Search results for: quality evaluation

Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Yosef Kassa

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Gondar City, a city in Ethiopia, is going through growth and increased use of motor vehicles, causing issues of traffic congestion, pollution, and limited mobility options. Despite the growing number of cars on the road, walking still accounts for 54% of all journeys. However, the city’s transportation planning has mainly focused on accommodating vehicles, leading to a lack of infrastructure for non-motorized transportation (nmt). This study utilized GIS analysis and surveys involving residents to examine how aspects of the city impact motorized transport. The GIS analysis objectively evaluated built environment factors influencing nmt, such as infrastructure quality, land usage patterns, topography features, and environmental factors using a multi-criteria analysis method (mca). The survey gathered feedback from residents on these factors and analyzed them statistically. The GIS analysis pinpointed areas with potential for nmt, slopes (<10.03°), mixed-use developments with 15% coverage, and high intersection densities (> 4.2/100m). On the hand, steep slopes (>23.77°) and low intersection areas require interventions. The MCA analysis indicated that 66% of areas in Gondar City had limited nmt accessibility levels, while only 7% were considered accessible. According to survey findings, environmental characteristics such as building density differed throughout sub-cities and demographics, with 1-3 story townhouses dominating Azezo Teda compared to connected kebele housing in Arada, while agreeing topography has obstructed walking. Correlation analysis shows significant relationships like topographies' negative associations with connectivity (-0.373**) and infrastructure (-0.391**). Although, regression analysis found housing type (1.036), safety (-0.688), land use (0.933), connectedness (0.585), and infrastructure (0.889) with p<0.05 were among the determinants of transportation frequency. The integrated analysis uncovered disparities between survey analysis and GIS analysis. In Azezo Teda, the GIS score is 2.27, while the survey score is 2.89. However, there is a correlation (rho=0.56, p<0.01) indicating the reliability of gis in assessing walkability. This research offers insights for enhancing nmt accessibility in Gondar City by promoting transportation planning that focuses on (nmt) and the needs of residents.

Keywords: non-motorized transportation, accessibility, built environment, infrastructure

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Authors: F. A. M. Safwan, H. N. N. Dilrukshi, P. U. S. Peiris

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Less availability of high quality green forages leads to low productivity of national dairy herd of Sri Lanka. Growing grass and fodder to suit the production system is an efficient and economical solution for this problem. CO-3 is placed in a higher category, especially on tillering capacity, green forage yield, regeneration capacity, leaf to stem ratio, high crude protein content, resistance to pests and diseases and free from adverse factors along with other fodder varieties grown within the country. An experiment was designed to determine the effect of organic sheep manure, inorganic fertilizers and liquid sheep manure on growth, yield and nutritive value of CO-3. The study was consisted with three treatments; sheep manure (T1), recommended inorganic fertilizers (T2) and liquid sheep manure (T3) which was prepared using bucket fermentation method and each treatment was consisted with three replicates and those were assigned randomly. First harvest was obtained after 40 days of plant establishment and number of leaves (NL), leaf area (LA), tillering capacity (TC), fresh weight (FW) and dry weight (DW) were recorded and second harvest was obtained after 30 days of first harvest and same set of data were recorded. SPSS 16 software was used for data analysis. For proximate analysis AOAC, 2000 standard methods were used. Results revealed that the plants treated with T1 recorded highest NL, LA, TC, FW and DW and were statistically significant at first and second harvest of CO-3 (p˂ 0.05) and it was found that T1 was statistically significant from T2 and T3. Although T3 was recorded higher than the T2 in almost all growth parameters; it was not statistically significant (p ˃0.05). In addition, the crude protein content was recorded highest in T1 with the value of 18.33±1.61 and was lowest in T2 with the value of 10.82±1.14 and was statistically significant (p˂ 0.05). Apart from this, other proximate composition crude fiber, crude fat, ash, moisture content and dry matter were not statistically significant between treatments (p ˃0.05). In accordance with the results, it was found that the organic fertilizer is the best fertilizer for CO-3 in terms of growth parameters and crude protein content.

Keywords: fertilizer, growth parameters, Hybrid Napier CO-3, proximate composition

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Authors: Shreya Poddar

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Legal drafting and revising are recognized as highly demanding tasks for legal professionals. This paper introduces an approach to automate and refine these processes through the use of advanced Artificial Intelligence (AI). The method employs Large Language Models (LLMs), with a specific focus on 'Chain of Thoughts' (CoT) and knowledge injection via prompt engineering. This approach differs from conventional methods that depend on comprehensive training or fine-tuning of models with extensive legal knowledge bases, which are often expensive and time-consuming. The proposed method incorporates knowledge injection directly into prompts, thereby enabling the AI to generate more accurate and contextually appropriate legal texts. This approach substantially decreases the necessity for thorough model training while preserving high accuracy and relevance in drafting. Additionally, the concept of guardrails is introduced. These are predefined parameters or rules established within the AI system to ensure that the generated content adheres to legal standards and ethical guidelines. The practical implications of this method for legal work are considerable. It has the potential to markedly lessen the time lawyers allocate to document drafting and revision, freeing them to concentrate on more intricate and strategic facets of legal work. Furthermore, this method makes high-quality legal drafting more accessible, possibly reducing costs and expanding the availability of legal services. This paper will elucidate the methodology, providing specific examples and case studies to demonstrate the effectiveness of 'Chain of Thoughts' and knowledge injection in legal drafting. The potential challenges and limitations of this approach will also be discussed, along with future prospects and enhancements that could further advance legal work. The impact of this research on the legal industry is substantial. The adoption of AI-driven methods by legal professionals can lead to enhanced efficiency, precision, and consistency in legal drafting, thereby altering the landscape of legal work. This research adds to the expanding field of AI in law, introducing a method that could significantly alter the nature of legal drafting and practice.

Keywords: AI-driven legal drafting, legal automation, futureoflegalwork, largelanguagemodels

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Authors: Frank Dorrian, Aniket Adhikari

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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.

Keywords: placenta, accreta, spectrum, MRI

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Authors: Fang Liu, JunShuai Xue, JiaJia Yao, GuanLin Wu, ZuMaoLi, XueYan Yang, HePeng Zhang, ZhiPeng Sun

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Terahertz spectra is in great demand since last two decades for many photonic and electronic applications. III-Nitride resonant tunneling diode is one of the promising candidates for portable and compact THz sources. Room temperature microwave oscillator based on GaN/AlN resonant tunneling diode was reported in this work. The devices, grown by plasma-assisted molecular-beam epitaxy on free-standing c-plane GaN substrates, exhibit highly repeatable and robust negative differential resistance (NDR) characteristics at room temperature. To improve the interface quality at the active region in RTD, indium surfactant assisted growth is adopted to enhance the surface mobility of metal atoms on growing film front. Thanks to the lowered valley current associated with the suppression of threading dislocation scattering on low dislocation GaN substrate, a positive peak current density of record-high 2.1 MA/cm2 in conjunction with a peak-to-valley current ratio (PVCR) of 1.2 are obtained, which is the best results reported in nitride-based RTDs up to now considering the peak current density and PVCR values simultaneously. When biased within the NDR region, microwave oscillations are measured with a fundamental frequency of 0.31 GHz, yielding an output power of 5.37 µW. Impedance mismatch results in the limited output power and oscillation frequency described above. The actual measured intrinsic capacitance is only 30fF. Using a small-signal equivalent circuit model, the maximum intrinsic frequency of oscillation for these diodes is estimated to be ~260GHz. This work demonstrates a microwave oscillator based on resonant tunneling effect, which can meet the demands of terahertz spectral devices, more importantly providing guidance for the fabrication of the complex nitride terahertz and quantum effect devices.

Keywords: GaN resonant tunneling diode, peak current density, microwave oscillation, intrinsic capacitance

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Authors: Omar Amoudi, Latifa Al Brashdi

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Construction projects are always subject to risks and uncertainties due to its unique and dynamic nature, outdoor work environment, the wide range of skills employed, various parties involved in addition to situation of construction business environment at large. Altogether, these risks and uncertainties affect projects objectives and lead to cost overruns, delay, and poor quality. Construction projects in Oman often experience cost overruns and delay. Managing these risks and reducing their impacts on construction cost requires firstly identifying these risks, and then analyzing their severity on project cost to obtain deep understanding about these risks. This in turn will assist construction managers in managing and tacking these risks. This paper aims to investigate the main risk factors that affect construction projects cost in the Sultanate of Oman. In order to achieve the main aim, literature review was carried out to identify the main risk factors affecting construction cost. Thirty-three risk factors were identified from the literature. Then, a questionnaire survey was designed and distributed among construction professionals (i.e., client, contractor and consultant) to obtain their opinion toward the probability of occurrence for each risk factor and its possible impact on construction project cost. The collected data was analyzed based on qualitative aspects and in several ways. The severity of each risk factor was obtained by multiplying the probability occurrence of a risk factor with its impact. The findings of this study reveal that the most significant risk factors that have high severity impact on construction project cost are: Change of Oil Price, Delay of Materials and Equipment Delivery, Changes in Laws and Regulations, Improper Budgeting, and Contingencies, Lack of Skilled Workforce and Personnel, Delays Caused by Contractor, Delays of Owner Payments, Delays Caused by Client, and Funding Risk. The results can be used as a basis for construction managers to make informed decisions and produce risk response procedures and strategies to tackle these risks and reduce their negative impacts on construction project cost.

Keywords: construction cost, construction projects, Oman, risk factors, risk management

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Authors: Lubisi L. V., Madumo M. B., Mudau N. P., Makhuvele L., Sibuyi M. M.

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Background and Aims: Learners with disabilities can be integrated into mainstream schools, whereas there are those learners that are accommodated in special schools based on the support needs they require. These needs, among others, pertain to access to high-intensity therapeutic support by physiotherapists, occupational therapists, and speech therapists. However, access to physiotherapists in low- and middle-income countries is limited, and this creates a knowledge gap in identifying, to the best of our knowledge, best practice patterns aligned with physiotherapy at special schools. This gap compromises the quality of support to be rendered towards strengthening rehabilitation and optimising the participation of learners with disabilities in special schools. The aim of the scoping review was to map the evidence on practice patterns employed by physiotherapists at special schools for learners with disabilities. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. Key terms regarding physiotherapy practice patterns for learners with disabilities at special schools were used to search the literature on the databases. Literature was sourced from Google Scholar, EBSCO, PEDro, PubMed, and Research Gate from 2013 to 2023. A total of 28 articles were initially retrieved and after a process of screening and exclusion, nine articles were included. All the researchers reviewed the articles for eligibility. Articles were initially screened based on the titles, followed by full text. Articles written in English or translated into English mentioned physical / physiotherapy interventions in special schools, both published and unpublished, were included. A qualitative data extraction template was developed and an inductive approach to thematic data analysis was used for included articles to see which themes emerged. Results: Three themes emerged after inductive thematic data analysis. 1. Collaboration with educators, parents, and therapists 2. Family Centred Approach 3. Telehealth. Conclusion: Collaboration is key in delivering therapeutic support to learners with disabilities at special schools. Physiotherapists need to be collaborators at the level of interprofessional and transprofessional. In addition, they need to explore technology to work remotely, especially when learners become absent physically from school.

Keywords: learners with disabilities, special school, physiotherapists, therapeutic support

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Kwizera Mireille, Kharesh Ahmed Al-Khadher

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This paper explores the critical issue of girls' and women's right to education, exploring the challenges they face in accessing and benefiting from quality education. Gender disparities in education have persisted globally, hindering social progress and sustainable development. The fundamental importance of education in empowering individuals and promoting gender equality is acknowledged, making it imperative to address the disparities that hinder girls' and women's educational opportunities. The paper discusses various factors contributing to these disparities, including cultural norms(common in third-world countries), socio-economic constraints, and systemic biases. Drawing on a wide range of scholarly sources, empirical studies, and reports from international organizations, this paper highlights the broader societal benefits of educating girls and women, ranging from improved health outcomes to enhanced economic development and greater social and political participation. The paper further outlines strategies and initiatives aimed at overcoming these challenges. These include policy interventions, community-based programs, and international collaborations that work towards eliminating gender-based discrimination in educational settings. The paper emphasizes the significance of not only ensuring access but also fostering an inclusive and safe learning environment that encourages girls and women to thrive academically and personally. By analyzing successful case studies and best practices from around the world, the paper offers insights into effective approaches that can be adopted to enhance girls' and women's right to education globally. Furthermore, it emphasizes the importance of raising awareness of girl's and women's education. In conclusion, this paper underscores the urgency of prioritizing and protecting the educational rights of girls and women's right to education as a fundamental human right and catalyst for gender equality. It calls for a concerted effort from governments, NGOs, educational institutions, and society as a whole to create an equitable and empowering educational landscape that contributes to gender equality and sustainable development.

Keywords: empowerment, gender equality, inclusive education, right to education

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Authors: Thomas Ruppert, Shana Jones, J. Scott Pippin

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State and federal government agencies within the United States have recently invested substantial resources into studies of future flood risk conditions associated with climate change and sea-level rise. A review of numerous case studies has uncovered several key themes that speak to an overall incoherence within current flood risk assessment procedures in the U.S. context. First, there are substantial local differences in the quality of available information about basic infrastructure, particularly with regard to local stormwater features and essential facilities that are fundamental components of effective flood hazard planning and mitigation. Second, there can be substantial mismatch between regulatory Flood Insurance Rate Maps (FIRMs) as produced by the National Flood Insurance Program (NFIP) and other 'current condition' flood assessment approaches. This is of particular concern in areas where FIRMs already seem to underestimate extant flood risk, which can only be expected to become a greater concern if future FIRMs do not appropriately account for changing climate conditions. Moreover, while there are incentives within the NFIP’s Community Rating System (CRS) to develop enhanced assessments that include future flood risk projections from climate change, the incentive structures seem to have counterintuitive implications that would tend to promote moral hazard. In particular, a technical finding of higher future risk seems to make it easier for a community to qualify for flood insurance savings, with much of these prospective savings applied to individual properties that have the most physical risk of flooding. However, there is at least some case study evidence to indicate that recognition of these issues is prompting broader discussion about the need to move beyond FIRMs as a standalone local flood planning standard. The paper concludes with approaches for developing climate adaptation and flood resilience strategies in the U.S. that move away from the social welfare model being applied through NFIP and toward more of an informed risk approach that transfers much of the investment responsibility over to individual private property owners.

Keywords: climate change adaptation, flood risk, moral hazard, sea-level rise

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Authors: Mohammad Anwarul Kabir, Fayezul Islam

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Language invariably is learned / taught to be used primarily as means of communications. Teaching a language for its native audience differs from teaching it to non-native audience. Moreover, teaching a language for communication only is different from teaching it for specific purposes. Arabic language is primarily regarded as the language of the Quran and the Sunnah (Prophetic tradition). Arabic is, therefore, learnt and spread all over the globe. However, Arabic is also a cultural heritage shared by all Islamic nations which has used Arabic for a long period to record the contributions of Muslim thinkers made in the field of wide spectrum of knowledge and scholarship. That is why the phenomenon of teaching Arabic by different educational institutes became quite rife, and the idea of teaching Arabic for specific purposes is heavily discussed in the academic sphere. Although the number of learners of Arabic is increasing consistently, yet their purposes vary. These include religious purpose, international trade, diplomatic purpose, better livelihood in the Arab world extra. By virtue of this high demand for learning Arabic, numerous institutes have been established all over the world including Bangladesh. This paper aims at focusing on the current status of the language institutes which has been established for learning Arabic for specific purposes in Bangladesh including teaching methodology, curriculum, and teachers’ quality. Such curricula and using its materials resulted in a lot of problems. The least, it confused teachers and students as well. Islamic educationalists have been working hard to professionally meet the need. They are following a systematic approach of stating clear and achievable goals, building suitable content, and applying new technology to present these learning experiences and evaluate them. It also suggests a model for designing instructional systems that responds to the need of non-Arabic speaking Islamic communities and provide the knowledge needed in both linguistic and cultural aspects. It also puts forward a number of suggestions for the improvement of the teaching / learning Arabic for specific purposes in Bangladesh after a detailed investigation in the following areas: curriculum, teachers’ skills, method of teaching and assessment policy.

Keywords: communication, Quran, sunnah, educational institutes, specific purposes, curriculum, method of teaching

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Authors: Jae Ni Jang, Young Uk Kim

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Background: Chat Generative Pre-training Transformer-3 (ChatGPT; San Francisco, California, Open Artificial Intelligence) is an artificial intelligence chatbot based on a large language model designed to generate human-like text. As the usage of ChatGPT is increasing among less knowledgeable patients, medical students, and anesthesia and pain medicine residents or trainees, we aimed to evaluate the accuracy of ChatGPT-3 responses to questions about the American Society of Anesthesiologists (ASA) classification based on patients’ underlying diseases and assess the quality of the generated responses. Methods: A total of 47 questions were submitted to ChatGPT using textual prompts. The questions were designed for ChatGPT-3 to provide answers regarding ASA classification in response to common underlying diseases frequently observed in adult patients. In addition, we created 18 questions regarding the ASA classification for pediatric patients and pregnant women. The accuracy of ChatGPT’s responses was evaluated by cross-referencing with Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, and the American Society of Anesthesiologists’ ASA Physical Status Classification System (2020). Results: Out of the 47 questions pertaining to adults, ChatGPT -3 provided correct answers for only 23, resulting in an accuracy rate of 48.9%. Furthermore, the responses provided by ChatGPT-3 regarding children and pregnant women were mostly inaccurate, as indicated by a 28% accuracy rate (5 out of 18). Conclusions: ChatGPT provided correct responses to questions relevant to the daily clinical routine of anesthesiologists in approximately half of the cases, while the remaining responses contained errors. Therefore, caution is advised when using ChatGPT to retrieve anesthesia-related information. Although ChatGPT may not yet be suitable for clinical settings, we anticipate significant improvements in ChatGPT and other large language models in the near future. Regular assessments of ChatGPT's ASA classification accuracy are essential due to the evolving nature of ChatGPT as an artificial intelligence entity. This is especially important because ChatGPT has a clinically unacceptable rate of error and hallucination, particularly in pediatric patients and pregnant women. The methodology established in this study may be used to continue evaluating ChatGPT.

Keywords: American Society of Anesthesiologists, artificial intelligence, Chat Generative Pre-training Transformer-3, ChatGPT

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Delphine Morales, Florian Lombart, Agathe Truchot, Pauline Maire, Pascale Vigneron, Antoine Galmiche, Catherine Lok, Muriel Vayssade

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Targeted therapy molecules are used as a first-line treatment for metastatic melanoma with B-Raf mutation. Nevertheless, these molecules can cause side effects to patients and are efficient on 50 to 60 % of them. Indeed, melanoma cell sensitivity to targeted therapy molecules is dependent on tumor microenvironment (cell-cell and cell-extracellular matrix interactions). To better unravel factors modulating cell sensitivity to B-Raf inhibitor, we have developed and compared several melanoma models: from metastatic melanoma cells cultured as monolayer (2D) to a co-culture in a 3D dermal equivalent. Cell response was studied in different melanoma cell lines such as SK-MEL-28 (mutant B-Raf (V600E), sensitive to Vemurafenib), SK-MEL-3 (mutant B-Raf (V600E), resistant to Vemurafenib) and a primary culture of dermal human fibroblasts (HDFn). Assays have initially been performed in a monolayer cell culture (2D), then a second time on a 3D dermal equivalent (dermal human fibroblasts embedded in a collagen gel). All cell lines were treated with Vemurafenib (a B-Raf inhibitor) for 48 hours at various concentrations. Cell sensitivity to treatment was assessed under various aspects: Cell proliferation (cell counting, EdU incorporation, MTS assay), MAPK signaling pathway analysis (Western-Blotting), Apoptosis (TUNEL), Cytokine release (IL-6, IL-1α, HGF, TGF-β, TNF-α) upon Vemurafenib treatment (ELISA) and histology for 3D models. In 2D configuration, the inhibitory effect of Vemurafenib on cell proliferation was confirmed on SK-MEL-28 cells (IC50=0.5 µM), and not on the SK-MEL-3 cell line. No apoptotic signal was detected in SK-MEL-28-treated cells, suggesting a cytostatic effect of the Vemurafenib rather than a cytotoxic one. The inhibition of SK-MEL-28 cell proliferation upon treatment was correlated with a strong expression decrease of phosphorylated proteins involved in the MAPK pathway (ERK, MEK, and AKT/PKB). Vemurafenib (from 5 µM to 10 µM) also slowed down HDFn proliferation, whatever cell culture configuration (monolayer or 3D dermal equivalent). SK-MEL-28 cells cultured in the dermal equivalent were still sensitive to high Vemurafenib concentrations. To better characterize all cell population impacts (melanoma cells, dermal fibroblasts) on Vemurafenib efficacy, cytokine release is being studied in 2D and 3D models. We have successfully developed and validated a relevant 3D model, mimicking cutaneous metastatic melanoma and tumor microenvironment. This 3D melanoma model will become more complex by adding a third cell population, keratinocytes, allowing us to characterize the epidermis influence on the melanoma cell sensitivity to Vemurafenib. In the long run, the establishment of more relevant 3D melanoma models with patients’ cells might be useful for personalized therapy development. The authors would like to thank the Picardie region and the European Regional Development Fund (ERDF) 2014/2020 for the funding of this work and Oise committee of "La ligue contre le cancer".

Keywords: 3D human skin model, melanoma, tissue engineering, vemurafenib efficiency

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Authors: Vera Lucia Teixeira da Silva, Sandra Regina Buttros Gattolin de Paula

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The present study focuses on academic literacy and addresses the impact of semantic-discursive resources on the constitution of genres that are produced in such context. The research considers the development of writing in the academic context in Portuguese. Researches that address academic literacy and the characteristics of the texts produced in this context are rare, mainly with focus on the development of writing, considering three variables: the constitution of the writer, the perception of the reader/interlocutor and the organization of the informational text flow. The research aims to map the semantic-discursive resources of the written register in texts of several genres and produced by students in the first semester of the undergraduate course in Letters. The hypothesis raised is that writing in the academic environment is not a recurrent literacy practice for these learners and can be explained by the ontogenetic and phylogenetic nature of language development. Qualitative in nature, the present research has as empirical data texts produced in a half-yearly course of Reading and Textual Production; these data result from the proposition of four different writing proposals, in a total of 600 texts. The corpus is analyzed based on semantic-discursive resources, seeking to contemplate relevant aspects of language (grammar, discourse and social context) that reveal the choices made in the reader/writer interrelationship and the organizational flow of the Text. Among the semantic-discursive resources, the analysis includes three resources, including (a) appraisal and negotiation to understand the attitudes negotiated (roles of the participants of the discourse and their relationship with the other); (b) ideation to explain the construction of the experience (activities performed and participants); and (c) periodicity to outline the flow of information in the organization of the text according to the genre it instantiates. The results indicate the organizational difficulties of the flow of the text information. Cartography contributes to the understanding of the way writers use language in an effort to present themselves, evaluate someone else’s work, and communicate with readers.

Keywords: academic writing, Portuguese mother tongue, semantic-discursive resources, academic context

Procedia PDF Downloads 132

Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Z. Karahaliloğlu, E. Yalçın, M. Demirbilek, E.B. Denkbaş

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Critical-sized bone defects caused by trauma, bone diseases, prosthetic implant revision or tumor excision cannot be repaired by physiological regenerative processes. Current orthopedic applications for critical-sized bone defects are to use autologous bone grafts, bone allografts, or synthetic graft materials. However, these strategies are unable to solve completely the problem, and motivate the development of novel effective biological scaffolds for tissue engineering applications and regenerative medicine applications. In particular, scaffolds combined with a variety of bio-agents as fundamental tools emerge to provide the regeneration of damaged bone tissues due to their ability to promote cell growth and function. In this study, a magnetic silk fibroin (SF) hydrogel scaffold was prepared by electrogelation process of the concentrated Bombxy mori silk fibroin (8 %wt) aqueous solution. For enhancement of osteoblast-like cells (SaOS-2) growth and adhesion, basal fibroblast growth factor (bFGF) were conjugated physically to the HSA-coated magnetic nanoparticles (Fe3O4) and magnetic SF e-gel scaffolds were prepared by incorporation of Fe3O4, HSA (human serum albumin)=Fe3O4 and HSA=Fe3O4-bFGF nanoparticles. HSA=Fe3O4, HSA=Fe3O4-bFGF loaded and bare SF e-gels scaffolds were characterized using scanning electron microscopy (SEM.) For cell studies, human osteoblast-like cell line (SaOS-2) was used and an MTT assay was used to assess the cytotoxicity of magnetic silk fibroin e-gel scaffolds and cell density on these surfaces. For the evaluation osteogenic activation, ALP (alkaline phosphatase), the amount of mineralized calcium, total protein and collagen were studied. Fe3O4 nanoparticles were successfully synthesized and bFGF was conjugated to HSA=Fe3O4 nanoparticles with %97.5 of binding yield which has a particle size of 71.52±2.3 nm. Electron microscopy images of the prepared HSA and bFGF incorporated SF e-gel scaffolds showed a 3D porous morphology. In terms of water uptake results, bFGF conjugated HSA=Fe3O4 nanoparticles has the best water absorbability behavior among all groups. In the in-vitro cell culture studies realized using SaOS-2 cell line, the coating of Fe3O4 nanoparticles surface with a protein enhance the cell viability and HSA coating and bFGF conjugation, the both have an inductive effect in the cell proliferation. One of the markers of bone formation and osteoblast differentiation, according to the ALP activity and total protein results, HSA=Fe3O4-bFGF loaded SF e-gels had significantly enhanced ALP activity. Osteoblast cultured HSA=Fe3O4-bFGF loaded SF e-gels deposited more calcium compared with SF e-gel. The proposed magnetic scaffolds seem to be promising for bone tissue regeneration and used in future work for various applications.

Keywords: basic fibroblast growth factor (bFGF), e-gel, iron oxide nanoparticles, silk fibroin

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Authors: Mohammad R. Bhuyan, Mohammad J. Khattak

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Deterioration of flexible pavements due to crack reflection from its soil-cement base layer is a major concern around the globe. The service life of flexible pavement diminishes significantly because of the reflective cracks. Highway agencies are struggling for decades to prevent or mitigate these cracks in order to increase pavement service lives. The root cause of reflective cracks is the shrinkage crack which occurs in the soil-cement bases during the cement hydration process. The primary factor that causes the shrinkage is the cement content of the soil-cement mixture. With the increase of cement content, the soil-cement base gains strength and durability, which is necessary to withstand the traffic loads. But at the same time, higher cement content creates more shrinkage resulting in more reflective cracks in pavements. Historically, various states of USA have used the soil-cement bases for constructing flexile pavements. State of Louisiana (USA) had been using 8 to 10 percent of cement content to manufacture the soil-cement bases. Such traditional soil-cement bases yield 2.0 MPa (300 psi) 7-day compressive strength and are termed as cement stabilized design (CSD). As these CSD bases generate significant reflective cracks, another design of soil-cement base has been utilized by adding 4 to 6 percent of cement content called cement treated design (CTD), which yields 1.0 MPa (150 psi) 7-day compressive strength. The reduction of cement content in the CTD base is expected to minimize shrinkage cracks thus increasing pavement service lives. Hence, this research study evaluates the long-term field performance of CTD bases with respect to CSD bases used in flexible pavements. Pavement Management System of the state of Louisiana was utilized to select flexible pavement projects with CSD and CTD bases that had good historical record and time-series distress performance data. It should be noted that the state collects roughness and distress data for 1/10th mile section every 2-year period. In total, 120 CSD and CTD projects were analyzed in this research, where more than 145 miles (CTD) and 175 miles (CSD) of roadways data were accepted for performance evaluation and benefit-cost analyses. Here, the service life extension and area based on distress performance were considered as benefits. It was found that CTD bases increased 1 to 5 years of pavement service lives based on transverse cracking as compared to CSD bases. On the other hand, the service lives based on longitudinal and alligator cracking, rutting and roughness index remain the same. Hence, CTD bases provide some service life extension (2.6 years, on average) to the controlling distress; transverse cracking, but it was inexpensive due to its lesser cement content. Consequently, CTD bases become 20% more cost-effective than the traditional CSD bases, when both bases were compared by net benefit-cost ratio obtained from all distress types.

Keywords: cement treated base, cement stabilized base, reflective cracking , service life, flexible pavement

Procedia PDF Downloads 172

Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

Procedia PDF Downloads 112

Authors: Bendes Ákos

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Digital evidence will be the most widely used type of evidence in the future. With the development of the modern world, more and more new types of crimes have evolved and transformed. For this reason, it is extremely important to examine these types of crimes in order to get a comprehensive picture of them, with which we can help the authorities work. In 1865, with early technologies, people were able to forge a picture of a quality that is not even recognized today. With the help of today's technology, authorities receive a lot of false evidence. Officials are not able to process such a large amount of data, nor do they have the necessary technical knowledge to get a real picture of the authenticity of the given evidence. The digital world has many dangers. Unfortunately, we live in an age where we must protect everything digitally: our phones, our computers, our cars, and all the smart devices that are present in our personal lives and this is not only a burden on us, since companies, state and public utilities institutions are also forced to do so. The training of specialists and experts is essential so that the authorities can manage the incoming digital evidence at some level. When analyzing evidence, it is important to be able to examine it from the moment it is created. Establishing authenticity is a very important issue during official procedures. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. Otherwise, they will not have sufficient probative value and in case of doubt, the court will always decide in favor of the defendant. One of the most common problems in the world of digital data and evidence is doubt, which is why it is extremely important to examine the above-mentioned problems. The most effective way to avoid digital crimes is to prevent them, for which proper education and knowledge are essential. The aim is to present the dangers inherent in the digital world and the new types of digital crimes. After the comparison of the Hungarian investigative techniques with international practice, modernizing proposals will be given. A sufficiently stable yet flexible legislation is needed that can monitor the rapid changes in the world and not regulate afterward but rather provide an appropriate framework. It is also important to be able to distinguish between digital and digitalized evidence, as the degree of probative force differs greatly. The aim of the research is to promote effective international cooperation and uniform legal regulation in the world of digital crimes.

Keywords: digital crime, digital law, cyber crime, international cooperation, new crimes, skepticism

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Joseph Falzon, Margaret Nelson

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Background: Policy makers at European Union (EU) and national levels address the re-use of historic buildings calling for sustainable practices and approaches. Implementation stages of policy are crucial so that EU and national strategic objectives for historic building sustainability are achieved. Governance remains one of the key objectives to ensure resource sustainability. Objective: The aim of the research was to critically examine policies for the regeneration and adaptive re-use of historic buildings in the EU and national level, and to analyse gaps between EU and national legislation and policies, taking Malta as a case study. The impact of policies on regeneration and re-use of historic buildings was also studied. Research Design: Six semi-structured interviews with stakeholders including architects, investors and community representatives informed the research. All interviews were audio recorded and transcribed in the English language. Thematic analysis utilising Atlas.ti was conducted for the semi-structured interviews. All phases of the study were governed by research ethics. Findings: Findings were grouped in main themes: resources, experiences and governance. Other key issues included identification of gaps in policies, key lessons and quality of regeneration. Abandonment of heritage buildings was discussed, for which main reasons had been attributed to governance related issues both from the policy making perspective as well as the attitudes of certain officials representing the authorities. The role of authorities, co-ordination between government entities, fairness in decision making, enforcement and management brought high criticism from stakeholders along with time factors due to the lengthy procedures taken by authorities. Policies presented an array from different perspectives of same stakeholder groups. Rather than policy, it is the interpretation of policy that presented certain gaps. Interpretations depend highly on the stakeholders putting forward certain arguments. All stakeholders acknowledged the value of heritage in regeneration. Conclusion: Active stakeholder involvement is essential in policy framework development. Research informed policies and streamlining of policies are necessary. National authorities need to shift from a segmented approach to a holistic approach.

Keywords: adaptive re-use, historic buildings, policy, sustainable

Procedia PDF Downloads 398

Authors: Loredana E. Nita, Aurica P. Chiriac, Elena Stoleru, Alina Diaconu, Tudorachi Nita

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Self-assembly processes are an attractive method to form new and complex structures between macromolecular compounds to be used for specific applications. In this context, intramolecular and intermolecular bonds play a key role during self-assembling processes in preparation of carrier systems of bioactive substances. Polyelectrolyte complexes (PECs) are formed through electrostatic interactions, and though they are significantly below of the covalent linkages in their strength, these complexes are sufficiently stable owing to the association processes. The relative ease way of PECs formation makes from them a versatile tool for preparation of various materials, with properties that can be tuned by adjusting several parameters, such as the chemical composition and structure of polyelectrolytes, pH and ionic strength of solutions, temperature and post-treatment procedures. For example, protein-polyelectrolyte complexes (PPCs) are playing an important role in various chemical and biological processes, such as protein separation, enzyme stabilization and polymer drug delivery systems. The present investigation is focused on evaluation of the PPC formation between a synthetic polypeptide (poly(aspartic acid) – PAS) and a natural protein (bovine serum albumin - BSA). The PPC obtained from PAS and BSA in different ratio was investigated by corroboration of various techniques of characterization as: spectroscopy, microscopy, thermo-gravimetric analysis, DLS and zeta potential determination, measurements which were performed in static and/or dynamic conditions. The static contact angle of the sample films was also determined in order to evaluate the changes brought upon surface free energy of the prepared PPCs in interdependence with the complexes composition. The evolution of hydrodynamic diameter and zeta potential of the PPC, recorded in situ, confirm changes of both co-partners conformation, a 1/1 ratio between protein and polyelectrolyte being benefit for the preparation of a stable PPC. Also, the study evidenced the dependence of PPC formation on the temperature of preparation. Thus, at low temperatures the PPC is formed with compact structure, small dimension and hydrodynamic diameter, close to those of BSA. The behavior at thermal treatment of the prepared PPCs is in agreement with the composition of the complexes. From the contact angle determination results the increase of the PPC films cohesion, which is higher than that of BSA films. Also, a higher hydrophobicity corresponds to the new PPC films denoting a good adhesion of the red blood cells onto the surface of PSA/BSA interpenetrated systems. The SEM investigation evidenced as well the specific internal structure of PPC concretized in phases with different size and shape in interdependence with the interpolymer mixture composition.

Keywords: polyelectrolyte – protein complex, bovine serum albumin, poly(aspartic acid), self-assembly

Procedia PDF Downloads 247

Authors: Ligang Wang, Theodoros Damartzis, Stefan Diethelm, Jan Van Herle, François Marechal

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Biogas production from anaerobic digestion of organic sludge from wastewater treatment as well as various urban and agricultural organic wastes is of great significance to achieve a sustainable society. Two upgrading approaches for cleaned biogas can be considered: (1) direct H₂ injection for catalytic CO₂ methanation and (2) CO₂ separation from biogas. The first approach usually employs electrolysis technologies to generate hydrogen and increases the biogas production rate; while the second one usually applies commercially-available highly-selective membrane technologies to efficiently extract CO₂ from the biogas with the latter being then sent afterward for compression and storage for further use. A straightforward way of utilizing the captured CO₂ is on-site catalytic CO₂ methanation. From the perspective of system complexity, the second approach may be questioned, since it introduces an additional expensive membrane component for producing the same amount of methane. However, given the circumstance that the sustainability of the produced biogas should be retained after biogas upgrading, renewable electricity should be supplied to drive the electrolyzer. Therefore, considering the intermittent nature and seasonal variation of renewable electricity supply, the second approach offers high operational flexibility. This indicates that these two approaches should be compared based on the availability and scale of the local renewable power supply and not only the technical systems themselves. Solid-oxide electrolysis generally offers high overall system efficiency, and more importantly, it can achieve simultaneous electrolysis of CO₂ and H₂O (namely, co-electrolysis), which may bring significant benefits for the case of CO₂ separation from the produced biogas. When taking co-electrolysis into account, two additional upgrading approaches can be proposed: (1) direct steam injection into the biogas with the mixture going through the SOE, and (2) CO₂ separation from biogas which can be used later for co-electrolysis. The case study of integrating SOE to a wastewater treatment plant is investigated with wind power as the renewable power. The dynamic production of biogas is provided on an hourly basis with the corresponding oxygen and heating requirements. All four approaches mentioned above are investigated and compared thermo-economically: (a) steam-electrolysis with grid power, as the base case for steam electrolysis, (b) CO₂ separation and co-electrolysis with grid power, as the base case for co-electrolysis, (c) steam-electrolysis and CO₂ separation (and storage) with wind power, and (d) co-electrolysis and CO₂ separation (and storage) with wind power. The influence of the scale of wind power supply is investigated by a sensitivity analysis. The results derived provide general understanding on the economic competitiveness of SOE for sustainable biogas upgrading, thus assisting the decision making for biogas production sites. The research leading to the presented work is funded by European Union’s Horizon 2020 under grant agreements n° 699892 (ECo, topic H2020-JTI-FCH-2015-1) and SCCER BIOSWEET.

Keywords: biogas upgrading, solid-oxide electrolyzer, co-electrolysis, CO₂ utilization, energy storage

Procedia PDF Downloads 159

Authors: H. Tavakoli, S. S. Mohtasebi, R. Alimardani, R. Gebbers

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Nitrogen (N) is one of the most important agricultural inputs affecting crop growth, yield and quality in rain-fed cereal production. N demand of crops varies spatially across fields due to spatial differences in soil conditions. In addition, the response of a crop to the fertilizer applications is heavily reliant on plant available water. Matching N supply to water availability is thus essential to achieve an optimal crop response. The objective of this study was to determine effect of drought stress on estimation of nitrogen status of winter wheat by some vegetation indices. During the 2012 growing season, a field experiment was conducted at the Bundessortenamt (German Plant Variety Office) Marquardt experimental station which is located in the village of Marquardt about 5 km northwest of Potsdam, Germany (52°27' N, 12°57' E). The experiment was designed as a randomized split block design with two replications. Treatments consisted of four N fertilization rates (0, 60, 120 and 240 kg N ha-1, in total) and two water regimes (irrigated (Irr) and non-irrigated (NIrr)) in total of 16 plots with dimension of 4.5 × 9.0 m. The indices were calculated using readings of a spectroradiometer made of tec5 components. The main parts were two “Zeiss MMS1 nir enh” diode-array sensors with a nominal rage of 300 to 1150 nm with less than 10 nm resolutions and an effective range of 400 to 1000 nm. The following vegetation indices were calculated: NDVI, GNDVI, SR, MSR, NDRE, RDVI, REIP, SAVI, OSAVI, MSAVI, and PRI. All the experiments were conducted during the growing season in different plant growth stages including: stem elongation (BBCH=32-41), booting stage (BBCH=43), inflorescence emergence, heading (BBCH=56-58), flowering (BBCH=65-69), and development of fruit (BBCH=71). According to the results obtained, among the indices, NDRE and REIP were less affected by drought stress and can provide reliable wheat nitrogen status information, regardless of water status of the plant. They also showed strong relations with nitrogen status of winter wheat.

Keywords: nitrogen status, drought stress, vegetation indices, precision agriculture

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Authors: Jacqueline Y. Thompson, Sam Watson, Lee Middleton, Karla Hemming

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Introduction: The odds ratio (estimated via logistic regression) is a well-established and common approach for estimating covariate-adjusted binary treatment effects when comparing a treatment and control group with dichotomous outcomes. Its popularity is primarily because of its stability and robustness to model misspecification. However, the situation is different for the relative risk and risk difference, which are arguably easier to interpret and better suited to specific designs such as non-inferiority studies. So far, there is no equivalent, widely acceptable approach to estimate an adjusted relative risk and risk difference when conducting clinical trials. This is partly due to the lack of a comprehensive evaluation of available candidate methods. Methods/Approach: A simulation study is designed to evaluate the performance of relevant candidate methods to estimate relative risks to represent conditional and marginal estimation approaches. We consider the log-binomial, generalised linear models (GLM) with iteratively weighted least-squares (IWLS) and model-based standard errors (SE); log-binomial GLM with convex optimisation and model-based SEs; log-binomial GLM with convex optimisation and permutation tests; modified-Poisson GLM IWLS and robust SEs; log-binomial generalised estimation equations (GEE) and robust SEs; marginal standardisation and delta method SEs; and marginal standardisation and permutation test SEs. Independent and identically distributed datasets are simulated from a randomised controlled trial to evaluate these candidate methods. Simulations are replicated 10000 times for each scenario across all possible combinations of sample sizes (200, 1000, and 5000), outcomes (10%, 50%, and 80%), and covariates (ranging from -0.05 to 0.7) representing weak, moderate or strong relationships. Treatment effects (ranging from 0, -0.5, 1; on the log-scale) will consider null (H0) and alternative (H1) hypotheses to evaluate coverage and power in realistic scenarios. Performance measures (bias, mean square error (MSE), relative efficiency, and convergence rates) are evaluated across scenarios covering a range of sample sizes, event rates, covariate prognostic strength, and model misspecifications. Potential Results, Relevance & Impact: There are several methods for estimating unadjusted and adjusted relative risks. However, it is unclear which method(s) is the most efficient, preserves type-I error rate, is robust to model misspecification, or is the most powerful when adjusting for non-prognostic and prognostic covariates. GEE estimations may be biased when the outcome distributions are not from marginal binary data. Also, it seems that marginal standardisation and convex optimisation may perform better than GLM IWLS log-binomial.

Keywords: binary outcomes, statistical methods, clinical trials, simulation study

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Authors: Stella Chioma Nwizu

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The National Commission for Adult and Non Formal Education (NMEC) in Nigeria is charged with the reduction of illiteracy rate through the development, monitoring, and supervision of literacy programmes in Nigeria. In spite of various efforts by NMEC to reduce illiteracy, literature still shows that the illiteracy rate is still high. According to NMEC/UNICEF, about 60 million Nigerians are non-literate, and nearly two thirds of them are women. This situation forced the government to search for innovative and better approaches to literacy promotion and delivery. The literacy by radio project was adopted as an innovative intervention to literacy delivery in Nigeria because the radio is the cheapest and most easily affordable medium for non-literates. The project aimed at widening access to literacy programmes for the non-literate marginalized and disadvantaged groups in Nigeria by taking literacy programmes to their door steps. The literacy by radio has worked perfectly well in non-literacy reduction in Cuba. This innovative intervention of literacy by radio is anchored on the diffusion of innovation theory by Rogers. The literacy by radio has been going on for fifteen years and the efficacy and contributions of this innovation need to be investigated. Thus, the purpose of this research is to review the contributions of the literacy by radio in Nigeria. The researcher adopted the survey research design for the study. The population for the study consisted of 2,706 participants and 47 facilitators of the literacy by radio programme in the 10 pilot states in Nigeria. A sample of four states made up of 302 participants and eight facilitators were used for the study. Information was collected through Focus Group Discussion (FGD), interviews and content analysis of official documents. The data were analysed qualitatively to review the contributions of literacy by radio project and determine the efficacy of this innovative approach in facilitating literacy in Nigeria. Results from the field experience showed, among others, that more non-literates have better access to literacy programmes through this innovative approach. The pilot project was 88% successful; not less than 2,110 adults were made literate through the literacy by radio project in 2017. However, lack of enthusiasm and commitment on the part of the technical committee and facilitators due to non-payment of honorarium, poor signals from radio stations, interruption of lectures with adverts, low community involvement in decision making in the project are challenges to the success rate of the project. The researcher acknowledges the need to customize all materials and broadcasts in all the dialects of the participants and the inclusion of more civil rights, environmental protection and agricultural skills into the project. The study recommends among others, improved and timely funding of the project by the Federal Government to enable NMEC to fulfill her obligations towards the greater success of the programme, setting up of independent radio stations for airing the programmes and proper monitoring and evaluation of the project by NMEC and State Agencies for greater effectiveness. In an era of the knowledge-driven economy, no one should be allowed to get saddled with the weight of illiteracy.

Keywords: innovative approach, literacy, project, radio, survey

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Authors: Mohamed Shafi Bin Mahboob Ali

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Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.

Keywords: synchronous, colon, tumor, adenocarcinoma

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Authors: Kim Haekyoung, Au Yunkyoung

Abstract:

As digital technology continues to advance and become more widely accessible, young children are also growing up experiencing various media from infancy. In this changing environment, educating young children on media literacy has become an increasingly important task. With the diversification of media, it has become more necessary for children to understand, utilize, and critically explore the meaning of multimodal texts, which include text, images, and sounds connected to each other. Early childhood is a period when media literacy can bloom, and educational and policy support are needed to enable young children to express their opinions, communicate, and participate fully. However, most current media literacy education for young children focuses solely on teaching how to use media, with limited practical application and utilization. Therefore, this study aims to develop an inquiry-based media literacy education program for young children using topic-specific media content and explore the program's potential and impact on children's media literacy learning. Based on a theoretical and literature review on media literacy education, analysis of existing educational programs, and a survey on the current status and teacher perception of media literacy education for young children, this study developed a media literacy education program for young children considering the components of media literacy (understanding media characteristics, self-regulation, self-expression, critical understanding, ethical norms, social communication). To verify the effectiveness of the program, it was implemented with 20 five-year-old children from C City S Kindergarten, starting from March 24 to May 26, 2022, once a week for a total of 6 sessions. To explore quantitative changes before and after program implementation, repeated-measures analysis of variance was conducted, and qualitative analysis was used to analyze observed changes in the process. significant improvement in media literacy levels, such as understanding media characteristics, self-regulation, self-expression, critical understanding, ethical norms, and social communication. The developed inquiry-based media literacy education program for young children in this study can be effectively applied to enhance children's media literacy education and help improve their media literacy levels. Observed changes in the process also confirmed that children improved their ability to learn various topics, express their thoughts, and communicate with others using media content. These findings emphasize the importance of developing and implementing media literacy education programs and can help children develop the ability to safely and effectively use media in their media environment. Based on exploring the potential and impact of the inquiry-based media literacy education program for young children, this study confirmed positive changes in children's media literacy levels as a result of the program's implementation. These findings suggest that beyond education on how to use media, it can help develop children's ability to safely and effectively use media in their media environment. Furthermore, to improve children's media literacy levels and create a safe media environment, a variety of content and methodologies are needed, and continuous development and evaluation of educational programs are anticipated.

Keywords: young children, media literacy, media literacy education program, media content

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