Search results for: combined evaluation of concurrent risk events

Authors: Temesgen Sidamo, Prakruti S. Rao, Eleni Akllilu, Workineh Shibeshi, Yumi Park, Yong-Soon Cho, Jae-Gook Shin, Scott K. Heysell, Stellah G. Mpagama, Ephrem Engidawork

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The fluoroquinolones (FQs) are used off-label for the treatment of multidrug-resistant tuberculosis (MDR-TB), and for evaluation in shortening the duration of drug-susceptible TB in recently prioritized regimens. Within the class, levofloxacin (LFX) and moxifloxacin (MXF) play a substantial role in ensuring success in treatment outcomes. However, sub-therapeutic plasma concentrations of either LFX or MXF may drive unfavorable treatment outcomes. To the best of our knowledge, the pharmacokinetics of LFX and MXF in Ethiopian patients with MDR-TB have not yet been investigated. Therefore, the aim of this study was to develop a population pharmacokinetic (PopPK) model of levofloxacin (LFX) and moxifloxacin (MXF) and assess the percent probability of target attainment (PTA) as defined by the ratio of the area under the plasma concentration-time curve over 24-h (AUC0-24) and the in vitro minimum inhibitory concentration (MIC) (AUC0-24/MIC) in Ethiopian MDR-TB patients. Steady-state plasma was collected from 39 MDR-TB patients enrolled in the programmatic treatment course and the drug concentrations were determined using optimized liquid chromatography-tandem mass spectrometry. In addition, the in vitro MIC of the patients' pretreatment clinical isolates was determined. PopPK and simulations were run at various doses, and PK parameters were estimated. The effect of covariates on the PK parameters and the PTA for maximum mycobacterial kill and resistance prevention was also investigated. LFX and MXF both fit in a one-compartment model with adjustments. The apparent volume of distribution (V) and clearance (CL) of LFX were influenced by serum creatinine (Scr), whereas the absorption constant (Ka) and V of MXF were influenced by Scr and BMI, respectively. The PTA for LFX maximal mycobacterial kill at the critical MIC of 0.5 mg/L was 29%, 62%, and 95% with the simulated 750 mg, 1000 mg, and 1500 mg doses, respectively, whereas the PTA for resistance prevention at 1500 mg was only 4.8%, with none of the lower doses achieving this target. At the critical MIC of 0.25 mg/L, there was no difference in the PTA (94.4%) for maximum bacterial kill among the simulated doses of MXF (600 mg, 800 mg, and 1000 mg), but the PTA for resistance prevention improved proportionately with dose. Standard LFX and MXF doses may not provide adequate drug exposure. LFX PopPK is more predictable for maximum mycobacterial kill, whereas MXF's resistance prevention target increases with dose. Scr and BMI are likely to be important covariates in dose optimization or therapeutic drug monitoring (TDM) studies in Ethiopian patients.

Keywords: population PK, PTA, moxifloxacin, levofloxacin, MDR-TB patients, ethiopia

Procedia PDF Downloads 115

Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

Procedia PDF Downloads 91

Authors: T. Elrazaz

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This paper examines accrual and real earnings management by publicly listed targets around mergers and acquisitions. Prior literature shows that earnings management around mergers and acquisitions can have a significant economic impact because of the associated wealth transfers among stakeholders. More importantly, acting on behalf of their shareholders or pursuing their self-interests, managers of both targets and acquirers may be equally motivated to manipulate earnings prior to an acquisition to generate higher gains for their shareholders or themselves. Building on the grounds of information asymmetry, agency conflicts, stewardship theory, and the revelation principle, this study addresses the question of whether takeover targets employ accrual and real earnings management in the periods prior to the announcement of Mergers and Acquisitions (M&A). Additionally, this study examines whether acquirers are able to detect targets’ earnings management, and in response, adjust the acquisition premium paid in order not to face the risk of overpayment. This study uses an aggregate accruals approach in estimating accrual earnings management as proxied by estimated abnormal accruals. Additionally, real earnings management is proxied for by employing widely used models in accounting and finance literature. The results of this study indicate that takeover targets manipulate their earnings using accruals in the second year with an earnings release prior to the announcement of the M&A. Moreover, in partitioning the sample of targets according to the method of payment used in the deal, the results are restricted only to targets of stock-financed deals. These results are consistent with the argument that targets of cash-only or mixed-payment deals do not have the same strong motivations to manage their earnings as their stock-financed deals counterparts do additionally supporting the findings of prior studies that the method of payment in takeovers is value relevant. The findings of this study also indicate that takeover targets manipulate earnings upwards through cutting discretionary expenses the year prior to the acquisition while they do not do so by manipulating sales or production costs. Moreover, in partitioning the sample of targets according to the method of payment used in the deal, the results are restricted only to targets of stock-financed deals, providing further robustness to the results derived under the accrual-based models. Finally, this study finds evidence suggesting that acquirers are fully aware of the accrual-based techniques employed by takeover targets and can unveil such manipulation practices. These results are robust to alternative accrual and real earnings management proxies, as well as controlling for the method of payment in the deal.

Keywords: accrual earnings management, acquisition premium, real earnings management, takeover targets

Procedia PDF Downloads 112

Authors: Damtew Samson Zerihun

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This paper primarily describes the concept of a hierarchical safety control (HSC) in discrete manufacturing to up-hold productivity with human intervention and machine failures using a systematic approach, through increasing the system availability and using additional knowledge on machines so as to improve the human machine collaboration (HMC). It also highlights the implemented PLC safety algorithm, in applying this generic concept to a concrete pro-duction line using a lab demonstrator called FATIE (Factory Automation Test and Integration Environment). Furthermore, the paper describes a model and provide a systematic representation of human-machine collabora-tion in discrete manufacturing and to this end, the Hierarchical Safety Control concept is proposed. This offers a ge-neric description of human-machine collaboration based on Finite State Machines (FSM) that can be applied to vari-ous discrete manufacturing lines instead of using ad-hoc solutions for each line. With its reusability, flexibility, and extendibility, the Hierarchical Safety Control scheme allows upholding productivity while maintaining safety with reduced engineering effort compared to existing solutions. The approach to the solution begins with a successful partitioning of different zones around the Integrated Manufacturing System (IMS), which are defined by operator tasks and the risk assessment, used to describe the location of the human operator and thus to identify the related po-tential hazards and trigger the corresponding safety functions to mitigate it. This includes selective reduced speed zones and stop zones, and in addition with the hierarchical safety control scheme and advanced safety functions such as safe standstill and safe reduced speed are used to achieve the main goals in improving the safe Human Ma-chine Collaboration and increasing the productivity. In a sample scenarios, It is shown that an increase of productivity in the order of 2.5% is already possible with a hi-erarchical safety control, which consequently under a given assumptions, a total sum of 213 € could be saved for each intervention, compared to a protective stop reaction. Thereby the loss is reduced by 22.8%, if occasional haz-ard can be refined in a hierarchical way. Furthermore, production downtime due to temporary unavailability of safety devices can be avoided with safety failover that can save millions per year. Moreover, the paper highlights the proof of the development, implementation and application of the concept on the lab demonstrator (FATIE), where it is realized on the new safety PLCs, Drive Units, HMI as well as Safety devices in addition to the main components of the IMS.

Keywords: discrete automation, hierarchical safety controller, human machine collaboration, programmable logical controller

Procedia PDF Downloads 366

Authors: Coriolano Salvini, Ambra Giovannelli

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The use of renewable energy sources for electric power production leads to reduced CO2 emissions and contributes to improving the domestic energy security. On the other hand, the intermittency and unpredictability of their availability poses relevant problems in fulfilling safely and in a cost efficient way the load demand along the time. Significant benefits in terms of “grid system applications”, “end-use applications” and “renewable applications” can be achieved by introducing energy storage systems. Among the currently available solutions, CAES (Compressed Air Energy Storage) shows favorable features. Small-medium size plants equipped with artificial air reservoirs can constitute an interesting option to get efficient and cost-effective distributed energy storage systems. The present paper is addressed to the design and off-design analysis of the compression system of small size CAES plants suited to absorb electric power in the range of hundreds of kilowatt. The system of interest is constituted by an intercooled (in case aftercooled) multi-stage reciprocating compressor and a man-made reservoir obtained by connecting large diameter steel pipe sections. A specific methodology for the system preliminary sizing and off-design modeling has been developed. Since during the charging phase the electric power absorbed along the time has to change according to the peculiar CAES requirements and the pressure ratio increases continuously during the filling of the reservoir, the compressor has to work at variable mass flow rate. In order to ensure an appropriately wide range of operations, particular attention has been paid to the selection of the most suitable compressor capacity control device. Given the capacity regulation margin of the compressor and the actual level of charge of the reservoir, the proposed approach allows the instant-by-instant evaluation of minimum and maximum electric power absorbable from the grid. The developed tool gives useful information to appropriately size the compression system and to manage it in the most effective way. Various cases characterized by different system requirements are analysed. Results are given and widely discussed.

Keywords: artificial air storage reservoir, compressed air energy storage (CAES), compressor design, compression system management.

Procedia PDF Downloads 224

Authors: Alija Uzunovic, Sasa Pilipovic, Aida Sapcanin, Zahida Ademovic, Berina Pilipović

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Capsaicin is a naturally occurring alkaloid extracted from capsicum fruit extracts of different of Capsicum species. It has been employed topically to treat many diseases such as rheumatoid arthritis, osteoarthritis, cancer pain and nerve pain in diabetes. The high degree of pre-systemic metabolism of intragastrical capsaicin and the short half-life of capsaicin by intravenous administration made topical application of capsaicin advantageous. In this study, we have evaluated differences in the dissolution characteristics of capsaicin patch 11 mg (purchased from market) at different dissolution rotation speed. The proposed patch area is 308 cm2 (22 cm x 14 cm; it contains 36 µg of capsaicin per square centimeter of adhesive). USP Apparatus 5 (Paddle Over Disc) is used for transdermal patch testing. The dissolution study was conducted using USP apparatus 5 (n=6), ERWEKA DT800 dissolution tester (paddle-type) with addition of a disc. The fabricated patch of 308 cm2 is to be cut into 9 cm2 was placed against a disc (delivery side up) retained with the stainless-steel screen and exposed to 500 mL of phosphate buffer solution pH 7.4. All dissolution studies were carried out at 32 ± 0.5 °C and different rotation speed (50± 5; 100± 5 and 150± 5 rpm). 5 ml aliquots of samples were withdrawn at various time intervals (1, 4, 8 and 12 hours) and replaced with 5 ml of dissolution medium. Withdrawn were appropriately diluted and analyzed by reversed-phase liquid chromatography (RP-LC). A Reversed Phase Liquid Chromatography (RP-LC) method has been developed, optimized and validated for the separation and quantitation of capsaicin in a transdermal patch. The method uses a ProntoSIL 120-3-C18 AQ 125 x 4,0 mm (3 μm) column maintained at 600C. The mobile phase consisted of acetonitrile: water (50:50 v/v), the flow rate of 0.9 mL/min, the injection volume 10 μL and the detection wavelength 222 nm. The used RP-LC method is simple, sensitive and accurate and can be applied for fast (total chromatographic run time was 4.0 minutes) and simultaneous analysis of capsaicin and dihydrocapsaicin in a transdermal patch. According to the results obtained in this study, we can conclude that the relative difference of dissolution rate of capsaicin after 12 hours was elevated by increase of dissolution rotation speed (100 rpm vs 50 rpm: 84.9± 11.3% and 150 rpm vs 100 rpm: 39.8± 8.3%). Although several apparatus and procedures (USP apparatus 5, 6, 7 and a paddle over extraction cell method) have been used to study in vitro release characteristics of transdermal patches, USP Apparatus 5 (Paddle Over Disc) could be considered as a discriminatory test. would be able to point out the differences in the dissolution rate of capsaicin at different rotation speed.

Keywords: capsaicin, in vitro, patch, RP-LC, transdermal

Procedia PDF Downloads 223

Authors: F. Saccucci

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Gamification has now started to take root in the post-secondary classroom. Educators have learned much about gamification to date but there is still a great deal to learn. One definition of gamification is the ability to engage post-secondary students with games that are fun and correlate to class room curriculum. There is no shortage of literature illustrating the advantages of gamification in the class room. This study is an extension of similar thought as well as an extension of a previous study where in class testing proved with the used of paired T-test that gamification did significantly improve the students’ understanding of subject material. Gamification itself in the class room can range from high end computer simulated software to paper based games of which both have advantages and disadvantages. This analysis used a paper based game to highlight certain qualitative advantages of gamification. The paper based game in this analysis was inexpensive, required low preparation time for the faculty member and consumed approximately 20 minutes of class room time. Data for the study was collected through in class student feedback surveys and narrative from the faculty member moderating the game. Students were randomly selected into groups of four. Qualitative advantages identified in this analysis included: 1. Students had a chance to meet, connect and know other students. 2. Students enjoyed the gamification process given there was a sense of fun and competition. 3. The post assessment that followed the simulation game was not part of their grade calculation therefore it was an opportunity to participate in a low risk activity whereby students could subsequently self-assess their understanding of the subject material. 4. In the view of the student, content knowledge did increase after the gamification process. These qualitative advantages identified in this analysis contribute to the argument that there should be an attempt to use gamification in today’s post-secondary class room. The analysis also highlighted that eighty (80) percent of the respondents believe twenty minutes devoted to the gamification process was appropriate, however twenty (20) percentage of respondents believed that rather than scheduling a gamification process and its post quiz in the last week, a review for the final exam may have been more useful. An additional study to this hopes to determine if the scheduling of the gamification had any correlation to a percentage of the students not wanting to be engaged in the process. As well, the additional study hopes to determine at what incremental level of time invested in class room gamification produce no material incremental benefits to the student as well as determine if any correlation exist between respondents preferring not to have it at the end of the semester to students not believing the gamification process added to the increase of their curricular knowledge.

Keywords: gamification, inexpensive, non-quantitative advantages, post-secondary

Procedia PDF Downloads 204

Authors: Iman Shabanzadeh

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Earthquake is known as one of the most frequent natural hazards in Iran. Therefore, policy making to improve the strengthening of structures is one of the requirements of the approach to prevent and reduce the risk of the destructive effects of earthquakes. In order to choose the optimal policy in the face of earthquakes, this article tries to examine the cost of financial damages caused by earthquakes in the building sector and compare it with the costs of retrofitting. In this study, the results of adopting the scenario of "action after the earthquake" and the policy scenario of "strengthening structures before the earthquake" have been collected, calculated and finally analyzed by putting them together. Methodologically, data received from governorates and building retrofitting engineering companies have been used. The scope of the study is earthquakes occurred in the geographical area of Iran, and among them, eight earthquakes have been specifically studied: Miane, Ahar and Haris, Qator, Momor, Khorasan, Damghan and Shahroud, Gohran, Hormozgan and Ezgole. The main basis of the calculations is the data obtained from retrofitting companies regarding the cost per square meter of building retrofitting and the data of the governorate regarding the power of earthquake destruction, the realized costs for the reconstruction and construction of residential units. The estimated costs have been converted to the value of 2021 using the time value of money method to enable comparison and aggregation. The cost-benefit comparison of the two policies of action after the earthquake and retrofitting before the earthquake in the eight earthquakes investigated shows that the country has suffered five thousand billion Tomans of losses due to the lack of retrofitting of buildings against earthquakes. Based on the data of the Budget Law's of Iran, this figure was approximately twice the budget of the Ministry of Roads and Urban Development and five times the budget of the Islamic Revolution Housing Foundation in 2021. The results show that the policy of retrofitting structures before an earthquake is significantly more optimal than the competing scenario. The comparison of the two policy scenarios examined in this study shows that the policy of retrofitting buildings before an earthquake, on the one hand, prevents huge losses, and on the other hand, by increasing the number of earthquake-resistant houses, it reduces the amount of earthquake destruction. In addition to other positive effects of retrofitting, such as the reduction of mortality due to earthquake resistance of buildings and the reduction of other economic and social effects caused by earthquakes. These are things that can prove the cost-effectiveness of the policy scenario of "strengthening structures before earthquakes" in Iran.

Keywords: disaster economy, earthquake economy, cost-benefit analysis, resilience

Procedia PDF Downloads 55

Authors: Buruk Kitachew Wossenyeleh

Abstract:

Groundwater is the largest freshwater reservoir in the world. Like the other reservoirs of the hydrologic cycle, it is a finite resource. This study focused on the groundwater modeling of the Ter Kamerenbos well field to understand the groundwater flow system and the impact of different scenarios. The study area covers 68.9Km2 in the Brussels Capital Region and is situated in two river catchments, i.e., Zenne River and Woluwe Stream. The aquifer system has three layers, but in the modeling, they are considered as one layer due to their hydrogeological properties. The catchment aquifer system is replenished by direct recharge from rainfall. The groundwater recharge of the catchment is determined using the spatially distributed water balance model called WetSpass, and it varies annually from zero to 340mm. This groundwater recharge is used as the top boundary condition for the groundwater modeling of the study area. During the groundwater modeling using Processing MODFLOW, constant head boundary conditions are used in the north and south boundaries of the study area. For the east and west boundaries of the study area, head-dependent flow boundary conditions are used. The groundwater model is calibrated manually and automatically using observed hydraulic heads in 12 observation wells. The model performance evaluation showed that the root means the square error is 1.89m and that the NSE is 0.98. The head contour map of the simulated hydraulic heads indicates the flow direction in the catchment, mainly from the Woluwe to Zenne catchment. The simulated head in the study area varies from 13m to 78m. The higher hydraulic heads are found in the southwest of the study area, which has the forest as a land-use type. This calibrated model was run for the climate change scenario and well operation scenario. Climate change may cause the groundwater recharge to increase by 43% and decrease by 30% in 2100 from current conditions for the high and low climate change scenario, respectively. The groundwater head varies for a high climate change scenario from 13m to 82m, whereas for a low climate change scenario, it varies from 13m to 76m. If doubling of the pumping discharge assumed, the groundwater head varies from 13m to 76.5m. However, if the shutdown of the pumps is assumed, the head varies in the range of 13m to 79m. It is concluded that the groundwater model is done in a satisfactory way with some limitations, and the model output can be used to understand the aquifer system under steady-state conditions. Finally, some recommendations are made for the future use and improvement of the model.

Keywords: Ter Kamerenbos, groundwater modelling, WetSpass, climate change, well operation

Procedia PDF Downloads 148

Authors: Mokgadi Julia Ngoepe-Ntsoane

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The article aims to make a case for a legislative framework for the fire sector in South Africa. Robust legislative framework is essential for empowering those with obligatory mandate within the sector. This article contributes to the body of knowledge in the field of policy reviews particularly with regards to the legal framework. It has been observed overtime that the scholarly contributions in this field are limited. Document analysis was the methodology selected for the investigation of the various legal frameworks existing in the country. It has been established that indeed the national legislation on the fire industry does not exist in South Africa. From the documents analysed, it was revealed that the sector is dominated by cartels who are exploiting the new entrants to the market particularly SMEs. It is evident that these cartels are monopolising the system as they have long been operating in the system turning it into self- owned entities. Commitment to addressing the challenges faced by fire services and creating a framework for the evolving role that fire brigade services are expected to execute in building safer and sustainable communities is vital. Legislation for the fire sector ought to be concluded with immediate effect. The outdated national fire legislation has necessitated the monopolisation and manipulation of the system by dominating organisations which cause a painful discrimination and exploitation of smaller service providers to enter the market for trading in that occupation. The barrier to entry bears long term negative effects on national priority areas such as employment creation, poverty, and others. This monopolisation and marginalisation practices by cartels in the sector calls for urgent attention by government because if left attended, it will leave a lot of people particularly women and youth being disadvantaged and frustrated. The downcast syndrome exercised within the fire sector has wreaked havoc and is devastating. This is caused by cartels that have been within the sector for some time, who know the strengths and weaknesses of processes, shortcuts, advantages and consequences of various actions. These people take advantage of new entrants to the sector who in turn find it difficult to manoeuvre, find the market dissonant and end up giving up their good ideas and intentions. There are many pieces of legislation which are industry specific such as housing, forestry, agriculture, health, security, environmental which are used to regulate systems within the institutions involved. Other regulations exist as bi-laws for guiding the management within the municipalities.

Keywords: sustainable job creation, growth and development, transformation, risk management

Procedia PDF Downloads 169

Authors: Ahmed. Abdel Bary, Omneya. Khowessah, Mojahed. al-jamrah

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Introduction: The major challenge with the design of oral dosage forms lies with their poor bioavailability. The most frequent causes of low oral bioavailability are attributed to poor solubility and low permeability. The aim of this study was to develop solid nanodispersed tablet formulation of Glimepiride for the enhancement of the solubility and bioavailability. Methodology: Solid nanodispersions of Glimepiride (GMP) were prepared using two different ratios of 2 different carriers, namely; PEG6000, pluronic F127, and by adopting two different techniques, namely; solvent evaporation technique and fusion technique. A full factorial design of 2 3 was adopted to investigate the influence of formulation variables on the prepared nanodispersion properties. The best chosen formula of nanodispersed powder was formulated into tablets by direct compression. The Differential Scanning Calorimetry (DSC) analysis and Fourier Transform Infra-Red (FTIR) analysis were conducted for the thermal behavior and surface structure characterization, respectively. The zeta potential and particle size analysis of the prepared glimepiride nanodispersions was determined. The prepared solid nanodispersions and solid nanodispersed tablets of GMP were evaluated in terms of pre-compression and post-compression parameters, respectively. Results: The DSC and FTIR studies revealed that there was no interaction between GMP and all the excipients used. Based on the resulted values of different pre-compression parameters, the prepared solid nanodispersions powder blends showed poor to excellent flow properties. The resulted values of the other evaluated pre-compression parameters of the prepared solid nanodispersion were within the limits of pharmacopoeia. The drug content of the prepared nanodispersions ranged from 89.6 ± 0.3 % to 99.9± 0.5% with particle size ranged from 111.5 nm to 492.3 nm and the resulted zeta potential (ζ ) values of the prepared GMP-solid nanodispersion formulae (F1-F8) ranged from -8.28±3.62 mV to -78±11.4 mV. The in-vitro dissolution studies of the prepared solid nanodispersed tablets of GMP concluded that GMP- pluronic F127 combinations (F8), exhibited the best extent of drug release, compared to other formulations, and to the marketed product. One way ANOVA for the percent of drug released from the prepared GMP-nanodispersion formulae (F1- F8) after 20 and 60 minutes showed significant differences between the percent of drug released from different GMP-nanodispersed tablet formulae (F1- F8), (P<0.05). Conclusion: Preparation of glimepiride as nanodispersed particles proven to be a promising tool for enhancing the poor solubility of glimepiride.

Keywords: glimepiride, solid Nanodispersion, nanodispersed tablets, poorly water soluble drugs

Procedia PDF Downloads 484

Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 93

Authors: Mariam Atef Zakaria Faltas

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 54

Authors: A. Díaz-Roa, P. I. Silva Junior, F. J. Bello

Abstract:

Sarconesiopsis magellanica (Diptera: Calliphoridae) is a medically important necrophagous fly which is used for establishing the post-mortem interval. Dipterous maggots release diverse proteins and peptides contained in larval excretion and secretion (ES) products playing a key role in digestion. The most important mechanism for combating infection using larval therapy depends on larval ES. These larvae are protected against infection by a diverse spectrum of antimicrobial peptides (AMPs), one already known like lucifensin. Special interest in these peptides has also been aroused regarding understanding their role in wound healing since they degrade necrotic tissue and kill different bacteria during larval therapy. The action of larvae on wounds occurs through 3 mechanisms of action: removal of necrotic tissue, stimulation of granulation tissue, and antibacterial action of larval ES. Some components of the ES include calcium, urea, allantoin ammonium bicarbonate and reducing the viability of Gram positive and Gram negative bacteria. The Lucilia sericata fly larvae have been the most used, however, we need to evaluate new species that could potentially be similar or more effective than fly above. This study was thus aimed at identifying and characterizing S. magellanica AMPs contained in ES products for the first time and compared them with the common fly used L. sericata. These products were obtained from third-instar larvae taken from a previously established colony. For the first analysis, ES fractions were separate by Sep-Pak C18 disposable columns (first step). The material obtained was fractionated by RP-HPLC by using Júpiter C18 semi-preparative column. The products were then lyophilized and their antimicrobial activity was characterized by incubation with different bacterial strains. The first chromatographic analysis of ES from L. sericata gives 6 fractions with antimicrobial activity against Gram-positive bacteria Micrococus luteus, and 3 fractions with activity against Gram-negative bacteria Pseudomonae aeruginosa while the one from S. magellanica gaves 1 fraction against M. luteus and 4 against P. aeruginosa. Maybe one of these fractions could correspond to the peptide already known from L. sericata. These results show the first work for supporting further experiments aimed at validating S. magellanica use in larval therapy. We still need to search if we find some new molecules, by making mass spectrometry and ‘de novo sequencing’. Further studies are necessary to identify and characterize them to better understand their functioning.

Keywords: antimicrobial peptides, larval therapy, Lucilia sericata, Sarconesiopsis magellanica

Procedia PDF Downloads 364

Authors: Randa Reda Luke Waheeb

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 49

Authors: Amany Nosshy Fawzy George

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 45

Authors: Abanoub Youssry Anwar Sadek

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 32

Authors: Wassim Azmy Abdalla Ishak

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 29

Authors: Ahmeda Ali, Mary Codd, Susan Brundage

Abstract:

Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

Procedia PDF Downloads 241

Authors: Omaima A. Sharaf, Tarek A. Moussa, Said M. Badr El-Din, H. Moawad

Abstract:

Background: Polycyclic aromatic hydrocarbons (PAHs) pose great environmental and human health concerns for their widespread occurrence, persistence, and carcinogenic properties. PAHs releases due to anthropogenic activities to the wider environment have led to higher concentrations of these contaminants than would be expected from natural processes alone. This may result in a wide range of environmental problems that can accumulate in agricultural ecosystems, which threatened to become a negative impact on sustainable agricultural development. Thus, this study aimed to evaluate the physico-chemical, and microbial properties of the compost leachate (CL) to assess its role as nutrient and microbial source (biostimulation/bioaugmentation) for developing a cost-effective bioremediation technology for PAHs contaminated sites. Material and Methods: PAHs-degrading bacteria were isolated from CL that was collected from a composting site located in central Scotland, UK. Isolation was carried out by enrichment using phenanthrene (PHR), pyrene (PYR) and benzo(a)pyrene (BaP) as the sole source of carbon and energy. The isolates were characterized using a variety of phenotypic and molecular properties. Six different isolates were identified based on the difference in morphological and biochemical tests. The efficiency of these isolates in PAHs utilization was assessed. Further analysis was performed to define taxonomical status and phylogenic relation between the most potent PAHs-utilizing bacterial strains and other standard strains, using molecular approach by partial 16S rDNA gene sequence analysis. Results indicated that the 16S rDNA sequence analysis confirmed the results of biochemical identification, as both of biochemical and molecular identification of the isolates assigned them to Bacillus licheniformis, Pseudomonas aeruginosa, Alcaligenes faecalis, Serratia marcescens, Enterobacter cloacae and Providenicia which were identified as the prominent PAHs-utilizers isolated from CL. Conclusion: This study indicates that the CL samples contain a diverse population of PAHs-degrading bacteria and the use of CL may have a potential for bioremediation of PAHs contaminated sites.

Keywords: polycyclic aromatic hydrocarbons, physico-chemical analyses, compost leachate, microbial and biochemical analyses, phylogenic relations, 16S rDNA sequence analysis

Procedia PDF Downloads 262

Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

Abstract:

Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

Procedia PDF Downloads 259

Authors: Marek Dosbaba

Abstract:

Within the mining sector, SEM-based Automated Mineralogy (AM) has been the standard application for quickly and efficiently handling mineral processing tasks. Over the last decade, the trend has been to analyze larger numbers of samples, often with a higher level of detail. This has necessitated a shift from interactive sample analysis performed by an operator using a SEM, to an increased reliance on offline processing to analyze and report the data. In response to this trend, TESCAN TIMA Mineral Analyzer is designed to quickly create a virtual copy of the studied samples, thereby preserving all the necessary information. Depending on the selected data acquisition mode, TESCAN TIMA can perform hyperspectral mapping and save an X-ray spectrum for each pixel or segment, respectively. This approach allows the user to browse through elemental distribution maps of all elements detectable by means of energy dispersive spectroscopy. Re-evaluation of the existing data for the presence of previously unconsidered elements is possible without the need to repeat the analysis. Additional tiers of data such as a secondary electron or cathodoluminescence images can also be recorded. To take full advantage of these information-rich datasets, TIMA utilizes a new archiving tool introduced by TESCAN. The dataset size can be reduced for long-term storage and all information can be recovered on-demand in case of renewed interest. TESCAN TIMA is optimized for network storage of its datasets because of the larger data storage capacity of servers compared to local drives, which also allows multiple users to access the data remotely. This goes hand in hand with the support of remote control for the entire data acquisition process. TESCAN also brings a newly extended open-source data format that allows other applications to extract, process and report AM data. This offers the ability to link TIMA data to large databases feeding plant performance dashboards or geometallurgical models. The traditional tabular particle-by-particle or grain-by-grain export process is preserved and can be customized with scripts to include user-defined particle/grain properties.

Keywords: Tescan, electron microscopy, mineralogy, SEM, automated mineralogy, database, TESCAN TIMA, open format, archiving, big data

Procedia PDF Downloads 105

Authors: Narges Arsanious Kamel Arsanious

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 53

Authors: Narges Arsanious Kamel Arsanious

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. It have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these ‘syndrome’ forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or ‘non-syndrome’ autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties (sticky attention), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism). In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

Procedia PDF Downloads 33

Authors: Mohammadjavad Sotoudeheian

Abstract:

COVID-19, which began in December 2019, uses the angiotensin-converting enzyme 2 (ACE2) receptor to enter and spread through the cells. ACE2 mRNA is present in almost every organ, including nasopharynx, lung, as well as the brain. Ports of entry of SARS-CoV-2 into the central nervous system (CNS) may include arterial circulation, while viremia is remarkable. However, it is imperious to develop neurological symptoms evaluation CSF analysis in patients with COVID-19, but theoretically, ACE2 receptors are expressed in cerebellar cells and may be a target for SARS-CoV-2 infection in the brain. Recent evidence agrees that SARS-CoV-2 can impact the brain through direct and indirect injury. Two biomarkers for CNS injury, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NFL) detected in the plasma of patients with COVID-19. NFL, an axonal protein expressed in neurons, is related to axonal neurodegeneration, and GFAP is over-expressed in CNS inflammation. GFAP cytoplasmic accumulation causes Schwan cells to misfunction, so affects myelin generation, reduces neuroskeletal support over NfLs during CNS inflammation, and leads to axonal degeneration. Interleukin-6 (IL-6), which extensively over-express due to interleukin storm during COVID-19 inflammation, regulates gene expression, as well as GFAP through STAT molecular pathway. IL-6 also impresses the phosphoinositide 3-kinase (PI3K)/STAT/smads pathway. The PI3K/ protein kinase B (Akt) pathway is the main modulator upstream of the mammalian target of rapamycin (mTOR), and alterations in this pathway are common in neurodegenerative diseases. Most neurodegenerative diseases show a disruption of autophagic function and display an abnormal increase in protein aggregation that promotes cellular death. Therefore, induction of autophagy has been recommended as a rational approach to help neurons clear abnormal protein aggregates and survive. The mTOR is a major regulator of the autophagic process and is regulated by cellular stressors. The mTORC1 pathway and mTORC2, as complementary and important elements in mTORC1 signaling, have become relevant in the regulation of the autophagic process and cellular survival through the extracellular signal-regulated kinase (ERK) pathway.

Keywords: mTORC1, COVID-19, PI3K, autophagy, neurodegeneration

Procedia PDF Downloads 83

Authors: Diego S. Caetano, Doreen E. Kalz, Louise L. B. Lomardo, Luiz P. Rosa

Abstract:

The energy consumption in non-residential buildings in Brazil has a great impact on the national infrastructure. The growth of the energy consumption has a special role over the building cooling systems, supported by the increased people's requirements on hygrothermal comfort. This paper presents how the occupants of office buildings notice and evaluate the hygrothermic comfort regarding temperature, humidity, and air movement, considering the cooling systems presented at the buildings studied, analyzed by real occupants in areas of hot and humid climate. The paper presents results collected over a long time from 3 office buildings in the cities of Rio de Janeiro and Niteroi (Brazil) in 2015 and 2016, from daily questionnaires with eight questions answered by 114 people between 3 to 5 weeks per building, twice a day (10 a.m. and 3 p.m.). The paper analyses 6 out of 8 questions, emphasizing on the perception of temperature, humidity, and air movement. Statistics analyses were made crossing participant answers and humidity and temperature data related to time high time resolution time. Analyses were made from regressions comparing: internal and external temperature, and then compared with the answers of the participants. The results were put in graphics combining statistic graphics related to temperature and air humidity with the answers of the real occupants. Analysis related to the perception of the participants to humidity and air movements were also analyzed. The hygrothermal comfort statistic model of the European standard DIN EN 15251 and that from the Brazilian standard NBR 16401 were compared taking into account the perceptions of the hygrothermal comfort of the participants, with emphasis on air humidity, taking basis on prior studies published on this same research. The studies point out a relative tolerance for higher temperatures than the ones determined by the standards, besides a variation on the participants' perception concerning air humidity. The paper presents a group of detailed information that permits to improve the quality of the buildings based on the perception of occupants of the office buildings, contributing to the energy reduction without health damages and demands of necessary hygrothermal comfort, reducing the consumption of electricity on cooling.

Keywords: thermal comfort, energy consumption, energy standards, comfort models

Procedia PDF Downloads 317

Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay

Abstract:

Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.

Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea

Procedia PDF Downloads 159

Authors: Siriwan Chatmaneerungcharoen

Abstract:

An emerging body of ‘21st century skills’-such as adaptability, complex communication skills, technology skills and the ability to solve non-routine problems--are valuable across a wide range of jobs in the national economy. Within the Thai context, a focus on the Philosophy of Sufficiency Economy is integrated into Science Education. Thai science education has advocated infusing 21st century skills and Philosophy of Sufficiency Economy into the school curriculum and several educational levels have launched such efforts. Therefore, developing science teachers to have proper knowledge is the most important factor to success of the goals. The purposes of this study were to develop 40 Cooperative Science teachers’ Technological Pedagogical Content Knowledge (TPACK) and to develop Professional Development Model integrated with Co-teaching Model and Coaching System (Co-TPACK). TPACK is essential to career development for teachers. Forty volunteer In-service teachers who were science cooperative teachers participated in this study for 2 years. Data sources throughout the research project consisted of teacher refection, classroom observations, Semi-structure interviews, Situation interview, questionnaires and document analysis. Interpretivist framework was used to analyze the data. Findings indicate that at the beginning, the teachers understood only the meaning of Philosophy of Sufficiency Economy but they did not know how to integrate the Philosophy of Sufficiency Economy into their science classrooms. Mostly, they preferred to use lecture based teaching and experimental teaching styles. While the Co- TPACK was progressing, the teachers had blended their teaching styles and learning evaluation methods. Co-TPACK consists of 3 cycles (Student Teachers’ Preparation Cycle, Cooperative Science Teachers Cycle, Collaboration cycle (Co-teaching, Co-planning, and Co-Evaluating and Coaching System)).The Co-TPACK enhances the 40 cooperative science teachers, student teachers and university supervisor to exchange their knowledge and experience on teaching science. There are many channels that they used for communication including online. They have used more Phuket context-integrated lessons, technology-integrated teaching and Learning that can explicit Philosophy of Sufficiency Economy. Their sustained development is shown in their lesson plans and teaching practices.

Keywords: technological pedagogical content knowledge, philosophy of sufficiency economy, professional development, coaching system

Procedia PDF Downloads 459

Authors: M. Joris, O. Agirdag

Abstract:

For over two decades, calls for citizenship education (CE) have been rising to the top of educational policy agendas in Europe. The main motive for the current treatment of CE as a key topic is a sense of crisis: social and political threats that go beyond the reach of nations and require action at the international and European level. On the one hand, this context has triggered abundant attention to the promotion of citizenship through education. On the other hand, the ubiquity of citizenship and education in policy language is paired with a self-evident manner of using the concepts: the more we call for citizenship in and through education, the less the concepts seem to be made explicit or be defined. Research and reflection on the normativity of the concepts of citizenship and CE in Europe are scarce. Departing from the idea that policies are always normative, this study, therefore, investigates the normativity of the current concepts of citizenship and education, in ’key’ European CE policy texts. The study consists of a content analysis of these texts, based on a normative framework developed around the different dimensions of citizenship as status, identity, virtues and agency. The framework also describes the purposes of education and its learning processes, content and practices, based on the assumption that good education always includes, next to qualification and socialisation, a purpose of emancipation: of helping young people become autonomous and independent subjects. The analysis shows how contemporary European citizenship is conceptualised around the dimension of competences. This focus on competences is also visible in the normative framing of education and its relationship to citizenship in the texts: CE should help young people learn how to become good citizens by acquiring a toolkit of competences, consisting of knowledge, skills, values and attitudes that can be predetermined, measured and evaluated. This ideal of citizenship-as-competence entails a focus on the educational purposes of socialisation and qualification. Current policy texts thus seem to leave out the educational purpose of emancipating young people, allowing them to take on citizenship as something to which they can determine their own relation and position. It is, however, this purpose of CE that seems increasingly important in our current context. Young people are stepping out of school and onto the streets by the thousands in Belgium and throughout Europe, protesting for more and better environmental policies. They are making use of existing modes of citizenship, exactly to indicate to policymakers how these are falling short and are claiming their right and entitlement to a future that established practices of politics are putting at risk. The importance of citizenship education might then lie, now more than ever, not in the fact that it would prepare young people for competent citizenship, but in offering them a possibility, an emancipatory experience of being able to do something new. It seems that this is what we might want to expect from the school if we want it to educate our truly future citizens.

Keywords: citizenship education, normativity, policy, purposes of education

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Authors: Lee Rui, Rajeev Ramachandran

Abstract:

The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

Procedia PDF Downloads 98