Search results for: pulmonary delivery

Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: S. Alfalah, J. Falah, T. Alfalah, M. Elfalah, O. Falah

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The field of education is an ever-evolving area constantly enriched by newly discovered techniques provided by active research in all areas of technologies. The recent years have witnessed the introduction of a number of promising technologies and applications to enhance the teaching and learning experience. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing education in many fields. VR creates an artificial environment, using computer hardware and software, which is similar to the real world. This simulation provides a solution to improve the delivery of materials, which facilitates the teaching process by providing a useful aid to instructors, and enhances the learning experience by providing a beneficial learning aid. In order to assure future utilization of such systems, students’ perceptions were examined toward utilizing VR as an educational tool in the Faculty of Information Technology (IT) in The University of Jordan. A questionnaire was administered to IT undergraduates investigating students’ opinions about the potential opportunities that VR technology could offer and its implications as learning and teaching aid. The results confirmed the end users’ willingness to adopt VR systems as a learning aid. The result of this research forms a solid base for investing in a VR system for IT education.

Keywords: information, technology, virtual reality, education

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Authors: Garba Iliyasu, Lamaran Dattijo

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Introduction: Ebola virus disease (EVD) is a disease of humans and other primates caused by Ebola viruses. The most widespread epidemic of EVD in history occurred recently in several West African countries. The burden and outcome of EVD in pregnant women remains uncertain. There are very few studies to date reporting on maternal and fetal outcomes among pregnant women with EVD, hence the justification for this comprehensive review of these published studies. Methods: Published studies in English that reported on maternal and or fetal outcome among pregnant women with EVD up to May 2016 were searched in electronic databases (Google Scholar, Medline, Embase, PubMed, AJOL, and Scopus). Studies that did not satisfy the inclusion criteria were excluded. We extracted the following variables from each study: geographical location, year of the study, settings of the study, participants, maternal and fetal outcome.Result: There were 12 studies that reported on 108 pregnant women and 110 fetal outcomes. Six of the studies were case reports, 3 retrospective studies, 2 cross-sectional studies and 1 was a technical report. There were 91(84.3%) deaths out of the 108 pregnant women, while only 1(0.9%) fetal survival was reported out of 110. Survival rate among the 15 patients that had spontaneous abortion/stillbirth or induced delivery was 100%. Conclusion: There was a poor maternal and fetal outcome among pregnant women with EVD, and fetal evacuation significantly improves maternal survival.

Keywords: Africa, ebola, maternofetal, outcome

Procedia PDF Downloads 264

Authors: Mihai Liviu Despa

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The paper tackles the topic of determining the cost of innovation in software development projects. Innovation can be achieved either in a planned or unplanned manner. The paper approaches the scenarios were innovation is planned for. As a starting point an innovative software development project is analyzed. The project is depicted step by step as it was implemented, from inception to delivery. Costs that are proprietary to innovation in software development are isolated based on the author’s personal experience in managing the above mentioned project. Innovation costs components identified by the author are then validated using open discussions with software development professionals and projects managers on LinkedIn groups. In order to receive relevant feedback only groups that focus on software development and innovation management are targeted. Additional innovation cost components suggested by software development professionals and projects managers are also considered. Based on the identified cost components an indicator is built. The indicator is meant to formalize the process of determining the cost of innovation in a software development project. The indicator aggregates all the innovation cost components that are identified in the research process. The process of calculating each cost component is also described. Conclusions are formulated and new related research topics are submitted for debate.

Keywords: innovation cost, IT project management, software development, innovation management

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Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

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Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

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Authors: Mohd Mudasir Shafi, Zafrul Hasan, Talat Saleem

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Information and communication Technology (ICT) services have been defined as a route to good governance. Introduction of ICT into Governance has given rise to the idea of e-governance which helps in enhancing transparency, generating accountability and responsiveness in the system in order to provide faster and quality service to the citizen. Advancement in ICT has provided governments all over the world to speed up the delivery of information and services to citizens and businesses and increase their participation in governance. There has been varying degree of success over the past decade into providing services to the citizens using internet and different web services. These e-government initiatives have been extensively researched. Our research is aimed at the transition from electronic government to mobile government (m-government) initiatives implementing the mobile services and concerned to understand the major factors which will aid to adoption and distribution of these services. There must be some amount of research done in the integration process between e-government and m-government. There must also be enough amount of investigation done all the factors that could affect the transition process. Such factors differ between different places and the advancement in information and technology available there. In this paper, we have discussed why mobile communication system can be used for effective e-governance and the areas where m-governance can be implemented. The paper will examine some of the reasons as well as the main opportunities for improving effective governance through mobile phones.

Keywords: e-governance, mobile phones, information technology, m-government

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Authors: M. Aladwani, Y. Alarfaj

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The construction industry is currently experiencing a shift towards digitisation. This transformation is driven by adopting technologies like Building Information Modelling (BIM), drones, and augmented reality (AR). These advancements are revolutionizing the process of designing, constructing, and operating projects. BIM, for instance, is a new way of communicating and exploiting technology such as software and machinery. It enables the creation of a replica or virtual model of buildings or infrastructure projects. It facilitates simulating construction procedures, identifying issues beforehand, and optimizing designs accordingly. Drones are another tool in this revolution, as they can be utilized for site surveys, inspections, and even deliveries. Moreover, AR technology provides real-time information to workers involved in the project. Implementing these technologies in the construction industry has brought about improvements in efficiency, safety measures, and sustainable practices. BIM helps minimize rework and waste materials, while drones contribute to safety by reducing workers' exposure to areas. Additionally, AR plays a role in worker safety by delivering instructions and guidance during operations. Although the digital transformation within the construction industry is still in its early stages, it holds the potential to reshape project delivery methods entirely. By embracing these technologies, construction companies can boost their profitability while simultaneously reducing their environmental impact and ensuring safer practices.

Keywords: BIM, digital construction, construction technologies, digital transformation

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Authors: Sushil Kumar Singh, Kumar Rahul, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: Rheumatic mitral stenosis continues to be a major public health problem in developing countries. When the left atrium (LA) is unable to fill the left ventricle (LV) at normal LA pressures due to impaired relaxation and impaired compliance, diastolic dysfunction occurs. The assessment of left ventricular (LV) diastolic function and filling pressures is of clinical importance to identify underlying cardiac disease, its treatment, and to assess prognosis. 2D echocardiography can detect diastolic dysfunction with excellent sensitivity and minimal risk when compared to the gold standard of invasive pressure-volume measurements. Material and Method: This was a one-year study consisting of twenty-nine patients of isolated rheumatic severe mitral stenosis. Data was analyzed preoperative and post operative (at one month follow-up). Transthoracic 2D echocardiographic parameters of the diastolic function are transmitral flow, pulmonary venous flow, mitral annular tissue doppler, and color M-mode doppler. In our study, mitral valve orifice area, ejection fraction, deceleration time, E/A-wave, E/E’-wave, myocardial performance index of left ventricle (Tei index ), and Mitral inflow propagation velocity were included for echocardiographic evaluation. The statistical analysis was performed on SPSS Version 15.0 statistical analysis software. Result: Twenty-nine patients underwent successful closed mitral commissurotomy for isolated mitral stenosis. The outcome measures were observed pre-operatively and at one-month follow-up. The majority of patients were in NYHA grade III (69.0%) in the preoperative period, which improved to NYHA grade I (48.3%) after closed mitral commissurotomy. Post-surgery mitral valve area increased from 0.77 ± 0.13 to 2.32 ± 0.26 cm, ejection fraction increased from 61.38 ± 4.61 to 64.79 ± 3.22. There was a decrease in deceleration time from 231.55 ± 49.31 to 168.28 ± 14.30 ms, E/A ratio from 1.70 ± 0.54 from 0.89 ± 0.39, E/E’ ratio from 14.59 ± 3.34 to 8.86 ± 3.03. In addition, there was improvement in TIE index from 0.50 ± 0.03 to 0.39 ± 0.06 and mitral inflow propagation velocity from 47.28 ± 3.71 to 57.86 ± 3.19 cm/sec. In peri-operative and follow-up, there was no incidence of severe mitral regurgitation (MR). There was no thromboembolic incident and no mortality.

Keywords: closed mitral valvotomy, mitral stenosis, open mitral commissurotomy, balloon mitral valvotomy

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Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Moses Banda Aron, Julia Higgins, Manuel Mulwafu, Kondwani Mpinga, Mwayi Chunga, Grace Momba, Enock Ndarama, Dickson Sumphi, Atupere Phiri, Fabien Munyaneza

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Background: Data is key to supporting health service delivery as stakeholders, including NGOs rely on it for effective service delivery, decision-making, and system strengthening. Several studies generated debate on data quality from national health management information systems (HMIS) in sub-Saharan Africa. This limits the utilization of data in resource-limited settings, which already struggle to meet standards set by the World Health Organization (WHO). We aimed to evaluate data quality improvement of Neno district HMIS over a 4-year period (2018 – 2021) following quarterly data reviews introduced in January 2020 by the district health management team and Partners In Health. Methods: Exploratory Mixed Research was used to examine report rates, followed by in-depth interviews using Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). We used the WHO module desk review to assess the quality of HMIS data in the Neno district captured from 2018 to 2021. The metrics assessed included the completeness and timeliness of 34 reports. Completeness was measured as a percentage of non-missing reports. Timeliness was measured as the span between data inputs and expected outputs meeting needs. We computed T-Test and recorded P-values, summaries, and percentage changes using R and Excel 2016. We analyzed demographics for key informant interviews in Power BI. We developed themes from 7 FGDs and 11 KIIs using Dedoose software, from which we picked perceptions of healthcare workers, interventions implemented, and improvement suggestions. The study was reviewed and approved by Malawi National Health Science Research Committee (IRB: 22/02/2866). Results: Overall, the average reporting completeness rate was 83.4% (before) and 98.1% (after), while timeliness was 68.1% and 76.4 respectively. Completeness of reports increased over time: 2018, 78.8%; 2019, 88%; 2020, 96.3% and 2021, 99.9% (p< 0.004). The trend for timeliness has been declining except in 2021, where it improved: 2018, 68.4%; 2019, 68.3%; 2020, 67.1% and 2021, 81% (p< 0.279). Comparing 2021 reporting rates to the mean of three preceding years, both completeness increased from 88% to 99% (in 2021), while timeliness increased from 68% to 81%. Sixty-five percent of reports have maintained meeting a national standard of 90%+ in completeness while only 24% in timeliness. Thirty-two percent of reports met the national standard. Only 9% improved on both completeness and timeliness, and these are; cervical cancer, nutrition care support and treatment, and youth-friendly health services reports. 50% of reports did not improve to standard in timeliness, and only one did not in completeness. On the other hand, factors associated with improvement included improved communications and reminders using internal communication, data quality assessments, checks, and reviews. Decentralizing data entry at the facility level was suggested to improve timeliness. Conclusion: Findings suggest that data quality in HMIS for the district has improved following collaborative efforts. We recommend maintaining such initiatives to identify remaining quality gaps and that results be shared publicly to support increased use of data. These results can inform Ministry of Health and its partners on some interventions and advise initiatives for improving its quality.

Keywords: data quality, data utilization, HMIS, collaboration, completeness, timeliness, decision-making

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Authors: Zeineb Deymi-Gheriani

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In the last two decades, one can clearly observe a boom of interest for e-learning and web-supported programs. However, one can also notice that many of these programs focus on the accumulation and delivery of content generally as a business industry with no much concern for theoretical underpinnings. The existing research, at least in online English language teaching (ELT), has demonstrated a lack of an effective online teaching pedagogy anchored in a well-defined theoretical framework. Hence, this paper comes as an attempt to present constructivism as one of the theoretical bases for the design of an effective online language teaching pedagogy which is at the same time technologically intelligent and theoretically informed to help envision how education can best take advantage of the information and communication technology (ICT) tools. The present paper discusses the key principles underlying constructivism, its implications for online language teaching design, as well as its limitations that should be avoided in the e-learning instructional design. Although the paper is theoretical in nature, essentially based on an extensive literature survey on constructivism, it does have practical illustrations from an action research conducted by the author both as an e-tutor of English using Moodle online educational platform at the Virtual University of Tunis (VUT) from 2007 up to 2010 and as a face-to-face (F2F) English teaching practitioner in the Professional Certificate of English Language Teaching Training (PCELT) at AMIDEAST, Tunisia (April-May, 2013).

Keywords: active learning, constructivism, experiential learning, Piaget, Vygotsky

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Authors: Feng Ju Chuang, Yu Wen Wang, Tai Jung Hsieh, Shyh Ming Kuo

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Polylactic acid is a synthetic polymer with good biocompatibility and degradability, is widely used in clinical applications. In this study, we utilized Polylactic acid particles as stimulants for macrophages and the collagen synthesis of co-cultured fibroblasts was evaluated. The results indicated that Polylactic acid particles were nontoxic to cells from 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. No obvious inflammation effect was observed (under the PLLA concentration of 1 mg/mL) after 24-h co-culture of Raw264.7 and NIH3T3 cells (from TNF-α assay). The addition of PLLA particles to the Raw264.7 and NIH3T3 co-cultures increased the synthesis of collagen, the highest collagen synthesis from the fibroblast was the 0.2 mg/mL (approximately 60% increased as compared with without addition Polylactic acid particles). Moreover, a co-axial atomization delivery device was used to percutaneously introduce Polylactic acid particles into the dermis layer and stimulating macrophages to secrete growth factors promoting fibroblasts to produce collagen. The preliminary results demonstrated the synthesis of collagen was increased mildly after the introduction of Polylactic acid particles for 28-d post implantation. The Polylactic acid particles could be successfully introduced into the dermis layer from H&E staining examination, however, the optimum concentration of Polylactic acid particles and the time-period for collagen synthesis still need to be evaluated.

Keywords: collagen synthesis, macrophage, NIH3T3 cells, polylactic acid particles

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Authors: Rasheed A. Saliu, Sunday E. Ogundipe, Oluwaseun A. Adefila

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Information and Communication Technology (ICT) in recent time has transformed the means by which we inform ourselves, with world events and areas of personal interests, and further our learning. Today, for many, books and journals are no longer the first or primary source of information or learning. We now regularly rely on images, video, animations and sound to acquire information and to learn. Increased and improved access to the internet has accelerated this phenomenon. We now acquire and access information in ways fundamentally different from the pre-ICT era. But to what extent is academic staff in colleges of education, having access to and the utilising of ICT devices in their lecture deliveries especially in School of Science and Vocational and Technical? The main focus of this paper is to proffer solution to this salient question. It is essentially an empirical study carried out in five colleges of education in south-west zone of Nigeria. The target population was the academic staff in the selected institution. A total number of 150 male and female lecturers were contacted for the study. The main instrument was questionnaire. The finding reveals that male lecturers are much more ICT inclined than women folk in the academics. Some recommendations were made to endear academics to utilizing ICT at their disposal to foster qualitative delivery in this digital era.

Keywords: education, gender, ICT, Nigeria

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Authors: Gert Van Schalkwyk, Chris Cloete

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South Africa is experiencing a massive housing backlog in urban low-cost housing. A backlog in the transfer of low-cost housing units is exacerbated by various impediments and delays that exist in the current legal framework. Structured interviews were conducted with forty-five practicing conveyancers and fifteen deeds office examiners at the Deeds Office in Pretoria, South Africa. One of the largest, the Deeds Office in Pretoria implements a uniform registration process and can be regarded as representative of other deeds offices in South Africa. It was established that a low percentage of low-cost properties are freely transferable. The main economic impediments are the absence of financing and the affordability or payment of rates and taxes to local government. Encroachment of buildings on neighboring stands caused by the enlargement of existing small units on small stands also causes long-term unresolved legal disputes. In addition, as the transfer of properties is dependent on the proper functioning of administrative functions of various government departments, the adverse service delivery of government departments hampers transfer. Addressing the identified problems will contribute to a more sustainable process for the transfer of low-cost housing units in South Africa.

Keywords: conveyancing, low-cost housing, South Africa, tenure, titling, transfer

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Authors: Seyyed Masoud Seyyedoshohadaei, Borhanuddin Mohd Ali

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To support group mobility, the NEMO Basic Support Protocol has been standardized as an extension of Mobile IP that enables an entire network to change its point of attachment to the Internet. Using NEMO in IEEE 802.16e (WiMax) networks causes latency in handover procedure and affects seamless communication of real-time applications. To decrease handover latency and service disruption time, an integrated scheme named Optimized Fast NEMO (OFNEMO) was introduced by authors of this paper. In OFNEMO a pre-establish multi tunnels concept, cross function optimization and cross layer design are used. In this paper, an analytical model is developed to evaluate total cost consisting of signaling and packet delivery costs of the OFNEMO compared with RFC3963. Results show that OFNEMO increases probability of predictive mode compared with RFC3963 due to smaller handover latency. Even though OFNEMO needs extra signalling to pre-establish multi tunnel, it has less total cost thanks to its optimized algorithm. OFNEMO can minimize handover latency for supporting real time application in moving networks.

Keywords: fast mobile IPv6, handover latency, IEEE802.16e, network mobility

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Authors: Azizeh Chalak, Firouzeh Baktash

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Reticence is a prominent and complex phenomenon which occurs in foreign language classrooms and influences students’ oral passivity. The present study investigated the extent in which students experience reticence in the EFL classrooms and explored the underlying factors triggering reticence. The participants were 104 Iranian freshmen undergraduate male and female EFL students, who enrolled in listening and speaking courses, all majoring in English studying at Islamic Azad University Isfahan (Khorasgan) Branch and University of Isfahan, Isfahan, Iran. To collect the data, the Reticence Scale-12 (RS-12) questionnaire which measures the level of reticence consisting of six dimensions (anxiety, knowledge, timing, organization, skills, and memory) was administered to the participants. The statistical analyses showed that the reticent level was high among the Iranian EFL undergraduate students, and their major problems were feelings of anxiety and delivery skills. Moreover, the results revealed that factors such as low English proficiency, the teaching method, and lack of confidence contributed to the students’ reticence in Iranian EFL classrooms. It can be implied that language teachers’ awareness of learners’ reticence can help them choose more appropriate activities and provide a friendly environment enhancing hopefully more effective participation of EFL learners. The findings can have implications for EFL teachers, learners and policy makers.

Keywords: anxiety, Iranian EFL learners, reticence, reticence scale-12

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Authors: Olaiya Folorunsho, Comfort Y. Daramola, Joel N. Ugwu, Lawrence B. Adewole, Olufisayo S. Ekundayo

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In today world, there is a tremendous rise in the usage of internet due to the fact that almost all the communication and information sharing is done over the web. Conversely, there is a continuous growth of unauthorized access to confidential data. This has posed a challenge to information security expertise whose major goal is to curtail the menace. One of the approaches to secure the safety delivery of data/information to the rightful destination without any modification is steganography. Steganography is the art of hiding information inside an embedded information. This research paper aimed at designing a secured algorithm with the use of image steganographic technique that makes use of Least Significant Bit (LSB) algorithm for embedding the data into the bit map image (bmp) in order to enhance security and reliability. In the LSB approach, the basic idea is to replace the LSB of the pixels of the cover image with the Bits of the messages to be hidden without destroying the property of the cover image significantly. The system was implemented using C# programming language of Microsoft.NET framework. The performance evaluation of the proposed system was experimented by conducting a benchmarking test for analyzing the parameters like Mean Squared Error (MSE) and Peak Signal to Noise Ratio (PSNR). The result showed that image steganography performed considerably in securing data hiding and information transmission over the networks.

Keywords: steganography, image steganography, least significant bits, bit map image

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Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel

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Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.

Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension

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Authors: Sena Su, Burak Ozbek, Yesim M. Sahin, Sevil Yucel, Dilek Kazan, Faik N. Oktar, Nazmi Ekren, Oguzhan Gunduz

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In recent years, protein, lipid or polysaccharide-based polymers have been used in order to develop biodegradable materials and their chemical nature determines the physical properties of the resulting films. Among these polymers, proteins from different sources have been extensively employed because of their relative abundance, film forming ability, and nutritional qualities. In this study, the biodegradable composite nanofiber films based on fish sarcoplasmic protein (FSP) were prepared via electrospinning technique. Biodegradable polycaprolactone (PCL) was blended with the FSP to obtain hybrid FSP/PCL nanofiber mats with desirable physical properties. Mixture solutions of FSP and PCL were produced at different concentrations and their density, viscosity, electrical conductivity and surface tension were measured. Mechanical properties of electrospun nanofibers were evaluated. Morphology of composite nanofibers was observed using scanning electron microscopy (SEM). Moreover, Fourier transform infrared spectrometer (FTIR) studies were used for analysis chemical composition of composite nanofibers. This study revealed that the FSP based nanofibers have the potential to be used for different applications such as biodegradable packaging, drug delivery, and wound dressing, etc.

Keywords: edible film, electrospinning, fish sarcoplasmic protein, nanofiber

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Authors: Canan Mesutoglu, Evrim Baran

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Teachers have a prominent role in facilitating the place of engineering in K-12 classrooms. This study addresses the need to understand how teacher professional development programs focusing on K-12 engineering education can be designed and delivered more effectively. A systematic review of the literature on such programs can offer possible ideas and recommendations. The purpose of this study is to systematically synthesize the peer-reviewed articles published on K-12 engineering education teacher professional development programs. The methodology that guided the study was comprised of four phases: search, selection, coding, and synthesis. The search phase included articles published in the time period between 2000 and 2016. With a comprehensive search in databases, inclusion criteria were applied. This was followed by evaluation of the quality of articles with a checklist, and finally analysis of the results. The results revealed two categories of themes. These were 1) five themes related to the overarching agenda of the PD programs, and 2) five themes related to the instructional techniques of the PD programs. Finally, core elements were generated to guide the design and delivery of teacher PD programs for K-12 engineering education. The results aimed to provide a conceptual basis for future research and practice on teacher PD programs for K-12 engineering education.

Keywords: core elements, K-12 engineering education, systematic literature review, teacher professional development programs

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Authors: Malarvizhi Selvaraj, Paul Fergus, Andy Shaw

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Uterine contractions produced during labour have the potential to damage the foetus by diminishing the maternal blood flow to the placenta. In order to observe this phenomenon labour and delivery are routinely monitored using cardiotocography monitors. An obstetrician usually makes the diagnosis of foetus hypoxia by interpreting cardiotocography recordings. However, cardiotocography capture and interpretation is time-consuming and subjective, often lead to misclassification that causes damage to the foetus and unnecessary caesarean section. Both of these have a high impact on the foetus and the cost to the national healthcare services. Automatic detection of foetal heart rate may be an objective solution to help to reduce unnecessary medical interventions, as reported in several studies. This paper aim is to provide a system for better identification and interpretation of abnormalities of the fetal heart rate using RStudio. An open dataset of 552 Intrapartum recordings has been filtered with 0.034 Hz filters in an attempt to remove noise while keeping as much of the discriminative data as possible. Features were chosen following an extensive literature review, which concluded with FIGO features such as acceleration, deceleration, mean, variance and standard derivation. The five features were extracted from 552 recordings. Using these features, recordings will be classified either normal or abnormal. If the recording is abnormal, it has got more chances of hypoxia.

Keywords: cardiotocography, foetus, intrapartum, hypoxia

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Authors: Swapneel U. Naphade, Dushyant A. Patil, Satyabodh M. Kulkarni

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In this work, we propose the concept and geometrical design of a soil moisture control system (SMCS) module by following the product development approach to develop an inexpensive, easy to use and quick to install product targeted towards agriculture practitioners. The module delivers water to the agricultural land efficiently by sensing the soil moisture and activating the delivery valve. We start with identifying the general needs of the potential customer. Then, based on customer needs we establish product specifications and identify important measuring quantities to evaluate our product. Keeping in mind the specifications, we develop various conceptual solutions of the product and select the best solution through concept screening and selection matrices. Then, we develop the product architecture by integrating the systems into the final product. In the end, the geometric design is done using human factors engineering concepts like heuristic analysis, task analysis, and human error reduction analysis. The result of human factors analysis reveals the remedies which should be applied while designing the geometry and software components of the product. We find that to design the best grip in terms of comfort and applied force, for a power-type grip, a grip-diameter of 35 mm is the most ideal.

Keywords: agriculture, human factors, product design, soil moisture control

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Authors: J. H. Bang, H. J. Baek, K. I. Kim, B. J. Lee, H. J. Jung, H. J. Jang, S. K. Jung

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Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness (AHR), airway obstruction and airway wall remodeling responsible for significant morbidity and mortality worldwide. Genetic and environment factors may result in asthma, but there are no the exact causes of asthma. Chungpye-tang (CPT) has been prescribed as a representative aerosol agent for patients with dyspnea, cough and phlegm in the respiratory clinic at Kyung Hee Korean Medicine Hospital. This Korean herbal medicines have the effect of dispelling external pathogen and dampness pattern. CPT is composed of 4 species of herbal medicines. The 4 species of herbal medicines are Ephedrae herba, Pogostemonis(Agatachis) herba, Caryophylli flos and Zingiberis rhizoma crudus. CPT suppresses neutrophil infiltration and the production of pro-inflammatory cytokines in lipopolysaccharide (LPS)-induced acute lung injury (ALI) mouse model. Moreover, the anti-inflammatory effects of CPT on a mouse model of Chronic Obstructive Pulmonary Disease (COPD) was proved. Activation of the NF-κB has been proven that it plays an important role in inflammation via inducing transcription of pro-inflammatory genes. Over-expression of NF-κB has been believed be related to many inflammatory diseases such as arthritis, gastritis, asthma and COPD. So we firstly hypothesize whether CPT has an anti-inflammatory effect on asthmatic human airway epithelial tissue via inhibiting NF-κB pathway. In this study, CPT was extracted with distilled water for 3 hours at 100°C. After process of filtration and evaporation, it was freeze dried. And asthmatic human lung tissues were provided by MatTek Corp. We investigated the precise mechanism of the anti-inflammatory effect of CPT by western blotting analysis. We observed whether the decoction extracts could reduce NF-κB activation, COX-2 protein expression and NF-κB-mediated pro-inflammatory cytokines such as TNF-α, eotaxin, IL-4, IL-9 and IL-13 in asthmatic human lung tissue. As results of this study, there was a trend toward decreased NF-κB expression in asthmatic human airway epithelial tissue. We found that the inhibition effects of CPT on COX-2 expression was not determined. IL-9 and IL-13 secretion was significantly reduced in the asthmatic human lung tissue treated with CPT. Overall, our results indicate that CPT has an anti-inflammatory effect through blocking the signaling pathway of NF-κB, thereby CPT may be a potential remedial agent for allergic asthma.

Keywords: Chungpye-tang, allergic asthma, asthmatic human airway epithelial tissue, nuclear factor kappa B (NF-κB) pathway, COX-2

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Authors: Chaoren Lu

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Public policy is playing as one driving force that influencing service innovation implementation in public sector. However, public policy implications cannot be automatically derived from the analyses of innovation issues, and there lacks of researches about the influences of public policy onto innovation. Moreover, innovation in service system is hard to predictable and whether policy encourages or hidden innovation is still lack of study. Especially, by given the context that multiple actors are active involving within the service delivery process in public transport sector, the complex driving forces and challenges are emerged towards the service operation. This study is aim to analysis the service innovation practices within service operating organizations to understand the drivers and challenges of service operation based on policy requirements, and where the innovation idea generating from. The case studies of Changzhou Transit Group and Nanjing Jiangnan Public Transit Group will be launched. This paper reveals the ambidexterity between top-down and bottom-up demands within the public transport service operating organizations contribute to the innovation ideas. Meanwhile, it contributes to the understanding of fundamental elements of service innovation is the new relationship creation and new way of sharing knowledge. The policy contributes to the trigger of creation of such relationship. The research question is: what are the sources of service innovation practices in local public transport system in China in in facing the policy implementation?

Keywords: public value, service innovation, public transport service, China

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: Joachim Monkelbaan, Marcia Hale

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Now that global frameworks for sustainability governance (e.g. the Sustainable Development Goals, Paris Climate Agreement and Sendai Framework for Disaster Risk Reduction) are in place, the question is how these aspirations that represent major transitions can be put into practice. Water ‘infrasystems’ can play an especially significant role in strengthening regional sustainability. Infrasystems include both hard and soft infrastructure, such as pipes and technology for delivering water, as well as the institutions and governance models that direct its delivery. As such, an integrated infrasystems view is crucial for Integrative Water Management (IWM). Due to frequently contested ownership of and responsibility for water resources, these infrasystems can also play an important role in facilitating conflict and catalysing community empowerment, especially through participatory approaches to governance. In this paper, we analyze the water infrasystem of the Los Angeles region through the lens of global frameworks for sustainability governance. By complementing a solid overview of governance theories with empirical data from interviews with water actors in the LA metropolitan region (including NGOs, water managers, scientists and elected officials), this paper elucidates ways for this infrasystem to be better aligned with global sustainability frameworks. In addition, it opens up the opportunity to scrutinize the appropriateness of global frameworks when it comes to fostering sustainability action at the local level.

Keywords: governance, transitions, global frameworks, infrasystems

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Authors: Esra Cansever Mutlu, Muge Sennaroglu Bostan, Fatemeh Bahadori, Ebru Toksoy Oner, Mehmet S. Eroglu

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Paclitaxel is used in treatment of different cancer types mainly breast, ovarian, lung and Kaposi’s sarcoma. It is poorly soluble in water; therefore, currently used formulations tremendously show side-effects and high toxicity. Encapsulation of the drug in a nano drug carrier which causes both reducing side effects and increasing drug activity is a desired new approach for the nano-medicine to target the site of cancer. In this study, synthesis of a novel nano paclitaxel formulation made of a new amphiphilic monomer was followed by the investigation of its pharmacological properties. UV radical polymerization was carried out by using the monomer Lecithin-2-Acrylamido-2-methylpropane (L-AMPS) and the drug-spacer, to obtain sterically high stabilized, biocompatible and biodegradable phospholipid nanoparticles, in which the drug paclitaxel (Pxl) was encapsulated (NanoPxl). Particles showed high drug loading capacity (68%) and also hydrodynamic size less than 200 nm with slight negative surface charge. The drug release profile was obtained and in vitro cytotoxicity test was performed on MCF-7 cell line. Consequently, these data indicated that paclitaxel loaded Lecithin-AMPS/PCL-MAC nanoparticles can be considered as a new, safe and effective nanocarrier for the treatment of breast cancer.

Keywords: paclitaxel, nanoparticle, drug delivery, L-AMPS

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Authors: H. R. Kelidari, M. Saeedi, J. Akbari, K. Morteza-Semnani, H. Valizadeh

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Spironolactoe (SP) a synthetic steroid diuretic is a poorly water-soluble drug with a low and variable oral bioavailability. Regarding to the good solubility of SP in lipid materials, SP loaded Solid lipid nanoparticles (SP-SLNs) and nanostructured lipid carrier (SP-SLNs) were thus prepared in this work for accelerating dissolution of this drug. The SP loaded NLC with stearic acid (SA) as solid lipid and different Oleic Acid (OA) as liquid lipid content and SLN without OA were prepared by probe ultrasonication method. With increasing the percentage of OA from 0 to 30 wt% in SLN/NLC, the average size and zeta potential of nanoparticles felled down and entrapment efficiency (EE %) rose dramatically. The obtained micrograph particles showed pronounced spherical shape. Differential Scanning Calorimeter (DSC) measurements indicated that the presence of OA reduced the melting temperature and melting enthalpy of solid lipid in NLC structure. The results reflected good long-term stability of the nanoparticles and the measurements show that the particle size remains lower in NLC compare to SLN formulations, 6 months after production. Dissolution of SP-SLN and SP-NLC was about 5.1 and 7.2 times faster than raw drugs in 120 min respectively. These results indicated that the SP loaded NLC containing 70:30 solid lipid to liquid lipid ratio is a suitable carrier of SP with improved drug EE and steady drug release properties.

Keywords: drug release, lipid nanoparticles, spironolactone, stability

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Authors: Tareq Issa

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Lean manufacturing is concerned with the implementation of several tools and methodologies that aim for the continuous elimination of wastes throughout manufacturing process flow in the production system. This research addresses the implementation of lean principles and tools in a small-medium industry focusing on 'fused' plastic bags production company in Amman, Jordan. In this production operation, the major type of waste to eliminate include material, waiting-transportation, and setup wastes. The primary goal is to identify and implement selected lean strategies to eliminate waste in the manufacturing process flow. A systematic approach was used for the implementation of lean principles and techniques, through the application of Value Stream Mapping analysis. The current state value stream map was constructed to improve the plastic bags manufacturing process through identifying opportunities to eliminate waste and its sources. Also, the future-state value stream map was developed describing improvements in the overall manufacturing process resulting from eliminating wastes. The implementation of VSM, 5S, Kanban, Kaizen, and Reduced lot size methods have provided significant benefits and results. Productivity has increased to 95.4%, delivery schedule attained at 99-100%, reduction in total inventory to 1.4 days and the setup time for the melting process was reduced to about 30 minutes.

Keywords: lean implementation, plastic bags industry, value stream map, process flow

Procedia PDF Downloads 175