Search results for: balanced anesthesia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 641

Search results for: balanced anesthesia

521 A Hybrid Energy Storage Module for the Emergency Energy System of the Community Shelter in Yucatán, México

Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

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Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

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520 An Energy-Balanced Clustering Method on Wireless Sensor Networks

Authors: Yu-Ting Tsai, Chiun-Chieh Hsu, Yu-Chun Chu

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In recent years, due to the development of wireless network technology, many researchers have devoted to the study of wireless sensor networks. The applications of wireless sensor network mainly use the sensor nodes to collect the required information, and send the information back to the users. Since the sensed area is difficult to reach, there are many restrictions on the design of the sensor nodes, where the most important restriction is the limited energy of sensor nodes. Because of the limited energy, researchers proposed a number of ways to reduce energy consumption and balance the load of sensor nodes in order to increase the network lifetime. In this paper, we proposed the Energy-Balanced Clustering method with Auxiliary Members on Wireless Sensor Networks(EBCAM)based on the cluster routing. The main purpose is to balance the energy consumption on the sensed area and average the distribution of dead nodes in order to avoid excessive energy consumption because of the increasing in transmission distance. In addition, we use the residual energy and average energy consumption of the nodes within the cluster to choose the cluster heads, use the multi hop transmission method to deliver the data, and dynamically adjust the transmission radius according to the load conditions. Finally, we use the auxiliary cluster members to change the delivering path according to the residual energy of the cluster head in order to its load. Finally, we compare the proposed method with the related algorithms via simulated experiments and then analyze the results. It reveals that the proposed method outperforms other algorithms in the numbers of used rounds and the average energy consumption.

Keywords: auxiliary nodes, cluster, load balance, routing algorithm, wireless sensor network

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519 The Origin and Development of Entrepreneurial Cognition: The Impact of Entrepreneurship Education on Cognitive Style and Subsequent Entrepreneurial Intention

Authors: Salma Hussein, Hadia Aziz

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Entrepreneurship plays a significant and imperative role in economic and social growth, and therefore, is stimulated and encouraged by governments and academics as a mean of creating job opportunities, innovation, and wealth. Indicative of its importance, it is essential to identify factors that encourage and promote entrepreneurial behavior. This is particularly true for developing countries where the need for entrepreneurial development is high and the resources are scarce, thus, there is a need to maximize the outcomes of investing in entrepreneurial development. Entrepreneurial education has been the center of attention and interest among researchers as it is believed to be one of the most critical factors in promoting entrepreneurship over the long run. Accordingly, the urgency to encourage entrepreneurship education and develop an enterprise culture is now a main concern in Egypt. Researchers have postulated that cognition has the potential to make a significant contribution to the study of entrepreneurship. One such contribution that future studies need to consider in entrepreneurship research is the cognitive processes that occur within the individual such as cognitive style. During the past decade, there has been an increasing interest in cognitive style among researchers and practitioners specifically in innovation and entrepreneurship field. Limited studies pay attention to study the antecedent dynamics that fuel entrepreneurial cognition to better understand its role in entrepreneurship. Moreover, while many studies were conducted on entrepreneurship education, scholars are still hesitant regarding the teachability of entrepreneurship due to the lack of clear evidence of its impact. Furthermore, the relation between cognitive style and entrepreneurial intentions, has yet to be discovered. Hence, this research aims to test the impact of entrepreneurship education on cognitive style and subsequent intention in order to evaluate whether student’s and potential entrepreneur’s cognitive styles are affected by entrepreneurial education and in turn affect their intentions. Understanding the impact of Entrepreneurship Education on ways of thinking and intention is critical for the development of effective education and training in entrepreneurship field. It is proposed that students who are exposed to entrepreneurship education programs will have a more balanced thinking style compared to those students who are not exposed. Moreover, it is hypothesized that students having a balanced cognitive style will exhibit higher levels of entrepreneurial intentions than students having an intuitive or analytical cognitive style. Finally, it is proposed that non-formal entrepreneurship education will be more positively associated with entrepreneurial intentions than will formal entrepreneurship education. The proposed methodology is a pre and post Experimental Design. The sample will include young adults, their age range from 18 till 35 years old including both students enrolled in formal entrepreneurship education programs in private universities as well as young adults who are willing to participate in a Non-Formal entrepreneurship education programs in Egypt. Attention is now given on how far individuals are analytical or intuitive in their cognitive style, to what extent it is possible to have a balanced thinking style and whether or not this can be aided by training or education. Therefore, there is an urge need for further research on entrepreneurial cognition in educational contexts.

Keywords: cognitive style, entrepreneurial intention, entrepreneurship education, experimental design

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518 Balanced Score Card a Tool to Improve Naac Accreditation – a Case Study in Indian Higher Education

Authors: CA Kishore S. Peshori

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Introduction: India, a country with vast diversity and huge population is going to have largest young population by 2020. Higher education has and will always be the basic requirement for making a developing nation to a developed nation. To improve any system it needs to be bench-marked. There have been various tools for bench-marking the systems. Education is delivered in India by universities which are mainly funded by government. This universities for delivering the education sets up colleges which are again funded mainly by government. Recently however there has also been autonomy given to universities and colleges. Moreover foreign universities are waiting to enter Indian boundaries. With a large number of universities and colleges it has become more and more necessary to measure this institutes for bench-marking. There have been various tools for measuring the institute. In India college assessments have been made compulsory by UGC. Naac has been offically recognised as the accrediation criteria. The Naac criteria has been based on seven criterias namely: 1. Curricular assessments, 2. Teaching learning and evaluation, 3. Research Consultancy and Extension, 4. Infrastructure and learning resources, 5. Student support and progression, 6. Governance leadership and management, 7. Innovation and best practices. The Naac tries to bench mark the institution for identification, sustainability, dissemination and adaption of best practices. It grades the institution according to this seven criteria and the funding of institution is based on these grades. Many of the colleges are struggling to get best of grades but they have not come across a systematic tool to achieve the results. Balanced Scorecard developed by Kaplan has been a successful tool for corporates to develop best of practices so as to increase their financial performance and also retain and increase their customers so as to grow the organization to next level.It is time to test this tool for an educational institute. Methodology: The paper tries to develop a prototype for college based on the secondary data. Once a prototype is developed the researcher based on questionnaire will try to test this tool for successful implementation. The success of this research will depend on its implementation of BSC on an institute and its grading improved due to this successful implementation. Limitation of time is a major constraint in this research as Naac cycle takes minimum 4 years for accreditation and reaccreditation the methodology will limit itself to secondary data and questionnaire to be circulated to colleges along with the prototype model of BSC. Conclusion: BSC is a successful tool for enhancing growth of an organization. Educational institutes are no exception to these. BSC will only have to be realigned to suit the Naac criteria. Once this prototype is developed the success will be tested only on its implementation but this research paper will be the first step towards developing this tool and will also initiate the success by developing a questionnaire and getting and evaluating the responses for moving to the next level of actual implementation

Keywords: balanced scorecard, bench marking, Naac, UGC

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517 Transformer-Driven Multi-Category Classification for an Automated Academic Strand Recommendation Framework

Authors: Ma Cecilia Siva

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This study introduces a Bidirectional Encoder Representations from Transformers (BERT)-based machine learning model aimed at improving educational counseling by automating the process of recommending academic strands for students. The framework is designed to streamline and enhance the strand selection process by analyzing students' profiles and suggesting suitable academic paths based on their interests, strengths, and goals. Data was gathered from a sample of 200 grade 10 students, which included personal essays and survey responses relevant to strand alignment. After thorough preprocessing, the text data was tokenized, label-encoded, and input into a fine-tuned BERT model set up for multi-label classification. The model was optimized for balanced accuracy and computational efficiency, featuring a multi-category classification layer with sigmoid activation for independent strand predictions. Performance metrics showed an F1 score of 88%, indicating a well-balanced model with precision at 80% and recall at 100%, demonstrating its effectiveness in providing reliable recommendations while reducing irrelevant strand suggestions. To facilitate practical use, the final deployment phase created a recommendation framework that processes new student data through the trained model and generates personalized academic strand suggestions. This automated recommendation system presents a scalable solution for academic guidance, potentially enhancing student satisfaction and alignment with educational objectives. The study's findings indicate that expanding the data set, integrating additional features, and refining the model iteratively could improve the framework's accuracy and broaden its applicability in various educational contexts.

Keywords: tokenized, sigmoid activation, transformer, multi category classification

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516 Development of Automated Quality Management System for the Management of Heat Networks

Authors: Nigina Toktasynova, Sholpan Sagyndykova, Zhanat Kenzhebayeva, Maksat Kalimoldayev, Mariya Ishimova, Irbulat Utepbergenov

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Any business needs a stable operation and continuous improvement, therefore it is necessary to constantly interact with the environment, to analyze the work of the enterprise in terms of employees, executives and consumers, as well as to correct any inconsistencies of certain types of processes and their aggregate. In the case of heat supply organizations, in addition to suppliers, local legislation must be considered which often is the main regulator of pricing of services. In this case, the process approach used to build a functional organizational structure in these types of businesses in Kazakhstan is a challenge not only in the implementation, but also in ways of analyzing the employee's salary. To solve these problems, we investigated the management system of heating enterprise, including strategic planning based on the balanced scorecard (BSC), quality management in accordance with the standards of the Quality Management System (QMS) ISO 9001 and analysis of the system based on expert judgment using fuzzy inference. To carry out our work we used the theory of fuzzy sets, the QMS in accordance with ISO 9001, BSC according to the method of Kaplan and Norton, method of construction of business processes according to the notation IDEF0, theory of modeling using Matlab software simulation tools and graphical programming LabVIEW. The results of the work are as follows: We determined possibilities of improving the management of heat-supply plant-based on QMS; after the justification and adaptation of software tool it has been used to automate a series of functions for the management and reduction of resources and for the maintenance of the system up to date; an application for the analysis of the QMS based on fuzzy inference has been created with novel organization of communication software with the application enabling the analysis of relevant data of enterprise management system.

Keywords: balanced scorecard, heat supply, quality management system, the theory of fuzzy sets

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515 Balanced Scorecard (BSC) Project : A Methodological Proposal for Decision Support in a Corporate Scenario

Authors: David de Oliveira Costa, Miguel Ângelo Lellis Moreira, Carlos Francisco Simões Gomes, Daniel Augusto de Moura Pereira, Marcos dos Santos

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Strategic management is a fundamental process for global companies that intend to remain competitive in an increasingly dynamic and complex market. To do so, it is necessary to maintain alignment with their principles and values. The Balanced Scorecard (BSC) proposes to ensure that the overall business performance is based on different perspectives (financial, customer, internal processes, and learning and growth). However, relying solely on the BSC may not be enough to ensure the success of strategic management. It is essential that companies also evaluate and prioritize strategic projects that need to be implemented to ensure they are aligned with the business vision and contribute to achieving established goals and objectives. In this context, the proposition involves the incorporation of the SAPEVO-M multicriteria method to indicate the degree of relevance between different perspectives. Thus, the strategic objectives linked to these perspectives have greater weight in the classification of structural projects. Additionally, it is proposed to apply the concept of the Impact & Probability Matrix (I&PM) to structure and ensure that strategic projects are evaluated according to their relevance and impact on the business. By structuring the business's strategic management in this way, alignment and prioritization of projects and actions related to strategic planning are ensured. This ensures that resources are directed towards the most relevant and impactful initiatives. Therefore, the objective of this article is to present the proposal for integrating the BSC methodology, the SAPEVO-M multicriteria method, and the prioritization matrix to establish a concrete weighting of strategic planning and obtain coherence in defining strategic projects aligned with the business vision. This ensures a robust decision-making support process.

Keywords: MCDA process, prioritization problematic, corporate strategy, multicriteria method

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514 Impact of Ventilation Systems on Indoor Air Quality in Swedish Primary School Classrooms

Authors: Sarka Langer, Despoina Teli, Blanka Cabovska, Jan-Olof Dalenbäck, Lars Ekberg, Gabriel Bekö, Pawel Wargocki, Natalia Giraldo Vasquez

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The aim of the study was to investigate the impact of various ventilation systems on indoor climate, air pollution, chemistry, and perception. Measurements of thermal environment and indoor air quality were performed in 45 primary school classrooms in Gothenburg, Sweden. The classrooms were grouped into three categories according to their ventilation system: category A) natural or exhaust ventilation or automated window opening; category B) balanced mechanical ventilation systems with constant air volume (CAV); and category C) balanced mechanical ventilation systems with variable air volume (VAV). A questionnaire survey about indoor air quality, perception of temperature, odour, noise and light, and sensation of well-being, alertness focus, etc., was distributed among the 10-12 years old children attending the classrooms. The results (medians) showed statistically significant differences between ventilation category A and categories B and C, but not between categories B and C in air change rates, median concentrations of carbon dioxide, individual volatile organic compounds formaldehyde and isoprene, in-door-to-outdoor ozone ratios and products of ozonolysis of squalene, a constituent of human skin oils, 6-methyl-5-hepten-2-one and decanal. Median ozone concentration, ozone loss -a difference between outdoor and indoor ozone concentrations- were different only between categories A and C. Median concentration of total VOCs and a perception index based on survey responses on perceptions and sensations indoors were not significantly different. In conclusion, ventilation systems have an impact on air change rates, indoor air quality, and chemistry, but the Swedish primary school children’s perception did not differ with the ventilation systems of the classrooms.

Keywords: indoor air pollutants, indoor climate, indoor chemistry, air change rate, perception

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513 Application of Compressed Sensing and Different Sampling Trajectories for Data Reduction of Small Animal Magnetic Resonance Image

Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias

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Magnetic Resonance Imaging (MRI) is a vital imaging technique used in both clinical and pre-clinical areas to obtain detailed anatomical and functional information. However, MRI scans can be expensive, time-consuming, and often require the use of anesthetics to keep animals still during the imaging process. Anesthetics are commonly administered to animals undergoing MRI scans to ensure they remain still during the imaging process. However, prolonged or repeated exposure to anesthetics can have adverse effects on animals, including physiological alterations and potential toxicity. Minimizing the duration and frequency of anesthesia is, therefore, crucial for the well-being of research animals. In recent years, various sampling trajectories have been investigated to reduce the number of MRI measurements leading to shorter scanning time and minimizing the duration of animal exposure to the effects of anesthetics. Compressed sensing (CS) and sampling trajectories, such as cartesian, spiral, and radial, have emerged as powerful tools to reduce MRI data while preserving diagnostic quality. This work aims to apply CS and cartesian, spiral, and radial sampling trajectories for the reconstruction of MRI of the abdomen of mice sub-sampled at levels below that defined by the Nyquist theorem. The methodology of this work consists of using a fully sampled reference MRI of a female model C57B1/6 mouse acquired experimentally in a 4.7 Tesla MRI scanner for small animals using Spin Echo pulse sequences. The image is down-sampled by cartesian, radial, and spiral sampling paths and then reconstructed by CS. The quality of the reconstructed images is objectively assessed by three quality assessment techniques RMSE (Root mean square error), PSNR (Peak to Signal Noise Ratio), and SSIM (Structural similarity index measure). The utilization of optimized sampling trajectories and CS technique has demonstrated the potential for a significant reduction of up to 70% of image data acquisition. This result translates into shorter scan times, minimizing the duration and frequency of anesthesia administration and reducing the potential risks associated with it.

Keywords: compressed sensing, magnetic resonance, sampling trajectories, small animals

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512 Linkage between a Plant-based Diet and Visual Impairment: A Systematic Review and Meta-Analysis

Authors: Cristina Cirone, Katrina Cirone, Monali S. Malvankar-Mehta

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Purpose: An increased risk of visual impairment has been observed in individuals lacking a balanced diet. The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Design: Systematic review and meta-analysis. Methods: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The databases MEDLINE, EMBASE, Cochrane, and PubMed, were systematically searched up until May 27, 2021. Of the 503 articles independently screened by two reviewers, 21 were included in this review. Quality assessment and data extraction were performed by both reviewers. Meta-analysis was conducted using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Results: A total of 503 studies were identified which then underwent duplicate removal and a title and abstract screen. The remaining 61 studies underwent a full-text screen, 21 progressed to data extraction and fifteen were included in the quantitative analysis. Meta-analysis indicated that regular consumption of fish (OR = 0.70; CI: [0.62-0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61-0.79]) is positively correlated with a reduced risk of visual impairment (age-related macular degeneration, age-related maculopathy, cataract development, and central geographic atrophy) among adults. Consumption of red meat [OR = 1.41; CI: [1.07-1.86]) is associated with an increased risk of visual impairment. Conclusion: Overall, a pescatarian diet is associated with the most favorable visual outcomes among adults, while the consumption of red meat appears to negatively impact vision. Results suggest a need for more local and government-led interventions promoting a healthy and balanced diet.

Keywords: plant-based diet, pescatarian diet, visual impairment, systematic review, meta-analysis

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511 Online Dietary Management System

Authors: Kyle Yatich Terik, Collins Oduor

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The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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510 Close Loop Controlled Current Nerve Locator

Authors: H. A. Alzomor, B. K. Ouda, A. M. Eldeib

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Successful regional anesthesia depends upon precise location of the peripheral nerve or nerve plexus. Locating peripheral nerves is preferred to be done using nerve stimulation. In order to generate a nerve impulse by electrical means, a minimum threshold stimulus of current “rheobase” must be applied to the nerve. The technique depends on stimulating muscular twitching at a close distance to the nerve without actually touching it. Success rate of this operation depends on the accuracy of current intensity pulses used for stimulation. In this paper, we will discuss a circuit and algorithm for closed loop control for the current, theoretical analysis and test results and compare them with previous techniques.

Keywords: Close Loop Control (CLC), constant current, nerve locator, rheobase

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509 Exploring Pre-Trained Automatic Speech Recognition Model HuBERT for Early Alzheimer’s Disease and Mild Cognitive Impairment Detection in Speech

Authors: Monica Gonzalez Machorro

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Dementia is hard to diagnose because of the lack of early physical symptoms. Early dementia recognition is key to improving the living condition of patients. Speech technology is considered a valuable biomarker for this challenge. Recent works have utilized conventional acoustic features and machine learning methods to detect dementia in speech. BERT-like classifiers have reported the most promising performance. One constraint, nonetheless, is that these studies are either based on human transcripts or on transcripts produced by automatic speech recognition (ASR) systems. This research contribution is to explore a method that does not require transcriptions to detect early Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This is achieved by fine-tuning a pre-trained ASR model for the downstream early AD and MCI tasks. To do so, a subset of the thoroughly studied Pitt Corpus is customized. The subset is balanced for class, age, and gender. Data processing also involves cropping the samples into 10-second segments. For comparison purposes, a baseline model is defined by training and testing a Random Forest with 20 extracted acoustic features using the librosa library implemented in Python. These are: zero-crossing rate, MFCCs, spectral bandwidth, spectral centroid, root mean square, and short-time Fourier transform. The baseline model achieved a 58% accuracy. To fine-tune HuBERT as a classifier, an average pooling strategy is employed to merge the 3D representations from audio into 2D representations, and a linear layer is added. The pre-trained model used is ‘hubert-large-ls960-ft’. Empirically, the number of epochs selected is 5, and the batch size defined is 1. Experiments show that our proposed method reaches a 69% balanced accuracy. This suggests that the linguistic and speech information encoded in the self-supervised ASR-based model is able to learn acoustic cues of AD and MCI.

Keywords: automatic speech recognition, early Alzheimer’s recognition, mild cognitive impairment, speech impairment

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508 Vertical and Lateral Vibration Analysis of Conventional Elevator

Authors: Mohammadreza Saviz, Sina Najafian

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This paper presents an analytical study of vibration moving elevator and shows the elevator 2D dynamic model to evaluate the vertical and lateral motion. Most elevators applied to tall buildings include compensating ropes to satisfy the balanced rope tension between the car and the counterweight. The elasticity of these ropes and springs of sets that connect cabin to ropes make the elevator car to vibrate. A two-dimensional model is derived to calculate vibrations and displacements. The simulation results were validated by the results of similar works.

Keywords: elevator, vibration, simulation, analytical solution, 2D modeling

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507 Experimental Damping Performance of Composite Materials with Different Fibre Orientations

Authors: Ferhat Kadioglu

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A clamped-free vibrating beam technique was used to evaluate dynamic properties of glass fiber reinforced polymer matrix composite. In the experiment, an electromagnetic shaker and a non-contact laser head were used to vibrate and to take the response of the specimens, respectively. Test results showed that damping and elastic modulus of the material, as dynamic properties, could be obtained successfully using this technique. It was found that the balanced and symmetric specimens with 45 degrees are the best for damping performance. It is believed that such results could be used for the modal design of aerospace structures.

Keywords: composite materials, damping values, dynamic properties, non-contact measurements

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506 A Comparison and Discussion of Modern Anaesthetic Techniques in Elective Lower Limb Arthroplasties

Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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505 Brainwave Classification for Brain Balancing Index (BBI) via 3D EEG Model Using k-NN Technique

Authors: N. Fuad, M. N. Taib, R. Jailani, M. E. Marwan

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In this paper, the comparison between k-Nearest Neighbor (kNN) algorithms for classifying the 3D EEG model in brain balancing is presented. The EEG signal recording was conducted on 51 healthy subjects. Development of 3D EEG models involves pre-processing of raw EEG signals and construction of spectrogram images. Then, maximum PSD values were extracted as features from the model. There are three indexes for the balanced brain; index 3, index 4 and index 5. There are significant different of the EEG signals due to the brain balancing index (BBI). Alpha-α (8–13 Hz) and beta-β (13–30 Hz) were used as input signals for the classification model. The k-NN classification result is 88.46% accuracy. These results proved that k-NN can be used in order to predict the brain balancing application.

Keywords: power spectral density, 3D EEG model, brain balancing, kNN

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504 Comparison between LQR and ANN Active Anti-Roll Control of a Single Unit Heavy Vehicle

Authors: Babesse Saad, Ameddah Djemeleddine

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In this paper, a learning algorithm using neuronal networks to improve the roll stability and prevent the rollover in a single unit heavy vehicle is proposed. First, LQR control to keep balanced normalized rollovers, between front and rear axles, below the unity, then a data collected from this controller is used as a training basis of a neuronal regulator. The ANN controller is thereafter applied for the nonlinear side force model, and gives satisfactory results than the LQR one.

Keywords: rollover, single unit heavy vehicle, neural networks, nonlinear side force

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503 Mobile Smart Application Proposal for Predicting Calories in Food

Authors: Marcos Valdez Alexander Junior, Igor Aguilar-Alonso

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Malnutrition is the root of different diseases that universally affect everyone, diseases such as obesity and malnutrition. The objective of this research is to predict the calories of the food to be eaten, developing a smart mobile application to show the user if a meal is balanced. Due to the large percentage of obesity and malnutrition in Peru, the present work is carried out. The development of the intelligent application is proposed with a three-layer architecture, and for the prediction of the nutritional value of the food, the use of pre-trained models based on convolutional neural networks is proposed.

Keywords: volume estimation, calorie estimation, artificial vision, food nutrition

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502 Creating Positive Learning Environment

Authors: Samia Hassan, Fouzia Latif

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In many countries, education is still far from being a knowledge industry in the sense of own practices that are not yet being transformed by knowledge about the efficacy of those practices. The core question of this paper is why students get bored in class? Have we balanced between the creation and advancement of an engaging learning community and effective learning environment? And between, giving kids confidence to achieve their maximum and potential goals, we sand managing student’s behavior. We conclude that creating a positive learning environment enhances opportunities for young children to feel safe, secure, and to supported in order to do their best learning. Many factors can use in classrooms aid to the positive environment like course content, class preparation, and behavior.

Keywords: effective, environment, learning, positive

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501 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy

Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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500 Burnout in the Resident Physician and a Simple Means of Improvement

Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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499 A Theoretical Hypothesis on Ferris Wheel Model of University Social Responsibility

Authors: Le Kang

Abstract:

According to the nature of the university, as a free and responsible academic community, USR is based on a different foundation —academic responsibility, so the Pyramid and the IC Model of CSR could not fully explain the most distinguished feature of USR. This paper sought to put forward a new model— Ferris Wheel Model, to illustrate the nature of USR and the process of achievement. The Ferris Wheel Model of USR shows the university creates a balanced, fairness and neutrality systemic structure to afford social responsibilities; that makes the organization could obtain a synergistic effect to achieve more extensive interests of stakeholders and wider social responsibilities.

Keywords: USR, achievement model, ferris wheel model, social responsibilities

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498 Performance Comparison of Cooperative Banks in the EU, USA and Canada

Authors: Matěj Kuc

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This paper compares different types of profitability measures of cooperative banks from two developed regions: the European Union and the United States of America together with Canada. We created balanced dataset of more than 200 cooperative banks covering 2011-2016 period. We made series of tests and run Random Effects estimation on panel data. We found that American and Canadian cooperatives are more profitable in terms of return on assets (ROA) and return on equity (ROE). There is no significant difference in net interest margin (NIM). Our results show that the North American cooperative banks accommodated better to the current market environment.

Keywords: cooperative banking, panel data, profitability measures, random effects

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497 Guidance on Writing Operation Notes in Ophthalmic Surgeries

Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

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A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

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496 Anticancer Activity of Milk Fat Rich in Conjugated Linoleic Acid Against Ehrlich Ascites Carcinoma Cells in Female Swiss Albino Mice

Authors: Diea Gamal Abo El-Hassan, Salwa Ahmed Aly, Abdelrahman Mahmoud Abdelgwad

Abstract:

The major conjugated linoleic acid (CLA) isomers have anticancer effect, especially breast cancer cells, inhibits cell growth and induces cell death. Also, CLA has several health benefits in vivo, including antiatherogenesis, antiobesity, and modulation of immune function. The present study aimed to assess the safety and anticancer effects of milk fat CLA against in vivo Ehrlich ascites carcinoma (EAC) in female Swiss albino mice. This was based on acute toxicity study, detection of the tumor growth, life span of EAC bearing hosts, and simultaneous alterations in the hematological, biochemical, and histopathological profiles. Materials and Methods: One hundred and fifty adult female mice were equally divided into five groups. Groups (1-2) were normal controls, and Groups (3-5) were tumor transplanted mice (TTM) inoculated intraperitoneally with EAC cells (2×106 /0.2 mL). Group (3) was (TTM positive control). Group (4) TTM fed orally on balanced diet supplemented with milk fat CLA (40 mg CLA/kg body weight). Group (5) TTM fed orally on balanced diet supplemented with the same level of CLA 28 days before tumor cells inoculation. Blood samples and specimens from liver and kidney were collected from each group. The effect of milk fat CLA on the growth of tumor, life span of TTM, and simultaneous alterations in the hematological, biochemical, and histopathological profiles were examined. Results: For CLA treated TTM, significant decrease in tumor weight, ascetic volume, viable Ehrlich cells accompanied with increase in life span were observed. Hematological and biochemical profiles reverted to more or less normal levels and histopathology showed minimal effects. Conclusion: The present study proved the safety and anticancer efficiency of milk fat CLA and provides a scientific basis for its medicinal use as anticancer attributable to the additive or synergistic effects of its isomers.

Keywords: anticancer activity, conjugated linoleic acid, Ehrlich ascites carcinoma, % increase in life span, mean survival time, tumor transplanted mice.

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495 International Relations and the Transformation of Political Regimes in Post-Soviet States

Authors: Sergey Chirun

Abstract:

Using of a combination of institutional analysis and network access has allowed the author to identify the characteristics of the informal institutions of regional political power and political regimes. According to the author, ‘field’ of activity of post-Soviet regimes, formed under the influence of informal institutions, often contradicts democratic institutional regional changes which are aimed at creating of a legal-rational type of political domination and balanced model of separation of powers. This leads to the gap between the formal structure of institutions and the real nature of power, predetermining the specific character of the existing political regimes.

Keywords: authoritarianism, institutions, political regime, social networks, transformation

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494 The Effect of Social Structural Change on the Traditional Turkish Houses Becoming Unusable

Authors: Gamze Fahriye Pehlivan, Tulay Canitez

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The traditional Turkish houses becoming unusable are a result of the deterioration of the balanced interaction between users and house (human and house) continuing during the history. Especially depending upon the change in social structure, the houses becoming neglected do not meet the desires of the users and do not have the meaning but the shelter are becoming unusable and are being destroyed. A conservation policy should be developed and renovations should be made in order to pass the traditional houses carrying the quality of a cultural and historical document presenting the social structure, the lifestyle and the traditions of its own age to the next generations and to keep them alive.

Keywords: house, social structural change, social structural, traditional Turkish houses

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493 Promoting Non-Formal Learning Mobility in the Field of Youth

Authors: Juha Kettunen

Abstract:

The purpose of this study is to develop a framework for the assessment of research and development projects. The assessment map is developed in this study based on the strategy map of the balanced scorecard approach. The assessment map is applied in a project that aims to reduce the inequality and risk of exclusion of young people from disadvantaged social groups. The assessment map denotes that not only funding but also necessary skills and qualifications should be carefully assessed in the implementation of the project plans so as to achieve the objectives of projects and the desired impact. The results of this study are useful for those who want to develop the implementation of the Erasmus+ Programme and the project teams of research and development projects.

Keywords: non-formal learning, youth work, social inclusion, innovation

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492 The Missing Link in Holistic Health Care: Value-Based Medicine in Entrustable Professional Activities for Doctor-Patient Relationship

Authors: Ling-Lang Huang

Abstract:

Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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