Search results for: complicated pregnancy.

Authors: Seulki Lee, Seoung Bum Kim

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Statistical process control (SPC) is a practical and effective method for quality control. The most important and widely used technique in SPC is a control chart. The main goal of a control chart is to detect any assignable changes that affect the quality output. Most conventional control charts, such as Hotelling’s T2 charts, are commonly based on the assumption that the quality characteristics follow a multivariate normal distribution. However, in modern complicated manufacturing systems, appropriate control chart techniques that can efficiently handle the nonnormal processes are required. To overcome the shortcomings of conventional control charts for nonnormal processes, several methods have been proposed to combine statistical learning algorithms and multivariate control charts. Statistical learning-based control charts, such as support vector data description (SVDD)-based charts, k-nearest neighbors-based charts, have proven their improved performance in nonnormal situations compared to that of the T2 chart. Beside the nonnormal property, time-varying operations are also quite common in real manufacturing fields because of various factors such as product and set-point changes, seasonal variations, catalyst degradation, and sensor drifting. However, traditional control charts cannot accommodate future condition changes of the process because they are formulated based on the data information recorded in the early stage of the process. In the present paper, we propose a SVDD algorithm-based control chart, which is capable of adaptively monitoring time-varying and nonnormal processes. We reformulated the SVDD algorithm into a time-adaptive SVDD algorithm by adding a weighting factor that reflects time-varying situations. Moreover, we defined the updating region for the efficient model-updating structure of the control chart. The proposed control chart simultaneously allows efficient model updates and timely detection of out-of-control signals. The effectiveness and applicability of the proposed chart were demonstrated through experiments with the simulated data and the real data from the metal frame process in mobile device manufacturing.

Keywords: multivariate control chart, nonparametric method, support vector data description, time-varying process

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Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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Authors: Hilly Moodrick-Even Khen

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This study analyzes the legal regulation of the use of force in international law in the context of three emerging Palestinian forms of struggle against Israeli occupation: the Knife Intifada, Gaza border disturbances, and the launching of incendiary kites. It discusses what legal paradigms or concepts should regulate the type and level of force used in each situation—a question that is complicated by various dilemmas—and appraises the Israel Defence Forces policies tailored in response. Methodologically, the study is based on analysis of scholarship on the conceptual legal issues as well as dicta of the courts. It evaluates the applicability of two legal paradigms regulating the use of force in military operations—(i) the conduct of hostilities and (ii) law enforcement—as well as the concept of self-defense in international law and the escalation of force procedure. While the “Knife Intifada” clearly falls under the law enforcement paradigm, the disturbances at the border and the launching of incendiary kites raise more difficult questions, as applying law enforcement, especially in the latter case, can have undesirable ramifications for safeguarding humanitarian interests. The use of force in the cases of the border disturbances and the incendiary kites should thus be regulated, mutatis mutandis, by the concept of self-defense and escalation of force procedures; and in the latter case, the hostilities paradigm can also be applied. The study provides a factual description and analysis of the background and nature of the forms of struggle in Gaza and the West Bank—in each case surveying the geo-political developments since operation Protective Edge, contextualizing how the organized and unorganized violent activities evolved, and analyzing them in terms of level of organization and intensity. It then presents the two paradigms of the use of force—law enforcement and conduct of hostilities—and the concept of self-defense. Lastly, it uses the factual findings as the basis for legally analyzing which paradigm or concept regulating the use of force applies for each form of struggle. The study concludes that in most cases, the concept of self-defense is preferable to the hostilities or the law enforcement paradigms, as it best safeguards humanitarian interests and ensures the least loss of civilian lives.

Keywords: Israeli-Palestinian conflict, self defense, terrorism, use of force

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Authors: Geum Yeon Sim, Tyler Pigott, Julio Vasquez

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A 38-year-old obese female with no apparent past medical history presented with left knee pain. Six months ago, she sustained a left knee dislocation in a motor vehicle accident that was managed with a skin graft over the left lower extremity without any reconstructive surgery. She developed persistent pain and stiffness in her left knee that worsened with walking and stair climbing. Examination revealed healed extensive skin graft over the left lower extremity, including the left knee. Palpation showed moderate tenderness along the superior border of the patella, exquisite tenderness over MCL, and mild tenderness on the tibial tuberosity. There was normal sensation, reflexes, and strength in her lower extremities. There was limited active and passive range of motion of her left knee during flexion. There was instability noted upon the valgus stress test of the left knee. Left knee magnetic resonance imaging showed high-grade (grade 2-3) injury of the proximal superficial fibers of the MCL and diffuse thickening and signal abnormality of the cruciate ligaments, as well as edema-like subchondral marrow signal change in the anterolateral aspect of the lateral femoral condyle weight-bearing surface. There was also notable extensive scarring and edema of the skin, subcutaneous soft tissues, and musculature surrounding the knee. The patient was managed with left knee immobilization for five months, which was complicated by limited knee flexion. Physical therapy consisting of quadriceps, hamstrings, gastrocnemius stretching and strengthening, range of motion exercises, scar/soft tissue mobilization, and gait training was given with marked improvement in pain and range of motion. The patient experienced a further reduction in pain as well as an improvement in function with home exercises consisting of continued strengthening and stretching.

Keywords: ligamentous injury, trauma, rehabilitation, knee pain

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Authors: Gedefaye Nibret Mihretie

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Background: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. Many primary studies in Sub-Saharan Africa have been conducted to assess the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Cross-sectional studies were systematically searched from March 6, 2022, to April 24, 2022, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of transactional sex and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years, source of data, sample sizes and geographical location. Results: Four thousand one hundred thirty articles were extracted from various databases. The final thirty-two studies were included in this systematic review, including 108,075 participants. The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55%, with a confidence interval of 9.59% to 15.52%. Educational status (OR = .48, 95%CI, 0.27, 0.69) was the protective factors of transactional sex whereas, alcohol use (OR = 1.85, 95% CI: 1.19, 2.52), early sex debut (OR = 2.57, 95%CI, 1.17, 3.98), substance abuse (OR = 4.21, 95% CI: 2.05, 6.37), having history of sexual experience abuse (OR = 4.08, 95% CI: 1.38, 6.78), physical violence abuse (OR = 6.59, 95% CI: 1.17, 12.02), and sexual violence abuse (OR = 3.56, 95% CI: 1.15, 8.27) were the risk factors of transactional sex. Conclusion: The prevalence of transactional sex among women in Sub-Saharan Africa was high. Educational status, alcohol use, substance abuse, early sex debut, having a history of sexual experiences, physical violence, and sexual violence were predictors of transaction sex. Governmental and other stakeholders are designed to reduce alcohol utilization, provide health information about the negative consequences of early sex debut, substance abuse, and reduce sexual violence, ensuring gender equality through mass media, which should be included in state policy.

Keywords: women’s health, child health, reproductive health, midwifery

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Authors: Aizati N. A. Daud, Jorieke E. H. Bergman, Wilhelmina S. Kerstjens-Frederikse, Pieter Van Der Vlies, Eelko Hak, Rolf M. F. Berger, Henk Groen, Bob Wilffert

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Prenatal use of SRIs was previously associated with Congenital Heart Anomalies (CHA). The aim of the study is to explore whether pharmacogenetics plays a role in this teratogenicity using a gene-environment interaction study. A total of 33 case-mother dyads and 2 mother-only (children deceased) registered in EUROCAT Northern Netherlands were included in a case-only study. Five case-mother dyads and two mothers-only were exposed to SRIs (paroxetine=3, fluoxetine=2, venlafaxine=1, paroxetine and venlafaxine=1) in the first trimester of pregnancy. The remaining 28 case-mother dyads were not exposed to SRIs. Ten genes that encode the enzymes or proteins important in determining fetal exposure to SRIs or its mechanism of action were selected: CYPs (CYP1A2, CYP2C9, CYP2C19, CYP2D6), ABCB1 (placental P-glycoprotein), SLC6A4 (serotonin transporter) and serotonin receptor genes (HTR1A, HTR1B, HTR2A, and HTR3B). All included subjects were genotyped for 58 genetic variations in these ten genes. Logistic regression analyses were performed to determine the interaction odds ratio (OR) between genetic variations and SRIs exposure on the risk of CHA. Due to low phenotype frequencies of CYP450 poor metabolizers among exposed cases, the OR cannot be calculated. For ABCB1, there was no indication of changes in the risk of CHA with any of the ABCB1 SNPs in the children and their mothers. Several genetic variations of the serotonin transporter and receptors (SLC6A4 5-HTTLPR and 5-HTTVNTR, HTR1A rs1364043, HTR1B rs6296 & rs6298, HTR3B rs1176744) were associated with an increased risk of CHA, but with too limited sample size to reach statistical significance. For SLC6A4 genetic variations, the mean genetic scores of the exposed case-mothers tended to be higher than the unexposed mothers (2.5 ± 0.8 and 1.88 ± 0.7, respectively; p=0.061). For SNPs of the serotonin receptors, the mean genetic score for exposed cases (children) tended to be higher than the unexposed cases (3.4 ± 2.2, and 1.9 ± 1.6, respectively; p=0.065). This study might be among the first to explore the potential gene-environment interaction between pharmacogenetic determinants and SRIs use on the risk of CHA. With small sample sizes, it was not possible to find a significant interaction. However, there were indications for a role of serotonin receptor polymorphisms in fetuses exposed to SRIs on fetal risk of CHA which warrants further investigation.

Keywords: gene-environment interaction, heart defects, pharmacogenetics, serotonin reuptake inhibitors, teratogenicity

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Authors: Thomai Voulgari, Vasilis Vasilopoulos, Antonis Skamnakis

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The aim of this study is to investigate the effect of the European election campaigns (May 23-26, 2019) on Twitter achieving with artificial intelligence tools such as troll factories and automated inauthentic accounts. Our research focuses on the last European Parliamentary elections that took place between 23 and 26 May 2019 specifically in Italy, Greece, Germany and France. It is difficult to estimate how many Twitter users are actually bots (Echeverría, 2017). Detection for fake accounts is becoming even more complicated as AI bots are made more advanced. A political bot can be programmed to post comments on a Twitter account for a political candidate, target journalists with manipulated content or engage with politicians and artificially increase their impact and popularity. We analyze variables related to 1) the scope of activity of automated bots accounts and 2) degree of coherence and 3) degree of interaction taking into account different factors, such as the type of content of Twitter messages and their intentions, as well as the spreading to the general public. For this purpose, we collected large volumes of Twitter accounts of party leaders and MEP candidates between 10th of May and 26th of July based on content analysis of tweets based on hashtags while using an innovative network analysis tool known as MediaWatch.io (https://mediawatch.io/). According to our findings, one of the highest percentage (64.6%) of automated “bot” accounts during 2019 European election campaigns was in Greece. In general terms, political bots aim to proliferation of misinformation on social media. Targeting voters is a way that it can be achieved contribute to social media manipulation. We found that political parties and individual politicians create and promote purposeful content on Twitter using algorithmic tools. Based on this analysis, online political advertising play an important role to the process of spreading misinformation during elections campaigns. Overall, inauthentic accounts and social media algorithms are being used to manipulate political behavior and public opinion.

Keywords: artificial intelligence tools, human-bot interactions, political manipulation, social networking, troll factories

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Authors: Rafikoddin Kazi

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Almost all the major religions of the world condemn the transactions based on interest which promotes self-centered and materialistic thinking. Still, it is amazing to note that it has become the tradition of transaction at world level hence it is called traditional financial system. The main feature of this system is that it considers economic aspects of the transaction only. This system supports the economic development and not the welfare of humankind. However, it is worth mentioning the fact that, except Islamic financial system no other financial system stood in front of it as a viable alternative system. Although many countries have tried to create financial infrastructure and system, still the Malaysian Islamic financial system has got its own peculiarity. It has made tremendous progress in creating sound Islamic Financial system. However, the historical aspect of this country which has passed through Islamic and traditional financial system has got its own advantages and disadvantages. The advantageous factor is that, despite having mix and heterogeneous culture, it has succeeded in creating Islamic Financial System based on the dual legal system to satisfy the needs of multi-cultural factors. This fact has proved that Islamic Financial System does not need purely Muslim population. However, due to adoption of the dual legal system, several legal issues have been taken place. According to this system, the application of Islamic Law has been limited only up to some family and religious matters. The rest of the matters are being dealt with under the traditional laws, the principles and practices of which are different from that of the Islamic Legal System. The matter becomes all the more complicated when the cases are partially or simultaneously concerned with traditional vis-à-vis Islamic Laws as it requires expertise in both the legal systems. However, the educational principles and systems are different in respect of both the systems. To face this problem, Shariah Advisory Council has been established. But the Multiplicity of Shariah authorities without judicial power has created confusion at various levels. Therefore, some experts have stressed the need for improving, empowering the Islamic financial, legal system to make it more integrated and holistic. In view of the above, an endeavor has been made in this paper to throw some light on the matters related to the adoption of the dual legal system. The paper is conceptual in nature and the method adopted is the intensive survey of literature thereby all the information has been gathered from the secondary sources.

Keywords: Islamic financial system, Islamic legal system, Islamic capital market (ICM) , traditional financial system

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Authors: Kayode A. Olaniyi, Tola. M. Osifeko, Adeola A. Ogunleye

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Text line segmentation is an important step in document image processing. It represents a labeling process that assigns the same label using distance metric probability to spatially aligned units. Text line detection techniques have successfully been implemented mainly in printed documents. However, processing of the handwritten texts especially unconstrained documents has remained a key problem. This is because the unconstrained hand-written text lines are often not uniformly skewed. The spaces between text lines may not be obvious, complicated by the nature of handwriting and, overlapping ascenders and/or descenders of some characters. Hence, text lines detection and segmentation represents a leading challenge in handwritten document image processing. Text line detection methods that rely on the traditional global projection profile of the text document cannot efficiently confront with the problem of variable skew angles between different text lines. Hence, the formulation of a horizontal line as a separator is often not efficient. This paper presents a technique to segment a handwritten document into distinct lines of text. The proposed algorithm starts, by partitioning the initial text image into columns, across its width into chunks of about 5% each. At each vertical strip of 5%, the histogram of horizontal runs is projected. We have worked with the assumption that text appearing in a single strip is almost parallel to each other. The algorithm developed provides a sliding window through the first vertical strip on the left side of the page. It runs through to identify the new minimum corresponding to a valley in the projection profile. Each valley would represent the starting point of the orientation line and the ending point is the minimum point on the projection profile of the next vertical strip. The derived text-lines traverse around any obstructing handwritten vertical strips of connected component by associating it to either the line above or below. A decision of associating such connected component is made by the probability obtained from a distance metric decision. The technique outperforms the global projection profile for text line segmentation and it is robust to handle skewed documents and those with lines running into each other.

Keywords: connected-component, projection-profile, segmentation, text-line

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Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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Authors: Bernard Kumi-Boateng, Issaka Yakubu

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Forest fire, which is, an uncontrolled fire occurring in nature has become a major concern for the Forestry Commission of Ghana (FCG). The forest fires in Ghana usually result in massive destruction and take a long time for the firefighting crews to gain control over the situation. In order to assess the effect of forest fire at local scale, it is important to consider the role fire plays in vegetation composition, biodiversity, soil erosion, and the hydrological cycle. The occurrence, frequency and behaviour of forest fires vary over time and space, primarily as a result of the complicated influences of changes in land use, vegetation composition, fire suppression efforts, and other indigenous factors. One of the forest zones in Ghana with a high level of vegetation stress is the Goaso forest area. The area has experienced changes in its traditional land use such as hunting, charcoal production, inefficient logging practices and rural abandonment patterns. These factors which were identified as major causes of forest fire, have recently modified the incidence of fire in the Goaso area. In spite of the incidence of forest fires in the Goaso forest area, most of the forest services do not provide a cartographic representation of the burned areas. This has resulted in significant amount of information being required by the firefighting unit of the FCG to understand fire risk factors and its spatial effects. This study uses Remote Sensing and Geographic Information System techniques to develop a fire risk hazard model using the Goaso Forest Area (GFA) as a case study. From the results of the study, natural forest, agricultural lands and plantation cover types were identified as the major fuel contributing loads. However, water bodies, roads and settlements were identified as minor fuel contributing loads. Based on the major and minor fuel contributing loads, a forest fire risk hazard model with a reasonable accuracy has been developed for the GFA to assist decision making.

Keywords: forest, GIS, remote sensing, Goaso

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Authors: Mirjana Dokmanovic

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In recent years, the disadvantaged and marginalised position of rural women in the Republic of Serbia has been recognised in a number of national strategies and policy papers. A number of measures have been adopted by the government aimed at economic empowerment of rural women and eliminating barriers to accessing decision making and economic and social opportunities. However, their implementation pace is still slow. The aim of the paper is to indicate the necessity of a comprehensive policy approach to eliminating discrimination against rural women that would include policy and financial commitments for enhancing agricultural and rural development as a whole, instead of taking fragmented measures targeting consequences instead of causes. The paper introduces main findings of the study of challenges, constraints, and opportunities of rural women in Serbia to enjoy their economic and social rights. The research methodology included the desk research and the qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, ministries and other governmental bodies, independent human rights bodies, and civil society organizations (CSOs). The findings of the study reveal that rural women are at great risk of poverty, particularly in remote areas, and when getting old or widowed. Young rural women working in agriculture are also in unfavorable position, as they do not have opportunities to enjoy their rights during pregnancy and maternity leave, childcare leave and leave due to the special care of a child. The study indicates that the main causes of their unfavorable position are related to the prevalent patriarchal surrounding and economic and social underdevelopment of rural areas in Serbia. Gender inequalities have been particularly present in accessing land and property rights, inheritance, education, social protection, healthcare, and decision making. Women living in the rural areas are exposed at high risk of discrimination in all spheres of public and private life that undermine their enjoyment of basic economic, social and cultural rights. The vulnerability of rural women to discrimination increases in cases of the intersectionality of other grounds of discrimination, such as disability, ethnicity, age, health condition and sexual discrimination. If they are victims of domestic violence, their experience lack of access to shelters and protection services. Despite the State’s recognition of the marginalized position of rural women, there is still a lack of a comprehensive policy approach to improving the economic and social position of rural women.

Keywords: agricultural and rural development, care economy, discrimination against women, economic and social rights, feminization of poverty, Republic of Serbia, rural women

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Ola Jon Mork, Lars Andre Giske, Emil Bjørlykhaug

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Stabilization of critical processes in order to have the right quality of the products, more efficient production and smoother flow is a key issue in lean production. This paper presents how simulation of key welding processes can stabilize complicated welding processes in small scale production, and how simulation can impact the entire production concept seen from the perspective of lean production. First, a field study was made to learn the production processes in the factory, and subsequently the field study was transformed into a value stream map to get insight into each operation, the quality issues, operation times, lead times and flow of materials. Valuable practical knowledge of how the welding operations were done by operators, appropriate tools and jigs, and type of robots that could be used, was collected. All available information was then implemented into a simulation environment for further elaboration and development. Three researchers, the management of the company and skilled operators at the work floor where working on the project over a period of eight months, and a detailed description of the process was made by the researchers. The simulation showed that simulation could solve a number of technical challenges, the robot program can be tuned in off line mode, and the design and testing of the robot cell could be made in the simulator. Further on the design of the product could be optimized for robot welding and the jigs could be designed and tested in simulation environment. This means that a key issue of lean production can be solved; the welding operation will work with almost 100% performance when it is put into real production. Stabilizing of one key process is critical to gain control of the entire value chain, then a Takt Time can be established and the focus can be directed towards the next process in the production which should be stabilized. Results show that industrial parameters like welding time, welding cost and welding quality can be defined on the simulation stage. Further on, this gives valuable information for calculation of the factories business performance, like manufacturing volume and manufacturing efficiency. Industrial impact from simulation is more efficient implementation of lean manufacturing, since the welding process can be stabilized. More research should be done to gain more knowledge about simulation as a tool for implementation of lean, especially where there complex processes.

Keywords: simulation, lean, stabilization, welding process

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Authors: Narmina Ismayilova, Shamil Zabitov, Fuad Askerzadeh, Raqif Seyfullayev

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Tulallar volcano-tectonic structure is located in the conjugation zone of the Gekgel horst-uplift, Dashkesan, and Agzhakend synclinorium. Regionally, these geological structures are an integral part of the Lok-Karabakh island arc system. Tulallar field is represented by three areas (Central, East, West). The area of the ore field is located within a partially eroded oblong volcano-tectonic depression. In the central part, the core is divided by the deep Tulallar-Chiragdara-Toganalinsky fault with arcuate fragments of the ring structure into three blocks -East, Central, and West, within which the same areas of the Tulallar field are located. In general, for the deposit, the position of both ore-bearing vein zones and ore-bearing blocks is controlled by fractures of two systems - sub-latitudinal and near-meridional orientations. Mineralization of gold-sulfide ores is confined to these zones of disturbances. The zones have a northwestern and northeastern (near-meridian) strike with a steep dip (70-85◦) to the southwest and southeast. The average thickness of the zones is 35 m; they are traced for 2.5 km along the strike and 500 m along with the dip. In general, for the indicated thickness, the zones contain an average of 1.56 ppm Au; however, areas enriched in noble metal are distinguished within them. The zones are complicated by postore fault tectonics. Gold mineralization is localized in the Kimmeridgian volcanics of andesi-basalt-porphyritic composition and their vitrolithoclastic, agglomerate tuffs, and tuff breccias. For the central part of the Tulallar ore field, a map of geochemical anomalies was built on the basis of analysis data carried out in an international laboratory. The total gold content ranges from 0.1-5 g/t, and in some places, even more than 5 g/t. The highest gold content is observed in the monoquartz facies among the secondary quartzites with quartz veins. The smallest amount of gold content appeared in the quartz-kaolin facies. And also, anomalous values of gold content are located in the upper part of the quartz vein. As a result, an en-echelon arrangement of anomalous values of gold along the strike and dip was revealed.

Keywords: geochemical anomaly, gold deposit, mineralization, Tulallar

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Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge

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The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.

Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure

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Authors: B. Vinod, L. Jsudev

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Natural fibers as reinforcement in polymer matrix material is gaining lot of attention in recent years, as they are light in weight, less in cost, and ecologically advanced surrogate material to glass and carbon fibers in composites. Natural fibers like jute, sisal, coir, hemp, banana etc. have attracted substantial importance as a potential structural material because of its attractive features along with its good mechanical properties. Cryogenic applications of natural fiber reinforced polymer composites like cryogenic wind tunnels, cryogenic transport vessels, support structures in space shuttles and rockets are gaining importance. In these unique cryogenic applications, the requirements of polymer composites are extremely severe and complicated. These materials need to possess good mechanical and physical properties at cryogenic temperatures such as liquid helium (4.2 K), liquid hydrogen (20 K), liquid nitrogen (77 K), and liquid oxygen (90 K) temperatures, etc., to meet the high requirements by the cryogenic engineering applications. The objective of this work is to investigate the mechanical behavior of hybrid hemp/jute fibers reinforced epoxy composite material at liquid nitrogen temperature. Hemp and Jute fibers are used as reinforcement material as they have high specific strength, stiffness and good adhering property and has the potential to replace the synthetic fibers. Hybrid hemp/jute fibers reinforced polymer composite is prepared by hand lay-up method and test specimens are cut according to ASTM standards. These test specimens are dipped in liquid nitrogen for different time durations. The tensile properties, flexural properties and impact strength of the specimen are tested immediately after the specimens are removed from liquid nitrogen container. The experimental results indicate that the cryogenic treatment of the polymer composite has a significant effect on the mechanical properties of this material. The tensile properties and flexural properties of the hybrid hemp/jute fibers epoxy composite at liquid nitrogen temperature is higher than at room temperature. The impact strength of the material decreased after subjecting it to liquid nitrogen temperature.

Keywords: liquid nitrogen temperature, polymer composite, tensile properties, flexural properties

Procedia PDF Downloads 320

Authors: Guoqing Wang, Yanhua Zhao, Lina Zhang, Jingbin Bai, Ruican Zhu

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Friction stir welding with bobbin tool is a simple technique compared to conventional FSW since the backing fixture is no longer needed and assembling labor is reduced. It gets adopted more and more in the aerospace industry as a result. However, a post-weld problem, the left keyhole, has to be fixed by forced repair welding. To close the keyhole, the conventional fusion repair could be an option if the joint properties are not deteriorated; friction push plug welding, a forced repair, could be another except that a rigid support unit is demanded at the back of the weldment. Therefore, neither of the above ways is satisfaction in welding a large enclosed structure, like rocket propellant tank. Although friction pulls plug welding does not need a backing plate, the wide applications are still held back because of the disadvantages in respects of unappropriated tensile stress, (i.e. excessive stress causing neck shrinkage of plug that will bring about back defects while insufficient stress causing lack of heat input that will bring about face defects), complicated welding parameters (including rotation speed, transverse speed, friction force, welding pressure and upset)，short welding time (approx. 0.5 sec.), narrow windows and poor stability of process. In this research, an updated technique called inertia friction pull plug welding, and its equipment was developed. The influencing rules of technological parameters on joint properties of inertia friction pull plug welding were observed. The microstructure characteristics were analyzed. Based on the elementary performance data acquired, the conclusion is made that the uniform energy provided by an inertia flywheel will be a guarantee to a stable welding process. Meanwhile, due to the abandon of backing plate, the inertia friction pull plug welding is considered as a promising technique in repairing keyhole of bobbin tool FSW and point type defects of aluminium base material.

Keywords: defect repairing, equipment, inertia friction pull plug welding, technological parameters

Procedia PDF Downloads 286

Authors: Rahman Davtalab

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Florida is one of the most vulnerable states to natural disasters among the 50 states of the USA. The state exposed by tropical storms, hurricanes, storm surge, landslide, etc. Besides, the mentioned natural phenomena, global warming, sea-level rise, and other anthropogenic environmental changes make a very complicated and unpredictable system for decision-makers. In this study, we tried to highlight the effects of climate change and sea-level rise on surface water and groundwater systems for three different geographical locations in Florida; Main Canal of Jacksonville Beach (in the northeast of Florida adjacent to the Atlantic Ocean), Grace Lake in central Florida, far away from surrounded coastal line, and Mc Dill in Florida and adjacent to Tampa Bay and Mexican Gulf. An integrated hydrologic and hydraulic model was developed and simulated for all three cases, including surface water, groundwater, or a combination of both. For the case study of Main Canal-Jacksonville Beach, the investigation showed that a 76 cm sea-level rise in time horizon 2060 could increase the flow velocity of the tide cycle for the main canal's outlet and headwater. This case also revealed how the sea level rise could change the tide duration, potentially affecting the coastal ecosystem. As expected, sea-level rise can raise the groundwater level. Therefore, for the Mc Dill case, the effect of groundwater rise on soil storage and the performance of stormwater retention ponds is investigated. The study showed that sea-level rise increased the pond’s seasonal high water up to 40 cm by time horizon 2060. The reliability of the retention pond is dropped from 99% for the current condition to 54% for the future. The results also proved that the retention pond could not retain and infiltrate the designed treatment volume within 72 hours, which is a significant indication of increasing pollutants in the future. Grace Lake case study investigates the effects of climate change on groundwater recharge. This study showed that using the dynamically downscaled data of the groundwater recharge can decline up to 24% by the mid-21st century.

Keywords: groundwater, surface water, Florida, retention pond, tide, sea level rise

Procedia PDF Downloads 159

Authors: Jun Ren, Zhen-Hua Ming, He-Feng Huang, Jian-Zhong Sheng

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Adverse intrauterine stimulus during critical or sensitive periods in early life, may lead to health risk not only in later life span, but also further generations. Intrauterine hyperglycaemia, as a major feature of gestational diabetes mellitus (GDM), is a typical adverse environment for both F1 fetus and F1 gamete cells development. However, there is scare information of phenotypic difference of metabolic memory between somatic cells and germ cells exposed by intrauterine hyperglycaemia. The direct transmission effect of intrauterine hyperglycaemia per se has not been assessed either. In this study, we built a GDM mice model and selected male GDM offspring without pre-diabetic phenotype as our founders, to exclude postnatal diabetic influence on gametes, thereby investigate the direct transmission effect of intrauterine hyperglycaemia exposure on F2 offspring, and we further compared the metabolic difference of affected F1-GDM male offspring and F2 offspring. A GDM mouse model of intrauterine hyperglycemia was established by intraperitoneal injection of streptozotocin after pregnancy. Pups of GDM mother were fostered by normal control mothers. All the mice were fed with standard food. Male GDM offspring without metabolic dysfunction phenotype were crossed with normal female mice to obtain F2 offspring. Body weight, glucose tolerance test, insulin tolerance test and homeostasis model of insulin resistance (HOMA-IR) index were measured in both generations at 8 week of age. Some of F1-GDM male mice showed impaired glucose tolerance (p < 0.001), none of F1-GDM male mice showed impaired insulin sensitivity. Body weight of F1-GDM mice showed no significance with control mice. Some of F2-GDM offspring exhibited impaired glucose tolerance (p < 0.001), all the F2-GDM offspring exhibited higher HOMA-IR index (p < 0.01 of normal glucose tolerance individuals vs. control, p < 0.05 of glucose intolerance individuals vs. control). All the F2-GDM offspring exhibited higher ITT curve than control (p < 0.001 of normal glucose tolerance individuals, p < 0.05 of glucose intolerance individuals, vs. control). F2-GDM offspring had higher body weight than control mice (p < 0.001 of normal glucose tolerance individuals, p < 0.001 of glucose intolerance individuals, vs. control). While glucose intolerance is the only phenotype that F1-GDM male mice may exhibit, F2 male generation of healthy F1-GDM father showed insulin resistance, increased body weight and/or impaired glucose tolerance. These findings imply that intrauterine hyperglycaemia exposure affects germ cells and somatic cells differently, thus F1 and F2 offspring demonstrated distinct metabolic dysfunction phenotypes. And intrauterine hyperglycaemia exposure per se has a strong influence on F2 generation, independent of postnatal metabolic dysfunction exposure.

Keywords: inheritance, insulin resistance, intrauterine hyperglycaemia, offspring

Procedia PDF Downloads 220

Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

Procedia PDF Downloads 176

Authors: I. Bochev, A. Shterev, S. Kyurkchiev

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One of the factors associated with poor success rates in human in vitro fertilization (IVF) is the suboptimal culture conditions in which fertilization and early embryonic growth occur. Co-culture systems with helper cell lines appear to enhance the in vitro conditions and allow embryos to demonstrate improved in vitro development. The co-culture of human embryos with monolayers of autologous endometrial stromal cell (EnSCs) results in increased blastocyst development with a larger number of blastomeres, lower incidence of fragmentation and higher pregnancy rates in patients with recurrent implantation failure (RIF). The aim of the study was to examine the influence of autologous endometrial stromal cell (EnSC) co-culture on day 3 embryo quality by comparing the morphological status of the embryos from the same patients undergoing consecutive IVF/Intracytoplasmic sperm injection (ICSI) cycles without and with EnSC co-culture. This retrospective randomized study (2015-2017) includes 20 couples and a total of 46 IVF/ICSI cycles. Each patient couple included had at least two IVF/ICSI procedures – one with and one without autologous EnSC co-culture. Embryo quality was assessed at 68±1 hours in culture, according to Istanbul consensus criteria (2010). Day 3 embryos were classified into three groups: good – grade 1; fair – grade 2; poor – grade 3. Embryos from all cycles were divided into two groups (A – co-cultivated; B – not co-cultivated) and analyzed. Second, for each patient couple, embryos from matched IVF/ICSI cycles (with and without co-culture) were analyzed separately. When an analysis of co-cultivated day 3 embryos from all cycles was performed (n=137; group A), 43.1% of the embryos were graded as “good”, which was not significantly different from the respective embryo quality rate of 42.2% (p = NS) in group B (n=147) with non-co-cultivated embryos. The proportions of fair and poor quality embryos in group A and group B were similar as well – 11.7% vs 10.2% and 45.2% vs 47.6% (p=NS), respectively. Nevertheless, the separate embryo analysis by matched cycles for each couple revealed that in 65% of the cases the proportion of morphologically better embryos was increased in cycles with co-culture in comparison with those without co-culture. A decrease in this proportion after endometrial stromal cell co-cultivation was found in 30% of the cases, whereas no difference was observed in only one couple. The results demonstrated that there is no marked difference in the overall morphological quality between co-cultured and non-co-cultured embryos on day 3. However, in significantly greater percentage of couples the process of autologous EnSC co-culture could increase the proportion of morphologically improved day 3 embryos. By mimicking the in vivo relationship between embryo and maternal environment, co-culture in autologous EnSC system represents a perspective approach to improve the quality of embryos in cases with elevated risk for development of embryos with impaired morphology.

Keywords: autologous endometrial stromal cells, co-culture, day 3 embryo, morphological quality

Procedia PDF Downloads 202

Authors: Zairunisha

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This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

Procedia PDF Downloads 346

Authors: Mahtab Makaremi Masouleh, Günter Wozniak

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This research is part of an interdisciplinary project, promoting the design of a light temporary installable textile defence system against flood. In case river water levels increase abruptly especially in winter time, one can expect massive extra load on a textile protective structure in term of impact as a result of floating debris and even tree trunks. Estimation of this impulsive force on such structures is of a great importance, as it can ensure the reliability of the design in critical cases. This fact provides the motivation for the numerical analysis of a fluid structure interaction application, comprising flexible slender shaped and free-surface water flow, where an accelerated heavy flotsam tends to approach the membrane. In this context, the analysis on both the behavior of the flexible membrane and its interaction with moving flotsam is conducted by finite elements based solvers of the explicit solver and implicit Abacus solver available as products of SIMULIA software. On the other hand, a study on how free surface water flow behaves in response to moving structures, has been investigated using the finite volume solver of Star CCM+ from Siemens PLM Software. An automatic communication tool (CSE, SIMULIA Co-Simulation Engine) and the implementation of an effective partitioned strategy in form of an implicit coupling algorithm makes it possible for partitioned domains to be interconnected powerfully. The applied procedure ensures stability and convergence in the solution of these complicated issues, albeit with high computational cost; however, the other complexity of this study stems from mesh criterion in the fluid domain, where the two structures approach each other. This contribution presents the approaches for the establishment of a convergent numerical solution and compares the results with experimental findings.

Keywords: co-simulation, flexible thin structure, fluid-structure interaction, implicit coupling algorithm, moving flotsam

Procedia PDF Downloads 362

Authors: Wai Ha Leung

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Mother tongue language (MTL) curriculum is core to school education in most countries/regions' school curriculum. Through mother tongue language learning, students are expected to enhance their understanding of the nation's culture and foster the sense of cultural and ethnic identity. However, MTL education in Hong Kong is complicated by the colonial history. This study examines Hong Kong Chinese language teachers' perceptions of MTL education, and the implication on MTL curriculum development. The questionnaire was administrated to 97 teachers, and interviews were carried out on 17 teachers. Usually, MTL is both the tool with which knowledge and skills are taught and learned and the vehicle for students to learn about the traditions of the countries' literature and culture. In Hong Kong, 95% of the population is of Chinese descent. Traditionally, education in China was a mixture of philosophy, history, politics and literacy. Chinese as an MTL subject in pre-colonial Hong Kong has always been assigned the mission of developing students' cultural identity in addition to the development of linguistic proficiency. During the colonial period, the Chinese Language curriculum shifted to be more language skills based with less emphasis on Chinese culture and moral education. After the sovereignty of Hong Kong was returned to China in 1997, although a new curriculum was implemented in 2002, teaching and learning in school as well as public examinations seem to be remaining language skills oriented instead of culturally based. This deviation from the trend of both Chinese traditional education and global mother tongue language education makes some Chinese language teachers feel confused. In addition, there is comment that in general Hong Kong students' Chinese language proficiency is becoming weaker and weaker in recent years. Thus, effectiveness of the skills oriented language curriculum has come under question. How a language teacher views the aims and objectives of the language subject he or she is teaching has a direct effect on the curriculum delivery and pedagogies used. It is, therefore, important to investigate what is the language teachers' perception of MTL education, and whether the current school curriculum can meet the teachers' expectation as well as achieve the aims of MTL education. Given this context, this study explored the views of Hong Kong Chinese language teachers on MTL education. The data indicate that teachers showed a strong resentment towards the current curriculum. Results may have implications on mother tongue language curriculum development.

Keywords: Chinese language education, curriculum development, mother tongue language education, teachers' perception

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Authors: Madhawa Basnayaka, Jouni Paltakari

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Fully passive backscattering chipless RFID tags are an emerging wireless technology with low cost, higher reading distance, and fast automatic identification without human interference, unlike already available technologies like optical barcodes. The design optimization of chipless RFID tags is crucial as it requires replacing integrated chips found in conventional RFID tags with printed geometric designs. These designs enable data encoding and decoding through backscattered electromagnetic (EM) signatures. The applications of chipless RFID tags have been limited due to the constraints of data encoding capacity and the ability to design accurate yet efficient configurations. The traditional approach to accomplishing design parameters for a desired EM response involves iterative adjustment of design parameters and simulating until the desired EM spectrum is achieved. However, traditional numerical simulation methods encounter limitations in optimizing design parameters efficiently due to the speed and resource consumption. In this work, a deep learning neural network (DNN) is utilized to establish a correlation between the EM spectrum and the dimensional parameters of nested centric rings, specifically square and octagonal. The proposed bi-directional DNN has two simultaneously running neural networks, namely spectrum prediction and design parameters prediction. First, spectrum prediction DNN was trained to minimize mean square error (MSE). After the training process was completed, the spectrum prediction DNN was able to accurately predict the EM spectrum according to the input design parameters within a few seconds. Then, the trained spectrum prediction DNN was connected to the design parameters prediction DNN and trained two networks simultaneously. For the first time in chipless tag design, design parameters were predicted accurately after training bi-directional DNN for a desired EM spectrum. The model was evaluated using a randomly generated spectrum and the tag was manufactured using the predicted geometrical parameters. The manufactured tags were successfully tested in the laboratory. The amount of iterative computer simulations has been significantly decreased by this approach. Therefore, highly efficient but ultrafast bi-directional DNN models allow rapid and complicated chipless RFID tag designs.

Keywords: artificial intelligence, chipless RFID, deep learning, machine learning

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Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

Procedia PDF Downloads 126

Authors: Diogo Prosdocimi, Don Ross, Matthew Townshend

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Road authorities are mandated within limited budgets to both deliver improved access to basic services and facilitate economic growth. This responsibility is further complicated if maintenance backlogs and funding shortfalls exist, as evident in many countries including South Africa. These conditions require authorities to make difficult prioritisation decisions, with the effect that Road Asset Management Systems with a one-dimensional focus on traffic volumes may overlook the maintenance of low-volume roads that provide isolated communities with vital access to basic services. Given these challenges, this paper overlays the full South African road network with geo-referenced information for population, primary and secondary schools, and healthcare facilities to identify the network of connective roads between communities and basic service centres. This connective network is then rationalised according to the Gross Value Added and number of jobs per mesozone, administrative and functional road classifications, speed limit, and road length, location, and name to estimate the Basic Access Road Network. A two-step floating catchment area (2SFCA) method, capturing a weighted assessment of drive-time to service centres and the ratio of people within a catchment area to teachers and healthcare workers, is subsequently applied to generate a Multivariate Road Index. This Index is used to assign higher maintenance priority to roads within the Basic Access Road Network that provide more people with better access to services. The relatively limited incidence of Basic Access Roads indicates that authorities could maintain the entire estimated network without exhausting the available road budget before practical economic considerations get any purchase. Despite this fact, a final case study modelling exercise is performed for the Namakwa District Municipality to demonstrate the extent to which optimal relocation of schools and healthcare facilities could minimise the Basic Access Road Network and thereby release budget for investment in roads that best promote GDP growth.

Keywords: basic access roads, multivariate road index, road prioritisation, two-step floating catchment area method

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Authors: Rafal Sochaczewski, Marcin Szlachetka, Miroslaw Wendeker

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Increasing requirements to reduce exhaust emissions and fuel consumption while increasing the power factor is increasingly becoming applicable to internal combustion engines intended for aircraft applications. As a result, intensive research work is underway to develop a diesel-powered unit for aircraft propulsion. Due to a number of advantages, such as lack of the head (lower heat loss) and timing system, opposite movement of pistons conducive to balancing the engine, the two-stroke compression-ignition engine with the opposite pistons has been developed and upgraded. Of course, such construction also has drawbacks. The main one is the necessity of using a gear connecting two crankshafts or a complicated crank system with one shaft. The peculiarity of the arrangement of pistons with sleeves, as well as the fulfillment of rigorous requirements, makes it necessary to apply the most modern technologies and constructional solutions. In the case of the fuel supply system, it was decided to use common rail system elements. The paper presents an analysis of the possibility of using a common rail pump to supply an aircraft compression-ignition engine. It is an engine with a two-stroke cycle, three cylinders, opposing pistons, and 100 kW power. Each combustion chamber is powered by two injectors controlled by electromagnetic valves. In order to assess the possibility of using a common rail pump, four high-pressure pumps were tested on a bench. They are piston pumps differing in the number and geometry of the pumping sections. The analysis included the torque on the pump drive shaft and the power needed to drive the pump depending on the rotational speed, pumping pressure and fuel dispenser settings. The research allowed to optimize the engine power supply system depending on the fuel demand and the way the pump is mounted on the engine. Acknowledgment: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish Nation-al Centre for Research and Development.

Keywords: diesel engine, fuel pump, opposing pistons, two-stroke

Procedia PDF Downloads 118

Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

Procedia PDF Downloads 59