and Reweighting for Standing Postural Control among Children and Adolescents with Autistic Spectrum Disorder Compared with Typically Developing Children and Adolescents

Authors: Eglal Y. Ali, Smita Rao, Anat Lubetzky, Wen Ling

Abstract:

Background: Postural abnormalities, rigidity, clumsiness, and frequent falls are common among children with autism spectrum disorders (ASD). The central nervous system’s ability to process all reliable sensory inputs (weighting) and disregard potentially perturbing sensory input (reweighting) is critical for successfully maintaining standing postural control. This study examined how sensory inputs (visual and somatosensory) are weighted and reweighted to maintain standing postural control in children with ASD compared with typically developing (TD) children. Subjects: Forty (20 (TD) and 20 ASD) children and adolescents participated in this study. The groups were matched for age, weight, and height. Participants had normal somatosensory (no somatosensory hypersensitivity), visual, and vestibular perception. Participants with ASD were categorized with severity level 1 according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and Social Responsiveness Scale. Methods: Using one force platform, the center of pressure (COP) was measured during quiet standing for 30 seconds, 3 times first standing on stable surface with eyes open (Condition 1), followed by randomization of the following 3 conditions: Condition 2 standing on stable surface with eyes closed, (visual input perturbed); Condition 3 standing on a compliant foam surface with eyes open, (somatosensory input perturbed); and Condition 4 standing on a compliant foam surface with eyes closed, (both visual and somatosensory inputs perturbed). Standing postural control was measured by three outcome measures: COP sway area, COP anterior-posterior (AP), and mediolateral (ML) path length (PL). A repeated measure mixed model analysis of variance was conducted to determine whether there was a significant difference between the two groups in the mean of the three outcome measures across the four conditions. Results: According to all three outcome measures, both groups showed a gradual increase in postural sway from condition 1 to condition 4. However, TD participants showed a larger postural sway than those with ASD. There was a significant main effect of the condition on three outcome measures (p< 0.05). Only the COP AP PL showed a significant main effect of the group (p<0.05) and a significant group by condition interaction (p<0.05). In COP AP PL, TD participants showed a significant difference between condition 2 and the baseline (p<0.05), whereas the ASD group did not. This suggests that the ASD group did not weigh visual input as much as the TD group. A significant difference between conditions for the ASD group was seen only when participants stood on foam regardless of the visual condition, suggesting that the ASD group relied more on the somatosensory inputs to maintain the standing postural control. Furthermore, the ASD group exhibited significantly smaller postural sway compared with TD participants during standing on a stable surface, whereas the postural sway of the ASD group was close to that of the TD group on foam. Conclusion: These results suggest that participants with high-functioning ASD (level 1, no somatosensory hypersensitivity in ankles and feet) over-rely on somatosensory inputs and use a stiffening strategy for standing postural control. This deviation in the reweighting mechanism might explain the postural abnormalities mentioned above among children with ASD.

Keywords: autism spectrum disorders, postural sway, sensory weighting and reweighting, standing postural control

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50 Consumers Attitude toward the Latest Trends in Decreasing Energy Consumption of Washing Machine

Authors: Farnaz Alborzi, Angelika Schmitz, Rainer Stamminger

Abstract:

Reducing water temperatures in the wash phase of a washing programme and increasing the overall cycle durations are the latest trends in decreasing energy consumption of washing programmes. Since the implementation of the new energy efficiency classes in 2010, manufacturers seem to apply the aforementioned washing strategy with lower temperatures combined with longer programme durations extensively to realise energy-savings needed to meet the requirements of the highest energy efficiency class possible. A semi-representative on-line survey in eleven European countries (Czech Republic, Finland, France, Germany, Hungary, Italy, Poland, Romania, Spain, Sweden and the United Kingdom) was conducted by Bonn University in 2015 to shed light on consumer opinion and behaviour regarding the effects of the lower washing temperature and longer cycle duration in laundry washing on consumers’ acceptance of the programme. The risk of the long wash cycle is that consumers might not use the energy efficient Standard programmes and will think of this option as inconvenient and therefore switch to shorter, but more energy consuming programmes. Furthermore, washing in a lower temperature may lead to the problem of cross-contamination. Washing behaviour of over 5,000 households was studied in this survey to provide support and guidance for manufacturers and policy designers. Qualified households were chosen following a predefined quota: -Involvement in laundry washing: substantial, -Distribution of gender: more than 50 % female , -Selected age groups: -20–39 years, -40–59 years, -60–74 years, -Household size: 1, 2, 3, 4 and more than 4 people. Furthermore, Eurostat data for each country were used to calculate the population distribution in the respective age class and household size as quotas for the consumer survey distribution in each country. Before starting the analyses, the validity of each dataset was controlled with the aid of control questions. After excluding the outlier data, the number of the panel diminished from 5,100 to 4,843. The primary outcome of the study is European consumers are willing to save water and energy in a laundry washing but reluctant to use long programme cycles since they don’t believe that the long cycles could be energy-saving. However, the results of our survey don’t confirm that there is a relation between frequency of using Standard cotton (Eco) or Energy-saving programmes and the duration of the programmes. It might be explained by the fact that the majority of washing programmes used by consumers do not take so long, perhaps consumers just choose some additional time reduction option when selecting those programmes and this finding might be changed if the Energy-saving programmes take longer. Therefore, it may be assumed that introducing the programme duration as a new measure on a revised energy label would strongly influence the consumer at the point of sale. Furthermore, results of the survey confirm that consumers are more willing to use lower temperature programmes in order to save energy than accepting longer programme cycles and majority of them accept deviation from the nominal temperature of the programme as long as the results are good.

Keywords: duration, energy-saving, standard programmes, washing temperature

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49 Deep Learning Framework for Predicting Bus Travel Times with Multiple Bus Routes: A Single-Step Multi-Station Forecasting Approach

Authors: Muhammad Ahnaf Zahin, Yaw Adu-Gyamfi

Abstract:

Bus transit is a crucial component of transportation networks, especially in urban areas. Any intelligent transportation system must have accurate real-time information on bus travel times since it minimizes waiting times for passengers at different stations along a route, improves service reliability, and significantly optimizes travel patterns. Bus agencies must enhance the quality of their information service to serve their passengers better and draw in more travelers since people waiting at bus stops are frequently anxious about when the bus will arrive at their starting point and when it will reach their destination. For solving this issue, different models have been developed for predicting bus travel times recently, but most of them are focused on smaller road networks due to their relatively subpar performance in high-density urban areas on a vast network. This paper develops a deep learning-based architecture using a single-step multi-station forecasting approach to predict average bus travel times for numerous routes, stops, and trips on a large-scale network using heterogeneous bus transit data collected from the GTFS database. Over one week, data was gathered from multiple bus routes in Saint Louis, Missouri. In this study, Gated Recurrent Unit (GRU) neural network was followed to predict the mean vehicle travel times for different hours of the day for multiple stations along multiple routes. Historical time steps and prediction horizon were set up to 5 and 1, respectively, which means that five hours of historical average travel time data were used to predict average travel time for the following hour. The spatial and temporal information and the historical average travel times were captured from the dataset for model input parameters. As adjacency matrices for the spatial input parameters, the station distances and sequence numbers were used, and the time of day (hour) was considered for the temporal inputs. Other inputs, including volatility information such as standard deviation and variance of journey durations, were also included in the model to make it more robust. The model's performance was evaluated based on a metric called mean absolute percentage error (MAPE). The observed prediction errors for various routes, trips, and stations remained consistent throughout the day. The results showed that the developed model could predict travel times more accurately during peak traffic hours, having a MAPE of around 14%, and performed less accurately during the latter part of the day. In the context of a complicated transportation network in high-density urban areas, the model showed its applicability for real-time travel time prediction of public transportation and ensured the high quality of the predictions generated by the model.

Keywords: gated recurrent unit, mean absolute percentage error, single-step forecasting, travel time prediction.

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48 Assessment of Neurodevelopmental Needs in Duchenne Muscular Dystrophy

Authors: Mathula Thangarajh

Abstract:

Duchenne muscular dystrophy (DMD) is a severe form of X-linked muscular dystrophy caused by mutations in the dystrophin gene resulting in progressive skeletal muscle weakness. Boys with DMD also have significant cognitive disabilities. The intelligence quotient of boys with DMD, compared to peers, is approximately one standard deviation below average. Detailed neuropsychological testing has demonstrated that boys with DMD have a global developmental impairment, with verbal memory and visuospatial skills most significantly affected. Furthermore, the total brain volume and gray matter volume are lower in children with DMD compared to age-matched controls. These results are suggestive of a significant structural and functional compromise to the developing brain as a result of absent dystrophin protein expression. There is also some genetic evidence to suggest that mutations in the 3’ end of the DMD gene are associated with more severe neurocognitive problems. Our working hypothesis is that (i) boys with DMD do not make gains in neurodevelopmental skills compared to typically developing children and (ii) women carriers of DMD mutations may have subclinical cognitive deficits. We also hypothesize that there may be an intergenerational vulnerability of cognition, with boys of DMD-carrier mothers being more affected cognitively than boys of non-DMD-carrier mothers. The objectives of this study are: 1. Assess the neurodevelopment in boys with DMD at 4-time points and perform baseline neuroradiological assessment, 2. Assess cognition in biological mothers of DMD participants at baseline, 3. Assess possible correlation between DMD mutation and cognitive measures. This study also explores functional brain abnormalities in people with DMD by exploring how regional and global connectivity of the brain underlies executive function deficits in DMD. Such research can contribute to a better holistic understanding of the cognition alterations due to DMD and could potentially allow clinicians to create better-tailored treatment plans for the DMD population. There are four study visits for each participant (baseline, 2-4 weeks, 1 year, 18 months). At each visit, the participant completes the NIH Toolbox Cognition Battery, a validated psychometric measure that is recommended by NIH Common Data Elements for use in DMD. Visits 1, 3, and 4 also involve the administration of the BRIEF-2, ABAS-3, PROMIS/NeuroQoL, PedsQL Neuromuscular module 3.0, Draw a Clock Test, and an optional fMRI scan with the N-back matching task. We expect to enroll 52 children with DMD, 52 mothers of children with DMD, and 30 healthy control boys. This study began in 2020 during the height of the COVID-19 pandemic. Due to this, there were subsequent delays in recruitment because of travel restrictions. However, we have persevered and continued to recruit new participants for the study. We partnered with the Muscular Dystrophy Association (MDA) and helped advertise the study to interested families. Since then, we have had families from across the country contact us about their interest in the study. We plan to continue to enroll a diverse population of DMD participants to contribute toward a better understanding of Duchenne Muscular Dystrophy.

Keywords: neurology, Duchenne muscular dystrophy, muscular dystrophy, cognition, neurodevelopment, x-linked disorder, DMD, DMD gene

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47 An Indispensable Parameter in Lipid Ratios to Discriminate between Morbid Obesity and Metabolic Syndrome in Children: High Density Lipoprotein Cholesterol

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Obesity is a low-grade inflammatory disease and may lead to health problems such as hypertension, dyslipidemia, diabetes. It is also associated with important risk factors for cardiovascular diseases. This requires the detailed evaluation of obesity, particularly in children. The aim of this study is to enlighten the potential associations between lipid ratios and obesity indices and to introduce those with discriminating features among children with obesity and metabolic syndrome (MetS). A total of 408 children (aged between six and eighteen years) participated in the scope of the study. Informed consent forms were taken from the participants and their parents. Ethical Committee approval was obtained. Anthropometric measurements such as weight, height as well as waist, hip, head, neck circumferences and body fat mass were taken. Systolic and diastolic blood pressure values were recorded. Body mass index (BMI), diagnostic obesity notation model assessment index-II (D2 index), waist-to-hip, head-to-neck ratios were calculated. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDLChol), low-density lipoprotein cholesterol (LDLChol) analyses were performed in blood samples drawn from 110 children with normal body weight, 164 morbid obese (MO) children and 134 children with MetS. Age- and sex-adjusted BMI percentiles tabulated by World Health Organization were used to classify groups; normal body weight, MO and MetS. 15th-to-85th percentiles were used to define normal body weight children. Children, whose values were above the 99th percentile, were described as MO. MetS criteria were defined. Data were evaluated statistically by SPSS Version 20. The degree of statistical significance was accepted as p≤0.05. Mean±standard deviation values of BMI for normal body weight children, MO children and those with MetS were 15.7±1.1, 27.1±3.8 and 29.1±5.3 kg/m2, respectively. Corresponding values for the D2 index were calculated as 3.4±0.9, 14.3±4.9 and 16.4±6.7. Both BMI and D2 index were capable of discriminating the groups from one another (p≤0.01). As far as other obesity indices were considered, waist-to hip and head-to-neck ratios did not exhibit any statistically significant difference between MO and MetS groups (p≥0.05). Diagnostic obesity notation model assessment index-II was correlated with the triglycerides-to-HDL-C ratio in normal body weight and MO (r=0.413, p≤0.01 and r=0.261, (p≤0.05, respectively). Total cholesterol-to-HDL-C and LDL-C-to-HDL-C showed statistically significant differences between normal body weight and MO as well as MO and MetS (p≤0.05). The only group in which these two ratios were significantly correlated with waist-to-hip ratio was MetS group (r=0.332 and r=0.334, p≤0.01, respectively). Lack of correlation between the D2 index and the triglycerides-to-HDL-C ratio was another important finding in MetS group. In this study, parameters and ratios, whose associations were defined previously with increased cardiovascular risk or cardiac death have been evaluated along with obesity indices in children with morbid obesity and MetS. Their profiles during childhood have been investigated. Aside from the nature of the correlation between the D2 index and triglycerides-to-HDL-C ratio, total cholesterol-to-HDL-C as well as LDL-C-to- HDL-C ratios along with their correlations with waist-to-hip ratio showed that the combination of obesity-related parameters predicts better than one parameter and appears to be helpful for discriminating MO children from MetS group.

Keywords: children, lipid ratios, metabolic syndrome, obesity indices

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46 The Derivation of a Four-Strain Optimized Mohr's Circle for Use in Experimental Reinforced Concrete Research

Authors: Edvard P. G. Bruun

Abstract:

One of the best ways of improving our understanding of reinforced concrete is through large-scale experimental testing. The gathered information is critical in making inferences about structural mechanics and deriving the mathematical models that are the basis for finite element analysis programs and design codes. An effective way of measuring the strains across a region of a specimen is by using a system of surface mounted Linear Variable Differential Transformers (LVDTs). While a single LVDT can only measure the linear strain in one direction, by combining several measurements at known angles a Mohr’s circle of strain can be derived for the whole region under investigation. This paper presents a method that can be used by researchers, which improves the accuracy and removes experimental bias in the calculation of the Mohr’s circle, using four rather than three independent strain measurements. Obtaining high quality strain data is essential, since knowing the angular deviation (shear strain) and the angle of principal strain in the region are important properties in characterizing the governing structural mechanics. For example, the Modified Compression Field Theory (MCFT) developed at the University of Toronto, is a rotating crack model that requires knowing the direction of the principal stress and strain, and then calculates the average secant stiffness in this direction. But since LVDTs can only measure average strains across a plane (i.e., between discrete points), localized cracking and spalling that typically occur in reinforced concrete, can lead to unrealistic results. To build in redundancy and improve the quality of the data gathered, the typical experimental setup for a large-scale shell specimen has four independent directions (X, Y, H, and V) that are instrumented. The question now becomes, which three should be used? The most common approach is to simply discard one of the measurements. The problem is that this can produce drastically different answers, depending on the three strain values that are chosen. To overcome this experimental bias, and to avoid simply discarding valuable data, a more rigorous approach would be to somehow make use of all four measurements. This paper presents the derivation of a method to draw what is effectively a Mohr’s circle of 'best-fit', which optimizes the circle by using all four independent strain values. The four-strain optimized Mohr’s circle approach has been utilized to process data from recent large-scale shell tests at the University of Toronto (Ruggiero, Proestos, and Bruun), where analysis of the test data has shown that the traditional three-strain method can lead to widely different results. This paper presents the derivation of the method and shows its application in the context of two reinforced concrete shells tested in pure torsion. In general, the constitutive models and relationships that characterize reinforced concrete are only as good as the experimental data that is gathered – ensuring that a rigorous and unbiased approach exists for calculating the Mohr’s circle of strain during an experiment, is of utmost importance to the structural research community.

Keywords: reinforced concrete, shell tests, Mohr’s circle, experimental research

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