Search results for: hospital information system
Commenced in January 2007
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Edition: International
Paper Count: 26454

Search results for: hospital information system

13374 New Coating Materials Based on Mixtures of Shellac and Pectin for Pharmaceutical Products

Authors: M. Kumpugdee-Vollrath, M. Tabatabaeifar, M. Helmis

Abstract:

Shellac is a natural polyester resin secreted by insects. Pectins are natural, non-toxic and water-soluble polysaccharides extracted from the peels of citrus fruits or the leftovers of apples. Both polymers are allowed for the use in the pharmaceutical industry and as a food additive. SSB Aquagold® is the aqueous solution of shellac and can be used for a coating process as an enteric or controlled drug release polymer. In this study, tablets containing 10 mg methylene blue as a model drug were prepared with a rotary press. Those tablets were coated with mixtures of shellac and one of the pectin different types (i.e. CU 201, CU 501, CU 701 and CU 020) mostly in a 2:1 ratio or with pure shellac in a small scale fluidized bed apparatus. A stable, simple and reproducible three-stage coating process was successfully developed. The drug contents of the coated tablets were determined using UV-VIS spectrophotometer. The characterization of the surface and the film thickness were performed with the scanning electron microscopy (SEM) and the light microscopy. Release studies were performed in a dissolution apparatus with a basket. Most of the formulations were enteric coated. The dissolution profiles showed a delayed or sustained release with a lagtime of at least 4 h. Dissolution profiles of coated tablets with pure shellac had a very long lagtime ranging from 13 to 17.5 h and the slopes were quite high. The duration of the lagtime and the slope of the dissolution profiles could be adjusted by adding the proper type of pectin to the shellac formulation and by variation of the coating amount. In order to apply a coating formulation as a colon delivery system, the prepared film should be resistant against gastric fluid for at least 2 h and against intestinal fluid for 4-6 h. The required delay time was gained with most of the shellac-pectin polymer mixtures. The release profiles were fitted with the modified model of the Korsmeyer-Peppas equation and the Hixson-Crowell model. A correlation coefficient (R²) > 0.99 was obtained by Korsmeyer-Peppas equation.

Keywords: shellac, pectin, coating, fluidized bed, release, colon delivery system, kinetic, SEM, methylene blue

Procedia PDF Downloads 397
13373 Software Architectural Design Ontology

Authors: Muhammad Irfan Marwat, Sadaqat Jan, Syed Zafar Ali Shah

Abstract:

Software architecture plays a key role in software development but absence of formal description of software architecture causes different impede in software development. To cope with these difficulties, ontology has been used as artifact. This paper proposes ontology for software architectural design based on IEEE model for architecture description and Kruchten 4+1 model for viewpoints classification. For categorization of style and views, ISO/IEC 42010 has been used. Corpus method has been used to evaluate ontology. The main aim of the proposed ontology is to classify and locate software architectural design information.

Keywords: semantic-based software architecture, software architecture, ontology, software engineering

Procedia PDF Downloads 527
13372 A POX Controller Module to Collect Web Traffic Statistics in SDN Environment

Authors: Wisam H. Muragaa, Kamaruzzaman Seman, Mohd Fadzli Marhusin

Abstract:

Software Defined Networking (SDN) is a new norm of networks. It is designed to facilitate the way of managing, measuring, debugging and controlling the network dynamically, and to make it suitable for the modern applications. Generally, measurement methods can be divided into two categories: Active and passive methods. Active measurement method is employed to inject test packets into the network in order to monitor their behaviour (ping tool as an example). Meanwhile the passive measurement method is used to monitor the traffic for the purpose of deriving measurement values. The measurement methods, both active and passive, are useful for the collection of traffic statistics, and monitoring of the network traffic. Although there has been a work focusing on measuring traffic statistics in SDN environment, it was only meant for measuring packets and bytes rates for non-web traffic. In this study, a feasible method will be designed to measure the number of packets and bytes in a certain time, and facilitate obtaining statistics for both web traffic and non-web traffic. Web traffic refers to HTTP requests that use application layer; while non-web traffic refers to ICMP and TCP requests. Thus, this work is going to be more comprehensive than previous works. With a developed module on POX OpenFlow controller, information will be collected from each active flow in the OpenFlow switch, and presented on Command Line Interface (CLI) and wireshark interface. Obviously, statistics that will be displayed on CLI and on wireshark interfaces include type of protocol, number of bytes and number of packets, among others. Besides, this module will show the number of flows added to the switch whenever traffic is generated from and to hosts in the same statistics list. In order to carry out this work effectively, our Python module will send a statistics request message to the switch requesting its current ports and flows statistics in every five seconds; while the switch will reply with the required information in a message called statistics reply message. Thus, POX controller will be notified and updated with any changes could happen in the entire network in a very short time. Therefore, our aim of this study is to prepare a list for the important statistics elements that are collected from the whole network, to be used for any further researches; particularly, those that are dealing with the detection of the network attacks that cause a sudden rise in the number of packets and bytes like Distributed Denial of Service (DDoS).

Keywords: mininet, OpenFlow, POX controller, SDN

Procedia PDF Downloads 216
13371 The Role of Hypothalamus Mediators in Energy Imbalance

Authors: Maftunakhon Latipova, Feruza Khaydarova

Abstract:

Obesity is considered a chronic metabolic disease that occurs at any age. Regulation of body weight in the body is carried out through complex interaction of a complex of interrelated systems that control the body's energy system. Energy imbalance is the cause of obesity and overweight, in which the supply of energy from food exceeds the energy needs of the body. Obesity is closely related to impaired appetite regulation, and a hypothalamus is a key place for neural regulation of food consumption. The nucleus of the hypothalamus is connected and interdependent on receiving, integrating and sending hunger signals to regulate appetite. Purpose of the study: to identify markers of food behavior. Materials and methods: The screening was carried out to identify eating disorders in 200 men and women aged 18 to 35 years with overweight and obesity and to check the effects of Orexin A and Neuropeptide Y markers. A questionnaire and questionnaires were conducted with over 200 people aged 18 to 35 years. Questionnaires were for eating disorders and hidden depression (on the Zang scale). Anthropometry is measured by OT, OB, BMI, Weight, and Height. Based on the results of the collected data, 3 groups were divided: People with obesity, People with overweight, Control Group of Healthy People. Results: Of the 200 analysed persons, 86% had eating disorders. Of these, 60% of eating disorders were associated with childhood. According to the Zang test result: Normal condition was about 37%, mild depressive disorder 20%, moderate depressive disorder 25% and 18% of people suffered from severe depressive disorder without knowing it. One group of people with obesity had eating disorders and moderate and severe depressive disorder, and group 2 was overweight with mild depressive disorder. According to laboratory data, the first group had the lowest concentration of Orexin A and Neuropeptide U in blood serum. Conclusions: Being overweight and obese are the first signal of many diseases, and prevention and detection of these disorders will prevent various diseases, including type 2 diabetes. Obesity etiology is associated with eating disorders and signal transmission of the orexinorghetic system of the hypothalamus.

Keywords: obesity, endocrinology, hypothalamus, overweight

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13370 Understanding the Influence of Fibre Meander on the Tensile Properties of Advanced Composite Laminates

Authors: Gaoyang Meng, Philip Harrison

Abstract:

When manufacturing composite laminates, the fibre directions within the laminate are never perfectly straight and inevitably contain some degree of stochastic in-plane waviness or ‘meandering’. In this work we aim to understand the relationship between the degree of meandering of the fibre paths, and the resulting uncertainty in the laminate’s final mechanical properties. To do this, a numerical tool is developed to automatically generate meandering fibre paths in each of the laminate's 8 plies (using Matlab) and after mapping this information into finite element simulations (using Abaqus), the statistical variability of the tensile mechanical properties of a [45°/90°/-45°/0°]s carbon/epoxy (IM7/8552) laminate is predicted. The stiffness, first ply failure strength and ultimate failure strength are obtained. Results are generated by inputting the degree of variability in the fibre paths and the laminate is then examined in all directions (from 0° to 359° in increments of 1°). The resulting predictions are output as flower (polar) plots for convenient analysis. The average fibre orientation of each ply in a given laminate is determined by the laminate layup code [45°/90°/-45°/0°]s. However, in each case, the plies contain increasingly large amounts of in-plane waviness (quantified by the standard deviation of the fibre direction in each ply across the laminate. Four different amounts of variability in the fibre direction are tested (2°, 4°, 6° and 8°). Results show that both the average tensile stiffness and the average tensile strength decrease, while the standard deviations increase, with an increasing degree of fibre meander. The variability in stiffness is found to be relatively insensitive to the rotation angle, but the variability in strength is sensitive. Specifically, the uncertainty in laminate strength is relatively low at orientations centred around multiples of 45° rotation angle, and relatively high between these rotation angles. To concisely represent all the information contained in the various polar plots, rotation-angle dependent Weibull distribution equations are fitted to the data. The resulting equations can be used to quickly estimate the size of the errors bars for the different mechanical properties, resulting from the amount of fibre directional variability contained within the laminate. A longer term goal is to use these equations to quickly introduce realistic variability at the component level.

Keywords: advanced composite laminates, FE simulation, in-plane waviness, tensile properties, uncertainty quantification

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13369 Event Monitoring Based On Web Services for Heterogeneous Event Sources

Authors: Arne Koschel

Abstract:

This article discusses event monitoring options for heterogeneous event sources as they are given in nowadays heterogeneous distributed information systems. It follows the central assumption, that a fully generic event monitoring solution cannot provide complete support for event monitoring; instead, event source specific semantics such as certain event types or support for certain event monitoring techniques have to be taken into account. Following from this, the core result of the work presented here is the extension of a configurable event monitoring (Web) service for a variety of event sources. A service approach allows us to trade genericity for the exploitation of source specific characteristics. It thus delivers results for the areas of SOA, Web services, CEP and EDA.

Keywords: event monitoring, ECA, CEP, SOA, web services

Procedia PDF Downloads 725
13368 External Sulphate Attack: Advanced Testing and Performance Specifications

Authors: G. Massaad, E. Roziere, A. Loukili, L. Izoret

Abstract:

Based on the monitoring of mass, hydrostatic weighing, and the amount of leached OH- we deduced the nature of leached and precipitated minerals, the amount of lost aggregates and the evolution of porosity and cracking during the sulphate attack. Using these information, we are able to draw the volume / mass changes brought by mineralogical variations and cracking of the cement matrix. Then we defined a new performance indicator, the averaged density, capable to resume along the test of sulphate attack the occurred physicochemical variation occurred in the cementitious matrix and then highlight.

Keywords: monitoring strategy, performance indicator, sulphate attack, mechanism of degradation

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13367 Arabic Quran Search Tool Based on Ontology

Authors: Mohammad Alqahtani, Eric Atwell

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This paper reviews and classifies most of the important types of search techniques that have been applied on the holy Quran. Then, it addresses the limitations in these techniques. Additionally, this paper surveys most existing Quranic ontologies and what are their deficiencies. Finally, it explains a new search tool called: A semantic search tool for Al Quran based on Qur’anic ontologies. This tool will overcome all limitations in the existing Quranic search applications.

Keywords: holy Quran, natural language processing (NLP), semantic search, information retrieval (IR), ontology

Procedia PDF Downloads 557
13366 Modelling and Simulation of Aero-Elastic Vibrations Using System Dynamic Approach

Authors: Cosmas Pandit Pagwiwoko, Ammar Khaled Abdelaziz Abdelsamia

Abstract:

Flutter as a phenomenon of flow-induced and self-excited vibration has to be recognized considering its harmful effect on the structure especially in a stage of aircraft design. This phenomenon is also important for a wind energy harvester based on the fluttering surface due to its effective operational velocity range. This multi-physics occurrence can be presented by two governing equations in both fluid and structure simultaneously in respecting certain boundary conditions on the surface of the body. In this work, the equations are resolved separately by two distinct solvers, one-time step of each domain. The modelling and simulation of this flow-structure interaction in ANSYS show the effectiveness of this loosely coupled method in representing flutter phenomenon however the process is time-consuming for design purposes. Therefore, another technique using the same weak coupled aero-structure is proposed by using system dynamics approach. In this technique, the aerodynamic forces were calculated using singularity function for a range of frequencies and certain natural mode shapes are transformed into time domain by employing an approximation model of fraction rational function in Laplace variable. The representation of structure in a multi-degree-of-freedom coupled with a transfer function of aerodynamic forces can then be simulated in time domain on a block-diagram platform such as Simulink MATLAB. The dynamic response of flutter at certain velocity can be evaluated with another established flutter calculation in frequency domain k-method. In this method, a parameter of artificial structural damping is inserted in the equation of motion to assure the energy balance of flow and vibrating structure. The simulation in time domain is particularly interested as it enables to apply the structural non-linear factors accurately. Experimental tests on a fluttering airfoil in the wind tunnel are also conducted to validate the method.

Keywords: flutter, flow-induced vibration, flow-structure interaction, non-linear structure

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13365 Body of Dialectics: Exploring a Dynamic-Adaptational Model of Physical Self-Integrity and the Pursuit of Happiness in a Hostile World

Authors: Noam Markovitz

Abstract:

People with physical disabilities constitute a very large and simultaneously a diverse group of general population, as the term physical disabilities is extensive and covers a wide range of disabilities. Therefore, individuals with physical disabilities are often faced with a new, threatening and stressful reality leading possibly to a multi-crisis in their lives due to the great changes they experience in somatic, socio-economic, occupational and psychological level. The current study seeks to advance understanding of the complex adaptation to physical disabilities by expanding the dynamic-adaptational model of the pursuit of happiness in a hostile world with a new conception of physical self-integrity. Physical self-integrity incorporates an objective dimension, namely physical self-functioning (PSF), and a subjective dimension, namely physical self-concept (PSC). Both of these dimensions constitute an experience of wholeness in the individual’s identification with her or his physical body. The model guiding this work is dialectical in nature and depicts two systems in the individual’s sense of happiness: subjective well-being (SWB) and meaning in life (MIL). Both systems serve as self-adaptive agents that moderate the complementary system of the hostile-world scenario (HWS), which integrates one’s perceived threats to one’s integrity. Thus, in situations of increased HWS, the moderation may take a form of joint activity in which SWB and MIL are amplified or a form of compensation in which one system produces a stronger effect while the other system produces a weaker effect. The current study investigated PSC in relations to SWB and MIL through pleasantness and meanings that are physically or metaphorically grounded in one’s body. In parallel, PSC also relates to HWS by activating representations of inappropriateness, deformation and vulnerability. In view of possibly dialectical positions of opposing and complementary forces within the current model, the current field study that aims to explore PSC as appearing in an independent, cross-sectional, design addressing the model’s variables in a focal group of people with physical disabilities. This study delineated the participation of the PSC in the adaptational functions of SWB and MIL vis-à-vis HWS-related life adversities. The findings showed that PSC could fully complement the main variables of the pursuit of happiness in a hostile world model. The assumed dialectics in the form of a stronger relationship between SWB and MIL in the face of physical disabilities was not supported. However, it was found that when HWS increased, PSC and MIL were strongly linked, whereas PSC and SWB were weakly linked. This highlights the compensatory role of MIL. From a conceptual viewpoint, the current investigation may clarify the role of PSC as an adaptational agent of the individual’s positive health in complementary senses of bodily wholeness. Methodologically, the advantage of the current investigation is the application of an integrative, model-based approach within a specially focused design with a particular relevance to PSC. Moreover, from an applicative viewpoint, the current investigation may suggest how an innovative model may be translated to therapeutic interventions used by clinicians, counselors and practitioners in improving wellness and psychological well-being, particularly among people with physical disabilities.

Keywords: older adults, physical disabilities, physical self-concept, pursuit of happiness in a hostile-world

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13364 Tax Criminal Case Settlement Through Obligative Justice Approach to Increase the State Revenue

Authors: Pujiyono, Reda Manthovani, Deny Tri Ardianto, Rabani Halawa, Isharyanto

Abstract:

This research has background that the taxpayer (defendant) who has paid off the tax payable and the tax penalty payable after the tax case file has been transferred to the court, while the legality of stopping the prosecution of tax cases on the grounds that in the interest of state revenue is not regulated in the provisions of Law Number 8 of 1981 concerning The Criminal Procedure Code and Law Number 28 of 2007 concerning the Third Amendment to Law Number 6 of 1983 concerning General Provisions and Tax Procedures as amended several times, most recently by Law Number 16 of 2009 concerning Stipulation of Government Regulation in Lieu of Law Number 5 of 2008 concerning Fourth Amendment to Law Number 6 0f 1983 concerning General Provisions and Tax Procedures to become Law, even though at the investigation stage it regulates the mechanism for stopping the investigation for the sake of the interest of acceptance ne this is because before the case file is transferred to the court where at the request of the Minister of Finance of The Republic of Indonesia can stop the investigation in the interest of state revenue so that based on this phenomenon a legal vacuum is found. Therefore, a non-penal policy is needed from the public prosecutor to resolve tax crime cases without going through litigation in court through the penal mediation method using the Plea Bargaining System which adheres to the principles of restorative justice and obligative justice based on the ultimum remedium principle and the principle of opportunity in order to realize the principle of fast, simple and low cost justice (content principle). This research is a normative legal research, using a statutory approach, conceptual approach, and comparative law approach. Regulations that is used in many countries, include America, The Netherlands and Singapore. The results of this study indicate that there is a reformulation of the tax criminal justice system which regulates the mechanism, qualifications and authority to terminate the prosecution of tax cases in the interest of state revenues in order to achieve legal goals which are not only for legal certainty but more that, namely providing benefits and legal justice for people seeking justice.

Keywords: obligative justice, regulation, state reveneus, tax criminal

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13363 Special Single Mode Fiber Tests of Polarization Mode Dispersion Changes in a Harsh Environment

Authors: Jan Bohata, Stanislav Zvanovec, Matej Komanec, Jakub Jaros, David Hruby

Abstract:

Even though there is a rapid development in new optical networks, still optical communication infrastructures remain composed of thousands of kilometers of aging optical cables. Many of them are located in a harsh environment which contributes to an increased attenuation or induced birefringence of the fibers leading to the increase of polarization mode dispersion (PMD). In this paper, we report experimental results from environmental optical cable tests and characterization in the climate chamber. We focused on the evaluation of optical network reliability in a harsh environment. For this purpose, a special thermal chamber was adopted, targeting to the large temperature changes between -60 °C and 160 C° with defined humidity. Single mode optical cable 230 meters long, having six tubes and a total number of 72 single mode optical fibers was spliced together forming one fiber link, which was afterward tested in the climate chamber. The main emphasis was put to the polarization mode dispersion (PMD) changes, which were evaluated by three different PMD measuring methods (general interferometry technique, scrambled state-of-polarization analysis and polarization optical time domain reflectometer) in order to fully validate obtained results. Moreover, attenuation and chromatic dispersion (CD), as well as the PMD, were monitored using 17 km long single mode optical cable. Results imply a strong PMD dependence on thermal changes, imposing the exceeding 200 % of its value during the exposure to extreme temperatures and experienced more than 20 dB insertion losses in the optical system. The derived statistic is provided in the paper together with an evaluation of such as optical system reliability, which could be a crucial tool for the optical network designers. The environmental tests are further taken in context to our previously published results from long-term monitoring of fundamental parameters within an optical cable placed in a harsh environment in a special outdoor testbed. Finally, we provide a correlation between short-term and long-term monitoring campaigns and statistics, which are necessary for optical network safety and reliability.

Keywords: optical fiber, polarization mode dispersion, harsh environment, aging

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13362 Metamorphosis of Teaching-Learning During COVID-19 Crisis and Challenges of Education in India

Authors: Saroj Pandey

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COVID-19, declared by the World Health Organization a pandemic (WHO,2020), has created an unprecedented crisis world over endangering the human survival itself. Corona induced lockdowns forced approximately 140 million students of 190 countries at various levels of education from preprimary to higher education to remain confined to their homes. In India, approximately 360 million students were affected by the forced shut down of schools due to the countrywide lockdown in March 2020 and resultant disruption of education. After the initial shock and anxiety the Indian polity and education system bounced back with a number of initiatives, and online education came as a major rescuer for the education system of the country. The distance and online mode of learning that was treated as the poor cousin of conventional mode and often criticized for its quality became the major crusader overnight changing the entire ecosystem of traditional teaching -leaning towards the virtual mode. Teachers who were averse to technology were forced to remodel their educational pedagogies and reorient themselves overnight to use various online platforms such as Zoom, Google meet, and other such platforms to reach the learners. This metamorphosis through ensured students was meaningfully engaged in their studies during the lockdown period but it has its own set of challenges. This paper deals with the government initiatives, and teachers' self-efforts to keep the channel of teaching learning on providing academic and socio emotional support to students during the most difficult period of their life as well as the digital divide between the rich and poor, rural and urban, and boys and girls in India and resultant challenges. It also provides an overview of few significant self-initiatives of teachers to reach their students during the crisis period, who did not have internet and smartphone facilities as well as the initiatives being taken at the government level to address the learning needs and mitigate the learning gaps of learners, bridge the digital divide, strategic planning and upskilling of teachers to overcome the effect of COVID-19 crisis.

Keywords: COVID-19, online education, initiatives, challenges

Procedia PDF Downloads 102
13361 Improving Ride Comfort of a Bus Using Fuzzy Logic Controlled Suspension

Authors: Mujde Turkkan, Nurkan Yagiz

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In this study an active controller is presented for vibration suppression of a full-bus model. The bus is modelled having seven degrees of freedom. Using the achieved model via Lagrange Equations the system equations of motion are derived. The suspensions of the bus model include air springs with two auxiliary chambers are used. Fuzzy logic controller is used to improve the ride comfort. The numerical results, verifies that the presented fuzzy logic controller improves the ride comfort.

Keywords: ride comfort, air spring, bus, fuzzy logic controller

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13360 Numerical Simulation of Precast Concrete Panels for Airfield Pavement

Authors: Josef Novák, Alena Kohoutková, Vladimír Křístek, Jan Vodička

Abstract:

Numerical analysis software belong to the main tools for simulating the real behavior of various concrete structures and elements. In comparison with experimental tests, they offer an affordable way to study the mechanical behavior of structures under various conditions. The contribution deals with a precast element of an innovative airfield pavement system which is being developed within an ongoing scientific project. The proposed system consists a two-layer surface course of precast concrete panels positioned on a two-layer base of fiber-reinforced concrete with recycled aggregate. As the panels are supposed to be installed directly on the hardened base course, imperfections at the interface between the base course and surface course are expected. Considering such circumstances, three various behavior patterns could be established and considered when designing the precast element. Enormous costs of full-scale experiments force to simulate the behavior of the element in a numerical analysis software using finite element method. The simulation was conducted on a nonlinear model in order to obtain such results which could fully compensate results from the experiments. First, several loading schemes were considered with the aim to observe the critical one which was used for the simulation later on. The main objective of the simulation was to optimize reinforcement of the element subject to quasi-static loading from airplanes. When running the simulation several parameters were considered. Namely, it concerns geometrical imperfections, manufacturing imperfections, stress state in reinforcement, stress state in concrete and crack width. The numerical simulation revealed that the precast element should be heavily reinforced to fulfill all the demands assumed. The main cause of using high amount of reinforcement is the size of the imperfections which could occur at real structure. Improving manufacturing quality, the installation of the precast panels on a fresh base course or using a bedding layer underneath the surface course belong to the main steps how to reduce the size of imperfections and consequently lower the consumption of reinforcement.

Keywords: nonlinear analysis, numerical simulation, precast concrete, pavement

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13359 The Effect of the COVID-19 Pandemic on Frailty, Sarcopenia, and Other Comorbidities in Liver Transplant Candidates: A Retrospective Review of an Extensive Frailty Database

Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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13358 Autonomous Learning Motivates EFL Students to Learn English at Al Buraimi University College in the Sultanate of Oman: A Case Study

Authors: Yahia A. M. AlKhoudary

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This Study presents the outcome of an investigation to evaluate the importance of autonomous learning as a means of motivation. However, very little research done in this field. Thus, the aims of this study are to ascertain the needs of the learners and to investigate their attitudes and motivation towards the mode of learning. Various suggestions made on how to improve learners’ participation in the learning process. A survey conducted on a sample group of 60 Omani College students. Self-report questionnaires and retrospective interviews conducted to find out their material-type preferences in a self-access learning context. Achieving autonomous learning system, which learners is one of the Ministry of Education goals in the Sultanate of Oman. As a result, this study presents the outcome of an investigation to evaluate the students’ performance in English as a Foreign Language (EFL). It focuses on the effect of autonomous learning that encourages students to learn English, a research conducted at Buraimi city, the Sultanate of Oman. The procedure of this investigation based on four dimensions: (1) sixty students are selected and divided into two groups, (2) pre and posttest projects are given to them, and (3) questionnaires are administered to both students who are involved in the experiment and 50 teachers (25 males and 25 females) to collect accurate data, (4) an interview with students and teachers to find out their attitude towards autonomous learning. Analysis of participants’ responses indicated that autonomous learning motivates students to learn English independently and increase the intrinsic rather than extrinsic motivation to improve their English language as a long-life active learning. The findings of this study show that autonomous learning approach is the best remedy to empower the students’ skills and overcome all relevant difficulties. They also show that secondary school teachers can fully rely on this learning approach that encourages language learners to monitor their progress, increase both learners and teachers’ motivation and ameliorate students’ behavior in the classroom. This approach is also an ongoing process, which takes time, patience and support to be lifelong learning.

Keywords: Omani, autonomous learning system, English as a Foreign Language (EFL), learning approach

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13357 The Effect of Rheological Properties and Spun/Meltblown Fiber Characteristics on “Hotmelt Bleed through” Behavior in High Speed Textile Backsheet Lamination Process

Authors: Kinyas Aydin, Fatih Erguney, Tolga Ceper, Serap Ozay, Ipar N. Uzun, Sebnem Kemaloglu Dogan, Deniz Tunc

Abstract:

In order to meet high growth rates in baby diaper industry worldwide, the high-speed textile backsheet lamination lines have recently been introduced to the market for non-woven/film lamination applications. It is a process where two substrates are bonded to each other via hotmelt adhesive (HMA). Nonwoven (NW) lamination system basically consists of 4 components; polypropylene (PP) nonwoven, polyethylene (PE) film, HMA and applicator system. Each component has a substantial effect on the process efficiency of continuous line and final product properties. However, for a precise subject cover, we will be addressing only the main challenges and possible solutions in this paper. The NW is often produced by spunbond method (SSS or SMS configuration) and has a 10-12 gsm (g/m²) basis weight. The NW rolls can have a width and length up to 2.060 mm and 30.000 linear meters, respectively. The PE film is the 2ⁿᵈ component in TBS lamination, which is usually a 12-14 gsm blown or cast breathable film. HMA is a thermoplastic glue (mostly rubber based) that can be applied in a large range of viscosity ranges. The main HMA application technology in TBS lamination is the slot die application in which HMA is spread on the top of the NW along the whole width at high temperatures in the melt form. Then, the NW is passed over chiller rolls with a certain open time depending on the line speed. HMAs are applied at certain levels in order to provide a proper de-lamination strength in cross and machine directions to the entire structure. Current TBS lamination line speed and width can be as high as 800 m/min and 2100 mm, respectively. They also feature an automated web control tension system for winders and unwinders. In order to run a continuous trouble-free mass production campaign on the fast industrial TBS lines, rheological properties of HMAs and micro-properties of NWs can have adverse effects on the line efficiency and continuity. NW fiber orientation and fineness, as well as spun/melt blown composition fabric micro-level properties, are the significant factors to affect the degree of “HMA bleed through.” As a result of this problem, frequent line stops are observed to clean the glue that is being accumulated on the chiller rolls, which significantly reduces the line efficiency. HMA rheology is also important and to eliminate any bleed through the problem; one should have a good understanding of rheology driven potential complications. So, the applied viscosity/temperature should be optimized in accordance with the line speed, line width, NW characteristics and the required open time for a given HMA formulation. In this study, we will show practical aspects of potential preventative actions to minimize the HMA bleed through the problem, which may stem from both HMA rheological properties and NW spun melt/melt blown fiber characteristics.

Keywords: breathable, hotmelt, nonwoven, textile backsheet lamination, spun/melt blown

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13356 Investigating Constructions and Operation of Internal Combustion Engine Water Pumps

Authors: Michał Gęca, Konrad Pietrykowski, Grzegorz Barański

Abstract:

The water pump in the compression-ignition internal combustion engine transports a hot coolant along a system of ducts from the engine block to the radiator where coolant temperature is lowered. This part needs to maintain a constant volumetric flow rate. Its power should be regulated to avoid a significant drop in pressure if a coolant flow decreases. The internal combustion engine cooling system uses centrifugal pumps for suction. The paper investigates 4 constructions of engine pumps. The pumps are from diesel engine of a maximum power of 75 kW. Each of them has a different rotor shape, diameter and width. The test stand was created and the geometry inside the all 4 engine blocks was mapped. For a given pump speed on the inverter of the electric engine motor, the valve position was changed and volumetric flow rate, pressure, and power were recorded. Pump speed was regulated from 1200 RPM to 7000 RPM every 300 RPM. The volumetric flow rates and pressure drops for the pump speeds and efficiencies were specified. Accordingly, the operations of each pump were mapped. Our research was to select a pump for the aircraft compression-ignition engine. There was calculated a pressure drop at a given flow on the block and radiator of the designed aircraft engine. The water pump should be lightweight and have a low power demand. This fact shall affect the shape of a rotor and bearings. The pump volumetric flow rate was assumed as 3 kg/s (previous AVL BOOST research model) where the temperature difference was 5°C between the inlet (90°C) and outlet (95°C). Increasing pump speed above the boundary flow power defined by pressure and volumetric flow rate does not increase it but pump efficiency decreases. The maximum total pump efficiency (PCC) is 45-50%. When the pump is driven by low speeds with a 90% closed valve, its overall efficiency drops to 15-20%. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: aircraft engine, diesel engine, flow, water pump

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13355 A Smart Sensor Network Approach Using Affordable River Water Level Sensors

Authors: Dian Zhang, Brendan Heery, Maria O’Neill, Ciprian Briciu-Burghina, Noel E. O’Connor, Fiona Regan

Abstract:

Recent developments in sensors, wireless data communication and the cloud computing have brought the sensor web to a whole new generation. The introduction of the concept of ‘Internet of Thing (IoT)’ has brought the sensor research into a new level, which involves the developing of long lasting, low cost, environment friendly and smart sensors; new wireless data communication technologies; big data analytics algorithms and cloud based solutions that are tailored to large scale smart sensor network. The next generation of smart sensor network consists of several layers: physical layer, where all the smart sensors resident and data pre-processes occur, either on the sensor itself or field gateway; data transmission layer, where data and instructions exchanges happen; the data process layer, where meaningful information is extracted and organized from the pre-process data stream. There are many definitions of smart sensor, however, to summarize all these definitions, a smart sensor must be Intelligent and Adaptable. In future large scale sensor network, collected data are far too large for traditional applications to send, store or process. The sensor unit must be intelligent that pre-processes collected data locally on board (this process may occur on field gateway depends on the sensor network structure). In this case study, three smart sensing methods, corresponding to simple thresholding, statistical model and machine learning based MoPBAS method, are introduced and their strength and weakness are discussed as an introduction to the smart sensing concept. Data fusion, the integration of data and knowledge from multiple sources, are key components of the next generation smart sensor network. For example, in the water level monitoring system, weather forecast can be extracted from external sources and if a heavy rainfall is expected, the server can send instructions to the sensor notes to, for instance, increase the sampling rate or switch on the sleeping mode vice versa. In this paper, we describe the deployment of 11 affordable water level sensors in the Dublin catchment. The objective of this paper is to use the deployed river level sensor network at the Dodder catchment in Dublin, Ireland as a case study to give a vision of the next generation of a smart sensor network for flood monitoring to assist agencies in making decisions about deploying resources in the case of a severe flood event. Some of the deployed sensors are located alongside traditional water level sensors for validation purposes. Using the 11 deployed river level sensors in a network as a case study, a vision of the next generation of smart sensor network is proposed. Each key component of the smart sensor network is discussed, which hopefully inspires the researchers who are working in the sensor research domain.

Keywords: smart sensing, internet of things, water level sensor, flooding

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13354 Re-Engineering Management Process in IRAN’s Smart Schools

Authors: M. R. Babaei, S. M. Hosseini, S. Rahmani, L. Moradi

Abstract:

Today, the quality of education and training systems and the effectiveness of the education systems of most concern to stakeholders and decision-makers of our country's development in each country. In Iran this is a double issue of concern to numerous reasons; So that governments, over the past decade have hardly even paid the running costs of education. ICT is claiming it has the power to change the structure of a program for training, reduce costs and increase quality, and do education systems and products consistent with the needs of the community and take steps to practice education. Own of the areas that the introduction of information technology has fundamentally changed is the field of education. The aim of this research is process reengineering management in schools simultaneously has been using field studies to collect data in the form of interviews and a questionnaire survey. The statistical community of this research has been the country of Iran and smart schools under the education. Sampling was targeted. The data collection tool was a questionnaire composed of two parts. The questionnaire consists of 36 questions that each question designates one of effective factors on the management of smart schools. Also each question consists of two parts. The first part designates the operating position in the management process, which represents the domain's belonging to the management agent (planning, organizing, leading, controlling). According to the classification of Dabryn and in second part the factors affect the process of managing the smart schools were examined, that Likert scale is used to classify. Questions the validity of the group of experts and prominent university professors in the fields of information technology, management and reengineering of approved and Cronbach's alpha reliability and also with the use of the formula is evaluated and approved. To analyse the data, descriptive and inferential statistics were used to analyse the factors contributing to the rating of (Linkert scale) descriptive statistics (frequency table data, mean, median, mode) was used. To analyse the data using analysis of variance and nonparametric tests and Friedman test, the assumption was evaluated. The research conclusions show that the factors influencing the management process re-engineering smart schools in school performance is affected.

Keywords: re-engineering, management process, smart school, Iran's school

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13353 Developing a Deep Understanding of the Immune Response in Hepatitis B Virus Infected Patients Using a Knowledge Driven Approach

Authors: Hanan Begali, Shahi Dost, Annett Ziegler, Markus Cornberg, Maria-Esther Vidal, Anke R. M. Kraft

Abstract:

Chronic hepatitis B virus (HBV) infection can be treated with nucleot(s)ide analog (NA), for example, which inhibits HBV replication. However, they have hardly any influence on the functional cure of HBV, which is defined by hepatitis B surface antigen (HBsAg) loss. NA needs to be taken life-long, which is not available for all patients worldwide. Additionally, NA-treated patients are still at risk of developing cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Although each patient has the same components of the immune system, immune responses vary between patients. Therefore, a deeper understanding of the immune response against HBV in different patients is necessary to understand the parameters leading to HBV cure and to use this knowledge to optimize HBV therapies. This requires seamless integration of an enormous amount of diverse and fine-grained data from viral markers, e.g., hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg). The data integration system relies on the assumption that profiling human immune systems requires the analysis of various variables (e.g., demographic data, treatments, pre-existing conditions, immune cell response, or HLA-typing) rather than only one. However, the values of these variables are collected independently. They are presented in a myriad of formats, e.g., excel files, textual descriptions, lab book notes, and images of flow cytometry dot plots. Additionally, patients can be identified differently in these analyses. This heterogeneity complicates the integration of variables, as data management techniques are needed to create a unified view in which individual formats and identifiers are transparent when profiling the human immune systems. The proposed study (HBsRE) aims at integrating heterogeneous data sets of 87 chronically HBV-infected patients, e.g., clinical data, immune cell response, and HLA-typing, with knowledge encoded in biomedical ontologies and open-source databases into a knowledge-driven framework. This new technique enables us to harmonize and standardize heterogeneous datasets in the defined modeling of the data integration system, which will be evaluated in the knowledge graph (KG). KGs are data structures that represent the knowledge and data as factual statements using a graph data model. Finally, the analytic data model will be applied on top of KG in order to develop a deeper understanding of the immune profiles among various patients and to evaluate factors playing a role in a holistic profile of patients with HBsAg level loss. Additionally, our objective is to utilize this unified approach to stratify patients for new effective treatments. This study is developed in the context of the project “Transforming big data into knowledge: for deep immune profiling in vaccination, infectious diseases, and transplantation (ImProVIT)”, which is a multidisciplinary team composed of computer scientists, infection biologists, and immunologists.

Keywords: chronic hepatitis B infection, immune response, knowledge graphs, ontology

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13352 Autophagy Suppresses Bladder Tumor Formation in a Mouse Orthotopic Bladder Tumor Formation Model

Authors: Wan-Ting Kuo, Yi-Wen Liu, Hsiao-Sheng Liu

Abstract:

Annual incidence of bladder cancer increases in the world and occurs frequently in the male. Most common type is transitional cell carcinoma (TCC) which is treated by transurethral resection followed by intravesical administration of agents. In clinical treatment of bladder cancer, chemotherapeutic drugs-induced apoptosis is always used in patients. However, cancers usually develop resistance to chemotherapeutic drugs and often lead to aggressive tumors with worse clinical outcomes. Approximate 70% TCC recurs and 30% recurrent tumors progress to high-grade invasive tumors, indicating that new therapeutic agents are urgently needed to improve the successful rate of overall treatment. Nonapoptotic program cell death may assist to overcome worse clinical outcomes. Autophagy which is one of the nonapoptotic pathways provides another option for bladder cancer patients. Autophagy is reported as a potent anticancer therapy in some cancers. First of all, we established a mouse orthotopic bladder tumor formation model in order to create a similar tumor microenvironment. IVIS system and micro-ultrasound were utilized to noninvasively monitor tumor formation. In addition, we carried out intravesical treatment in our animal model to be consistent with human clinical treatment. In our study, we carried out intravesical instillation of the autophagy inducer in mouse orthotopic bladder tumor to observe tumor formation by noninvasive IVIS system and micro-ultrasound. Our results showed that bladder tumor formation is suppressed by the autophagy inducer, and there are no significant side effects in the physiology of mice. Furthermore, the autophagy inducer upregulated autophagy in bladder tissues of the treated mice was confirmed by Western blot, immunohistochemistry, and immunofluorescence. In conclusion, we reveal that a novel autophagy inducer with low side effects suppresses bladder tumor formation in our mouse orthotopic bladder tumor model, and it provides another therapeutic approach in bladder cancer patients.

Keywords: bladder cancer, transitional cell carcinoma, orthotopic bladder tumor formation model, autophagy

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13351 Enhanced Functional Production of a Crucial Biomolecule Human Serum Albumin in Escherichia coli

Authors: Ashima Sharma

Abstract:

Human Serum Albumin (HSA)- one of the most demanded therapeutic proteins with immense biotechnological applications- is a large multidomain protein containing 17 disulfide bonds. The current source of HSA is human blood plasma which is a limited and unsafe source. Thus, there exists an indispensable need to promote non-animal derived recombinant HSA (rHSA) production. Escherichia coli is one of the most convenient hosts which had contributed to the production of more than 30% of the FDA approved recombinant pharmaceuticals. It grows rapidly and reaches high cell density using inexpensive and simple substrates. E. coli derived recombinant products have more economic potential as fermentation processes are cheaper compared to the other expression hosts. The major bottleneck in exploiting E. coli as a host for a disulfide-rich multidomain protein is the formation of aggregates of overexpressed protein. The majority of the expressed HSA forms inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA from inclusion bodies is not preferred because it is difficult to obtain a large multidomain disulfide bond rich protein like rHSA in its functional native form. Purification is tedious, time-consuming, laborious and expensive. Because of such limitations, the E. coli host system was neglected for rHSA production for the past few decades despite its numerous advantages. In the present work, we have exploited the capabilities of E. coli as a host for the enhanced functional production of rHSA (~60% of the total expressed rHSA in the soluble fraction). Parameters like intracellular environment, temperature, induction type, duration of induction, cell lysis conditions etc. which play an important role in enhancing the level of production of the desired protein in its native form in vivo have been optimized. We have studied the effect of assistance of different types of exogenously employed chaperone systems on the functional expression of rHSA in the E. coli host system. Different aspects of cell growth parameters during the production of rHSA in presence and absence of molecular chaperones in E. coli have also been studied. Upon overcoming the difficulties to produce functional rHSA in E. coli, it has been possible to produce significant levels of functional protein through engineering the biological system of protein folding in the cell, the E. coli-derived rHSA has been purified to homogeneity. Its detailed physicochemical characterization has been performed by monitoring its conformational properties, secondary and tertiary structure elements, surface properties, ligand binding properties, stability issues etc. These parameters of the recombinant protein have been compared with the naturally occurring protein from the human source. The outcome of the comparison reveals that the recombinant protein resembles exactly the same as the natural one. Hence, we propose that the E. coli-derived rHSA is an ideal biosimilar for human blood plasma-derived serum albumin. Therefore, in the present study, we have introduced and promoted the E. coli- derived rHSA as an alternative to the preparation from a human source, pHSA.

Keywords: recombinant human serum albumin, Escherichia coli, biosimilar, chaperone assisted protein folding

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13350 Effectiveness of Control Measures for Ambient Fine Particulate Matters Concentration Improvement in Taiwan

Authors: Jiun-Horng Tsai, Shi-Jie, Nieh

Abstract:

Fine particulate matter (PM₂.₅) has become an important issue all over the world over the last decade. Annual mean PM₂.₅ concentration has been over the ambient air quality standard of PM₂.₅ (annual average concentration as 15μg/m³) which adapted by Taiwan Environmental Protection Administration (TEPA). TEPA, therefore, has developed a number of air pollution control measures to improve the ambient concentration by reducing the emissions of primary fine particulate matter and the precursors of secondary PM₂.₅. This study investigated the potential improvement of ambient PM₂.₅ concentration by the TEPA program and the other scenario for further emission reduction on various sources. Four scenarios had been evaluated in this study, including a basic case and three reduction scenarios (A to C). The ambient PM₂.₅ concentration was evaluated by Community Multi-scale Air Quality modelling system (CMAQ) ver. 4.7.1 along with the Weather Research and Forecasting Model (WRF) ver. 3.4.1. The grid resolutions in the modelling work are 81 km × 81 km for domain 1 (covers East Asia), 27 km × 27 km for domain 2 (covers Southeast China and Taiwan), and 9 km × 9 km for domain 3 (covers Taiwan). The result of PM₂.₅ concentration simulation in different regions of Taiwan shows that the annual average concentration of basic case is 24.9 μg/m³, and are 22.6, 18.8, and 11.3 μg/m³, respectively, for scenarios A to C. The annual average concentration of PM₂.₅ would be reduced by 9-55 % for those control scenarios. The result of scenario C (the emissions of precursors reduce to allowance levels) could improve effectively the airborne PM₂.₅ concentration to attain the air quality standard. According to the results of unit precursor reduction contribution, the allowance emissions of PM₂.₅, SOₓ, and NOₓ are 16.8, 39, and 62 thousand tons per year, respectively. In the Kao-Ping air basin, the priority for reducing precursor emissions is PM₂.₅ > NOₓ > SOₓ, whereas the priority for reducing precursor emissions is PM₂.₅ > SOₓ > NOₓ in others area. The result indicates that the target pollutants that need to be reduced in different air basin are different, and the control measures need to be adapted to local conditions.

Keywords: airborne PM₂.₅, community multi-scale air quality modelling system, control measures, weather research and forecasting model

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13349 The Development Status of Terahertz Wave and Its Prospect in Wireless Communication

Authors: Yiquan Liao, Quanhong Jiang

Abstract:

Since terahertz was observed by German scientists, we have obtained terahertz through different generation technologies of broadband and narrowband. Then, with the development of semiconductor and other technologies, the imaging technology of terahertz has become increasingly perfect. From the earliest application of nondestructive testing in aviation to the present application of information transmission and human safety detection, the role of terahertz will shine in various fields. The weapons produced by terahertz were epoch-making, which is a crushing deterrent against technologically backward countries. At the same time, terahertz technology in the fields of imaging, medical and livelihood, communication and communication are for the well-being of the country and the people.

Keywords: terahertz, imaging, communication, medical treatment

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13348 Trans-Activator of Transcription-Tagged Active AKT1 Variants for Delivery to Mammalian Cells

Authors: Tarana Siddika, Ilka U. Heinemann, Patrick O’Donoghue

Abstract:

Protein kinase B (AKT1) is a serine/threonine kinase and central transducer of cell survival pathways. Typical approaches to study AKT1 biology in cells rely on growth factor or insulin stimulation that activates AKT1 via phosphorylation at two key regulatory sites (Threonine308, Serine473), yet cell stimulation also activates many other kinases and fails to differentiate the effect of the two main activating sites of AKT1 on downstream substrate phosphorylation and cell growth. While both AKT1 activating sites are associated with disease and used as clinical markers, in some cancers, high levels of Threonine308 phosphorylation are associated with poor prognosis while in others poor survival correlates with high Serine473 levels. To produce cells with specific AKT1 activity, a system was developed to deliver active AKT1 to human cells. AKT1 phospho-variants were produced from Escherichia coli with programmed phosphorylation by genetic code expansion. Tagging of AKT1 with an N-terminal cell penetrating peptide tag derived from the human immunodeficiency virus trans-activator of transcription (TAT) helped to enter AKT1 proteins in mammalian cells. The TAT-tag did not alter AKT1 kinase activity and was necessary and sufficient to rapidly deliver AKT1 protein variants that persisted in human cells for 24 h without the need to use transfection reagents. TAT-pAKT1T308, TAT-pAKT1S473 and TAT-pAKT1T308S473 proteins induced selective phosphorylation of the known AKT1 substrate GSK-3αβ, and downstream stimulation of the AKT1 pathway as evidenced by phosphorylation of ribosomal protein S6 at Serine240/244 in transfected cells. Increase in cell growth and proliferation was observed due to the transfection of different phosphorylated AKT1 protein variants compared to cells with TAT-AKT1 protein. The data demonstrate efficient delivery of AKT1 with programmed phosphorylation to human cells, thus establishing a cell-based model system to investigate signaling that is dependent on specific AKT1 activity and phosphorylation.

Keywords: cell penetrating peptide, cell signaling, protein kinase b (AKT1), phosphorylation

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13347 Management of Hypoglycemia in Von Gierke’s Disease

Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

Abstract:

Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

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13346 The Contribution of Hip Strategy in Dynamic Postural Control in Recurrent Ankle Sprain

Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

Abstract:

Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System Results: Repeated measures MANOVA was used to compare between and within group differences, In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p= 0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to relay more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance

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13345 Restorative Justice to the Victims of Terrorism in the Criminal Justice System of India

Authors: Sumanta Meher, Gaurav Shukla

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The torments of the victims of terrorism have not only confined to loss of life and limp but also includes the physiological trauma to the innocent victims. The physical wounds may heal, but the trauma remains in the mind and heart of the victims and their loved ones; however, one should not deny that these terrorist activities affect to a major extent to their livelihood. To protect their human rights and restore the shattered lives of the victims of terrorism all the Nations beyond their differences have to show solidarity and frame a comprehensive restorative policy with an effective implementing mechanism. The General Assembly of United Nations, through its several resolutions, has appealed Nations to show solidarity and also committed to helping the Members State to frame the law and policy to support the victims of terrorism. To achieve the objectives of the resolutions adopted by the United Nations, the Indian legislators in 2008 amended the Code of Criminal Procedure, 1973 and incorporated Section 357A to provide financial assistance to the victims of terrorism. In India, the contemporary developments in the victims’ oriented studies have increased the dimension of the traditional criminal justice systems to protect the rights of the victims. In this regard, the paper has ascertained the Indian legal framework in respect to the restorative justice to the victims of terrorism and also addressed the question as to whether the statutory provisions and enforcement mechanisms are efficient enough to protect the human rights of the victims of terrorism. For that purpose, the paper has analyzed the International instruments and the reports with regard to the compensation to the victims of terrorist attacks, with that, the article also evaluates the initiatives of United Nations to help Members State to frame the law and policies to support the victims of terrorism. The study also made an attempt to critically analyze the legal provisions of compensation and rehabilitation of the victims of terrorist attacks in India and whether they are in alignment with the International standards. While concluding, the paper has made an endeavor for a robust legal framework towards the restorative justice for the victims of terrorism in India.

Keywords: victims of terrorism, restorative justice, human rights, criminal justice system of India

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