Search results for: medical factors

Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: Angelis P. Barlampas

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Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.

Keywords: fahr disease, fahr syndrome, CT, brain calcifications

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Authors: A. Zapata, Orlando Arroyo, R. Bonett

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Over the last two decades, the growing demand for housing in Latin American countries has led to the development of construction projects based on low and medium-rise buildings with thin reinforced concrete walls. This system, known as Thin Walls Reinforced Concrete Buildings (TWRCB), uses walls with thicknesses from 100 to 150 millimetres, with flexural reinforcement formed by welded wire mesh (WWM) with diameters between 5 and 7 millimetres, arranged in one or two layers. These walls often have irregular structural configurations, including combinations of rectangular shapes. Experimental and numerical research conducted in regions where this structural system is commonplace indicates inherent weaknesses, such as limited ductility due to the WWM reinforcement and thin element dimensions. Because of its complexity, numerical analyses have relied on two-dimensional models that don't explicitly account for the floor system, even though it plays a crucial role in distributing seismic forces among the resilient elements. Nonetheless, the numerical analyses assume a rigid diaphragm hypothesis. For this purpose, two study cases of buildings were selected, low-rise and mid-rise characteristics of TWRCB in Colombia. The buildings were analyzed in Opensees using the MVLEM-3D for walls and shell elements to simulate the slabs to involve the effect of coupling diaphragm in the nonlinear behaviour. Three cases are considered: a) models without a slab, b) models with rigid slabs, and c) models with flexible slabs. An incremental static (pushover) and nonlinear dynamic analyses were carried out using a set of 44 far-field ground motions of the FEMA P-695, scaled to 1.0 and 1.5 factors to consider the probability of collapse for the design base earthquake (DBE) and the maximum considered earthquake (MCE) for the model, according to the location sites and hazard zone of the archetypes in the Colombian NSR-10. Shear base capacity, maximum displacement at the roof, walls shear base individual demands and probabilities of collapse were calculated, to evaluate the effect of absence, rigid and flexible slabs in the nonlinear behaviour of the archetype buildings. The pushover results show that the building exhibits an overstrength between 1.1 to 2 when the slab is considered explicitly and depends on the structural walls plan configuration; additionally, the nonlinear behaviour considering no slab is more conservative than if the slab is represented. Include the flexible slab in the analysis remarks the importance to consider the slab contribution in the shear forces distribution between structural elements according to design resistance and rigidity. The dynamic analysis revealed that including the slab reduces the collapse probability of this system due to have lower displacements and deformations, enhancing the safety of residents and the seismic performance. The strategy of including the slab in modelling is important to capture the real effect on the distribution shear forces in walls due to coupling to estimate the correct nonlinear behaviour in this system and the adequate distribution to proportionate the correct resistance and rigidity of the elements in the design to reduce the possibility of damage to the elements during an earthquake.

Keywords: thin wall reinforced concrete buildings, coupling slab, rigid diaphragm, flexible diaphragm

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Authors: K. C. Apil, Keshab Sharma, Bigul Pokharel

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Kathmandu Valley, capital city of Nepal houses numerous historical monuments as well as religious structures which are as old as from the 4th century A.D. The city alone is home to seven UNESCO’s world heritage sites including various public squares and religious sanctums which are often regarded as living heritages by various historians and archeological explorers. Recently on April 25, 2015, the capital city including other nearby locations was struck with Gorkha earthquake of moment magnitude (Mw) 7.8, followed by the strongest aftershock of moment magnitude (Mw) 7.3 on May 12. This study reports structural failures and collapse of heritage structures in Kathmandu Valley during the earthquake and presents preliminary findings as to the causes of failures and collapses. Field reconnaissance was carried immediately after the main shock and the aftershock, in major heritage sites: UNESCO world heritage sites, a number of temples and historic buildings in Kathmandu Durbar Square, Patan Durbar Square, and Bhaktapur Durbar Square. Despite such catastrophe, a significant number of heritage structures stood high, performing very well during the earthquake. Preliminary reports from archeological department suggest that 721 of such structures were severely affected, whereas numbers within the valley only were 444 including 76 structures which were completely collapsed. This study presents recorded accelerograms and geology of Kathmandu Valley. Structural typology and architecture of the heritage structures in Kathmandu Valley are briefly described. Case histories of damaged heritage structures, the patterns, and the failure mechanisms are also discussed in this paper. It was observed that performance of heritage structures was influenced by the multiple factors such as structural and architecture typology, configuration, and structural deficiency, local ground site effects and ground motion characteristics, age and maintenance level, material quality etc. Most of such heritage structures are of masonry type using bricks and earth-mortar as a bonding agent. The walls' resistance is mainly compressive, thus capable of withstanding vertical static gravitational load but not horizontal dynamic seismic load. There was no definitive pattern of damage to heritage structures as most of them behaved as a composite structure. Some structures were extensively damaged in some locations, while structures with similar configuration at nearby location had little or no damage. Out of major heritage structures, Dome, Pagoda (2, 3 or 5 tiered temples) and Shikhara structures were studied with similar variables. Studying varying degrees of damages in such structures, it was found that Shikhara structures were most vulnerable one where Dome structures were found to be the most stable one, followed by Pagoda structures. The seismic performance of the masonry-timber and stone masonry structures were slightly better than that of the masonry structures. Regular maintenance and periodic seismic retrofitting seems to have played pivotal role in strengthening seismic performance of the structure. The study also recommends some key functions to strengthen the seismic performance of such structures through study based on structural analysis, building material behavior and retrofitting details. The result also recognises the importance of documentation of traditional knowledge and its revised transformation in modern technology.

Keywords: Gorkha earthquake, field observation, heritage structure, seismic performance, masonry building

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: D. Signore, M. Ferraiuolo, P. Caramuta, O. Petrella, C. Toscano

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The Digital Image Correlation (DIC) is a newly developed optical technique that is spreading in all engineering sectors because it allows the non-destructive estimation of the entire surface deformation without any contact with the component under analysis. These characteristics make the DIC very appealing in all the cases the global deformation state is to be known without using strain gages, which are the most used measuring device. The DIC is applicable to any material subjected to distortion caused by either thermal or mechanical load, allowing to obtain high-definition mapping of displacements and deformations. That is why in the civil and the transportation industry, DIC is very useful for studying the behavior of metallic materials as well as of composite materials. DIC is also used in the medical field for the characterization of the local strain field of the vascular tissues surface subjected to uniaxial tensile loading. DIC can be carried out in the two dimension mode (2D DIC) if a single camera is used or in a three dimension mode (3D DIC) if two cameras are involved. Each point of the test surface framed by the cameras can be associated with a specific pixel of the image, and the coordinates of each point are calculated knowing the relative distance between the two cameras together with their orientation. In both arrangements, when a component is subjected to a load, several images related to different deformation states can be are acquired through the cameras. A specific software analyzes the images via the mutual correlation between the reference image (obtained without any applied load) and those acquired during the deformation giving the relative displacements. In this paper, a metrological characterization of the digital image correlation is performed on aluminum and composite targets both in static and dynamic loading conditions by comparison between DIC and strain gauges measures. In the static test, interesting results have been obtained thanks to an excellent agreement between the two measuring techniques. In addition, the deformation detected by the DIC is compliant with the result of a FEM simulation. In the dynamic test, the DIC was able to follow with a good accuracy the periodic deformation of the specimen giving results coherent with the ones given by FEM simulation. In both situations, it was seen that the DIC measurement accuracy depends on several parameters such as the optical focusing, the parameters chosen to perform the mutual correlation between the images and, finally, the reference points on image to be analyzed. In the future, the influence of these parameters will be studied, and a method to increase the accuracy of the measurements will be developed in accordance with the requirements of the industries especially of the aerospace one.

Keywords: accuracy, deformation, image correlation, mechanical analysis

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Authors: Maris Eugênia Dela Rosa, Ana Luiza Menegatti Pavan, Marcela De Oliveira, Diana Rodrigues De Pina, Luis Carlos Vulcano

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In medical veterinary as well as in human medicine, radiological study is essential for a safe diagnosis in clinical practice. Thus, the quality of radiographic image is crucial. In last year’s there has been an increasing substitution of image acquisition screen-film systems for computed radiology equipment (CR) without technical charts adequacy. Furthermore, to carry out a radiographic examination in veterinary patient is required human assistance for restraint this, which can compromise image quality by generating dose increasing to the animal, for Occupationally Exposed and also the increased cost to the institution. The image optimization procedure and construction of radiographic techniques are performed with the use of homogeneous phantoms. In this study, we sought to develop a homogeneous phantom of canine chest to be applied to the optimization of these images for the CR system. In carrying out the simulator was created a database with retrospectives chest images of computed tomography (CT) of the Veterinary Hospital of the Faculty of Veterinary Medicine and Animal Science - UNESP (FMVZ / Botucatu). Images were divided into four groups according to the animal weight employing classification by sizes proposed by Hoskins & Goldston. The thickness of biological tissues were quantified in a 80 animals, separated in groups of 20 animals according to their weights: (S) Small - equal to or less than 9.0 kg, (M) Medium - between 9.0 and 23.0 kg, (L) Large – between 23.1 and 40.0kg and (G) Giant – over 40.1 kg. Mean weight for group (S) was 6.5±2.0 kg, (M) 15.0±5.0 kg, (L) 32.0±5.5 kg and (G) 50.0 ±12.0 kg. An algorithm was developed in Matlab in order to classify and quantify biological tissues present in CT images and convert them in simulator materials. To classify tissues presents, the membership functions were created from the retrospective CT scans according to the type of tissue (adipose, muscle, bone trabecular or cortical and lung tissue). After conversion of the biologic tissue thickness in equivalent material thicknesses (acrylic simulating soft tissues, bone tissues simulated by aluminum and air to the lung) were obtained four different homogeneous phantoms, with (S) 5 cm of acrylic, 0,14 cm of aluminum and 1,8 cm of air; (M) 8,7 cm of acrylic, 0,2 cm of aluminum and 2,4 cm of air; (L) 10,6 cm of acrylic, 0,27 cm of aluminum and 3,1 cm of air and (G) 14,8 cm of acrylic, 0,33 cm of aluminum and 3,8 cm of air. The developed canine homogeneous phantom is a practical tool, which will be employed in future, works to optimize veterinary X-ray procedures.

Keywords: radiation protection, phantom, veterinary radiology, computed radiography

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Authors: Islam Sherif, Ahmed Ashour, Ahmed Hassan, Hatem Osman

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Anterior Cruciate Ligament (ACL) injuries are common among athletes and individuals participating in sports with sudden stops, pivots, and changes in direction. Arthroscopic surgery is the gold standard for ACL reconstruction, aiming to restore knee stability and function. Recent years have witnessed significant advancements in arthroscopic surgery techniques, graft materials, and technological innovations, revolutionizing the field of ACL reconstruction. This presentation delves into the latest advancements in arthroscopic surgery techniques for ACL reconstruction and their potential impact on patient outcomes. Traditionally, autografts from the patellar tendon, hamstring tendon, or quadriceps tendon have been commonly used for ACL reconstruction. However, recent studies have explored the use of allografts, synthetic scaffolds, and tissue-engineered grafts as viable alternatives. This abstract evaluates the benefits and potential drawbacks of each graft type, considering factors such as graft incorporation, strength, and risk of graft failure. Moreover, the application of augmented reality (AR) and virtual reality (VR) technologies in surgical planning and intraoperative navigation has gained traction. AR and VR platforms provide surgeons with detailed 3D anatomical reconstructions of the knee joint, enhancing preoperative visualization and aiding in graft tunnel placement during surgery. We discuss the integration of AR and VR in arthroscopic ACL reconstruction procedures, evaluating their accuracy, cost-effectiveness, and overall impact on surgical outcomes. Beyond graft selection and surgical navigation, patient-specific planning has gained attention in recent research. Advanced imaging techniques, such as MRI-based personalized planning, enable surgeons to tailor ACL reconstruction procedures to each patient's unique anatomy. By accounting for individual variations in the femoral and tibial insertion sites, this personalized approach aims to optimize graft placement and potentially improve postoperative knee kinematics and stability. Furthermore, rehabilitation and postoperative care play a crucial role in the success of ACL reconstruction. This abstract explores novel rehabilitation protocols, emphasizing early mobilization, neuromuscular training, and accelerated recovery strategies. Integrating technology, such as wearable sensors and mobile applications, into postoperative care can facilitate remote monitoring and timely intervention, contributing to enhanced rehabilitation outcomes. In conclusion, this presentation provides an overview of the cutting-edge advancements in arthroscopic surgery techniques for ACL reconstruction. By embracing innovative graft materials, augmented reality, patient-specific planning, and technology-driven rehabilitation, orthopedic surgeons and sports medicine specialists can achieve superior outcomes in ACL injury management. These developments hold great promise for improving the functional outcomes and long-term success rates of ACL reconstruction, benefitting athletes and patients alike.

Keywords: arthroscopic surgery, ACL, autograft, allograft, graft materials, ACL reconstruction, synthetic scaffolds, tissue-engineered graft, virtual reality, augmented reality, surgical planning, intra-operative navigation

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Authors: Miguel A. Figueroa, José A. Lara-Ramos, Miguel A. Mueses

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Pharmaceutical residues are a section of emerging contaminants of anthropogenic origin that are present in a myriad of waters with which human beings interact daily and are starting to affect the ecosystem directly. Conventional waste-water treatment systems are not capable of degrading these pharmaceutical effluents because their designs cannot handle the intermediate products and biological effects occurring during its treatment. That is why it is necessary to hybridize conventional waste-water systems with non-conventional processes. In the specific case of an ozonation process, its efficiency highly depends on a perfect dispersion of ozone, long times of interaction of the gas-liquid phases and the size of the ozone bubbles formed through-out the reaction system. In order to increase the efficiency of these parameters, the use of a modified flotation cell has been proposed recently as a reactive system, which is used at an industrial level to facilitate the suspension of particles and spreading gas bubbles through the reactor volume at a high rate. The objective of the present work is the development of a mathematical model that can closely predict the kinetic rates of reactions taking place in the flotation cell at an experimental scale by means of identifying proper reaction mechanisms that take into account the modified chemical and hydrodynamic factors in the FeO-catalyzed Ozonation of Diclofenac aqueous solutions in a flotation cell. The methodology is comprised of three steps: an experimental phase where a modified flotation cell reactor is used to analyze the effects of ozone concentration and loading catalyst over the degradation of Diclofenac aqueous solutions. The performance is evaluated through an index of utilized ozone, which relates the amount of ozone supplied to the system per milligram of degraded pollutant. Next, a theoretical phase where the reaction mechanisms taking place during the experiments must be identified and proposed that details the multiple direct and indirect reactions the system goes through. Finally, a kinetic model is obtained that can mathematically represent the reaction mechanisms with adjustable parameters that can be fitted to the experimental results and give the model a proper physical meaning. The expected results are a robust reaction rate law that can simulate the improved results of Diclofenac mineralization on water using the modified flotation cell reactor. By means of this methodology, the following results were obtained: A robust reaction pathways mechanism showcasing the intermediates, free-radicals and products of the reaction, Optimal values of reaction rate constants that simulated Hatta numbers lower than 3 for the system modeled, degradation percentages of 100%, TOC (Total organic carbon) removal percentage of 69.9 only requiring an optimal value of FeO catalyst of 0.3 g/L. These results showed that a flotation cell could be used as a reactor in ozonation, catalytic ozonation and photocatalytic ozonation processes, since it produces high reaction rate constants and reduces mass transfer limitations (Ha > 3) by producing microbubbles and maintaining a good catalyst distribution.

Keywords: advanced oxidation technologies, iron oxide, emergent contaminants, AOTS intensification

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Muhammad Hanif Amiri, Edris Sadeqy, Ahmad Freed Osman

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International Conference on Architectural Engineering and Skyscraper (ICAES 2016) on January 18 - 19, 2016 is aimed to exchange new ideas and application experiences face to face, to establish business or research relations and to find global partners for future collaboration. Therefore, we are very keen to participate and share our issues in order to get valuable feedbacks of the conference participants. Urbanization is a controversial issue all around the world. Substandard and unplanned urbanization has many implications on a social, cultural and economic situation of population life. Unplanned and illegal construction has become a critical issue in Afghanistan particularly Kabul city. In addition, lack of municipal bylaws, poor municipal governance, lack of development policies and strategies, budget limitation, low professional capacity of ainvolved private sector in development and poor coordination among stakeholders are the other factors which made the problem more complicated. The main purpose of this research paper is to review urbanization pattern of Kabul city and find out the improvement solutions and to evaluate the increasing of population density which caused vast illegal and unplanned development which finally converts the Kabul city to a slam area as the whole. The Kabul city Master Plan was reviewed in the year 1978 and revised for the planned 2million population. In 2001, the interim administration took place and the city became influx of returnees from neighbor countries and other provinces of Afghanistan mostly for the purpose of employment opportunities, security and better quality of life, therefore, Kabul faced with strange population growth. According to Central Statistics Organization of Afghanistan population of Kabul has been estimated approx. 5 million (2015), however a new Master Plan has been prepared in 2009, but the existing challenges have not been dissolved yet. On the other hand, 70% of Kabul population is living in unplanned (slam) area and facing the shortage of drinking water, inexistence of sewerage and drainage network, inexistence of proper management system for solid waste collection, lack of public transportation and traffic management, environmental degradation and the shortage of social infrastructure. Although there are many problems in Kabul city, but still the development of 22 townships are in progress which caused the great attraction of population. The research is completed with a detailed analysis on four main issues such as elimination of duplicated administrations, Development of regions, Rehabilitation and improvement of infrastructure, and prevention of new townships establishment in Kabul Central Core in order to mitigate the problems and constraints which are the foundation and principal to find the point of departure for an objective based future development of Kabul city. The closure has been defined to reflect the stage-wise development in light of prepared policy and strategies, development of a procedure for the improvement of infrastructure, conducting a preliminary EIA, defining scope of stakeholder’s contribution and preparation of project list for initial development. In conclusion this paper will help the transformation of Kabul city.

Keywords: development of regions, illegal construction, population density, urbanization pattern

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Authors: Ankush Raina, Ankush Anand

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Plyometric training is a form of specialised strength training that uses fast muscular contractions to improve power and speed in sports conditioning by coaches and athletes. Despite its useful role in sports conditioning programme, the information about plyometric training on the athletes cardiovascular health especially Electrocardiogram (ECG) has not been established in the literature. The purpose of the study was to determine the effects of lower and upper body plyometric training on ECG of athletes. The study was guided by three null hypotheses. Quasi–experimental research design was adopted for the study. Seventy-two university male athletes constituted the population of the study. Thirty male athletes aged 18 to 24 years volunteered to participate in the study, but only twenty-three completed the study. The volunteered athletes were apparently healthy, physically active and free of any lower and upper extremity bone injuries for past one year and they had no medical or orthopedic injuries that may affect their participation in the study. Ten subjects were purposively assigned to one of the three groups: lower body plyometric training (LBPT), upper body plyometric training (UBPT), and control (C). Training consisted of six plyometric exercises: lower (ankle hops, squat jumps, tuck jumps) and upper body plyometric training (push-ups, medicine ball-chest throws and side throws) with moderate intensity. The general data were collated and analysed using Statistical Package for Social Science (SPSS version 22.0). The research questions were answered using mean and standard deviation, while paired samples t-test was also used to test for the hypotheses. The results revealed that athletes who were trained using LBPT had reduced ECG parameters better than those in the control group. The results also revealed that athletes who were trained using both LBPT and UBPT indicated lack of significant differences following ten weeks plyometric training than those in the control group in the ECG parameters except in Q wave, R wave and S wave (QRS) complex. Based on the findings of the study, it was recommended among others that coaches should include both LBPT and UBPT as part of athletes’ overall training programme from primary to tertiary institution to optimise performance as well as reduce the risk of cardiovascular diseases and promotes good healthy lifestyle.

Keywords: boundary lubrication, copper oxide, friction, nano diamond

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Authors: Shanhua Hu

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Social media as a critical propagandizing form of film, video games, and digital products has received substantial research attention, but there exists several critical barriers such as: (1) few studies exploring the internal and external connections of a product as part of the multimodal context that gives rise to readability and commercial return; (2) the lack of study of multimodal analysis in product’s official account of game publishers and its impact on users’ behaviors including purchase intention, social media engagement, and playing time; (3) no standardized ecologically-valid, game type-varying data can be used to study the complexity of official account’s postings within a time period. This proposed research helps to tackle these limitations in order to develop a model of readability study that is more ecologically valid, robust, and thorough. To accomplish this objective, this paper provides a more diverse dataset comprising different visual elements and messages collected from the official Twitter accounts of the Top 20 best-selling games of 2021. Video game companies target potential users through social media, a popular approach is to set up an official account to maintain exposure. Typically, major game publishers would create an official account on Twitter months before the game's release date to update on the game's development, announce collaborations, and reveal spoilers. Analyses of tweets from those official Twitter accounts would assist publishers and marketers in identifying how to efficiently and precisely deploy advertising to increase game sales. The purpose of this research is to determine how official game accounts use Twitter to attract new customers, specifically which types of messages are most effective at increasing sales. The dataset includes the number of days until the actual release date on Twitter posts, the readability of the post (Flesch Reading Ease Score, FRES), the number of emojis used, the number of hashtags, the number of followers of the mentioned users, the categorization of the posts (i.e., spoilers, collaborations, promotions), and the number of video views. The timeline of Twitter postings from official accounts will be compared to the history of pre-orders and sales figures to determine the potential impact of social media posts. This study aims to determine how the above-mentioned characteristics of official accounts' Twitter postings influence the sales of the game and to examine the possible causes of this influence. The outcome will provide researchers with a list of potential aspects that could influence people's judgments in limited-word posts. With the increased average online time, users would adapt more quickly than before in online information exchange and readings, such as the word to use sentence length, and the use of emojis or hashtags. The study on the promotion of official game accounts will not only enable publishers to create more effective promotion techniques in the future but also provide ideas for future research on the influence of social media posts with a limited number of words on consumers' purchasing decisions. Future research can focus on more specific linguistic aspects, such as precise word choice in advertising.

Keywords: engagement, official account, promotion, twitter, video game

Procedia PDF Downloads 60

Authors: L. Abubakar, B. M. Sokoto, I. U. Mohammed, M. S. Na’allah, A. Mohammad, A. N. Garba, T. S. Bubuche

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Onion (Allium cepa var. cepa L.) is the most important species of the Allium group belonging to family Alliaceae and genus Allium. It can be regarded as the single important vegetable species in the world after tomatoes. Despite the similarities, which bring the species together, the genus is a strikingly diverse one, with more than five hundred species, which are perennial and mostly bulbous plants. Out of these, only seven species are in cultivation, and five are the most important species of the cultivated Allium. However, Allium cepa (onion) and Allium sativum (Garlic) are the two major cultivated species grown all over the world of which the onion crop is the most important. North Western Nigeria (Sokoto, Kebbi and Zamfara States) constitute the major onion producing zone in Nigeria, which is primarily during the dry season. However, onion production in the zone is seriously affected by two main factors i.e. diseases and storage losses, in addition to other constraints that limits the cultivation of the crop during the rainy season which include lack of prolonged rainy season to allow for proper maturation of the crop. The major onion disease in this zone is purple blotch caused by a fungus Alternaria porri and currently efforts are on to develop onion hybrids resistant to the disease. Genetic diversity plays an important role in plant breeding either to exploit heterosis or to generate productive recombinants. Assessment of a large number of genotypes for a genetic diversity is the first step in this direction. The objective of this research therefore is to evaluate the genetic potentials of the onion cultivars of North Western Nigeria, with a view of developing new cultivars that address the major production challenges to onion cultivation in North Western, Nigeria. Thirteen onion cultivars were collected during an expedition covering North western Nigeria and Southern part of Niger Republic during 2013, which are areas noted for onion production. The cultivars were evaluated at two locations; Sokoto, in Sokoto State and Jega in Kebbi State all in Nigeria during the 2013/14 onion season (dry season) under irrigation. The objective of the research was to determine the genetic potentials of onion cultivars of north western Nigeria as a basis for breeding purposes. Combined analysis of the results revealed highly significant variation between the cultivars across the locations with respect to plant height, number of leaves/plant, bolting %, bulb height, bulb weight, mean bulb yield and cured bulb weight, with significant variation in terms of bulb diameter. Tasa from Warra Local Government Area of Kebbi State (V4) recorded the greatest mean fresh bulb yield with Jar Albasa (V8) from Illela Local Government Area of Sokoto State recording the least. Similarly Marsa (V5) from Silame Local Government Area recorded the greatest mean cured bulb yield (marketable bulb)with Kiba (V11) from Goronyo Local Government of Sokoto State recording the least. Significant variation was recorded between the locations with respect to all characters, with Sokoto being better in terms of plant height, number of leaves/plant, bolting % and bulb diameter. Jega was better in terms of bulb height, bulb yield and cured bulb weight. Significant variation was therefore observed between the cultivars.

Keywords: evaluation, genetic, onions, North Western Nigeria

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Authors: Takashi Mitsuishi

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Fuzzy logic has gained acceptance in the recent years in the fields of social sciences and humanities such as psychology and linguistics because it can manage the fuzziness of words and human subjectivity in a logical manner. However, the major field of application of the fuzzy logic is control engineering as it is a part of the set theory and mathematical logic. Mamdani method, which is the most popular technique for approximate reasoning in the field of fuzzy control, is one of the ways to numerically represent the control afforded by human language and sensitivity and has been applied in various practical control plants. Fuzzy logic has been gradually developing as an artificial intelligence in different applications such as neural networks, expert systems, and operations research. The objects of inference vary for different application fields. Some of these include time, angle, color, symptom and medical condition whose fuzzy membership function is a periodic function. In the defuzzification stage, the domain of the membership function should be unique to obtain uniqueness its defuzzified value. However, if the domain of the periodic membership function is determined as unique, an unintuitive defuzzified value may be obtained as the inference result using the center of gravity method. Therefore, the authors propose a method of circular-polar-coordinates transformation and defuzzification of the periodic membership functions in this study. The transformation to circular polar coordinates simplifies the domain of the periodic membership function. Defuzzified value in circular polar coordinates is an argument. Furthermore, it is required that the argument is calculated from a closed plane figure which is a periodic membership function on the circular polar coordinates. If the closed plane figure is continuous with the continuity of the membership function, a significant amount of computation is required. Therefore, to simplify the practice example and significantly reduce the computational complexity, we have discretized the continuous interval and the membership function in this study. In this study, the following three methods are proposed to decide the argument from the discrete polygon which the continuous plane figure is transformed into. The first method provides an argument of a straight line passing through the origin and through the coordinate of the arithmetic mean of each coordinate of the polygon (physical center of gravity). The second one provides an argument of a straight line passing through the origin and the coordinate of the geometric center of gravity of the polygon. The third one provides an argument of a straight line passing through the origin bisecting the perimeter of the polygon (or the closed continuous plane figure).

Keywords: defuzzification, fuzzy membership function, periodic function, polar coordinates transformation

Procedia PDF Downloads 341

Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

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Authors: Adedayo B. Adegbaju, Carel B. Schoeman, Ilse M. Schoeman

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The unique urban contexts that emanated from the apartheid history of South Africa informed the transport landscape of the City of Johannesburg. Apartheid‘s divisive spatial planning and land use management policies promoted sprawling and separated workers from job opportunities. This was further exacerbated by poor funding of public transport and road designs that encouraged the use of private cars. However, the democratization of the country in 1994 and the hosting of the 2010 FIFA World Cup provided a new impetus to the city’s public transport-oriented urban planning inputs. At the same time, the state’s new approach to policy formulations that entails the provision of public transport as one of the tools to end years of marginalization and inequalities soon began to largely reflect in planning decisions of other spheres of government. The Rea Vaya BRT and the Gautrain were respectively implemented by the municipal and provincial governments to demonstrate strong political will and commitment to the new policy direction. While the Gautrain was implemented to facilitate elite movement within Gauteng and to crowd investments and economic growths around station nodes, the BRT was provided for previously marginalized public transport users to provide a sustainable alternative to the dominant minibus taxi. The aim of this research is to evaluate the spatial impacts of the Gautrain and Rea Vaya BRT on the City of Johannesburg and to inform future outcomes by determining the existing potentials. By using the case study approach with a focus on the BRT and fast rail in a metropolitan context, the triangulation research method, which combines various data collection methods, was used to determine the research outcomes. The use of interviews, questionnaires, field observation, and databases such as REX, Quantec, StatsSA, GCRO observatory, national and provincial household travel surveys, and the quality of life surveys provided the basis for data collection. The research concludes that the Gautrain has demonstrated that viable alternatives to the private car can be provided, with its satisfactory feedbacks from users; while some of its station nodes (Sandton, Rosebank) have shown promises of transit-oriented development, one of the project‘s key objectives. The other stations have been unable to stimulate growth due to reasons like non-implementation of their urban design frameworks and lack of public sector investment required to attract private investors. The Rea Vaya BRT continues to be expanded in spite of both its inability to induce modal change and its low ridership figures. The research identifies factors like the low peak to base ratio, pricing, and the city‘s disjointed urban fabric as some of the reasons for its below-average performance. By drawing from the highlights and limitations, the study recommends that public transport provision should be institutionally integrated across and within spheres of government. Similarly, harmonization of the funding structure, better understanding of users’ needs, and travel patterns, underlined with continuity of policy direction and objectives, will equally promote optimal outcomes.

Keywords: bus rapid transit, Gautrain, Rea Vaya, sustainable transport, spatial and transport planning, transit oriented development

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Authors: Sameh S. Namnqani, Yaqoob Y. Abobakar, Ahmed M. Alsewehri, Khaled M. AlQethami

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The main objective of this research is to know the impact of the application of the electronic supply system on the performance of the supply department of health organizations. To reach this goal, the study adopted independent variables to measure the dependent variable (performance of the supply department), namely: integration with suppliers, integration with intermediaries and distributors and knowledge of supply size, inventory, and demand. The study used the descriptive method and was aided by the questionnaire tool that was distributed to a sample of workers in the Supply Chain Management Department of King Abdullah Medical City. After the statistical analysis, the results showed that: The 70 sample members strongly agree with the (electronic integration with suppliers) axis with a p-value of 0.001, especially with regard to the following: Opening formal and informal communication channels between management and suppliers (Mean 4.59) and exchanging information with suppliers with transparency and clarity (Mean 4.50). It also clarified that the sample members agree on the axis of (electronic integration with brokers and distributors) with a p-value of 0.001 and this is represented in the following elements: Exchange of information between management, brokers and distributors with transparency, clarity (Mean 4.18) , and finding a close cooperation relationship between management, brokers and distributors (Mean 4.13). The results also indicated that the respondents agreed to some extent on the axis (knowledge of the size of supply, stock, and demand) with a p-value of 0.001. It also indicated that the respondents strongly agree with the existence of a relationship between electronic procurement and (the performance of the procurement department in health organizations) with a p-value of 0.001, which is represented in the following: transparency and clarity in dealing with suppliers and intermediaries to prevent fraud and manipulation (Mean 4.50) and reduce the costs of supplying the needs of the health organization (Mean 4.50). From the results, the study recommended several recommendations, the most important of which are: that health organizations work to increase the level of information sharing between them and suppliers in order to achieve the implementation of electronic procurement in the supply management of health organizations. Attention to using electronic data interchange methods and using modern programs that make supply management able to exchange information with brokers and distributors to find out the volume of supply, inventory, and demand. To know the volume of supply, inventory, and demand, it recommended the application of scientific methods of supply for storage. Take advantage of information technology, for example, electronic data exchange techniques and documents, where it can help in contact with suppliers, brokers, and distributors, and know the volume of supply, inventory, and demand, which contributes to improving the performance of the supply department in health organizations.

Keywords: healthcare supply chain, performance, electronic system, ERP

Procedia PDF Downloads 120

Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

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Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

Procedia PDF Downloads 138

Authors: Tamal Roy, Anuradha Bhat

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Cognitive abilities aid fishes in foraging, avoiding predators & locating mates. Factors like predation pressure & habitat complexity govern learning & memory in fishes. This study aims to compare spatial learning & memory across four natural populations of zebrafish. Zebrafish, a small cyprinid inhabits a diverse range of freshwater habitats & this makes it amenable to studies investigating role of native environment in spatial cognitive abilities. Four populations were collected across India from waterbodies with contrasting ecological conditions. Habitat complexity of the water-bodies was evaluated as a combination of channel substrate diversity and diversity of vegetation. Experiments were conducted on populations under controlled laboratory conditions. A square shaped spatial testing arena (maze) was constructed for testing the performance of adult zebrafish. The square tank consisted of an inner square shaped layer with the edges connected to the diagonal ends of the tank-walls by connections thereby forming four separate chambers. Each of the four chambers had a main door in the centre. Each chamber had three sections separated by two windows. A removable coloured window-pane (red, yellow, green or blue) identified each main door. A food reward associated with an artificial plant was always placed inside the left-hand section of the red-door chamber. The position of food-reward and plant within the red-door chamber was fixed. A test fish would have to explore the maze by taking turns and locate the food inside the right-side section of the red-door chamber. Fishes were sorted from each population stock and kept individually in separate containers for identification. At a time, a test fish was released into the arena and allowed 20 minutes to explore in order to find the food-reward. In this way, individual fishes were trained through the maze to locate the food reward for eight consecutive days. The position of red door, with the plant and the reward, was shuffled every day. Following training, an intermission of four days was given during which the fishes were not subjected to trials. Post-intermission, the fishes were re-tested on the 13th day following the same protocol for their ability to remember the learnt task. Exploratory tendencies and latency of individuals to explore on 1st day of training, performance time across trials, and number of mistakes made each day were recorded. Additionally, mechanism used by individuals to solve the maze each day was analyzed across populations. Fishes could be expected to use algorithm (sequence of turns) or associative cues in locating the food reward. Individuals of populations did not differ significantly in latencies and tendencies to explore. No relationship was found between exploration and learning across populations. High habitat-complexity populations had higher rates of learning & stronger memory while low habitat-complexity populations had lower rates of learning and much reduced abilities to remember. High habitat-complexity populations used associative cues more than algorithm for learning and remembering while low habitat-complexity populations used both equally. The study, therefore, helped understand the role of natural ecology in explaining variations in spatial learning abilities across populations.

Keywords: algorithm, associative cue, habitat complexity, population, spatial learning

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Authors: Vivek Rangarajan, Kim G. Clarke

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Bacillus lipopeptides are biosurfactants with wide ranging applications in the medical, food, agricultural, environmental and cosmetic industries. They are produced as a mix of three families, surfactin, iturin and fengycin, each comprising a large number of homologues of varying functionalities. Consequently, the method and degree of purification of the lipopeptide cocktail becomes particularly important if the functionality of the lipopeptide end-product is to be maximized for the specific application. However, downstream processing of Bacillus lipopeptides is particularly challenging due to the subtle variations observed in the different lipopeptide homologues and isoforms. To date, the most frequently used lipopeptide purification operations have been acid precipitation, solvent extraction, membrane ultrafiltration, adsorption and size exclusion. RP-HPLC (reverse phase high pressure liquid chromatography) also has potential for fractionation of the lipopeptide homologues. In the studies presented here, membrane ultrafiltration and RP-HPLC were evaluated for lipopeptide purification to different degrees of purities for maximum functionality. Batch membrane ultrafiltration using 50 kDa polyether sulphone (PES) membranes resulted in lipopeptide recovery of about 68% for surfactin and 82 % for fengycin. The recovery was further improved to 95% by using size-conditioned lipopeptide micelles. The conditioning of lipopeptides with Ca2+ ions resulted in uniformly sized micelles with average size of 96.4 nm and a polydispersity index of 0.18. The size conditioning also facilitated removal of impurities (molecular weight ranging between 2335-3500 Da) through operation of the system under dia-filtration mode, in a way similar to salt removal from protein by dialysis. The resultant purified lipopeptide was devoid of macromolecular impurities and could ideally suit applications in the cosmetic and food industries. Enhanced purification using RP-HPLC was carried out in an analytical C18 column, with the aim to fractionate lipopeptides into their constituent homologues. The column was eluted with mobile phase comprising acetonitrile and water over an acetonitrile gradient, 35% - 80%, over 70 minutes. The gradient elution program resulted in as many as 41 fractions of individual lipopeptide homologues. The efficacy test of these fractions against fungal phytopathogens showed that first 21 fractions, identified to be homologues of iturins and fengycins, displayed maximum antifungal activities, suitable for biocontrol in the agricultural industry. Thus, in the current study, the downstream processing of lipopeptides leading to tailor-made products for selective applications was demonstrated using two major downstream unit operations.

Keywords: bacillus lipopeptides, membrane ultrafiltration, purification, RP-HPLC

Procedia PDF Downloads 191

Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Mohammad Khatib, Salam Hadid

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Introduction: Developing nurses' cultural competence begins in their basic training and requires them to participate in an array of activities which raise their awareness and stimulate their interest, desire and curiosity about different cultures, by creating opportunities for intercultural meetings promoting the concept of 'culture' and its components, including recognition of cultural diversity and the legitimacy of the other. Importantly, professionals need to acquire specific cultural knowledge and thorough understanding of the values, norms, customs, beliefs and symbols of different cultures. Similarly, they need to be given opportunities to practice the verbal and non-verbal communication skills of other cultures according to their cultural codes. Such a system is being implemented as part of nursing studies at Zefat Academic College in two study frameworks; firstly, a course integrating nursing theory and practice in multicultural nursing; secondly, a course in learning the languages spoken in Israel focusing on medical and nursing terminology. Methods: Students participating in the 'Transcultural Nursing' course come from a variety of backgrounds: Jews, or Arabs, religious, or secular; Muslim, Christian, new immigrants, Ethiopians or from other cultural affiliations. They are required to present and discuss cultural practices that affect health. In addition, as part of the language course, students learn and teach their friends 5 spoken languages (Arabic, Russian, Amharian, Yidish, and Sign language) focusing on therapeutic interaction and communication using the vocabulary and concepts necessary for the therapeutic encounter. An evaluation of the process and the results was done using a structured questionnaire which includes series of questions relating to the contributions of the courses to their cultural knowledge, awareness and skills. 155 students completed the questionnaire. Results: A preliminary assessment of this educational system points an increase in cultural awareness and knowledge among the students as well as in their willingness to recognize the other's difference. A positive atmosphere of multiculturalism is reflected in students' mutual interest and respect was created. Students showed a deep understanding of cultural issues relating to health and care (consanguinity and genetics, food customs; cultural events, reincarnation, traditional treatments etc.). Most of the students were willing to recommend the courses to others and suggest some changes relating learning methods (more simulations, role playing and activities).

Keywords: cultural competence, nursing education, culture, language

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Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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Authors: Claudia Trillo

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Regional innovation eco-ecosystems are composed of a variety of interconnected urban innovation eco-systems, mutually reinforcing each other and making the whole territorial system successful. Combining principles drawn from the new economic growth theory and from the socio-constructivist approach to the economic growth, with the new geography of innovation emerging from the networked nature of innovation districts, this paper explores the spatial configuration of urban innovation districts, with the aim of unveiling replicable spatial patterns and transferable portfolios of urban policies. While some authors suggest that cities should be considered ideal natural clusters, supporting cross-fertilization and innovation thanks to the physical setting they provide to the construction of collective knowledge, still a considerable distance persists between regional development strategies and urban policies. Moreover, while public and private policies supporting entrepreneurship normally consider innovation as the cornerstone of any action aimed at uplifting the competitiveness and economic success of a certain area, a growing body of literature suggests that innovation is non-neutral, hence, it should be constantly assessed against equity and social inclusion. This paper draws from a robust qualitative empirical dataset gathered through 4-years research conducted in Boston to provide readers with an evidence-based set of recommendations drawn from the lessons learned through the investigation of the chosen innovation districts in the Boston area. The evaluative framework used for assessing the overall performance of the chosen case studies stems from the Habitat III Sustainable Development Goals rationale. The concept of inclusive growth has been considered essential to assess the social innovation domain in each of the chosen cases. The key success factors for the development of the Boston innovation ecosystem can be generalized as follows: 1) a quadruple helix model embedded in the physical structure of the two cities (Boston and Cambridge), in which anchor Higher Education (HE) institutions continuously nurture the Entrepreneurial Environment. 2) an entrepreneurial approach emerging from the local governments, eliciting risk-taking and bottom-up civic participation in tackling key issues in the city. 3) a networking structure of some intermediary actors supporting entrepreneurial collaboration, cross-fertilization and co-creation, which collaborate at multiple-scales thus enabling positive spillovers from the stronger to the weaker contexts. 4) awareness of the socio-economic value of the built environment as enabler of cognitive networks allowing activation of the collective intelligence. 5) creation of civic-led spaces enabling grassroot collaboration and cooperation. Evidence shows that there is not a single magic recipe for the successful implementation of place-based and social innovation-driven strategies. On the contrary, the variety of place-grounded combinations of micro and macro initiatives, embedded in the social and spatial fine grain of places and encompassing a diversity of actors, can create the conditions enabling places to thrive and local economic activities to grow in a sustainable way.

Keywords: innovation-driven sustainable Eco-systems , place-based sustainable urban development, sustainable innovation districts, social innovation, urban policie

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Authors: Zhenmin Tao, Jasper De Smet, Koen Laurijssen, Jeroen Stuyts, Sonja Sioncke

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Today, the quality of knowledge management (KM)become one of the underpinning factors in the success of an organization, as it determines the effectiveness of capitalizing the organization’s knowledge. Overall, KMin an organization consists of five aspects: (knowledge) creation, validation, presentation, distribution, and application. Among others, KM in research institutes is considered as the cornerstone as their activities cover all five aspects. Furthermore, KM in a research institute facilitates the steering committee to envision the future roadmap, identify knowledge gaps, and make decisions on future research directions. Likewise, KMis even more challenging in industrial research institutes. From a technical perspective, technology advancement in the past decades calls for combinations of breadth and depth in expertise that poses challenges in talent acquisition and, therefore, knowledge creation. From a regulatory perspective, the strict intellectual property protection from industry collaborators and/or the contractual agreements made by possible funding authoritiesform extra barriers to knowledge validation, presentation, and distribution. From a management perspective, seamless KM activities are only guaranteed by inter-disciplinary talents that combine technical background knowledge, management skills, and leadership, let alone international vision. From a financial perspective, the long feedback period of new knowledge, together with the massive upfront investment costs and low reusability of the fixed assets, lead to low RORC (return on research capital) that jeopardize KM practice. In this study, we aim to address the challenges, practices, and opportunitiesof KM in Flanders Make – a leading European research institute specialized in the manufacturing industry. In particular, the analyses encompass an internal KM project which involves functionalities ranging from management to technical domain experts. This wide range of functionalities provides comprehensive empirical evidence on the challenges and practices w.r.t.the abovementioned KMaspects. Then, we ground our analysis onto the critical dimensions ofKM–individuals, socio‐organizational processes, and technology. The analyses have three steps: First, we lay the foundation and define the environment of this study by briefing the KM roles played by different functionalities in Flanders Make. Second, we zoom in to the CoreLab MotionS where the KM project is located. In this step, given the technical domains covered by MotionS products, the challenges in KM will be addressed w.r.t. the five KM aspects and three critical dimensions. Third, by detailing the objectives, practices, results, and limitations of the MotionSKMproject, we justify the practices and opportunities derived in the execution ofKMw.r.t. the challenges addressed in the second step. The results of this study are twofold: First, a KM framework that consolidates past knowledge is developed. A library based on this framework can, therefore1) overlook past research output, 2) accelerate ongoing research activities, and 3) envision future research projects. Second, the challenges inKM on both individual (actions) level and socio-organizational level (e.g., interactions between individuals)are identified. By doing so, suggestions and guidelines will be provided in KM in the context of industrial research institute. To this end, the results in this study are reflected towards the findings in existing literature.

Keywords: technical knowledge management framework, industrial research institutes, individual knowledge management, socio-organizational knowledge management.

Procedia PDF Downloads 94

Authors: Abdul Wohab

Abstract:

Context: The role of religion in the transformation of Bangladesh society has been significant since 1975. There has been a rise in religious presence, particularly Islam, in both private and public spheres supported by the state apparatuses. In 2009, a 'secular' political party came into power for the second time since independence and initiated the modernization of religious education systems. This research focuses on the transformation observed among the educated middle class who now prefer their children to attend modern, English medium madrasas that offer both religion-based and secular education. Research Aim: This research aims to investigate two main questions: a) what motivates the educated middle class to send their children to madrasa education? b) To what extent can it be argued that Bangladeshi society is transforming from its secular nature to being more religious?Methodology: The research applies a combination of primary and secondary methods. Case studies serve as the primary method, allowing for an in-depth exploration of the motivations of the educated middle class. The secondary method involves analyzing published news articles, op-eds, and websites related to madrasa education, as well as studying the reading syllabus of Aliya and Qwami madrasas in Bangladesh. Findings: Preliminary findings indicate that the educated middle class chooses madrasa education for reasons such as remembering and praying for their departed relatives, keeping their children away from substance abuse, fostering moral and ethical values, and instilling respect for seniors and relatives. The research also reveals that religious education is believed to help children remain morally correct according to the Quran and Hadith. Additionally, the establishment of madrasas in Bangladesh is attributed to economic factors, with demand and supply mechanisms playing a significant role. Furthermore, the findings suggest that government-run primary education institutions in rural areas face more challenges in enrollment compared to religious educational institutions like madrasas. Theoretical Importance: This research contributes to the understanding of societal transformation and the role of religion in this process. By examining the case of Bangladesh, it provides insights into how religion influences education choices and societal values. Data Collection and Analysis Procedures: Data for this research is collected through case studies, including interviews and observations of educated middle-class families who send their children to madrasas. In addition, analysis is conducted on relevant published materials such as news articles, op-eds, and websites. The reading syllabus of Aliya and Qwami madrasas is also analyzed to gain a comprehensive understanding of the education system. Questions Addressed: The research addresses two questions: a) what motivates the educated middle class to choose madrasa education for their children? b) To what extent can it be argued that Bangladeshi society is transforming from its secular nature to being more religious?Conclusion: The preliminary findings of this research highlight the motivations of the educated middle class in opting for madrasa education, including the desire to maintain religious traditions, promote moral values, and provide a strong foundation for their children. It also suggests that Bangladeshi society is experiencing a transformation towards a more religious orientation. This research contributes to the understanding of societal changes and the role of religion within Bangladesh, shedding light on the complex dynamics between religion and education.

Keywords: madrasa education, transformation, Bangladesh, religion and society, education

Procedia PDF Downloads 45

Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

Procedia PDF Downloads 62

Authors: André Python

Abstract:

To this day, terrorism persists as a worldwide threat, exemplified by the recent deadly attacks in January 2015 in Paris and the ongoing massacres perpetrated by ISIS in Iraq and Syria. In response to this threat, states deploy various counterterrorism measures, the cost of which could be reduced through effective preventive measures. In order to increase the efficiency of preventive measures, policy-makers may benefit from accurate predictive models that are able to capture the complex spatial dynamics of terrorism occurring at a local scale. Despite empirical research carried out at country-level that has confirmed theories explaining the diffusion processes of terrorism across space and time, scholars have failed to assess diffusion’s theories on a local scale. Moreover, since scholars have not made the most of recent statistical modelling approaches, they have been unable to build up predictive models accurate in both space and time. In an effort to address these shortcomings, this research suggests a novel approach to systematically assess the theories of terrorism’s diffusion on a local scale and provide a predictive model of the local spatial dynamics of terrorism worldwide. With a focus on the lethal terrorist events that occurred after 9/11, this paper addresses the following question: why and how does lethal terrorism diffuse in space and time? Based on geolocalised data on worldwide terrorist attacks and covariates gathered from 2002 to 2013, a binomial spatio-temporal point process is used to model the probability of terrorist attacks on a sphere (the world), the surface of which is discretised in the form of Delaunay triangles and refined in areas of specific interest. Within a Bayesian framework, the model is fitted through an integrated nested Laplace approximation - a recent fitting approach that computes fast and accurate estimates of posterior marginals. Hence, for each location in the world, the model provides a probability of encountering a lethal terrorist attack and measures of volatility, which inform on the model’s predictability. Diffusion processes are visualised through interactive maps that highlight space-time variations in the probability and volatility of encountering a lethal attack from 2002 to 2013. Based on the previous twelve years of observation, the location and lethality of terrorist events in 2014 are statistically accurately predicted. Throughout the global scope of this research, local diffusion processes such as escalation and relocation are systematically examined: the former process describes an expansion from high concentration areas of lethal terrorist events (hotspots) to neighbouring areas, while the latter is characterised by changes in the location of hotspots. By controlling for the effect of geographical, economical and demographic variables, the results of the model suggest that the diffusion processes of lethal terrorism are jointly driven by contagious and non-contagious factors that operate on a local scale – as predicted by theories of diffusion. Moreover, by providing a quantitative measure of predictability, the model prevents policy-makers from making decisions based on highly uncertain predictions. Ultimately, this research may provide important complementary tools to enhance the efficiency of policies that aim to prevent and combat terrorism.

Keywords: diffusion process, terrorism, spatial dynamics, spatio-temporal modeling

Procedia PDF Downloads 336