Search results for: patient related elbow evaluation scale

Authors: Boxiang Zhuang

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This study analyzes the clinical manifestations, hearing rehabilitation methods and outcomes of a complex case of neurofibromatosis type II (NF2). Methods: The clinical manifestations, medical history, clinical data, surgical methods and postoperative hearing rehabilitation outcomes of an NF2 patient were analyzed to determine the hearing reconstruction method and postoperative effect for a special type of NF2 acoustic neuroma. Results: The patient had bilateral acoustic neuromas with profound sensorineural hearing loss in both ears. Peripheral blood genetic testing did not reveal pathogenic gene mutations, suggesting mosaicism. The patient had an intracochlear schwannoma in the right ear and severely impaired vision in both eyes. Cochlear implantation with tumor retention was performed in the right ear. After 2 months of family-based auditory and speech rehabilitation, the Categories of Auditory Performance (CAP) score improved from 0 to 5. Conclusion: NF2 has complex clinical manifestations and poor prognosis. For NF2 patients with intracochlear tumors, cochlear implantation with tumor retention can be used to reconstruct hearing.

Keywords: NF2, intracochlear schwannoma, hearing reconstruction, cochlear implantation

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Authors: Yun-na Wu, Zhen Wang

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Due to the economic downturn and the deterioration of the living environment, the development of residential buildings as high energy consuming building is gradually changing from “extensive” to green building in China. So, the evaluation system of green building is continuously improved, but the current evaluation work has the following problems: (1) There are differences in the cost of the actual investment and the purchasing power of residents, also construction target of green residential building is single and lacks multi-objective performance development. (2) Green building evaluation lacks regional characteristics and cannot reflect the different regional residents demand. (3) In the process of determining the criteria weight, the experts’ judgment matrix is difficult to meet the requirement of consistency. Therefore, to solve those problems, questionnaires which are about the green residential building for Ningxia area are distributed, and the results of questionnaires can feedback the purchasing power of residents and the acceptance of the green building cost. Secondly, combined with the geographical features of Ningxia minority areas, the evaluation criteria system of green residential building is constructed. Finally, using the improved group AHP method and the grey clustering method, the criteria weight is determined, and a real case is evaluated, which is located in Xing Qing district, Ningxia. A conclusion can be obtained that the professional evaluation for this project and good social recognition is basically the same.

Keywords: evaluation, green residential building, grey clustering method, group AHP

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Woo Young Jung, Bu Seog Ju

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This study described the seismic performance evaluation of bridge structures, located near Daegu metropolitan city in Korea. The structural design code or regulatory guidelines is focusing on the protection of brittle failure or collapse in bridges’ lifetime during an earthquake. This paper illustrated the procedure in terms of the safety evaluation of bridges using simple linear elastic 3D Finite Element (FE) model in ABAQUS platform. The design response spectra based on KBC 2009 were then developed, in order to understand the seismic behavior of bridge structures. Besides, the multiple directional earthquakes were applied and it revealed that the most dominated earthquake direction was transverse direction of the bridge. Also, the bridge structure under the compressive stress was more fragile than the tensile stress and the vertical direction of seismic ground motions was not significantly affected to the structural system.

Keywords: seismic, bridge, FEM, evaluation, numerical analysis

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Authors: Sibel Yoleri

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In this research it is aimed to determine the adjustment of students who attend the first class at elementary school to school in terms of several variables. The study group of the research consists of 286 students (131 female, 155 male) who continue attending the first class of elementary school in 2013-2014 academic year, in the city center of Uşak. In the research, ‘Personal Information Form’ and ‘Walker-Mcconnell Scale of Social Competence and School Adjustment’ have been used as data collection tools. In the analysis of data, the t-test has been applied in the independent groups to determine whether the sampling group students’ scores of school adjustment differ according to the sex variable or not. For the evaluation of data identified as not showing normal distribution, Mann Whitney U test has been applied for paired comparison, Kruskal Wallis H test has been used for multiple comparisons. In the research, all the statistical processes have been evaluated bidirectional and the level of significance has been accepted as .05. According to the results gathered from the research, a meaningful difference could not been identified in the level of students’ adjustment to school in terms of sex variable. At the end of the research, it is identified that the adjustment level of the students who have started school at the age of seven is higher than the ones who have started school at the age of five and the adjustment level of the students who have preschool education before the elementary school is higher than the ones who have not taken.

Keywords: starting school, preschool education, school adjustment, Walker-Mcconnell Scale

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Authors: Sarah Triller, Ferdi Schüth

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The challenges encountered in upscaling the mechanochemical synthesis of high surface area α-alumina are investigated in this study. After lab-scale experiments in shaker mills and planetary ball mills, the optimization of reaction parameters of the conversion in the smallest vessel of a scalable mill, named Simoloyer, was developed. Furthermore, the future perspectives by scaling up the conversion in several steps are described. Since abrasion from the steel equipment can be problematic, the process was transferred to a ceramically lined mill, which solved the contamination problem. The recovered alpha-alumina shows a high specific surface area in all investigated scales.

Keywords: mechanochemistry, scale-up, ball milling, ceramic lining

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Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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Authors: Aqsa Butt, Nida Zafar

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The study assesses the relationship between impulsivity, emotional regulation, problematic mukbang watching, and eating disorders in university students. It was hypothesized there is likely to be a relationship between impulsivity, emotional regulation, problematic mukbang watching, and eating disorders in university students; impulsivity and emotional regulation would predict problematic mukbang watching in university students; problematic mukbang watching would predict eating disorders in university students. A correlational research design was used. A sample of 200 students was taken from different public and private universities in Lahore. Emotional regulation questionnaire (Gross & John, 2003), Abbreviated Barrat Impulsiveness Scale (Christopher et al., 2014), Problematic Mukbang Watching Scale (Kircaburun et al., 2020), and Eating Disorder Diagnostic Scale (Stice et al., 2004) were used for assessment. Results showed a significant positive relationship between impulsivity and expressive suppression with problematic mukbang watching. However, there is a significant negative relationship between cognitive reappraisal and problematic mukbang watching. Problematic mukbang is significantly positively related to bulimia nervosa and binge eating. Furthermore, impulsivity and expressive suppression are significant positive predictors of problematic mukbang watching, and cognitive reappraisal is a significant negative predictor of problematic mukbang watching. Additionally, problematic mukbang watching significantly positively predicts bulimia nervosa and binge eating. The research has important implications for university students to understand that excessive watching of such videos can lead to eating disorders such as bulimia nervosa and binge eating. This research provides an understanding of the effects of Mukbang watching, and it also adds to the existing body of knowledge on eating disorders.

Keywords: impulsivity, emotional regulation, problematic Mukbang watching eating disorders, students

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Authors: S. Nikpour, S. Vahidi, H. Haghani

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Introduction: Exercise has mental and physical health benefits for patients with advanced stage cancer who actively receive chemotherapy, yet little is known about patients’ levels of interest in becoming more active or their confidence in increasing their activity level. Methods and materials: A convenience sample of 200 patients with advanced-stage cancer who were receiving chemotherapy completed self-report measures assessing physical activity level, mood, and quality-of-life variables. Qualitative data on patient-perceived benefits of, and barriers to, physical activity also were collected, coded by independent raters, and organized by predominant themes. Results: Current physical activity level, physical activity outcome expectations, and positive mood were significantly associated with self-efficacy. Fatigue was the most frequently listed barrier to physical activity; improved physical strength and health were the most commonly listed benefits. Participants identified benefits related to both general health and cancer-symptom management that were related to exercise. 59.5% of participants reported that they were seriously planning to increase or maintain their physical activity level, and over 40% reported having interest in receiving an intervention to become more active. Conclusion: These results suggested that many advanced-stage cancer patients who receive chemotherapy are interested in maintaining or increasing their physical activity level and in receiving professional support for exercise. In addition, these individuals identified general health and cancer-specific benefits of, and barriers to, physical activity. Future research will investigate how these findings may be incorporated into physical activity interventions for advanced-stage oncology patients receiving medical treatment.

Keywords: physical activity, cancer, self-efficacy

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Authors: Sruti Akula

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Assessment criteria are mostly used for assessing skills like writing and speaking. However, they could be used as a pedagogic tool to develop writing skills. A study was conducted with higher secondary learners (Class XII Kendriya Vidyalaya) to investigate the effectiveness of assessment criteria to develop argumentative essay writing. In order to raise awareness about the features of argumentative essay, assessment criteria were shared with the learners. Along with that, self-evaluation checklists were given to the learners to guide them through the writing process. During the study learners wrote multiple drafts with the help of assessment criteria, self-evaluation checklists and teacher feedback at different stages of their writing. It was observed that learners became more aware of the features of argumentative essay which in turn improved their argumentative essay writing. In addition the self evaluation checklists imporved their ability to reflect on their work there by increasing learner autonomy in the class. Hence, it can be claimed that both assessment criteria and self evaluation checklists are effective pedagogic tools to develop argumentative essay writing. Thus, teachers can be trained to create and use tools like assessment criteria and self-evaluation checklists to develop learners’ writing skills in an effective way. The presentation would discuss the approach adopted in the study to teach argumentative essay writing along with the rationale. The tools used in the study would be shared and the data collected in the form of written scripts, self-evaluation checklists and student interviews will be analyzed to validate the claims. Finally, the practical implication of the study like the ways of using assessment criteria and checklists to raise learner awareness and autonomy, using such tools to keep the learners informed about the task requirements and genre features, and the like will be put forward.

Keywords: argumentative essay writing, assessment criteria, self evaluation checklists, pedagogic

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Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

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Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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Authors: Natalie Rosales

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Based on an ethical vision which recognizes the vital role of human rights, shared values, social responsibility and justice, and environmental ethics, planning may be interpreted as a process aimed at reducing inequalities and overcoming marginality. Seen from this sustainability perspective, planning evaluation must utilize critical-evaluative and narrative receptive models which assist different stakeholders in their understanding of urban fabric while trigger reflexive processes that catalyze wider transformations. In this paper, this approach servers as a guide for the evaluation of Mexico´s urban planning systems, and postulates a framework to better integrate sustainability notions into planning evaluation. The paper is introduced by an overview of the current debate on evaluation in urban planning. The state of art presented includes: the different perspectives and paradigms of planning evaluation and their fundamentals and scope, which have focused on three main aspects; goal attainment (did planning instruments do what they were supposed to?); performance and effectiveness of planning (retrospective analysis of planning process and policy analysis assessment); and the effects of process-considering decision problems and contexts rather than the techniques and methods. As well as, methodological innovations and improvements in planning evaluation. This comprehensive literature review provides the background to support the authors’ proposal for a set of general principles to evaluate urban planning, grounded on a sustainability perspective. In the second part the description of the shortcomings of the approaches to evaluate urban planning in Mexico set the basis for highlighting the need of regulatory and instrumental– but also explorative- and collaborative approaches. As a response to the inability of these isolated methods to capture planning complexity and strengthen the usefulness of evaluation process to improve the coherence and internal consistency of the planning practice itself. In the third section the general proposal to evaluate planning is described in its main aspects. It presents an innovative methodology for establishing a more holistic and integrated assessment which considers the interdependence between values, levels, roles and methods, and incorporates different stakeholders in the evaluation process. By doing so, this piece of work sheds light on how to advance urban sustainability through the integration of evaluation methodologies into planning.

Keywords: urban planning, evaluation methodologies, urban sustainability, innovative approaches

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Authors: Kew-Cheol Shim, Sung-Hwan Moon, Ji-Hyon Kil, Kyoungho Kim

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The purpose of this paper was to examine views of secondary school science teachers about purposes to use practical works in school science. The instrument to survey consisted eighteen items, which were categorized into four components as follows: ‘Scientific inquiry’, ‘Scientific knowledge’, ‘Science-related attitude’, and ‘STS (science-technology-society)’. Subjects were 152 secondary school science teachers (male 70 and female 82; middle school 50 and high school 102), who are teaching in 42 schools of 8 provinces. On the survey, science teachers were asked to answer on 5-point Lickert scale (from 1 to 5) how they thought of using practical works on purposes with domains of science objectives in school. They had positive views about using practical works for improving scientific inquiry process skills, science-related attitudes, and perceptions about STS literacy, and acquiring scientific knowledge. They would have the most willingness of using practical works for ‘Scientific Inquiry’ among domains of science objectives in school.

Keywords: secondary school, science teacher, practical work, scientific inquiry, scientific knowledge, scientific attitude, STS

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Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: Ananya Hazare, Ranjit Kamble

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Introduction: Patients with Cleft lip and palate (CL/P) can present with a maxillary retrution after cleft repair. Anterior Maxillary distraction osteogenesis (AMD) is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues related to an anterior segment of the maxilla. This case presented is a case of AMD. The advantage of this technique is that the occlusion in the posterior segment can be maintained, and only the segment in cross bite is advanced for correction of the midfacial deficiency. The other alternative treatment is anterior movement by a Lefort 1 osteotomy. When a Lefort 1 osteotomy is compared with the Distraction osteogenesis or AMD, the disadvantages of the Le Fort 1 include a higher risk of morbidity, requirement of fixation, relapse tendency and unexpected changes in the nasal form. These complications were eliminated by AMD technique. This was followed by placement of the implant in the bone formed after AMD. Hence complete surgical, orthodontic and prosthodontics rehabilitation of the patient was done by an interdisciplinary approach. Methods: Patient presented with repaired UCL/P of the right side with midfacial retrusion. Intro-oral examination revealed a good occlusion in the posterior arch and anterior Crossbite from canine to canine. Patient's both maxillary lateral incisors were missing. The lower arch was well aligned with all teeth present. The study models when scored according to GOSLON yardstick received a score of 4. After pre-surgical orthodontic phase was completed an intraoral distractor was fabricated by modification of HYRAX expansion screw. After surgery, low subapical osteotomy cuts were placed and the distractor was fixed. The latency period of 5 days was observed after which the distraction was started. Distraction was done at a rate of 1 mm/day with a rhythm of 0.5mm in morning and 0.5mm in the evening. The total distraction of 12 mm was done. After a consolidation period, the distractor was removed, and retention by a removable partial denture was given. Radiographic examination confirmed mature bone formation in the distracted segment. Implants were placed and allowed to osseointegrate for approximately 4 months and were then loaded with abutments. Results: Total distraction done was 12mm and after relapse it was 8mm. After consolidation phase the radiographic examination revealed a B2 quality of bone according to the Misch's classification and sufficient height from the maxillary sinus. These findings were indicative for placement of implants in the distracted bone formed in premolar region. Implants were placed and after radiographic evidence of osseointegration was seen they were loaded with abutments. Thus resulting in a complete rehabilitation of a cleft patient by an interdisciplinary approach. Conclusion: Anterior maxillary distraction can be used as an alternative method instead of complete distraction osteogenesis or Lefort 1 advancement of maxilla in cases where the advancement needed is minimum. Use of HYRAX expansion screw modified as intra-oral distractor can be used in such cases, which significantly reduces the cost of treatment, as expensive distractors are not used. This technique is very useful and efficient in countries like India where the patient cannot afford expensive treatment options.

Keywords: cleft lip and palate, distraction osteogenesis, anterior maxillary distraction, orthodontics and dentofacial orthopaedics, hyrax expansion screw modification

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Guncel Ozturk

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Background: Rhinoplasty is the most commonly performed cosmetic operations in plastic surgery. Maneuvers used in rhinoplasty lead to a firm and stiff nasal tip in the early postoperative months. This unnatural stability of the nose may easily cause distortion in the reshaped nose after severe trauma. Moreover, a firm nasal tip may cause difficulties in performing activities such as touching, hugging, or kissing. Decreasing the stability and increasing the mobility of the nasal tip would help rhinoplasty patients to avoid these small but relatively important problems. Methods: We use delivery approach with closed rhinoplasty and changed positions of intranasal incisions to reach a dynamic and mobile nose. A total of 203 patients who had undergone primary closed rhinoplasty in private practice were inspected retrospectively. Posterior strut flap that was connected with connective tissues in the caudal of septum and the medial crurals were formed. Cartilage of the posterior strut graft was left 2 mm thick in the distal part of septum, it was cut vertically, and the connective tissue in the distal part was preserved. Results: The median patient age was 24 (range 17-42) years. The median follow-up period was15.2 (range12-26) months. Patient satisfaction was assessed with the 'Rhinoplasty Outcome Evaluation' (ROE) questionnaire. Twelve months after surgeries, 87.5% of patients reported excellent outcomes, according to ROE. Conclusion: The soft tissue connections between that segment and surrounding structures should be preserved to save the support of the tip while having a mobile tip at the same time with this method. These modifications would access to a mobile, non-stiff, and dynamic nasal tip in the early postoperative months. Further and prospective studies should be performed for supporting this method.

Keywords: closed rhinoplasty, dynamic, mobile, tip

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Nishtha Batra

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This study was conducted to identify the effect of perceived stress on emotional regulation, aggression and psychological well-being. Analysis was conducted using correlational and regression models to examine the relationships between perceived stress (independent variable) and psychological factors containing emotional intelligence, psychological well-being and aggression. Subjects N=100, Male students 50 and Female students 50. The data was collected using Cohen's Perceived Stress Scale, Gross’s Emotional Regulation Questionnaire (ERQ), Ryff’s Psychological Well-being scale and Orispina’s aggression scale. Correlation and regression (SPSS version 22) Emotional regulation and psychological well-being had a significant relationship with Perceived stress.

Keywords: perceived stress, psychological well-being, aggression, emotional regulation, students

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Authors: Shane D. Inder, Mehrdad Khamooshi

Abstract:

Efficient energy storage is a crucial factor in facilitating the uptake of renewable energy resources. Among the many options available for energy storage systems required to balance imbalanced supply and demand cycles, compressed air energy storage (CAES) is a proven technology in grid-scale applications. This paper reviews the current state of micro scale CAES technology and describes a micro-scale advanced adiabatic CAES (A-CAES) system, where heat generated during compression is stored for use in the discharge phase. It will also describe a thermodynamic model, developed in EES (Engineering Equation Solver) to evaluate the performance and critical parameters of the discharge phase of the proposed system. Three configurations are explained including: single turbine without preheater, two turbines with preheaters, and three turbines with preheaters. It is shown that the micro-scale A-CAES is highly dependent upon key parameters including; regulator pressure, air pressure and volume, thermal energy storage temperature and flow rate and the number of turbines. It was found that a micro-scale AA-CAES, when optimized with an appropriate configuration, could deliver energy input to output efficiency of up to 70%.

Keywords: CAES, adiabatic compressed air energy storage, expansion phase, micro generation, thermodynamic

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Authors: Rania E. Ramadan

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Dental esthetics is subjective, can be reported by the dentist and not noticed by the patient. However, if there is any imperfection seen by both the dentist and the patient, it is considered as an unesthetic like white and/or brown spot lesions. Many patients nowadays have been concerned about dental esthetics. Esthetic rehabilitation of anterior teeth and even maxillary premolars aid a lot in patients’ satisfaction of their smile consequently, gaining positive psychological impact for the patients. Many cases need esthetic rehabilitation such as diastema closure, spaced teeth and masking discolored teeth. Dental fluorosis and enamel hypo calcification can be presented as white and/or brown spot lesions. There are many treatment options for the management of these spotted teeth. Treatment options range from bleaching, microabrasion, direct composite restorations, porcelain veneers, and complete coverage crowns. The selection of certain options depends on many factors: the patient’s age, socioeconomic status and the severity of the lesion. In this clinical report, a 22-year-old male patient has been presented to the Department of Prosthodontics in Alexandria University, Egypt. His chief complaint was, “I was unpleased by white and brown spots in my teeth and I want to close the space between the two maxillary central.” Upon medical history, clinical examination, diagnostic photographs, and digital smile design by Exocad software, lithium disilicate veneers were chosen as the treatment of choice in maxillary anterior and first premolars.

Keywords: flourosis, ceramic veneers, case report, diastema closure

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Authors: Hind Bouami

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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedbacks helps to identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled.

Keywords: life-critical systems, situation awareness, human-machine interaction, decision-making

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Authors: R. Mohan, V. Jadhav, A. Ahmed, J. Rivas, A. Kelkar

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Cementitious materials are an excellent example of a composite material with complex hierarchical features and random features that range from nanometer (nm) to millimeter (mm) scale. Multi-scale modeling of complex material systems requires starting from fundamental building blocks to capture the scale relevant features through associated computational models. In this paper, molecular dynamics (MD) modeling is employed to predict the effect of plasticizer additive on the mechanical properties of key hydrated cement constituent calcium-silicate-hydrate (CSH) at the molecular, nanometer scale level. Due to complexity, still unknown molecular configuration of CSH, a representative configuration widely accepted in the field of mineral Jennite is employed. The effectiveness of the Molecular Dynamics modeling to understand the predictive influence of material chemistry changes based on molecular/nanoscale models is demonstrated.

Keywords: cement composite, mechanical properties, molecular dynamics, plasticizer additives

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Authors: Prakash Dhakal

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Hepatic portal venous gas (HPVG) is diagnosed via computed tomography due to unusual imaging features. HPVG, when linked with pneumatosis intestinalis, has a high mortality rate and requires urgent intervention. We present a case of a 26-year-old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain. He had a history of COVID vaccination (First dose of COVISHILED) 15 days back. On imaging, HPVG and pneumatosis intestinalis were seen owing to the urgent intervention of the patient. The reliable interpretation of the imaging findings along with quick intervention led to a favorable outcome in our case. Herein we present a thorough review of the patient with a history of COVID-19 vaccination with superior mesenteric artery thrombosis leading to bowel ischemia and hepatic portal venous gas. The patient underwent subtotal small bowel resection.

Keywords: COVID-19 vaccination, SMA thrombosis, portal venoius gas, pneumatosis intestinalis

Procedia PDF Downloads 90

Authors: Jatuphum Ketchatturat

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Value-added assessment has been used for developing the model of monitoring and evaluation of student's learning achievement. The steps of model development consist of 1) study and analyisis of the school and the district report system of student achievement and progress, 2) collecting the data of student achievement to develop the value added indicator, 3) developing the system of value-added assessment by participatory action research approach, 4) putting the system of value-added assessment into the educational district of secondary school, 5) determining the quality of the developed system of value-added assessment. The components of the developed model consist of 1) the database of value-added assessment of student's learning achievement, 2) the process of monitoring and evaluation the student's learning achievement, and 3) the reporting system of value-added assessment of student's learning achievement.

Keywords: learning achievement, monitoring and evaluation, value-added assessment

Procedia PDF Downloads 424

Authors: Jaspreet Singh, Gurvinder Singh, Prabhsimran Singh, Rajinder Singh, Prithvipal Singh, Karanjeet Singh Kahlon, Ravinder Singh Sawhney

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Morphological evaluation of Indian languages is one of the burgeoning fields in the area of Natural Language Processing (NLP). The evaluation of a language is an eminent task in the era of information retrieval and text mining. The extraction and classification of knowledge from text can be exploited for sentiment analysis and morphological evaluation. This study coalesce morphological evaluation and sentiment analysis for the task of classification of farmer suicide cases reported in Punjab state of India. The pre-processing of Punjabi text involves morphological evaluation and normalization of Punjabi word tokens followed by the training of proposed model using deep learning classification on Punjabi language text extracted from online Punjabi news reports. The class-wise accuracies of sentiment prediction for four negatively oriented classes of farmer suicide cases are 93.85%, 88.53%, 83.3%, and 95.45% respectively. The overall accuracy of sentiment classification obtained using proposed framework on 275 Punjabi text documents is found to be 90.29%.

Keywords: deep neural network, farmer suicides, morphological processing, punjabi text, sentiment analysis

Procedia PDF Downloads 326

Authors: Chuanbo Xu, Xinying Li, Gejirifu De, Yunna Wu

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Energy Internet (EI) is a new form that deeply integrates the Internet and the entire energy process from production to consumption. The assessment of energy efficient performance is of vital importance for the long-term sustainable development of EI project. Although the newly proposed fuzzy integrated cloud evaluation algorithm considers the randomness of uncertainty, it relies too much on the experience and knowledge of experts. Fortunately, the enrichment of EI data has enabled the utilization of data-driven methods. Therefore, the main purpose of this work is to assess the energy efficient of park-level EI by using a combination of a data-driven method with the fuzzy integrated cloud evaluation algorithm. Firstly, the indicators for the energy efficient are identified through literature review. Secondly, the artificial neural network (ANN)-based data-driven method is employed to cluster the values of indicators. Thirdly, the energy efficient of EI project is calculated through the fuzzy integrated cloud evaluation algorithm. Finally, the applicability of the proposed method is demonstrated by a case study.

Keywords: energy efficient, energy internet, data-driven, fuzzy integrated evaluation, cloud model

Procedia PDF Downloads 202

Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 303