Search results for: experience sampling methods
Commenced in January 2007
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Edition: International
Paper Count: 21181

Search results for: experience sampling methods

4771 Reliability Qualification Test Plan Derivation Method for Weibull Distributed Products

Authors: Ping Jiang, Yunyan Xing, Dian Zhang, Bo Guo

Abstract:

The reliability qualification test (RQT) is widely used in product development to qualify whether the product meets predetermined reliability requirements, which are mainly described in terms of reliability indices, for example, MTBF (Mean Time Between Failures). It is widely exercised in product development. In engineering practices, RQT plans are mandatorily referred to standards, such as MIL-STD-781 or GJB899A-2009. But these conventional RQT plans in standards are not preferred, as the test plans often require long test times or have high risks for both producer and consumer due to the fact that the methods in the standards only use the test data of the product itself. And the standards usually assume that the product is exponentially distributed, which is not suitable for a complex product other than electronics. So it is desirable to develop an RQT plan derivation method that safely shortens test time while keeping the two risks under control. To meet this end, for the product whose lifetime follows Weibull distribution, an RQT plan derivation method is developed. The merit of the method is that expert judgment is taken into account. This is implemented by applying the Bayesian method, which translates the expert judgment into prior information on product reliability. Then producer’s risk and the consumer’s risk are calculated accordingly. The procedures to derive RQT plans are also proposed in this paper. As extra information and expert judgment are added to the derivation, the derived test plans have the potential to shorten the required test time and have satisfactory low risks for both producer and consumer, compared with conventional test plans. A case study is provided to prove that when using expert judgment in deriving product test plans, the proposed method is capable of finding ideal test plans that not only reduce the two risks but also shorten the required test time as well.

Keywords: expert judgment, reliability qualification test, test plan derivation, producer’s risk, consumer’s risk

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4770 Navigating the Assessment Landscape in English Language Teaching: Strategies, Challengies and Best Practices

Authors: Saman Khairani

Abstract:

Assessment is a pivotal component of the teaching and learning process, serving as a critical tool for evaluating student progress, diagnosing learning needs, and informing instructional decisions. In the context of English Language Teaching (ELT), effective assessment practices are essential to promote meaningful learning experiences and foster continuous improvement in language proficiency. This paper delves into various assessment strategies, explores associated challenges, and highlights best practices for assessing student learning in ELT. The paper begins by examining the diverse forms of assessment, including formative assessments that provide timely feedback during the learning process and summative assessments that evaluate overall achievement. Additionally, alternative methods such as portfolios, self-assessment, and peer assessment play a significant role in capturing various aspects of language learning. Aligning assessments with learning objectives is crucial. Educators must ensure that assessment tasks reflect the desired language skills, communicative competence, and cultural awareness. Validity, reliability, and fairness are essential considerations in assessment design. Challenges in assessing language skills—such as speaking, listening, reading, and writing—are discussed, along with practical solutions. Constructive feedback, tailored to individual learners, guides their language development. In conclusion, this paper synthesizes research findings and practical insights, equipping ELT practitioners with the knowledge and tools necessary to design, implement, and evaluate effective assessment practices. By fostering meaningful learning experiences, educators contribute significantly to learners’ language proficiency and overall success.

Keywords: ELT, formative, summative, fairness, validity, reliability

Procedia PDF Downloads 56
4769 Analysis, Evaluation and Optimization of Food Management: Minimization of Food Losses and Food Wastage along the Food Value Chain

Authors: G. Hafner

Abstract:

A method developed at the University of Stuttgart will be presented: ‘Analysis, Evaluation and Optimization of Food Management’. A major focus is represented by quantification of food losses and food waste as well as their classification and evaluation regarding a system optimization through waste prevention. For quantification and accounting of food, food losses and food waste along the food chain, a clear definition of core terms is required at the beginning. This includes their methodological classification and demarcation within sectors of the food value chain. The food chain is divided into agriculture, industry and crafts, trade and consumption (at home and out of home). For adjustment of core terms, the authors have cooperated with relevant stakeholders in Germany for achieving the goal of holistic and agreed definitions for the whole food chain. This includes modeling of sub systems within the food value chain, definition of terms, differentiation between food losses and food wastage as well as methodological approaches. ‘Food Losses’ and ‘Food Wastes’ are assigned to individual sectors of the food chain including a description of the respective methods. The method for analyzing, evaluation and optimization of food management systems consist of the following parts: Part I: Terms and Definitions. Part II: System Modeling. Part III: Procedure for Data Collection and Accounting Part. IV: Methodological Approaches for Classification and Evaluation of Results. Part V: Evaluation Parameters and Benchmarks. Part VI: Measures for Optimization. Part VII: Monitoring of Success The method will be demonstrated at the example of an invesigation of food losses and food wastage in the Federal State of Bavaria including an extrapolation of respective results to quantify food wastage in Germany.

Keywords: food losses, food waste, resource management, waste management, system analysis, waste minimization, resource efficiency

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4768 Campaign Contributions as Freedom of Expression: A Comparative Study Between the United States and Germany

Authors: Kristof Lukas Heidemann

Abstract:

In times of democratic backsliding in Western nations restoring public trust in the electoral process ranks among the most urgent tasks on the public agenda. Addressing the role of money in politics is one major part of this effort, however, such an endeavor might affect the constitutional freedom of expression. Attempts to regulate political spending in the U.S. have in recent decades increasingly been overruled by the U.S. Supreme through an expansion of the protective umbrella of the First Amendment over campaign contributions by private organizations, especially in the decisions Buckley v. Valeo and Citizens United v. FEC. In Germany on the other hand this line of argumentation has so far not been submitted to the national Supreme Court. Given that voices calling for stricter and more transparent political financing laws in Germany are growing, it seems only a matter of time until the issue will have to be addressed by the country’s judiciary as well. Therefore, this paper conducts a comparative analysis of the constitutional right to free expression in these two leading democracies in to assess whether the problem of a lack of regulatory options to achieve stricter campaign spending laws due to constitutional restrictions will also arise in Germany. In order to present a comprehensive picture of the subject, the analysis does not only touch upon doctrinal aspects of both systems but also scrutinizes the practical implications from a socio-legal perspective. Although the list of forms of expression in the wording of Art. 5 of the German constitution is generally considered to be non-exhaustive, the investigation concludes that the subsumption of election campaign donations under it is not justifiable using recognized methods of interpretation, in particular concerning a systematic interpretation in light of the principle of equality in Art. 3 of the German constitution.

Keywords: comparative constitutional law, constitutional justice, constitutional law, election law, freedom of speech, fundamental rights, law reform

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4767 Rrelationship Between Intrauterine Growth Retardation and TORCH Infections in Neonates

Authors: Seyed Saeid Nabavi

Abstract:

Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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4766 Reflecting and Teaching on the Dialectical Nature of Social Work

Authors: Eli Buchbinder

Abstract:

Dialectics theory perceives two or more forces or themes as mutually opposed and negating on the one hand and as interdependent for their definition, existence, and resolution on the other. Such opposites might never be fully reconciled but might, simultaneously, continue to produce a higher level of integration and synthesis as well as tension, contradictions, and paradoxes. The identity of social work is constructed by poles; an understanding that emerges through key concepts that shape the profession. The key concept of person-in-environment creates dialectical tensions between the psychological versus the social pole. Important examples that reflect this focus on the psychological versus the social nature of human beings. This meta-perspective influences and constructs the implementation of values, ways of intervention, and professional relationships, e.g., creating a conflict between personal/social empowerment and social control and correction as the aims of the profession. Social work is dynamic and changing, with a unique way of perceiving and conceptualizing human behavior. Social workers must be able to face and accept the contradicting elements inherent in practicing social work. The basic philosophy for social work education is a dialectic conceptualization. In light of the above, social work students require dialectics as a critical mode of perception, reflection, and intervention. In the presentation, the focus will be on reflection on teaching students to conceptualize dialectics as a frame when training to be social workers. It is believed that the focus should emphasis two points: 1) the need to assist students to identify poles and to analyze the interrelationships created between them while coping emotionally with the tension and difficulties involved in containing these poles; 2) teaching students to integrate poles as a basis for assessment, planning, and intervention.

Keywords: professional ontology, a generic social work education, skills and values of social work, reflecting on social work teaching methods

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4765 Translating the Gendered Discourse: A Corpus-Based Study of the Chinese Science Fiction The Three Body Problem

Authors: Yi Gu

Abstract:

The Three-Body Problem by Cixin Liu has been a bestseller Chinese Sci-Fi novel for years since 2008. The book was translated into English by Ken Liu in 2014 and won the prestigious 2015 science fiction and fantasy writing Hugo Award, drawing greater attention from wider international communities. The story exposes the horrors of the Chinese Cultural Revolution in the 1960s, in an intriguing narrative for readers at home and abroad. However, without the access to the source text, western readers may not be aware that the original Chinese version of the book is rich in gender-bias. Some Chinese scholars have applied feminist translation theories to their analysis on this book before, based on isolated selected, cherry-picking examples. Thus this paper aims to obtain a more thorough picture of how translators can cope with gender discrimination and reshape the gendered discourse from the source text, by systematically investigating the lexical and syntactic patterns in the translation of Liu’s entire book of 400 pages. The source text and the translation were downloaded into digital files, automatically aligned at paragraph level and then manually post-edited. They were then compiled into a parallel corpus of 114,629 English words and 204,145 Chinese characters using Sketch Engine. Gender-discrimination markers such as the overuse of ‘girl’ to describe an adult woman were searched in the source text, and the alignment made it possible to identify the strategies adopted by the translator to mitigate gender discrimination. The results provide a framework for translators to address gender bias. The study also shows how corpus methods can be used to further research in feminist translation and critical discourse analysis.

Keywords: corpus, discourse analysis, feminist translation, science fiction translation

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4764 Psychological Distress Screening in Patients with Esophageal Cancer after Esophagectomy: A Scoping Review

Authors: Erietta-Christina Arnaoutaki, Stelios-Elion Bousi, Marinos Zachiotis, Simoni Zarkada, Alexandra Chrysagi, Mamdouh Fahad Alenazi, Dimitri Aristotle Raptis

Abstract:

Objective: This review aimed to evaluate the mental health status of patients with esophageal cancer following surgical treatment, as well as the role of psychological distress screening tests in this patient population. Methods: Studies reporting psychometric screening tools used in esophageal cancer patients after esophagectomy, published before January 2024 on PubMed, Scopus, and CENTRAL databases, were searched and analyzed. Results: Six non-randomized control trials were selected for inclusion in this scoping review, which involved 1059 patients undergoing esophagectomy for esophageal cancer. Among the included studies, five employed the Hospital Anxiety and Depression Scale (HADS) for anxiety and/or depression screening, while one used the MD Anderson Symptom Inventory for gastrointestinal cancer (MDASI-GI) for sadness screening. A range of time points was used to evaluate these patients: 102 patients were evaluated at 1 month, 230 patients at 3 months, 218 patients at 6 months, 653 patients at 12 months, and 154 patients at 24 months postoperatively. Analysis of data pooled from three studies employing the HADS revealed a prevalence of 19.45% for anxiety and 17.92% for depression at the 12-month follow-up and mean scores of 3.91 (3.12) and 3.56 (3.12) for the HADS anxiety (HADS-A) and depression (HADS-D) subscales respectively, at any time postoperatively. Conclusion: The findings show a neglected concern regarding the mental health of esophageal cancer survivors following surgical treatment. The use of psychometric screening tools is essential to address psychological distress and improve the quality of life of these patients.

Keywords: esophageal cancer, esophagectomy, psychological distress, anxiety, depression, psychometric tests, HADS, MDASI-GI

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4763 Evaluation of Mechanical Properties and Analysis of Rapidly Heat Treated M-42 High Speed Steel

Authors: R. N. Karthik Babu, R. Sarvesh, A. Rajendra Prasad, G. Swaminathan

Abstract:

M42 is a molybdenum-series high-speed alloy steel widely used because of its better hot-hardness and wear resistance. These steels are conventionally heat treated in a salt bath furnace with up to three stages of preheating with predetermined soaking and holding periods. Such methods often involve long periods of processing with a large amount of energy consumed. In this study, the M42 steel samples were heat-treated by rapidly heating the specimens to the austenising temperature of 1260 °C and cooled conventionally by quenching in a neutral salt bath at a temperature of 550 °C with the aid of a hybrid microwave furnace. As metals reflect microwaves, they cannot directly be heated up when placed in a microwave furnace. The technology used herein requires the specimens to be placed in a crucible lined with SiC which is a good absorber of microwaves and the SiC lining heats the metal through radiation which facilitates the volumetric heating of the metal. A sample of similar dimensions was heat treated conventionally and cooled in the same manner. Conventional tempering process was then carried out on both these samples and analysed for various parameters such as micro-hardness, processing time, etc. Microstructure analysis and scanning electron microscopy was also carried out. The objective of the study being that similar or better properties, with substantial time and energy saving and cost cutting are achievable by rapid heat treatment through hybrid microwave furnaces. It is observed that the heat treatment is done with substantial time and energy savings, and also with minute improvement in mechanical properties of the tool steel heat treated.

Keywords: rapid heating, heat treatment, metal processing, microwave heating

Procedia PDF Downloads 286
4762 Structural Damage Detection Using Modal Data Employing Teaching Learning Based Optimization

Authors: Subhajit Das, Nirjhar Dhang

Abstract:

Structural damage detection is a challenging work in the field of structural health monitoring (SHM). The damage detection methods mainly focused on the determination of the location and severity of the damage. Model updating is a well known method to locate and quantify the damage. In this method, an error function is defined in terms of difference between the signal measured from ‘experiment’ and signal obtained from undamaged finite element model. This error function is minimised with a proper algorithm, and the finite element model is updated accordingly to match the measured response. Thus, the damage location and severity can be identified from the updated model. In this paper, an error function is defined in terms of modal data viz. frequencies and modal assurance criteria (MAC). MAC is derived from Eigen vectors. This error function is minimized by teaching-learning-based optimization (TLBO) algorithm, and the finite element model is updated accordingly to locate and quantify the damage. Damage is introduced in the model by reduction of stiffness of the structural member. The ‘experimental’ data is simulated by the finite element modelling. The error due to experimental measurement is introduced in the synthetic ‘experimental’ data by adding random noise, which follows Gaussian distribution. The efficiency and robustness of this method are explained through three examples e.g., one truss, one beam and one frame problem. The result shows that TLBO algorithm is efficient to detect the damage location as well as the severity of damage using modal data.

Keywords: damage detection, finite element model updating, modal assurance criteria, structural health monitoring, teaching learning based optimization

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4761 Agroecology and Seasonal Disparity Nexus with Nutritional Status of Children in Ethiopia

Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

Abstract:

Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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4760 Dietary Supplementation with Coula edulis B. Walnuts Prevents Diet-Induced Obesity and Insulin Resistance in Rats

Authors: Eric Beyegue, Boris Azantza, Judith Laure Ngondi, Julius E. Oben

Abstract:

Background: Dietary supplement may potentially help to fight obesity and other metabolic disorders such as adipogenesis, insulin resistance, and inflammation. The present study aimed to test whether supplementation with African walnuts (Aw) could have an effect on adipogenesis and others dysfunctions associated with obesity in rats. Methods: Wistar rats were fed with standard diet (SD) or high-fat high-sucrose diet (HFS) and HFS with supplemented (HFS-Aw) for eight weeks. Results: HFS diet-induced body weight gain and increased fat mass compared to SD. In addition HFS-fed rats developed fasting hyperglycaemia and insulinaemia as well as insulin resistance. Aw supplementation in HFS rats had a protective effect against adipose tissues weigh gain but slightly against body weight gain and major study related disorders. This could be mainly due to decreased food intake dependently of effect in food intake in central nervous system, which decreased in HFS rats supplemented with African walnut compared to the HFS-diet group. Interestingly, African walnut supplementation induced a slight decrease of fasting glycaemia, insulinaemia and Nitric Oxide which could partially explain its minor protective effect against diet-induced insulin resistance. Additionally a decrease in hepatic TG and transaminases levels suggesting a protective effect against liver injury. Conclusion: Taken together these data suggested that supplementation of African walnut could be used to prevent adipose weight gain and related disorders on the other hand, minimally reduced insulin resistance.

Keywords: African walnut, dietary fiber, insulin resistance, oxidative stress

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4759 Neural Network based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children

Authors: Budhvin T. Withana, Sulochana Rupasinghe

Abstract:

The educational system faces a significant concern with regards to Dyslexia and Dysgraphia, which are learning disabilities impacting reading and writing abilities. This is particularly challenging for children who speak the Sinhala language due to its complexity and uniqueness. Commonly used methods to detect the risk of Dyslexia and Dysgraphia rely on subjective assessments, leading to limited coverage and time-consuming processes. Consequently, delays in diagnoses and missed opportunities for early intervention can occur. To address this issue, the project developed a hybrid model that incorporates various deep learning techniques to detect the risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16, and YOLOv8 models were integrated to identify handwriting issues. The outputs of these models were then combined with other input data and fed into an MLP model. Hyperparameters of the MLP model were fine-tuned using Grid Search CV, enabling the identification of optimal values for the model. This approach proved to be highly effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention. The Resnet50 model exhibited a training accuracy of 0.9804 and a validation accuracy of 0.9653. The VGG16 model achieved a training accuracy of 0.9991 and a validation accuracy of 0.9891. The MLP model demonstrated impressive results with a training accuracy of 0.99918, a testing accuracy of 0.99223, and a loss of 0.01371. These outcomes showcase the high accuracy achieved by the proposed hybrid model in predicting the risk of Dyslexia and Dysgraphia.

Keywords: neural networks, risk detection system, dyslexia, dysgraphia, deep learning, learning disabilities, data science

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4758 Remaining Useful Life Estimation of Bearings Based on Nonlinear Dimensional Reduction Combined with Timing Signals

Authors: Zhongmin Wang, Wudong Fan, Hengshan Zhang, Yimin Zhou

Abstract:

In data-driven prognostic methods, the prediction accuracy of the estimation for remaining useful life of bearings mainly depends on the performance of health indicators, which are usually fused some statistical features extracted from vibrating signals. However, the existing health indicators have the following two drawbacks: (1) The differnet ranges of the statistical features have the different contributions to construct the health indicators, the expert knowledge is required to extract the features. (2) When convolutional neural networks are utilized to tackle time-frequency features of signals, the time-series of signals are not considered. To overcome these drawbacks, in this study, the method combining convolutional neural network with gated recurrent unit is proposed to extract the time-frequency image features. The extracted features are utilized to construct health indicator and predict remaining useful life of bearings. First, original signals are converted into time-frequency images by using continuous wavelet transform so as to form the original feature sets. Second, with convolutional and pooling layers of convolutional neural networks, the most sensitive features of time-frequency images are selected from the original feature sets. Finally, these selected features are fed into the gated recurrent unit to construct the health indicator. The results state that the proposed method shows the enhance performance than the related studies which have used the same bearing dataset provided by PRONOSTIA.

Keywords: continuous wavelet transform, convolution neural net-work, gated recurrent unit, health indicators, remaining useful life

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4757 A Review on Potential Utilization of Water Hyacinth (Eichhornia crassipes) as Livestock Feed with Particular Emphasis to Developing Countries in Africa

Authors: Shigdaf Mekuriaw, Firew Tegegne, A. Tsunekawa, Dereje Tewabe

Abstract:

The purpose of this paper is to make a comprehensive review on the use of water hyacinth (Eichhornia crassipes) as a potential livestock feed and argue its utilization as complementary strategy to other control methods. Water Hyacinth is one of the most noxious plant invaders of rivers and lakes. Such weeds cause environmental disaster and interfere with economic and recreational activities such as water transportation and fishing. Economic impacts of the weed in seven African countries have been estimated at between 20-50 million US$ every year. It would, therefore, be prudent to suggest utilization as a complementary control method. The majority of people in developing countries are dependent on traditional and inefficient crop-livestock production system that constrains their ability to enhance economic productivity and quality of life. Livestock in developing countries faces shortage of feed, especially during the long dry seasons. Existing literature shows the use of water hyacinth as livestock and fish feed. The chemical composition of water hyacinth varies considerably. Due to its relatively high crude protein (CP) content (5.8-20.0%), water hyacinth can be considered as a potential protein supplement for livestock which commonly feed cereal crop residues whose contribution as source of feed is increasing in Africa. Though the effects of anti-nutritional factors (ANFs) present in water hyacinth is not investigated, their concentrations are not above threshold hinder its utilization as livestock feed. In conclusion, water hyacinth could provide large quantities of nutritious feed for animals. Like other feeds, water hyacinth may not be offered as a sole feed and based on existing literature its optimum inclusion level reaches 50%.

Keywords: Africa, livestock feed, water bodies, water hyacinth and weed control method

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4756 [Keynote Talk]: Caught in the Tractorbeam of Larger Influences: The Filtration of Innovation in Education Technology Design

Authors: Justin D. Olmanson, Fitsum Abebe, Valerie Jones, Eric Kyle, Xianquan Liu, Katherine Robbins, Guieswende Rouamba

Abstract:

The history of education technology--and designing, adapting, and adopting technologies for use in educational spaces--is nuanced, complex, and dynamic. Yet, despite a range of continually emerging technologies, the design and development process often yields results that appear quite similar in terms of affordances and interactions. Through this study we (1) verify the extent to which designs have been constrained, (2) consider what might account for it, and (3) offer a way forward in terms of how we might identify and strategically sidestep these influences--thereby increasing the diversity of our designs with a given technology or within a particular learning domain. We begin our inquiry from the perspective that a host of co-influencing elements, fields, and meta narratives converge on the education technology design process to exert a tangible, often homogenizing effect on the resultant designs. We identify several elements that influence design in often implicit or unquestioned ways (e.g. curriculum, learning theory, economics, learning context, pedagogy), we describe our methodology for identifying the elemental positionality embedded in a design, we direct our analysis to a particular subset of technologies in the field of literacy, and unpack our findings. Our early analysis suggests that the majority of education technologies designed for use/used in US public schools are heavily influenced by a handful of mainstream theories and meta narratives. These findings have implications for how we approach the education technology design process--which we use to suggest alternative methods for designing/ developing with emerging technologies. Our analytical process and re conceptualized design process hold the potential to diversify the ways emerging and established technologies get incorporated into our designs.

Keywords: curriculum, design, innovation, meta narratives

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4755 Design of Hybrid Auxetic Metamaterials for Enhanced Energy Absorption under Compression

Authors: Ercan Karadogan, Fatih Usta

Abstract:

Auxetic materials have a negative Poisson’s ratio (NPR), which is not often found in nature. They are metamaterials that have potential applications in many engineering fields. Mechanical metamaterials are synthetically designed structures with unusual mechanical properties. These mechanical properties are dependent on the properties of the matrix structure. They have the following special characteristics, i.e., improved shear modulus, increased energy absorption, and intensive fracture toughness. Non-auxetic materials compress transversely when they are stretched. The system naturally is inclined to keep its density constant. The transversal compression increases the density to balance the loss in the longitudinal direction. This study proposes to improve the crushing performance of hybrid auxetic materials. The re-entrant honeycomb structure has been combined with a star honeycomb, an S-shaped unit cell, a double arrowhead, and a structurally hexagonal re-entrant honeycomb by 9 X 9 cells, i.e., the number of cells is 9 in the lateral direction and 9 in the vertical direction. The Finite Element (FE) and experimental methods have been used to determine the compression behavior of the developed hybrid auxetic structures. The FE models have been developed by using Abaqus software. The specimens made of polymer plastic materials have been 3D printed and subjected to compression loading. The results are compared in terms of specific energy absorption and strength. This paper describes the quasi-static crushing behavior of two types of hybrid lattice structures (auxetic + auxetic and auxetic + non-auxetic). The results show that the developed hybrid structures can be useful to control collapse mechanisms and present larger energy absorption compared to conventional re-entrant auxetic structures.

Keywords: auxetic materials, compressive behavior, metamaterials, negative Poisson’s ratio

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4754 Pain Management in Burn Wounds with Dual Drug Loaded Double Layered Nano-Fiber Based Dressing

Authors: Sharjeel Abid, Tanveer Hussain, Ahsan Nazir, Abdul Zahir, Nabyl Khenoussi

Abstract:

Localized application of drug has various advantages and fewer side effects as compared with other methods. Burn patients suffer from swear pain and the major aspects that are considered for burn victims include pain and infection management. Nano-fibers (NFs) loaded with drug, applied on local wound area, can solve these problems. Therefore, this study dealt with the fabrication of drug loaded NFs for better pain management. Two layers of NFs were fabricated with different drugs. Contact layer was loaded with Gabapentin (a nerve painkiller) and the second layer with acetaminophen. The fabricated dressing was characterized using scanning electron microscope, Fourier Transform Infrared Spectroscopy, X-Ray Diffraction and UV-Vis Spectroscopy. The double layered based NFs dressing was designed to have both initial burst release followed by slow release to cope with pain for two days. The fabricated nanofibers showed diameter < 300 nm. The liquid absorption capacity of the NFs was also checked to deal with the exudate. The fabricated double layered dressing with dual drug loading and release showed promising results that could be used for dealing pain in burn victims. It was observed that by the addition of drug, the size of nanofibers was reduced, on the other hand, the crystallinity %age was increased, and liquid absorption decreased. The combination of fast nerve pain killer release followed by slow release of non-steroidal anti-inflammatory drug could be a good tool to reduce pain in a more secure manner with fewer side effects.

Keywords: pain management, burn wounds, nano-fibers, controlled drug release

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4753 The Prevalence of Cardiovascular Diseases in World-Class Triathletes: An Internet-Based Study from 2006 to 2019

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

Abstract:

Background: The prevalence of cardiovascular diseases (CVD) in different triathlon sports disciplines has not been determined. Purpose: The present study aimed to determine the prevalence of CVD in world-class triathletes according to their sex, sports disciplines (aquathlon, duathlon, triathlon…), and formats (short/medium, long, and ultra-long distance). Methods: Male and female elite athletes from eleven triathlon sport disciplines, ranked in the internationally yearly top 10 between 2006 and 2019, were included. The athlete’s name was associated in a Google search with selected key terms related to heart disease and/or cardiac abnormalities. The prevalence and the hazard function of the variation were calculated, and the differences were then compared. Results: From 1329 athletes (male 639, female 690), 13 cases of CVD (0.98%, 95% CI: [0.45-1.51]) were identified, and the mean age of their occurrence was 29±6 years. Although no sex differences were found in each sport discipline/format (p > 0.05), severe outcomes (sudden cardiac arrest/death and those who had to stop their sports practice) were only observed in males. Short-distance triathlon (5.08%, 95% CI: [1.12-9.05]) was more affected than other disciplines in short/medium, long, and ultra-long formats. The prevalence of CVD in athletes who participated in multi-type of sports disciplines (4.14%, 95% CI: [1.14-7.15]) was higher than in those who participated in one type (0.52%, 95% CI: [0.10-0.93]) (p = 0.0004). Conclusion: Athletes in short-distance triathlon were more affected than other disciplines in short/medium, long and ultra-long formats. Athletes who participate in short/medium distances and those who participate in multi-type of sports disciplines should be closely monitored regardless of sex.

Keywords: cardiovascular diseases, sudden cardiac death, triathlon sport disciplines, world-class athletes

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4752 Levels of Selected Adipokines in Women with Gestational Diabetes and Type 2 Diabetes, Their Relationship to Metabolic Parameters

Authors: David Karasek, Veronika Kubickova, Ondrej Krystynik, Dominika Goldmannova, Lubica Cibickova, Jan Schovanek

Abstract:

Introduction: Adiponectin, adipocyte-fatty acid-binding protein (A-FABP), and Wnt1 inducible signaling pathway protein-1 (WISP-1) are adipokines particularly associated with insulin resistance. The aim of the study was to compare their levels in women with gestational diabetes (GDM), type 2 diabetes mellitus (T2DM) and healthy controls and determine their relation with metabolic parameters. Methods: Fifty women with GDM, 50 women with T2DM, and 35 healthy women were included in the study. In addition to adipokines, anthropometric, lipid parameters, and markers, insulin resistance, and glucose control were assessed in all participants. Results: Compared to healthy controls only significantly lower levels of adiponectin were detected in women with GDM, whereas lower levels of adiponectin, higher levels of A-FABP and of WISP-1 were present in women with T2DM. Women with T2DM had also lower levels of adiponectin and higher levels of A-FABP compared to women with GDM. In women with GDM or T2DM adiponectin correlated negatively with body mass index (BMI), triglycerides (TG), C-peptide and positively with HDL-cholesterol; A-FABP positively correlated with BMI, TG, waist, and C-peptide. Moreover, there was a positive correlation between WISP-1 and C-peptide in women with T2DM. Conclusion: Adverse adipokines production detecting dysfunctional fat tissue is in women with GDM less presented than in women with T2DM, but more expressed compared to healthy women. Acknowledgment: Supported by AZV NV18-01-00139 and MH CZ DRO (FNOl, 00098892).

Keywords: adiponectin, adipocyte-fatty acid binding protein, wnt1 inducible signaling pathway protein-1, gestational diabetes, type 2 diabetes mellitus

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4751 Pregnant Women in Substance Abuse: Transition of Characteristics and Mining of Association from Teds-a 2011 to 2018

Authors: Md Tareq Ferdous Khan, Shrabanti Mazumder, MB Rao

Abstract:

Background: Substance use during pregnancy is a longstanding public health problem that results in severe consequences for pregnant women and fetuses. Methods: Eight (2011-2018) datasets on pregnant women’s admissions are extracted from TEDS-A. Distributions of sociodemographic, substance abuse behaviors, and clinical characteristics are constructed and compared over the years for trends by the Cochran-Armitage test. Market basket analysis is used in mining the association among polysubstance abuse. Results: Over the years, pregnant woman admissions as the percentage of total and female admissions remain stable, where total annual admissions range from 1.54 to about 2 million with the female share of 33.30% to 35.61%. Pregnant women aged 21-29, 12 or more years of education, white race, unemployed, holding independent living status are among the most vulnerable. Concerns prevail on a significant number of polysubstance users, young age at first use, frequency of daily users, and records of prior admissions (60%). Trends of abused primary substances show a significant rise in heroin (66%) and methamphetamine (46%) over the years, although the latest year shows a considerable downturn. On the other hand, significant decreasing patterns are evident for alcohol (43%), marijuana or hashish (24%), cocaine or crack (23%), other opiates or synthetics (36%), and benzodiazepines (29%). Basket analysis reveals some patterns of co-occurrence of substances consistent over the years. Conclusions: This comprehensive study can work as a reference to identify the most vulnerable groups based on their characteristics and deal with the most hazardous substances from their evidence of co-occurrence.

Keywords: basket analysis, pregnant women, substance abuse, trend analysis

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4750 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

Abstract:

Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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4749 Solving a Micromouse Maze Using an Ant-Inspired Algorithm

Authors: Rolando Barradas, Salviano Soares, António Valente, José Alberto Lencastre, Paulo Oliveira

Abstract:

This article reviews the Ant Colony Optimization, a nature-inspired algorithm, and its implementation in the Scratch/m-Block programming environment. The Ant Colony Optimization is a part of Swarm Intelligence-based algorithms and is a subset of biological-inspired algorithms. Starting with a problem in which one has a maze and needs to find its path to the center and return to the starting position. This is similar to an ant looking for a path to a food source and returning to its nest. Starting with the implementation of a simple wall follower simulator, the proposed solution uses a dynamic graphical interface that allows young students to observe the ants’ movement while the algorithm optimizes the routes to the maze’s center. Things like interface usability, Data structures, and the conversion of algorithmic language to Scratch syntax were some of the details addressed during this implementation. This gives young students an easier way to understand the computational concepts of sequences, loops, parallelism, data, events, and conditionals, as they are used through all the implemented algorithms. Future work includes the simulation results with real contest mazes and two different pheromone update methods and the comparison with the optimized results of the winners of each one of the editions of the contest. It will also include the creation of a Digital Twin relating the virtual simulator with a real micromouse in a full-size maze. The first test results show that the algorithm found the same optimized solutions that were found by the winners of each one of the editions of the Micromouse contest making this a good solution for maze pathfinding.

Keywords: nature inspired algorithms, scratch, micromouse, problem-solving, computational thinking

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4748 Poliovirus Vaccine Immunity among Chronically Malnourished Pakistani Infants: A Randomized Controlled Trial from Developing Country

Authors: Ali Faisal Saleem, Farheen Quadri, Mach Ondrej, Anita Zaidi

Abstract:

Purpose: Pakistan is the final frontier for a polio-free world. Chronic malnutrition is associated with lack of effective gut immunity, and possibly associated with poliomyelitis in children received multiple OPV. We evaluate IPV dose administered together with OPV results in higher immunogenicity and mucosal immunity compared to OPV alone in chronically malnourished infants. Methods AND Materials: A community-based, unblinded-randomized-trial, conducted in 5 peri-urban, low-middle-income households of Karachi, in infants 9-12 months. Two study groups were non-malnourished (HAZ= -2 or more) and chronic malnourished (HAZ <-2SD), with 2-arms each i) OPV and ii) OPV and IPV. Two blood specimens (2ml) at baseline and at day 28 and two stool specimens (6 gm.) at day 29 and after 7 days. All infants received a bOPV challenge dose after first stool specimen. Calculates sample size was 210 in each arm. Serological (baseline compared to 28 days post-vaccine) and mucosal immunity after one week of bOPV challenge dose were study outcomes. Results: Baseline seroprevalence in malnourished infants were low compared to non-malnourished (P1, P2 and P3 (p=<0.001). There is significant rise in antibody titer and P1 seroprevalence in Mal A and B after receiving study vaccine; much higher in Mal B. Infants randomized to bOPV + IPV study vaccine showed incremental immune response against P1 (Mal B, 92.2%; Nor B, 98.4%), P2 (Mal B, 90.4%; Nor B, 94.7%), and P3 (Mal B, 85.6% and Nor B, 93.5%) was observed. A significant proportion of infants in malnourished (P1, 13%; P2, 24%; P3, 26%) and normally nourished group (P1, 5%; P2, 11%; P3, 14%) were found to be seronegative at baseline. Infants who received BOPV + IPV as their study vaccine showed a very high seroconversion response after vaccine (p=<0.001 for P1, P2 and P3). Majority of the specimens were negative at baseline (Mal A, 2%, Mal B, 1%; Nor A, 2%; Nor B, 1%), and remains negative after bOPV challenge dose (Mal A, 8%, Mal B, 6%; Nor A, 11%; Nor B, 10%). Conclusion: Malnourished-infants have low poliovirus-seroprevalence that increased remarkably after IPV. There is less viral shedding after IPV in infants.

Keywords: chronic malnutrition, infants, IPV, OPV

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4747 Impact of Map Generalization in Spatial Analysis

Authors: Lin Li, P. G. R. N. I. Pussella

Abstract:

When representing spatial data and their attributes on different types of maps, the scale plays a key role in the process of map generalization. The process is consisted with two main operators such as selection and omission. Once some data were selected, they would undergo of several geometrical changing processes such as elimination, simplification, smoothing, exaggeration, displacement, aggregation and size reduction. As a result of these operations at different levels of data, the geometry of the spatial features such as length, sinuosity, orientation, perimeter and area would be altered. This would be worst in the case of preparation of small scale maps, since the cartographer has not enough space to represent all the features on the map. What the GIS users do is when they wanted to analyze a set of spatial data; they retrieve a data set and does the analysis part without considering very important characteristics such as the scale, the purpose of the map and the degree of generalization. Further, the GIS users use and compare different maps with different degrees of generalization. Sometimes, GIS users are going beyond the scale of the source map using zoom in facility and violate the basic cartographic rule 'it is not suitable to create a larger scale map using a smaller scale map'. In the study, the effect of map generalization for GIS analysis would be discussed as the main objective. It was used three digital maps with different scales such as 1:10000, 1:50000 and 1:250000 which were prepared by the Survey Department of Sri Lanka, the National Mapping Agency of Sri Lanka. It was used common features which were on above three maps and an overlay analysis was done by repeating the data with different combinations. Road data, River data and Land use data sets were used for the study. A simple model, to find the best place for a wild life park, was used to identify the effects. The results show remarkable effects on different degrees of generalization processes. It can see that different locations with different geometries were received as the outputs from this analysis. The study suggests that there should be reasonable methods to overcome this effect. It can be recommended that, as a solution, it would be very reasonable to take all the data sets into a common scale and do the analysis part.

Keywords: generalization, GIS, scales, spatial analysis

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4746 Development of Cost-Effective Protocol for Preparation of Dehydrated Paneer (Indian Cottage Cheese) Using Freeze Drying

Authors: Sadhana Sharma, P. K. Nema, Siddhartha Singha

Abstract:

Paneer or Indian cottage cheese is an acid and heat coagulated milk product, highly perishable because of high moisture (58-60 %). Typically paneer is marble to light creamy white in appearance. A good paneer should have cohesive body with slight sponginess or springiness. The texture must be smooth and velvety with close-knit compactness. It should have pleasing mild acidic, slightly sweet and nutty flavour. Consumers today demand simple to prepare, convenient, healthy and natural foods. Dehydrated paneer finds numerous ways to be used. It can be used in curry preparation similar to paneer-in-curry, a delicacy in Indian cuisine. It may be added to granola/ trail mix yielding a high energy snack. If grounded to a powder, it may be used as a cheesy spice mix or used as popcorn seasoning. Dried paneer powder may be added to pizza dough or to a white sauce to turn it into a paneer sauce. Drying of such food hydrogels by conventional methods is associated with several undesirable characteristics including case hardening, longer drying time, poor rehydration ability and fat loss during drying. The present study focuses on developing cost-effective protocol for freeze-drying of paneer. The dehydrated product would be shelf-stable and can be rehydrated to its original state having flavor and texture comparable to the fresh form. Moreover, the final product after rehydration would be more fresh and softer than its frozen counterparts. The developed product would be shelf-stable at room temperature without any addition of preservatives.

Keywords: color, freeze-drying, paneer, texture

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4745 Microbiota Effect with Cytokine in Hl and NHL Patient Group

Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

Abstract:

Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

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4744 Predictors of Pelvic Vascular Injuries in Patients with Pelvic Fractures from Major Blunt Trauma

Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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4743 Mechanical Advantages of the ‘KZ Bag’ on Spine and Posture of School Aged Children

Authors: Khulood Zahran

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Background and Purpose: The effects of backpack on 'school-age' children (Age 9–12) years, have been a critical subject of discussion throughout the past years. It has been one of the factors that contribute to a bad posture for 40% to 70% of developed countries. A child carrying a heavy backpack for a prolonged period, on a daily base has shown significant changes in the child's spinal posture, foot shape, and gait. The back pain caused by the compensatory posture, or "Backpack syndrome", is also known for its headaches, fatigue, cervical and lumber pain caused by the abnormal body posture. The child tends to balance himself by bending forward to match the heavy backpack, moving his Centre of Gravity forward, resulting in decreased lumber lordosis and increased thoracic kyphosis. Since currently available bags have not addressed the weight distribution issue till now. Therefore, KZ bag is believed to prevent the huge backward shift of COG due to the load, and hence all the symptoms accompanied. This is thought to be possible by combining the design of a normal backpack with a messenger bag. The purpose of this study is to investigate the improvement of the child's spine and to minimize the compensatory posture after using the KZ bag. Materials and Methods: KZ bag would compromise the pros of a messenger bag (keeping the COG in place) by a diagonal load strap and of a backpack (distributing the load on both shoulders) by connecting another load strap parallel to the sagittal plane of the body. The design would be made adjustable to match the child's height, and the bag load kept within limits, (10-15%) of the child's body weight. Measurements of Postural angles (Cervical, shoulders, and Trunk) would be taken after the use of KZ bag for a specified period. Conclusion: KZ bag will prove an improved distribution of weight of the bag on the child's body, and reduce the degree of the compensatory posture, that occurs in the attempt to balance the external weight of the bag.

Keywords: backpack, backpack syndrome, posture, spine

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4742 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital

Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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