Search results for: ultrasound assisted

Authors: Sergey N. Ermoliev, Margarita A. Belousova, Aida D. Goncharenko

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Application of the diagnostic complex of highly informative functional methods (electromyography, reodentography, laser Doppler flowmetry, reoperiodontography, vital computer capillaroscopy, optical tissue oximetry, laser fluorescence diagnosis) allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment. Introduction. It is necessary to create a complex of innovative highly informative and safe functional diagnostic methods for improvement of the quality of patient treatment by the early detection of stomatologic diseases. The purpose of the present study was to investigate the etiology and pathogenesis of functional disorders identified in the pathology of hard tissue, dental pulp, periodontal, oral mucosa and chewing function, and the creation of new approaches to the diagnosis of dental diseases. Material and methods. 172 patients were examined. Density of hard tissues of the teeth and jaw bone was studied by intraoral ultrasonic densitometry (USD). Electromyographic activity of masticatory muscles was assessed by electromyography (EMG). Functional state of dental pulp vessels assessed by reodentography (RDG) and laser Doppler flowmetry (LDF). Reoperiodontography method (RPG) studied regional blood flow in the periodontal tissues. Microcirculatory vascular periodontal studied by vital computer capillaroscopy (VCC) and laser Doppler flowmetry (LDF). The metabolic level of the mucous membrane was determined by optical tissue oximetry (OTO) and laser fluorescence diagnosis (LFD). Results and discussion. The results obtained revealed changes in mineral density of hard tissues of the teeth and jaw bone, the bioelectric activity of masticatory muscles, regional blood flow and microcirculation in the dental pulp and periodontal tissues. LDF and OTO methods estimated fluctuations of saturation level and oxygen transport in microvasculature of periodontal tissues. With LFD identified changes in the concentration of enzymes (nicotinamide, flavins, lipofuscin, porphyrins) involved in metabolic processes Conclusion. Our preliminary results confirmed feasibility and safety the of intraoral ultrasound densitometry technique in the density of bone tissue of periodontium. Conclusion. Application of the diagnostic complex of above mentioned highly informative functional methods allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment.

Keywords: electromyography (EMG), reodentography (RDG), laser Doppler flowmetry (LDF), reoperiodontography method (RPG), vital computer capillaroscopy (VCC), optical tissue oximetry (OTO), laser fluorescence diagnosis (LFD)

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Authors: Zuzanna Miodonska, Michal Krecichwost, Pawel Badura

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Sigmatism (lisping) is a speech disorder in which sibilant consonants are mispronounced. The diagnosis of this phenomenon is usually based on the auditory assessment. However, the progress in speech analysis techniques creates a possibility of developing computer-aided sigmatism diagnosis tools. The aim of the study is to statistically verify whether specific acoustic features of sibilant sounds may be related to pronunciation correctness. Such knowledge can be of great importance while implementing classifiers and designing novel tools for automatic sibilants pronunciation evaluation. The study covers analysis of various speech signal measures, including features proposed in the literature for the description of normative sibilants realization. Amplitudes and frequencies of three fricative formants (FF) are extracted based on local spectral maxima of the friction noise. Skewness, kurtosis, four normalized spectral moments (SM) and 13 mel-frequency cepstral coefficients (MFCC) with their 1st and 2nd derivatives (13 Delta and 13 Delta-Delta MFCC) are included in the analysis as well. The resulting feature vector contains 51 measures. The experiments are performed on the speech corpus containing words with selected sibilant sounds (/ʃ, ʒ/) pronounced by 60 preschool children with proper pronunciation or with natural pathologies. In total, 224 /ʃ/ segments and 191 /ʒ/ segments are employed in the study. The Mann-Whitney U test is employed for the analysis of stigmatism and normative pronunciation. Statistically, significant differences are obtained in most of the proposed features in children divided into these two groups at p < 0.05. All spectral moments and fricative formants appear to be distinctive between pathology and proper pronunciation. These metrics describe the friction noise characteristic for sibilants, which makes them particularly promising for the use in sibilants evaluation tools. Correspondences found between phoneme feature values and an expert evaluation of the pronunciation correctness encourage to involve speech analysis tools in diagnosis and therapy of sigmatism. Proposed feature extraction methods could be used in a computer-assisted stigmatism diagnosis or therapy systems.

Keywords: computer-aided pronunciation evaluation, sigmatism diagnosis, speech signal analysis, statistical verification

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Authors: D. Serero, L. Couton, J. D. Parisse, R. Leroy

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In urban planning, an increasing number of cities require wind analysis to verify comfort of public spaces and around buildings. These studies are made using computer fluid dynamic simulation (CFD). However, this technique is often based on wind information taken from meteorological stations located at several kilometers of the spot of analysis. The approximated input data on project surroundings produces unprecise results for this type of analysis. They can only be used to get general behavior of wind in a zone but not to evaluate precise wind speed. This paper presents another approach to this problem, based on collecting wind data and generating an urban wind cartography using connected ultrasound anemometers. They are wireless devices that send immediate data on wind to a remote server. Assembled in array, these devices generate geo-localized data on wind such as speed, temperature, pressure and allow us to compare wind behavior on a specific site or building. These Netatmo-type anemometers communicate by wifi with central equipment, which shares data acquired by a wide variety of devices such as wind speed, indoor and outdoor temperature, rainfall, and sunshine. Beside its precision, this method extracts geo-localized data on any type of site that can be feedback looped in the architectural design of a building or a public place. Furthermore, this method allows a precise calibration of a virtual wind tunnel using numerical aeraulic simulations (like STAR CCM + software) and then to develop the complete volumetric model of wind behavior over a roof area or an entire city block. The paper showcases connected ultrasonic anemometers, which were implanted for an 18 months survey on four study sites in the Grand Paris region. This case study focuses on Paris as an urban environment with multiple historical layers whose diversity of typology and buildings allows considering different ways of capturing wind energy. The objective of this approach is to categorize the different types of wind in urban areas. This, particularly the identification of the minimum and maximum wind spectrum, helps define the choice and performance of wind energy capturing devices that could be implanted there. The localization on the roof of a building, the type of wind, the altimetry of the device in relation to the levels of the roofs, the potential nuisances generated. The method allows identifying the characteristics of wind turbines in order to maximize their performance in an urban site with turbulent wind.

Keywords: computer fluid dynamic simulation in urban environment, wind energy harvesting devices, net-zero energy building, urban wind behavior simulation, advanced building skin design methodology

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Authors: Fakhreldin O. Suliman, Alia H. Al-Battashi

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This work explored the interaction of three different imidazoline drugs, naphazoline nitrate (NPH), oxymetazoline hydrochloride (OXY) and xylometazoline hydrochloride (XYL) with two different synthesized cucurbit[n]urils CB[n], cucurbit[7]uril (CB[7]) and cucuribit[8]uril (CB[8]). Three binary inclusion complexes have been investigated in solution and in the solid state. The solid complexes were obtained by lyophilization, whereas the physical mixtures of guests and hosts at a stoichiometric ratio of 1:1 were obtained for each drug. 1HNMR, electrospray ionization mass spectrometry (ESI-MS), and matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF) mass spectrometry was used to study the complexes prepared in aqueous media. The lyophilized solid complexes were characterized by Fourier transform-infrared spectroscopy (FT-IR), powder X-ray diffractometry (PXRD), thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC). MS, FT-IR and PXRD experimental results established in this work reveal that NPH, OXY and XYL molecules form stable inclusion complexes with the two hosts. The TGA and DSC confirmed the enhancement of the thermal stability of each drug and the production of a thermally stable solid complex. The 1HNMR has shown that the protons of the guests faced shifting in ppm and broadening of their peaks upon the formation of inclusion complexes with the selected CB[n]. The aromatic protons of the guest exhibited the highest changes in the chemical shifts and shape of the NMR peaks, suggesting their inclusion into the cavity of the CB[n]. The diffusion coefficients (D), developed from the diffusion-controlled NMR Spectroscopy (DOSY) measurements, for the complexation of the selected imidazoline drugs with CB[7] and CB[8], were decreased in the presence of hosts compared to the free guests indicating the formation of the guest-host adduct. Furthermore, we conducted molecular dynamic simulations and quantum mechanics calculations on these complexes. The results of the theoretical study corroborate the experimental findings and have also shed light on the mechanism of inclusion of the guests into the two hosts. This study generates initial data for potential drug delivery or drug formulation systems for these three selected imidazoline drug compounds based on their inclusion into the CB[n] cavities.

Keywords: cucurbit[n]urils, imidazoline, inclusion complexes, molecular dynamics, DFT calculations, mass spectrometry

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Vinko Lešić, Mario Vašak, Anita Martinčević, Marko Gulin, Antonio Starčić, Hrvoje Novak

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With 40% of total world energy consumption, building systems are developing into technically complex large energy consumers suitable for application of sophisticated power management approaches to largely increase the energy efficiency and even make them active energy market participants. Centralized control system of building heating and cooling managed by economically-optimal model predictive control shows promising results with estimated 30% of energy efficiency increase. The research is focused on implementation of such a method on a case study performed on two floors of our faculty building with corresponding sensors wireless data acquisition, remote heating/cooling units and central climate controller. Building walls are mathematically modeled with corresponding material types, surface shapes and sizes. Models are then exploited to predict thermal characteristics and changes in different building zones. Exterior influences such as environmental conditions and weather forecast, people behavior and comfort demands are all taken into account for deriving price-optimal climate control. Finally, a DC microgrid with photovoltaics, wind turbine, supercapacitor, batteries and fuel cell stacks is added to make the building a unit capable of active participation in a price-varying energy market. Computational burden of applying model predictive control on such a complex system is relaxed through a hierarchical decomposition of the microgrid and climate control, where the former is designed as higher hierarchical level with pre-calculated price-optimal power flows control, and latter is designed as lower level control responsible to ensure thermal comfort and exploit the optimal supply conditions enabled by microgrid energy flows management. Such an approach is expected to enable the inclusion of more complex building subsystems into consideration in order to further increase the energy efficiency.

Keywords: price-optimal building climate control, Microgrid power flow optimisation, hierarchical model predictive control, energy efficient buildings, energy market participation

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Authors: Raúl Jiménez Vilches

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Native (L1) speakers can mark prosodically one part of an utterance and make it more relevant as opposed to the rest of the constituents. Conversely, non-native (L2) speakers encounter problems when it comes to marking prosodically information structure in English. In fact, the L2 speaker’s choice for the prosodic realization of focus is not so clear and often obscures the intended pragmatic meaning and the communicative value in general. This paper reports some of the findings obtained in an L2 prosodic training course for Spanish learners of English within the context of public speaking. More specifically, it analyses the effects of the course experiment in relation to the non-native production of the tonic syllable to mark focus and compares it with the public speeches delivered by native English speakers. The whole experimental training was executed throughout eighteen input sessions (1,440 minutes total time) and all the sessions took place in the classroom. In particular, the first part of the course provided explicit instruction on the recognition and production of the tonic syllable and how the tonic syllable is used to express focus. The non-native and native oral presentations were acoustically analyzed using Praat software for speech analysis (7,356 words in total). The investigation adopted mixed and embedded methodologies. Quantitative information is needed when measuring acoustically the phonetic realization of focus. Qualitative data such as questionnaires, interviews, and observations were also used to interpret the quantitative data. The embedded experiment design was implemented through the analysis of the public speeches before and after the intervention. Results indicate that, even after the L2 prosodic training course, Spanish learners of English still show some major inconsistencies in marking focus effectively. Although there was occasional improvement regarding the choice for location and word classes, Spanish learners were, in general, far from achieving similar results to the ones obtained by the English native speakers in the two types of focus. The prosodic realization of focus seems to be one of the hardest areas of the English prosodic system to be mastered by Spanish learners. A funded research project is in the process of moving the present classroom-based experiment to an online environment (mobile app) and determining whether there is a more effective focus usage through CAPT (Computer-Assisted Pronunciation) tools.

Keywords: focus, prosody, public speaking, Spanish learners of English

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Authors: Huidan Yu, Anurag Deb, Rou Chen, I-Wen Wang

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The use of left ventricle assist devices (LVADs) in patients with heart failure has been a proven and effective therapy for patients with severe end-stage heart failure. Due to the limited availability of suitable donor hearts, LVADs will probably become the alternative solution for patient with heart failure in the near future. While the LVAD is being continuously improved toward enhanced performance, increased device durability, reduced size, a better understanding of implantation management becomes critical in order to achieve better long-term blood supplies and less post-surgical complications such as thrombi generation. Important issues related to the LVAD implantation include the location of outflow grafting (OG), the angle of the OG, the combination between LVAD and native heart pumping, uniform or pulsatile flow at OG, etc. We have hypothesized that an optimal implantation of LVAD is patient specific. To test this hypothesis, we employ a novel in-house computational modeling technique, named InVascular, to conduct a systematic evaluation of cardiac output at aortic arch together with other pertinent hemodynamic quantities for each patient under various implantation scenarios aiming to get an optimal implantation strategy. InVacular is a powerful computational modeling technique that integrates unified mesoscale modeling for both image segmentation and fluid dynamics with the cutting-edge GPU parallel computing. It first segments the aortic artery from patient’s CT image, then seamlessly feeds extracted morphology, together with the velocity wave from Echo Ultrasound image of the same patient, to the computation model to quantify 4-D (time+space) velocity and pressure fields. Using one NVIDIA Tesla K40 GPU card, InVascular completes a computation from CT image to 4-D hemodynamics within 30 minutes. Thus it has the great potential to conduct massive numerical simulation and analysis. The systematic evaluation for one patient includes three OG anastomosis (ascending aorta, descending thoracic aorta, and subclavian artery), three combinations of LVAD and native heart pumping (1:1, 1:2, and 1:3), three angles of OG anastomosis (inclined upward, perpendicular, and inclined downward), and two LVAD inflow conditions (uniform and pulsatile). The optimal LVAD implantation is suggested through a comprehensive analysis of the cardiac output and related hemodynamics from the simulations over the fifty-four scenarios. To confirm the hypothesis, 5 random patient cases will be evaluated.

Keywords: graphic processing unit (GPU) parallel computing, left ventricle assist device (LVAD), lumped-parameter model, patient-specific computational hemodynamics

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Authors: A. Vahanyan

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The paper touches upon the problem of revision and modernization of the current curriculum on translation studies at the Armenian Higher Education Institutions (HEIs). In the contemporary world where quality and speed of services provided are mostly valued, certain higher education centers in Armenia though do not demonstrate enough flexibility in terms of the revision and amendment of courses taught. This issue is present for various curricula at the university level and Translation Studies related curriculum, in particular. Technological innovations that are of great help for translators have been long ago smoothly implemented into the global Translation Industry. According to the European Master's in Translation (EMT) framework, translation service provision comprises linguistic, intercultural, information mining, thematic, and technological competencies. Therefore, to form the competencies mentioned above, the curriculum should be seriously restructured to meet the modern education and job market requirements, relevant courses should be proposed. New courses, in particular, should focus on the formation of technological competences. These suggestions have been made upon the author’s research of the problem across various HEIs in Armenia. The updated curricula should include courses aimed at familiarization with various computer-assisted translation (CAT) tools (MemoQ, Trados, OmegaT, Wordfast, etc.) in the translation process, creation of glossaries and termbases compatible with different platforms), which will ensure consistency in translation of similar texts and speeding up the translation process itself. Another aspect that may be strengthened via curriculum modification is the introduction of interdisciplinary and Project-Based Learning courses, which will enable info mining and thematic competences, which are of great importance as well. Of course, the amendment of the existing curriculum with the mentioned courses will require corresponding faculty development via training, workshops, and seminars. Finally, the provision of extensive internship with translation agencies is strongly recommended as it will ensure the synthesis of theoretical background and practical skills highly required for the specific area. Summing up, restructuring and modernization of the existing curricula on Translation Studies should focus on three major aspects, i.e., introduction of new courses that meet the global quality standards of education, professional development for faculty, and integration of extensive internship supervised by experts in the field.

Keywords: competencies, curriculum, modernization, technical literacy, translation studies

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Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite

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This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.

Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care

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Authors: Ali Alshumrani, Nathan Clarke, Bogdan Ghite, Stavros Shiaeles

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Digital forensics has become an essential tool in the investigation of cyber and computer-assisted crime. Arguably, given the prevalence of technology and the subsequent digital footprints that exist, it could have a significant role across almost all crimes. However, the variety of technology platforms (such as computers, mobiles, Closed-Circuit Television (CCTV), Internet of Things (IoT), databases, drones, cloud computing services), heterogeneity and volume of data, forensic tool capability, and the investigative cost make investigations both technically challenging and prohibitively expensive. Forensic tools also tend to be siloed into specific technologies, e.g., File System Forensic Analysis Tools (FS-FAT) and Network Forensic Analysis Tools (N-FAT), and a good deal of data sources has little to no specialist forensic tools. Increasingly it also becomes essential to compare and correlate evidence across data sources and to do so in an efficient and effective manner enabling an investigator to answer high-level questions of the data in a timely manner without having to trawl through data and perform the correlation manually. This paper proposes a Unified Forensic Analysis Tool (U-FAT), which aims to establish a common language for electronic information and permit multi-source forensic analysis. Core to this approach is the identification and development of forensic analyses that automate complex data correlations, enabling investigators to investigate cases more efficiently. The paper presents a systematic analysis of major crime categories and identifies what forensic analyses could be used. For example, in a child abduction, an investigation team might have evidence from a range of sources including computing devices (mobile phone, PC), CCTV (potentially a large number), ISP records, and mobile network cell tower data, in addition to third party databases such as the National Sex Offender registry and tax records, with the desire to auto-correlate and across sources and visualize in a cognitively effective manner. U-FAT provides a holistic, flexible, and extensible approach to providing digital forensics in technology, application, and data-agnostic manner, providing powerful and automated forensic analysis.

Keywords: digital forensics, evidence correlation, heterogeneous data, forensics tool

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Authors: Connie Edang, Siti Arpah Noordin, Shamila Mohamed Shuhidan

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For the past few decades, there are growing numbers of knowledge based industries in Malaysia. As competitive edge has become so important nowadays, the consideration of research and development (R&D) should be put at the highest priority. Alike other industries, HEIs are also contributors to the nation’s development and wealth. Hence, to become a hub for creating a knowledge-based society, HEIs not only responsible for producing skillful human capital, but also to get involved in R&D. With the importance of R&D in today’s modern economy and the rise of Science and Technology, it gives opportunities for researchers to explore this sector as to place Malaysia as a provider in some key strategic industries, including medical and health sciences field. Academic researchers/medical researchers possess unique tacit and skills based in accordance with their experience and professional expert areas. In completing a collaborative research work, there must be platforms to enable the conversion of their knowledge hence beneficial towards creation of new knowledge. The objectives of this study are to: i) explore the knowledge creation activities of medical researchers in the Malaysian Higher Education Institution (HEI); ii) explore the driving forces for knowledge creation activities among the researchers; and iii) explore the interpretation of medical researchers on the establishment of ‘ba’ in the creation of knowledge. Based on the SECI model was introduced by Nonaka and Takeuchi and the Japanese concept of ‘ba’, a qualitative study whereby semi structured interview was used as to gather the informants’ viewpoints and insights based on their experience capitalizing ‘ba’ to support their knowledge creation activities. A single the study was conducted at one of the HEIs located in Sabah. From this study, both face to face and the ICT-assisted tools are found to be significant to support interaction of their knowledge. ICT seems to ease their interaction with other research collaborator. However, this study revealed that interaction conducted in physical settings is still be best preferred by the medical researchers especially situations of whereby their knowledge is hard to be externalized. Moreover, it revealed that motivational factors play important roles as for driving forces affecting their knowledge creation activities. Other than that, the medical researchers addressed that the mix interaction bring forth value in terms of facilitating knowledge creation. Therefore this study would benefit the institution to highly optimize the utilization of good platform so that knowledge can be transferred and be made used by others in appropriate ways.

Keywords: ‘ba’, knowledge creation dynamics, Malaysia, higher education institution, medical researchers

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Authors: Jingwen Ou

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Writing for academic purposes in a second or foreign language poses a significant challenge for non-native speakers, particularly at the tertiary level, where English academic writing for L2 students is often hindered by difficulties in academic discourse, including vocabulary, academic register, and organization. The past two decades have witnessed a rising popularity in the application of the data-driven learning (DDL) approach in EAP writing instruction. In light of such a trend, this study aims to enhance the integration of DDL into English for academic purposes (EAP) writing classrooms by investigating the perception of Chinese college students regarding the use of corpus tools for improving EAP writing. Additionally, the research explores their corpus consultation behaviors during training to provide insights into corpus-assisted EAP instruction for DDL practitioners. Given the uprising popularity of DDL, this research aims to investigate Chinese university students’ use of corpus tools with three main foci: 1) the influence of corpus tools on learning behaviours, 2) the influence of corpus tools on students’ academic writing performance outcomes, and 3) students’ perceptions and potential perceptional changes towards the use of such tools. Three corpus tools, CQPWeb, Sketch Engine, and LancsBox X, are selected for investigation due to the scarcity of empirical research on patterns of learners’ engagement with a combination of multiple corpora. The research adopts a pre-test / post-test design for the evaluation of students’ academic writing performance before and after the intervention. Twenty participants will be divided into two groups: an intervention and a non-intervention group. Three corpus training workshops will be delivered at the beginning, middle, and end of a semester. An online survey and three separate focus group interviews are designed to investigate students’ perceptions of the use of corpus tools for improving academic writing skills, particularly the rhetorical functions in different essay sections. Insights from students’ consultation sessions indicated difficulties with DDL practice, including insufficiency of time to complete all tasks, struggle with technical set-up, unfamiliarity with the DDL approach and difficulty with some advanced corpus functions. Findings from the main study aim to provide pedagogical insights and training resources for EAP practitioners and learners.

Keywords: corpus linguistics, data-driven learning, English for academic purposes, tertiary education in China

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Authors: Senthil Kumar Anantharaman

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Providing telecommunications based network services in developing countries like India which has a population of 1.5 billion people, so that these services reach every individual, is one of the greatest challenges the country has been facing in its journey towards economic growth and development. With growing number of telecommunications service providers in the country, a constant challenge that has been faced by these providers is in providing not only quality but also delightful customer experience while simultaneously generating enhanced revenues and profits. Thus, the role played by process improvement methodologies like Six Sigma cannot be undermined and specifically in telecom service provider based operations, it has provided substantial benefits. Therefore, it advantages are quite comparable to its applications and advantages in other sectors like manufacturing, financial services, information technology-based services and Healthcare services. One of the key reasons that this methodology has been able to reap great benefits in telecommunications sector is that this methodology has been combined with many of its competing process improvement techniques like Theory of Constraints, Lean and Kaizen to give the maximum benefit to the service providers thereby creating a winning combination of organized process improvement methods for operational excellence thereby leading to business excellence. This paper discusses about some of the key projects and areas in the end to end ‘Quote to Cash’ process at big three Indian telecommunication companies that have been highly assisted by applying Six Sigma along with other process improvement techniques. While the telecommunication companies which we have considered, is primarily in India and run by both private operators and government based setups, the methodology can be applied equally well in any other part of developing countries around the world having similar context. This study also compares the enhanced revenues that can arise out of appropriate opportunities in emerging market scenarios, that Six Sigma as a philosophy and methodology can provide if applied with vigour and robustness. Finally, the paper also comes out with a winning framework in combining Six Sigma methodology with Kaizen, Lean and Theory of Constraints that will enhance both the top-line as well as the bottom-line while providing the customers a delightful experience.

Keywords: emerging markets, lean, process improvement, six sigma, telecommunications, theory of constraints

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Authors: Shasha Lv, Zhengcao Li

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Due to the CMOS compatibility, silicon-based field emission (FE) devices as potential electron sources have attracted much attention. The geometrical arrangement and dimensional features of aligned silicon nanowires (SiNWs) have a determining influence on the FE properties. We discuss a multistep template replication process of Ag-assisted chemical etching combined with polystyrene (PS) spheres to fabricate highly periodic and well-aligned silicon nanowires, then their diameter, aspect ratio and density were further controlled via dry oxidation and post chemical treatment. The FE properties related to proximity and aspect ratio were systematically studied. A remarkable improvement of FE propertiy was observed with the average nanowires tip interspace increasing from 80 to 820 nm. On the basis of adjusting SiNWs dimensions and morphology, addition of a secondary material whose properties complement the SiNWs could yield a combined characteristic. Three different nanoheterostructures were fabricated to control the FE performance, they are: NiSi/Si core-shell structures, ZnO/Si nanotrees, and Graphene/SiNWs. We successfully fabricated the high-quality NiSi/Si heterostructured nanowires with excellent conformality. First, nickle nanoparticles were deposited onto SiNWs, then rapid thermal annealing process were utilized to form NiSi shell. In addition, we demonstrate a new and simple method for creating 3D nanotree-like ZnO/Si nanocomposites with a spatially branched hierarchical structure. Compared with the as-prepared SiNRs and ZnO NWs, the high-density ZnO NWs on SiNRs have exhibited predominant FE characteristics, and the FE enhancement factors were attributed to band bending effect and geometrical morphology. The FE efficiency from flat sheet structure of graphene is low. We discussed an effective approach towards full control over the diameter of uniform SiNWs to adjust the protrusions of large-scale graphene sheet deposited on SiNWs. The FE performance regarding the uniformity and dimensional control of graphene protrusions supported on SiNWs was systematically clarified. Therefore, the hybrid SiNWs/graphene structures with protrusions provide a promising class of field emission cathodes.

Keywords: field emission, silicon nanowires, heterostructures, controllable synthesis

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Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

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Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

Procedia PDF Downloads 159

Authors: Hazel P. Atilano

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In this age of AI-assisted teaching and learning, there seems to be a dearth of research literature on the linguistic analysis of English as a Second Language (ESL) student-generated paraphrased academic texts. This study sought to examine the lexico-semantic, morphosyntactic features of paraphrased academic texts generated by ESL students. Employing a descriptive qualitative design, specifically linguistic analysis, the study involved a total of 85 students from senior high school, college, and graduate school enrolled in research courses. Data collection consisted of a 60-minute real-time, on-site paraphrasing practice exercise using excerpts from discipline-specific literature reviews of 150 to 200 words. A focus group discussion (FGD) was conducted to probe into the challenges experienced by the participants. The writing exercise yielded a total of 516 paraphrase pairs. A total of 176 paraphrase units (PUs) and 340 non-paraphrase pairs (NPPs) were detected. Findings from the linguistic analysis of PUs reveal that the modifications made to the original texts are predominantly syntax-based (Diathesis Alterations and Coordination Changes) and a combination of Miscellaneous Changes (Change of Order, Change of Format, and Addition/Deletion). Results of the analysis of paraphrase extremes (PE) show that Identical Structures resulting from the use of synonymous substitutions, with no significant change in the structural features of the original, is the most frequently occurring instance of PE. The analysis of paraphrase errors reveals that synonymous substitutions resulting in identical structures are the most frequently occurring error that leads to PE. Another type of paraphrasing error involves semantic and content loss resulting from the deletion or addition of meaning-altering content. Three major themes emerged from the FGD: (1) The Challenge of Preserving Semantic Content and Fidelity; (2) The Best Words in the Best Order: Grappling with the Lexico-semantic and Morphosyntactic Demands of Paraphrasing; and (3) Contending with Limited Vocabulary, Poor Comprehension, and Lack of Practice. A pedagogical paradigm was designed based on the major findings of the study for a sustainable instructional intervention.

Keywords: academic text, lexico-semantic analysis, linguistic analysis, morphosyntactic analysis, paraphrasing

Procedia PDF Downloads 37

Authors: Kirill M. Dubovikov, Ekaterina S. Marchenko, Gulsharat A. Baigonakova

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NiTi alloys are widely used as implants in medicine due to their unique properties such as superelasticity, shape memory effect and biocompatibility. However, despite these properties, one of the major problems is the release of nickel after prolonged use in the human body under dynamic stress. This occurs due to oxidation and cracking of NiTi implants, which provokes nickel segregation from the matrix to the surface and release into living tissues. As we know, nickel is a toxic element and can cause cancer, allergies, etc. One of the most popular ways to solve this problem is to create a corrosion resistant coating on NiTi. There are many coatings of this type, but not all of them have good biocompatibility, which is very important for medical implants. Coatings based on calcium phosphate phases have excellent biocompatibility because Ca and P are the main constituents of the mineral part of human bone. This fact suggests that a Ca-P coating on NiTi can enhance osteogenesis and accelerate the healing process. Therefore, the aim of this study is to investigate the structure of Ca-P coating on NiTi substrate. Plasma assisted radio frequency (RF) sputtering was used to obtain this film. This method was chosen because it allows the crystallinity and morphology of the Ca-P coating to be controlled by the sputtering parameters. It allows us to obtain three different NiTi samples with Ca-P coating. XRD, AFM, SEM and EDS were used to study the composition, structure and morphology of the coating phase. Scratch tests were carried out to evaluate the adhesion of the coating to the substrate. Wettability tests were used to investigate the hydrophilicity of the different coatings and to suggest which of them had better biocompatibility. XRD showed that the coatings of all samples were hydroxyapatite, but the matrix was represented by TiNi intermetallic compounds such as B2, Ti2Ni and Ni3Ti. The SEM shows that the densest and defect-free coating has only one sample after three hours of sputtering. Wettability tests show that the sample with the densest coating has the lowest contact angle of 40.2° and the largest free surface area of 57.17 mJ/m2, which is mostly disperse. A scratch test was carried out to investigate the adhesion of the coating to the surface and it was shown that all coatings were removed by a cohesive mechanism. However, at a load of 30N, the indenter reached the substrate in two out of three samples, except for the sample with the densest coating. It was concluded that the most promising sputtering mode was the third, which consisted of three hours of deposition. This mode produced a defect-free Ca-P coating with good wettability and adhesion.

Keywords: biocompatibility, calcium phosphate coating, NiTi alloy, radio frequency sputtering.

Procedia PDF Downloads 48

Authors: Lorand Ujhazi

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The vast majority of existing canonical studies about migration are focused on examining the general pastoral and legal regulations of the Catholic Church. The weakness of this approach is that it ignores a number of important factors; like the financial, legal and personal circumstances of a particular church or the canonical position of certain organizations which actually look after the immigrants. This paper is a case study, which analyses the current and historical migration related policies and activities of the Catholic Church in Hungary. To achieve this goal the study uses canon law, historical publications, various instructions and communications issued by church superiors, Hungarian and foreign media reports and the relevant Hungarian legislation. The paper first examines how the Hungarian Catholic Church assisted migrants like Armenians fleeing from the Ottoman Empire, Poles escaping during the Second World War, East German and Romanian citizens in the 1980s and refugees from the former Yugoslavia in the 1990s. These events underline the importance of past historical experience in the development of contemporary pastoral and humanitarian policy of the Catholic Church in Hungary. Then the paper turns to the events of the ongoing crisis by describing the unique challenges faced by churches in transit countries like Hungary. Then the research contrasts these findings with the typical responsibilities of churches in countries which are popular destinations for immigrants. The next part of the case study focuses on the changes to the pre-crisis legal and canonical framework which influenced the actions of hierarchical and charity organizations in Hungary. Afterwards, the paper illustrates the dangers of operating in an unclear legal environment, where some charitable activities of the church like a fundraising campaign may be interpreted as a national security risk by state authorities. Then the paper presents the reactions of Hungarian academics to the current migration crisis and finally it offers some proposals how to improve parts of Canon Law which govern immigration. The conclusion of the paper is that during the formulation of the central refugee policy of the Catholic Church decision makers must take into consideration the peculiar circumstances of its particular churches. This approach may prevent disharmony between the existing central regulations, the policy of the Vatican and the operations of the local church organizations.

Keywords: canon law, Catholic Church, civil law, Hungary, immigration, national security

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Authors: Valeria Tatano, Francesca Guidolin, Francesca Peltrera

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The preservation of historical Italian heritage, at the urban and architectural scale, has to consider restrictions and requirements connected with conservation issues and usability needs, which are often at odds with historical heritage preservation. Recent decades have been marked by the search for increased accessibility not only of public and private buildings, but to the whole historical city, also for people with disability. Moreover, in the last years the concepts of Smart City and Healthy City seek to improve accessibility both in terms of mobility (independent or assisted) and fruition of goods and services, also for historical cities. The principles of Inclusive Design have introduced new criteria for the improvement of public urban space, between current regulations and best practices. Moreover, they have contributed to transforming “special needs” into an opportunity of social innovation. These considerations find a field of research and analysis in the historical city of Venice, which is at the same time a site of UNESCO world heritage, a mass tourism destination bringing in visitors from all over the world and a city inhabited by an aging population. Due to its conformation, Venetian urban fabric is only partially accessible: about four thousand bridges divide thousands of islands, making it almost impossible to move independently. These urban characteristics and difficulties were the base, in the last 20 years, for several researches, experimentations and solutions with the aim of eliminating architectural barriers, in particular for the usability of bridges. The Venetian Municipality with the EBA Office and some external consultants realized several devices (e.g. the “stepped ramp” and the new accessible ramps for the Venice Marathon) that should determine an innovation for the city, passing from the use of mechanical replicable devices to specific architectural projects in order to guarantee autonomy in use. This paper intends to present the state-of-the-art in bridges accessibility, through an analysis based on Inclusive Design principles and on the current national and regional regulation. The purpose is to evaluate some possible strategies that could improve performances, between limits and possibilities of interventions. The aim of the research is to lay the foundations for the development of a strategic program for the City of Venice that could successfully bring together both conservation and improvement requirements.

Keywords: accessibility of historical cities, historical heritage preservation, inclusive design, technological and social innovation

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Authors: Chabungbam Niranjit Khuman, Makarand Madhao Ghangrekar, Arunabha Mitra

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The cost of aeration is one of the limiting factors in the upscaling of microbial fuel cells (MFC) for field-scale applications. Wetland macrophytes have the ability to release oxygen into the water to maintain aerobic conditions in their root zone. In this experiment, the efficacy of rhizospheric oxygen release of wetland macrophytes as a source of oxygen in the cathodic chamber of MFC was conducted. The experiment was conducted in an MFC consisting of a three-liter anodic chamber made of ceramic cylinder and a 27 L cathodic chamber. Untreated carbon felts were used as electrodes (i.e., anode and cathode) and connected to an external load of 100 Ω using stainless steel wire. Wetland macrophytes (Canna indica) were grown in the cathodic chamber of the MFC in a hydroponic fashion using a styrofoam sheet (termed as macrophytes assisted-microbial fuel cell, M-MFC). The catholyte (i.e., water) in the M-MFC had negligible contact with atmospheric air due to the styrofoam sheet used for maintaining the hydroponic condition. There was no mixing of the catholyte in the M-MFC. Sucrose based synthetic wastewater having chemical oxygen demand (COD) of 3000 mg/L was fed into the anodic chamber of the MFC in fed-batch mode with a liquid retention time of four days. The C. indica thrived well throughout the duration of the experiment without much care. The average dissolved oxygen (DO) concentration and pH value in the M-MFC were 3.25 mg/L and 7.07, respectively, in the catholyte. Since the catholyte was not in contact with air, the DO in the catholyte might be considered as solely liberated from the rhizospheric oxygen release of C. indica. The maximum COD removal efficiency of M-MFC observed during the experiment was 76.9%. The inadequacy of terminal electron acceptor in the cathodic chamber in M-MFC might have hampered the electron transfer, which in turn, led to slower specific microbial activity, thereby resulting in lower COD removal efficiency than the traditional MFC with aerated catholyte. The average operating voltage (OV) and open-circuit voltage (OCV) of 294 mV and 594 mV, respectively, were observed in M-MFC. The maximum power density observed during polarization was 381 mW/m³, and the maximum sustainable power density observed during the experiment was 397 mW/m³ in M-MFC. The maximum normalized energy recovery and coulombic efficiency of 38.09 Wh/m³ and 1.27%, respectively, were observed. Therefore, it was evidenced that rhizospheric oxygen release of wetland macrophytes (C. indica) was capable of sustaining the cathodic reaction in MFC for field-scale applications.

Keywords: hydroponic, microbial fuel cell, rhizospheric oxygen release, wetland macrophytes

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Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Even if both the economic and the human development are an axial pillar in its global policy, Algerian government seems to be more and more engaged in the international context aiming to reach of the so called millennium development goals, and this since its beginning. By looking closely at the Algerian economic policy, it is easy to mention the existence of several programs in which both economic and social realisations including among others, poverty reduction, enhancement of education level and conditions, woman statute and gender equity amelioration targets. The efforts of Algerian government in the field of these targets had been acheminated through three main plans, which are: -PSRE (Plan de Soutien à la Relance Economique), for the period of 2001 to 2004, initiated with about 7 billion US dollar, had been focused on three objectives, namely, poverty reduction, job creation and regional equilibrium with rural areas revitalization. -PCSC (le Programme complémentaire de soutien à la croissance économique), for the period of 2005 to 2009, with a starting funding of 114 billion US dollar. This program aims to develop public services and supporting public investments, especially in which concerns social infrastructures. Now, and at the end of the maturity of the MDGs agenda, an important question is to be asked: what are the main realizations regarding these MDGs? In order to answer this question, the present paper tries to examine the Algerian economic policy (but also the social one) by considering the MDGs challenges, for the period from 2000 to 2010, but also until 2015. This examination is focused on three main targets, namely poverty, education, and health. Firstly, statistical assessment for the Algerian economic and social situation shows that almost all MDGs had been reached during the period of 2000 to 2009 and it continues to maintain and improve them. This observation can be endorsed by invoking some achievements. Starting by the reduction of poverty, the proportion of population living with less than 1 US dollar per a day passed from 8.0 % in 2000 to 0.5 % in 2009, and 0.3 % in 2015. For education sphere, the enrolment ratio of six-year child, which is the most significant index for school attendance, is about 98 % for 2009 against 93 % in 1999, and only 43 % in 1966. Concluding with health care and relevant services; the Algerian government has accomplished big steps in providing easy access to this sector for the population. Moreover, the percentage of assisted accouchement had been raised from 91.2 % in 2000 to 97.2 % in 2009.

Keywords: Algerian economic policy, MDGs, poverty, education, health

Procedia PDF Downloads 232

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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Authors: Etsuko Sakairi

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In 2016 Japan started to enforce domestic legislation in the form of the Act of Elimination of Discrimination against Persons with Disability, along with ratifying the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2014. However, it is not clear what kind of situations would be considered cases of discrimination in relation to issues of sexuality according to this legislation. Furthermore, in March 2016, the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) made a recommendation to the Japanese government to conduct a study of the forced sterilization of women under the Eugenic Protection Act. This research is carried out against this background in which the experiences of people with disabilities have often been restricted by caregivers and family members—as evidenced by the high number of eugenics surgeries performed on people with disabilities without their consent. This research contributes to this topic by presenting voices and perspectives of key people, especially focusing on the voices of carers who are working with people with physical disabilities in a Non-Western country, Japan. Furthermore, since 90% of the research on the topic of sexuality of people with disabilities is conducted in Western countries, the voices from Non-Western countries in this regard are greatly lacking. In the part of the research presented here, the researcher has employed a feminist disability theory to understand the circumstances surrounding people with physical disabilities. She has gathered voices from 58 carers by using an on-line questionnaire (55) and by conducting face-to-face interviews (3). In this presentation, the researcher will introduce experiences and thoughts regarding sexuality and people with disabilities by using carers’ own words. One of the major findings was carers’ concern about a boundary issue. Although each carer has had unique experiences depending on their professional or personal relationship with people with physical disabilities, many of them shared some similar viewpoints. This included a concern that assisting with the meeting of some forms of sexual needs 9e.g. assisted masturbation) would result in the possibility of transgressing the boundary between the carer and the person with physical disability. Most of the carer did not have any opportunity to receive any trainings regarding to sexuality of people with disabilities. Furthermore, most of the carers conceptualized that ‘Keeping a sexual dignity of people with disabilities’ means practicing a ‘Principle of same sex assistance’. The researcher hopes that this presentation provides an opportunity for audiences to look back at their own community and to think about what sexuality of people with physical disabilities means to their carers as well as to look back at their own practice in relation to this issue.

Keywords: Carer, Japan, physical disabilities, sexuality

Procedia PDF Downloads 152

Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

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Authors: Rose Mini Agoes Salim, Shahnaz Safitri

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The aim of this study is to test the effectiveness of teaching kindness in preschool children by using several techniques. Kindness is a physical act or emotional support aimed to build or maintain relationships with others. Kindness is known to be essential in the development of moral reasoning to distinguish between the good and bad things. In this study, kindness is operationalized as several acts including helping friends, comforting sad friends, inviting friends to play, protecting others, sharing, saying hello, saying thank you, encouraging others, and apologizing. It is mentioned that kindness is crucial to be developed in preschool children because this is the time the children begin to interact with their social environment through play. Furthermore, preschool children's cognitive development makes them begin to represent the world with words, which then allows them to interact with others. On the other hand, preschool children egocentric thinking makes them still need to learn to consider another person's perspective. In relation to social interaction, preschool children need to be stimulated and assisted by adult to be able to pay attention to other and act with kindness toward them. On teaching kindness to children, the quality of interaction between children and their significant others is the key factor. It is known that preschool children learn about kindness by imitating adults on their two way interaction. Specifically, this study examines two types of teaching techniques that can be done by parents as a way to teach kindness, namely the picture-storybook reading and hand-puppet storytelling. These techniques were examined because both activities are easy to do and both also provide a model of behavior for the child based on the character in the story. To specifically examine those techniques effectiveness in teaching kindness, two studies were conducted. Study I involves 31 children aged 5-6 years old with picture-storybook reading technique, where the intervention is done by reading 8 picture books for 8 days. In study II, hand-puppet storytelling technique is examined to 32 children aged 3-5 years old. The treatments effectiveness are measured using an instrument in the form of nine colored cards that describe the behavior of kindness. Data analysis using Wilcoxon Signed-rank test shows a significant difference on the average score of kindness (p < 0.05) before and after the intervention has been held. For daily observation, a ‘kindness tree’ and observation sheets are used which are filled out by the teacher. Two weeks after interventions, an improvement on all kindness behaviors measured is intact. The same result is also gained from both ‘kindness tree’ and observational sheets.

Keywords: kindness, moral teaching, storytelling, hand puppet

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Authors: Hernan Arturo Blas López, Gustavo Henndel Lopes, Antonio Carlos Silva Costa Teixeira, Carmen Elena Flores Barreda, Patricia Araujo Pantoja

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Phenols are toxic for life and the environment and may come from many sources. Uncured phenolic monomers present in phenolic resins used as binders in grinding wheels and emery paper can contaminate industrial wastewaters in abrasives manufacture plants. Furthermore, vestiges of resol and novolacs resins generated by wear and tear of abrasives are also possible sources of water contamination by phenolics in these facilities. Fortunately, advanced oxidation by dark Fenton and photo-Fenton techniques are capable of oxidizing phenols and their degradation products up to their mineralization into H₂O and CO₂. The maximal allowable concentrations for phenols in Peruvian waterbodies is very low, such that insufficiently treated effluents from the abrasives industry are a potential environmental noncompliance. The current case study highlights findings obtained during the lab-scale application of Fenton’s and photo-assisted Fenton’s chemistries to real industrial wastewater samples from an abrasives manufacture plant in Peru. The goal was to reduce the phenolic content and sample toxicity. For this purpose, two independent variables-reaction time and effect of ultraviolet radiation–were studied as for their impacts on the concentration of total phenols, total organic carbon (TOC), biological oxygen demand (BOD) and chemical oxygen demand (COD). In this study, diluted samples (1 L) of the industrial effluent were treated with Fenton’s reagent (H₂O₂ and Fe²⁺ from FeSO₄.H₂O) during 10 min in a photochemical batch reactor (Alphatec RFS-500, Brazil) at pH 2.92. In the case of photo-Fenton tests with ultraviolet lamps of 9 W, UV-A, UV-B and UV-C lamps were evaluated. All process conditions achieved 100% of phenols degraded within 5 minutes. TOC, BOD and COD decreased by 49%, 52% and 86% respectively (all processes together). However, Fenton treatment was not capable of reducing BOD, COD and TOC below a certain value even after 10 minutes, contrarily to photo-Fenton. It was also possible to conclude that the processes here studied degrade other compounds in addition to phenols, what is an advantage. In all cases, elevated effluent dilution factors and high amounts of oxidant agent impact negatively the overall economy of the processes here investigated.

Keywords: fenton oxidation, wastewater treatment, phenols, abrasives industry

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Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

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Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

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Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

Abstract:

Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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