Search results for: large-scale assembly units

Authors: Cherrie Lowe

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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.

Keywords: maternity, acuity, research, nursing workloads

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Authors: Linda D. F. Bambara, Marie Sawadogo

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Jatropha curcas (jatropha) is the plant that has been the most studied for biofuel production in West Africa. There exist however other plants such as Balanites aegyptiaca (balanites) that have been targeted as a potential feedstock for biofuel production. This biomass could be an alternative feedstock for the production of straight vegetable oil (SVO) at costs lower than jatropha-based SVO production costs. This study aims firstly to determine, through an MILP model, the optimal organization that minimizes the costs of the oilseeds supply of two biomass conversion units (BCU) exploiting respectively jatropha seeds and the balanitès seeds. Secondly, the study aims to carry out a comparative study of these costs obtained for each BCU. The model was then implemented on two theoretical cases studies built on the basis of the common practices in Burkina Faso and two scenarios were carried out for each case study. In Scenario 1, 3 pre-processing locations ("at the harvesting area", "at the gathering points", "at the BCU") are possible. In scenario 2, only one location ("at the BCU") is possible. For each biomass, the system studied is the upstream supply chain (harvesting, transport and pre-processing (drying, dehulling, depulping)), including cultivation (for jatropha). The model optimizes the area of land to be exploited based on the productivity of the studied plants and material losses that may occur during the harvesting and the supply of the BCU. It then defines the configuration of the logistics network allowing an optimal supply of the BCU taking into account the most common means of transport in West African rural areas. For the two scenarios, the results of the implementation showed that the total area exploited for balanites (1807 ha) is 4.7 times greater than the total area exploited for Jatropha (381 ha). In both case studies, the location of pre-processing “at the harvesting area” was always chosen for scenario1. As the balanites trees were not planted and because the first harvest of the jatropha seeds took place 4 years after planting, the cost price of the seeds at the BCU without the pre-processing costs was about 430 XOF/kg. This cost is 3 times higher than the balanites's one, which is 140 XOF/kg. After the first year of harvest, i.e. 5 years after planting, and assuming that the yield remains constant, the same cost price is about 200 XOF/kg for Jatropha. This cost is still 1.4 times greater than the balanites's one. The transport cost of the balanites seeds is about 120 XOF/kg. This cost is similar for the jatropha seeds. However, when the pre-processing is located at the BCU, i.e. for scenario2, the transport costs of the balanites seeds is 1200 XOF/kg. These costs are 6 times greater than the transport costs of jatropha which is 200 XOF/kg. These results show that the cost price of the balanites seeds at the BCU can be competitive compared to the jatropha's one if the pre-processing is located at the harvesting area.

Keywords: Balanites aegyptiaca, biomass conversion, Jatropha curcas, optimization, post-harvest operations

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Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Dilyara R. Khusnutdinova, Dilyara R. Kamaldinova, Alexander V. Shestopalov

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Background. Obese patients have unequal risks of metabolic disorders. It is accepted to distinguish between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). MUHO patients have a high risk of metabolic disorders, insulin resistance, and diabetes mellitus. Among the other things, the gut microbiota also contributes to the development of metabolic disorders in obesity. Obesity is accompanied by significant changes in the gut microbial community. In turn, bacterial translocation from the intestine is the basis for the blood microbiome formation. The aim was to study the features of the blood microbiome in patients with various metabolic types of obesity. Patients, materials, methods. The study included 116 healthy donors and 101 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=36) and MUHO (n=53). Quantitative and qualitative assessment of the blood microbiome was based on metagenomic analysis. Blood samples were used to isolate DNA and perform sequencing of the variable v3-v4 region of the 16S rRNA gene. Alpha diversity indices (Simpson index, Shannon index, Chao1 index, phylogenetic diversity, the number of observed operational taxonomic units) were calculated. Moreover, we compared taxa (phyla, classes, orders, and families) in terms of isolation frequency and the taxon share in the total bacterial DNA pool between different patient groups. Results. In patients with MHO, the characteristics of the alpha-diversity of the blood microbiome were like those of healthy donors. However, MUHO was associated with an increase in all diversity indices. The main phyla of the blood microbiome were Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria. Cyanobacteria, TM7, Thermi, Verrucomicrobia, Chloroflexi, Acidobacteria, Planctomycetes, Gemmatimonadetes, and Tenericutes were found to be less significant phyla of the blood microbiome. Phyla Acidobacteria, TM7, and Verrucomicrobia were more often isolated in blood samples of patients with MUHO compared with healthy donors. Obese patients had a decrease in some taxonomic ranks (Bacilli, Caulobacteraceae, Barnesiellaceae, Rikenellaceae, Williamsiaceae). These changes appear to be related to the increased diversity of the blood microbiome observed in obesity. An increase of Lachnospiraceae, Succinivibrionaceae, Prevotellaceae, and S24-7 was noted for MUHO patients, which, apparently, is explained by a magnification in intestinal permeability. Conclusion. Blood microbiome differs in obese patients and healthy donors at class, order, and family levels. Moreover, the nature of the changes is determined by the metabolic type of obesity. MUHO linked to increased diversity of the blood microbiome. This appears to be due to increased microbial translocation from the intestine and non-intestinal sources.

Keywords: blood microbiome, blood bacterial DNA, obesity, metabolically healthy obesity, metabolically unhealthy obesity

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Authors: Yonas Shuke Kitawa

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Background: Although malaria incidence has substantially fallen sharply over the past few years, the rate of decline varies by district, time, and malaria type. Despite this turn-down, malaria remains a major public health threat in various districts of Ethiopia. Consequently, the present study is aimed at developing a predictive model that helps to identify the spatio-temporal variation in malaria risk by multiple plasmodium species. Methods: We propose a multivariate spatio-temporal Bayesian model to obtain a more coherent picture of the temporally varying spatial variation in disease risk. The spatial autocorrelation in such a data set is typically modeled by a set of random effects that assign a conditional autoregressive prior distribution. However, the autocorrelation considered in such cases depends on a binary neighborhood matrix specified through the border-sharing rule. Over here, we propose a graph-based optimization algorithm for estimating the neighborhood matrix that merely represents the spatial correlation by exploring the areal units as the vertices of a graph and the neighbor relations as the series of edges. Furthermore, we used aggregated malaria count in southern Ethiopia from August 2013 to May 2019. Results: We recognized that precipitation, temperature, and humidity are positively associated with the malaria threat in the area. On the other hand, enhanced vegetation index, nighttime light (NTL), and distance from coastal areas are negatively associated. Moreover, nonlinear relationships were observed between malaria incidence and precipitation, temperature, and NTL. Additionally, lagged effects of temperature and humidity have a significant effect on malaria risk by either species. More elevated risk of P. falciparum was observed following the rainy season, and unstable transmission of P. vivax was observed in the area. Finally, P. vivax risks are less sensitive to environmental factors than those of P. falciparum. Conclusion: The improved inference was gained by employing the proposed approach in comparison to the commonly used border-sharing rule. Additionally, different covariates are identified, including delayed effects, and elevated risks of either of the cases were observed in districts found in the central and western regions. As malaria transmission operates in a spatially continuous manner, a spatially continuous model should be employed when it is computationally feasible.

Keywords: disease mapping, MSTCAR, graph-based optimization algorithm, P. falciparum, P. vivax, waiting matrix

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Authors: Thelma Maria Melo Pinheiro, Guilherme Raposo Diniz Vieira, Sidney Matos da Silva, Leonardo Mendonça de Oliveira Queiroz, Mateus Sousa Pinheiro, Danyllo Wenceslau de Oliveira Lopes

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The present article has the objective to describe the regulatory impact analysis (RIA) of the contracting efficiency of the Brazilian transmission system usage. This contracting is made by users connected to the main transmission network and is used to guide necessary investments to supply the electrical energy demand. Therefore, an inefficient contracting of this energy amount distorts the real need for grid capacity, affecting the sector planning accuracy and resources optimization. In order to provide this efficiency, the Brazilian Electricity Regulatory Agency (ANEEL) homologated the Normative Resolution (NR) No. 666, from July 23th of 2015, which consolidated the procedures for the contracting of transmission system usage and the contracting efficiency verification. Aiming for a more efficient and rational transmission system contracting, the resolution established economic incentives denominated as Inefficiency installment for excess (IIE) and inefficiency installment for over-contracting (IIOC). The first one, IIE, is verified when the contracted demand exceeds the established regulatory limit; it is applied to consumer units, generators, and distribution companies. The second one, IIOC, is verified when the distributors over-contract their demand. Thus, the establishment of the inefficiency installments IIE and IIOC intends to avoid the agent contract less energy than necessary or more than it is needed. Knowing that RIA evaluates a regulatory intervention to verify if its goals were achieved, the results from the application of the above-mentioned normative resolution to the Brazilian transmission sector were analyzed through indicators that were created for this RIA to evaluate the contracting efficiency transmission system usage, using real data from before and after the homologation of the normative resolution in 2015. For this, indicators were used as the efficiency contracting indicator (ECI), excess of demand indicator (EDI), and over-contracting of demand indicator (ODI). The results demonstrated, through the ECI analysis, a decrease of the contracting efficiency, a behaviour that was happening even before the normative resolution of 2015. On the other side, the EDI showed a considerable decrease in the amount of excess for the distributors and a small reduction for the generators; moreover, the ODI notable decreased, which optimizes the usage of the transmission installations. Hence, with the complete evaluation from the data and indicators, it was possible to conclude that IIE is a relevant incentive for a more efficient contracting, indicating to the agents that their contracting values are not adequate to keep their service provisions for their users. The IIOC also has its relevance, to the point that it shows to the distributors that their contracting values are overestimated.

Keywords: contracting, electricity regulation, evaluation, regulatory impact analysis, transmission power system

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Authors: Fouad M. Bendimerad, Jerome B. Zayas, Michael Adrian T. Padilla

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With the increasing scale of severity and frequency of disasters worldwide, the performance of governance systems for disaster risk reduction and management in many countries are being put to the test. In the Philippines, the Disaster Risk Reduction and Management (DRRM) Act of 2010 (Republic Act 10121 or RA 10121) as the framework for disaster risk reduction and management was tested when Super Typhoon Haiyan hit the eastern provinces of the Philippines in November 2013. Typhoon Haiyan is considered to be the strongest recorded typhoon in history to make landfall with winds exceeding 252 km/hr. In assessing the performance of RA 10121 the authors conducted document reviews of related policies, plans, programs, and key interviews and focus groups with representatives of 21 national government departments, two (2) local government units, six (6) private sector and civil society organizations, and five (5) development agencies. Our analysis will argue that enhancements are needed in RA 10121 in order to meet the challenges of large-scale disasters. The current structure where government agencies and departments organize along DRRM thematic areas such response and relief, preparedness, prevention and mitigation, and recovery and response proved to be inefficient in coordinating response and recovery and in mobilizing resources on the ground. However, experience from various disasters has shown the Philippine government’s tendency to organize major recovery programs along development sectors such as infrastructure, livelihood, shelter, and social services, which is consistent with the concept of DRM mainstreaming. We will argue that this sectoral approach is more effective than the thematic approach to DRRM. The council-type arrangement for coordination has also been rendered inoperable by Typhoon Haiyan because the agency responsible for coordination does not have decision-making authority to mobilize action and resources of other agencies which are members of the council. Resources have been devolved to agencies responsible for each thematic area and there is no clear command and direction structure for decision-making. However, experience also shows that the Philippine government has appointed ad-hoc bodies with authority over other agencies to coordinate and mobilize action and resources in recovering from large-scale disasters. We will argue that this approach be institutionalized within the government structure to enable a more efficient and effective disaster risk reduction and management system.

Keywords: risk reduction and management, recovery, governance, typhoon haiyan response and recovery

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Jihede Haj Messaoud, Hamdi Omar, Hela Fakhfakh Ben Jemia, Chokri Yaich

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The Upper Lutetian alternating marl–limestone succession of Reineche Member was deposited over a warm shallow carbonate platform that permits Nummulites proliferation. High-resolution studies of 30 meters thick Nummulites-bearing Reineche Member, cropping out in Central Tunisia (Jebel Siouf), have been undertaken, regarding pronounced cyclical sedimentary sequences, in order to investigate the periodicity of cycles and their related orbital-scale oceanic and climatic changes. The palaeoenvironmental and palaeoclimatic data are preserved in several proxies obtainable through high-resolution sampling and laboratories measurement and analysis as magnetic susceptibility (MS) and carbonates contents in conjunction with a wireline logging tools. The time series analysis of proxies permits to establish cyclicity orders present in the studied intervals which could be linked to the orbital cycles. MS records provide high-resolution proxies for relative sea level change in Late Lutetian strata. The spectral analysis of MS fluctuations confirmed the orbital forcing by the presence of the complete suite of orbital frequencies in the precession of 23 ka, the obliquity of 41 ka, and notably the two modes of eccentricity of 100 and 405 ka. Regarding the two periodic sedimentary cycles detected by wavelet analysis of proxy fluctuations which coincide with the long-term 405 ka eccentricity cycle, the Reineche Member spanned 0,8 Myr. Wireline logging tools as gamma ray and sonic were used as a proxies to decipher cyclicity and trends in sedimentation and contribute to identifying and correlate units. There are used to constraint the highest frequency cyclicity modulated by a long term wavelength cycling apparently controlled by clay content. Interpreted as a result of variations in carbonate productivity, it has been suggested that the marl-limestone couplets, represent the sedimentary response to the orbital forcing. The calculation of cycle durations through Reineche Member, is used as a geochronometer and permit the astronomical calibration of the geologic time scale. Furthermore, MS coupled with carbonate contents, and fossil occurrences provide strong evidence for combined detrital inputs and marine surface carbonate productivity cycles. These two synchronous processes were driven by the precession index and ‘fingerprinted’ in the basic marl–limestone couplets, modulated by orbital eccentricity.

Keywords: magnetic susceptibility, cyclostratigraphy, orbital forcing, spectral analysis, Lutetian

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Authors: María Luisa Gonzalez-SanJose, Mihaela Mihnea, Vicente Gomez-Miguel

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The zoning methodology currently recommended by the OIVV as official methodology to carry out viticulture zoning studies and to define and delimit the ‘terroirs’ has been applied in this study. This methodology has been successfully applied on the most significant an important Spanish Oenological D.O. regions, such as Ribera de Duero, Rioja, Rueda and Toro, but also it have been applied around the world in Portugal, different countries of South America, and so on. This is a complex methodology that uses edaphoclimatic data but also other corresponding to vineyards and other soils’ uses The methodology is useful to determine Homogeneous Soil Units (HSU) to different scale depending on the interest of each study, and has been applied from viticulture regions to particular vineyards. It seems that this methodology is an appropriate method to delimit correctly the medium in order to enhance its uses and to obtain the best viticulture and oenological products. The present work is focused on the comparison of volatile composition of wines made from grapes grown in different HSU that coexist in a particular viticulture region of Castile-Lion cited near to Burgos. Three different HSU were selected for this study. They represented around of 50% of the global area of vineyards of the studied region. Five different vineyards on each HSU under study were chosen. To reduce variability factors, other criteria were also considered as grape variety, clone, rootstocks, vineyard’s age, training systems and cultural practices. This study was carried out during three consecutive years, then wine from three different vintage were made and analysed. Different red wines were made from grapes harvested in the different vineyards under study. Grapes were harvested to ‘Technological maturity’, which are correlated with adequate levels of sugar, acidity, phenolic content (nowadays named phenolic maturity), good sanitary stages and adequate levels of aroma precursors. Results of the volatile profile of the wines produced from grapes of each HSU showed significant differences among them pointing out a direct effect of the edaphoclimatic characteristic of each UHT on the composition of the grapes and then on the volatile composition of the wines. Variability induced by HSU co-existed with the well-known inter-annual variability correlated mainly with the specific climatic conditions of each vintage, however was most intense, so the wine of each HSU were perfectly differenced. A discriminant analysis allowed to define the volatiles with discriminant capacities which were 21 of the 74 volatiles analysed. Detected discriminant volatiles were chemical different, although .most of them were esters, followed by were superior alcohols and fatty acid of short chain. Only one lactone and two aldehydes were selected as discriminant variable, and no varietal aroma compounds were selected, which agree with the fact that all the wine were made from the same grape variety.

Keywords: viticulture zoning, terroir, wine, volatile profile

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Authors: Uma Krishnamoorthy, Vivienne Beavers, Janet Marshall

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Introduction: Cervical cytology showing features raising the suspicion of non cervical glandular neoplasia are reported as code 0 under the United Kingdom National Health Service Cervical screening programme ( NHSCSP). As the suspicion is regarding non cervical neoplasia, smear is reported as normal and patient informed that cervical screening result is normal. GP receives copy of results where it states further referral is indicated in small font within text of report. Background: There were several incidents of delayed diagnosis of endometrial cancer in Lancashire which prompted this Northwest Regional review to enable an understanding of underlying pathology outcome of code zero smears to raise awareness and also to review whether further action on wording of smear results was indicated to prevent such delay. Methodology: All Smears reported at the Manchester cytology centre who process cytology for Lancashire population from March 2013 to March 2014 were reviewed and histological diagnosis outcome of women in whom smear was reported as code zero was reviewed retrospectively . Results: Total smears reported by the cytology centre during this period was approximately 109400. Reports issued with result code 0 among this during this time period was 49.Results revealed that among three fourth (37) of women with code zero smear (N=49), evidence of underlying pathology of non cervical origin was confirmed. Of this, 73 % (36) were due to endometrial pathology with 49 % (24) endometrial carcinoma, 12 % (6)polyp, 4 % atypical endometrial hyperplasia (2), 6 % endometrial hyperplasia without atypia (3), and 2 % adenomyosis (1 case) and 2 % ( 1 case) due to ovarian adenocarcinoma. Conclusion: This review demonstrated that more than half (51 %) of women with a code 0 smear report were diagnosed with underlying carcinoma and 75 % had a confirmed underlying pathology contributory to code 0 smear findings. Recommendations and Action Plan: A local rapid access referral and management pathway for this group of women was implemented as a result of this in our unit. The findings and Pathway were shared with other regional units served by the cytology centre through the Pan Lancashire cervical screening board and through the Cytology centre. Locally, the smear report wording was updated to include a rubber stamp/ print in "Red Bold letters" stating that " URGENT REFERRAL TO GYNAECOLOGY IS INDICATED". Findings were also shared through the Pan Lancashire board with National cervical screening programme board, and revisions to wording of code zero smear reports to highlight the need for Urgent referral has now been agreed at National level to be implemented.

Keywords: code zero smears, endometrial cancer, non cervical glandular neoplasia, ovarian cancer

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Authors: Jesika A. Walker, Mohammed Aswad, Guy Lacroix, Denis Cousineau

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There is a fundamental disconnect between the experience of time passing and the chronometric units by which time is quantified. Specifically, there appears to be no relationship between the passage of time judgments (PoTJs) and verbal duration estimates at short durations (e.g., < 2000 milliseconds). When a duration is longer than several minutes, however, evidence suggests that a slower feeling of time passing is predictive of overestimation. Might the length of a task moderate the relation between PoTJs and duration estimates? Similarly, the estimation paradigm (prospective vs. retrospective) and the mental effort demanded of a task (task demand) have both been found to influence duration estimates. However, only a handful of experiments have investigated these effects for tasks of long durations, and the results have been mixed. Thus, might the length of a task also moderate the effects of the estimation paradigm and task demand on duration estimates? To investigate these questions, 273 participants performed either an easy or difficult visual and memory search task for either eight or 58 minutes, under prospective or retrospective instructions. Afterward, participants provided a duration estimate in minutes, followed by a PoTJ on a Likert scale (1 = very slow, 7 = very fast). A 2 (prospective vs. retrospective) × 2 (eight minutes vs. 58 minutes) × 2 (high vs. low difficulty) between-subjects ANOVA revealed a two-way interaction between task demand and task duration on PoTJs, p = .02. Specifically, time felt faster in the more challenging task, but only in the eight-minute condition, p < .01. Duration estimates were transformed into RATIOs (estimate/actual duration) to standardize estimates across durations. An ANOVA revealed a two-way interaction between estimation paradigm and task duration, p = .03. Specifically, participants overestimated the task more if they were given prospective instructions, but only in the eight-minute task. Surprisingly, there was no effect of task difficulty on duration estimates. Thus, the demands of a task may influence ‘feeling of time’ and ‘estimation time’ differently, contributing to the existing theory that these two forms of time judgement rely on separate underlying cognitive mechanisms. Finally, a significant main effect of task duration was found for both PoTJs and duration estimates (ps < .001). Participants underestimated the 58-minute task (m = 42.5 minutes) and overestimated the eight-minute task (m = 10.7 minutes). Yet, they reported the 58-minute task as passing significantly slower on a Likert scale (m = 2.5) compared to the eight-minute task (m = 4.1). In fact, a significant correlation was found between PoTJ and duration estimation (r = .27, p <.001). This experiment thus provides evidence for a compensatory effect at longer durations, in which people underestimate a ‘slow feeling condition and overestimate a ‘fast feeling condition. The results are discussed in relation to heuristics that might alter the relationship between these two variables when conditions range from several minutes up to almost an hour.

Keywords: duration estimates, long durations, passage of time judgements, task demands

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: A. M. Isakhanyan, F. N. Tkhruni, N. N. Yakimovich, Z. I. Kuvaeva, T. V. Khachatryan

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Introduction: At present, the simbiotics based on different genera and species of lactic acid bacteria (LAB) and yeasts are used. One of the basic properties of probiotics is presence of antimicrobial activity and therefore selection of LAB and yeast strains for their co-cultivation with the aim of increasing of the activity is topical. Since probiotic yeast and bacteria have different mechanisms of action, natural synergies between species, higher viability and increasing of antimicrobial activity might be expected from mixing both types of probiotics. Endemic strains of LAB Enterococcus faecium БТK-64, Lactobaccilus plantarum БТK-66, Pediococcus pentosus БТK-28, Lactobacillus rhamnosus БТK-109 and Kluyveromyces lactis БТX-412, Saccharomycopsis sp. БТX- 151 strains of yeast, with probiotic properties and hight antimicrobial activity, were selected. Strains are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB and yeast strains were isolated from different dairy products from rural households of Armenia. The genotyping by 16S rRNA sequencing for LAB and 26S RNA sequencing for yeast were used. Combined cultivation of LAB and yeast strains was carried out in the nutrient media on the basis of milk whey, in anaerobic conditions (without shaker, in a thermostat at 37oC, 48 hours). The complex preparations were obtained by purification of cell free culture broth (CFC) broth by the combination of ion-exchange chromatography and gel filtration methods. The spot-on-lawn method was applied for determination of antimicrobial activity and expressed in arbitrary units (AU/ml). Results. The obtained data showed that at the combined growth of bacteria and yeasts, the cultivation conditions (medium composition, time of growth, genera of LAB and yeasts) affected the display of antimicrobial activity. Purification of CFC broth allowed obtaining partially purified antimicrobial complex preparation which contains metabiotics from both bacteria and yeast. The complex preparation inhibited the growth of pathogenic and conditionally pathogenic bacteria, isolated from various internal organs from diseased animals and poultry with greater efficiency than the preparations derived individually alone from yeast and LAB strains. Discussion. Thus, our data shown perspectives of creation of a new class of antimicrobial preparations on the basis of combined cultivation of endemic strains of LAB and yeast. Obtained results suggest the prospect of use of the partially purified complex preparations instead antibiotics in the agriculture and for food safety. Acknowledgments: This work was supported by the RA MES State Committee of Science and Belarus National Foundation for Basic Research in the frames of the joint Armenian - Belarusian joint research project 13РБ-064.

Keywords: co-cultivation, antimicrobial activity, biosafety, metabiotics, lactic acid bacteria, yeast

Procedia PDF Downloads 313

Authors: Serap Gedikli, Hakan Çakmak, M. Buğra Güldiken, Duygu Yalnızoğlu

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Air, which is necessary for living things to survive; while it carries some useful substances in it, it can also carry foreign particles of different sizes that may be harmful to the health. All airborne organic substances of biological origin, including bacteria, fungi, fungal spores, viruses, pollen, and their components, are called "bioaerosols". Nowadays, everyone spends most of their time in closed areas such as home, workplace, school, etc. Although it is known that outdoor air pollution affects health, it is not known that indoor air pollution has harmful effects in terms of health. In this study, indoor air microbial load and SARS-CoV-2 virus cleaning efficiency of Froumann brand air cleaners were studied. This work in 300 m³, 600 m³, and 1000 m³ completely closed areas without any air circulation with Froumann N80, N90, and N100 air-cleaning devices. Analyzes were performed for both areas at 60 minutes before and after the device was operated using a particle measuring device (Particles Plus 7302) and an air sampler (Mas-100 ECO). The measurements were taken by placing the test equipment 1.5-2 m away from the air cleaner. At the same time, the efficiency of the HEPA filter was evaluated by taking samples from the air outlet point of the HEPA filter using the air sampling device (Mas-100 ECO) after the device was started. Nutrient agar and malt agar are used as total mesophilic bacteria and total fungi. The number of colony-forming units per m³ (cfu/m³) was calculated by counting colonies in Petri dishes after incubation for 48 hours at 37°C for bacteria and 72 hours at 30°C for fungi. The change in the number of colonies and the decrease in the microbial load was calculated as a percentage value. SARS-CoV-2 activity analysis studies were carried out by İnönü University Microbiology Department in accordance with the World Health Organization regulations. Finally, the HEPA filter in the devices used was taken and kept under a certain temperature and humidity, and the change in the microbial load on it was monitored over a 6-month period. At the end of the studies, a 91%-94% reduction was determined in the total mesophilic bacteria count of Frouman brand N80, N90, and N100 model air cleaners. A decrease of 94%-96% was detected in the total number of yeast/molds. HEPA filter efficiency was evaluated, and at the end of the analysis, 98% of the bacterial load and approximately 100% of yeast/mold load at the HEPA filter air outlet point were decreased. According to the SARS- CoV-2 analysis results, when the device is operating at the medium airflow level 3, it can filter virus-carrying aerosols by 99%. As a result, it was determined that the Froumann model air cleaner was effective in controlling and reducing the microbial load in the indoor air.

Keywords: HEPA filter, indoor air quality, microbial load, SARS-CoV-2

Procedia PDF Downloads 174

Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

Procedia PDF Downloads 423

Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal

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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.

Keywords: Ethiopia, clinical triak, zoonoses, disease

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

Procedia PDF Downloads 277

Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

Procedia PDF Downloads 44

Authors: Rima Abu Jaber Bransi, Rawya Jarjoura Burbara

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This study deals with two pioneering approaches in teaching Arabic as a mother tongue: first, computerization of literary and functional texts in the mother tongue; second, the pioneering model in teaching writing skills by computerization. The significance of the study lies in its treatment of a serious problem that is faced in the era of technology, which is the widening gap between the pupils and their mother tongue. The innovation in the study is that it introduces modern methods and tools and a pioneering instructional model that turns the process of mother tongue teaching into an effective, meaningful, interesting and motivating experience. In view of the Arabic language diglossia, standard Arabic and spoken Arabic, which constitutes a serious problem to the pupil in understanding unused words, and in order to bridge the gap between the pupils and their mother tongue, we resorted to computerized techniques; we took texts from the pre-Islamic period (Jahiliyya), starting with the Mu'allaqa of Imru' al-Qais and other selected functional texts and computerized them for teaching in an interesting way that saves time and effort, develops high thinking strategies, expands the literary good taste among the pupils, and gives the text added values that neither the book, the blackboard, the teacher nor the worksheets provide. On the other hand, we have developed a pioneering computerized model that aims to develop the pupil's ability to think, to provide his imagination with the elements of growth, invention and connection, and motivate him to be creative, and raise level of his scores and scholastic achievements. The model consists of four basic stages in teaching according to the following order: 1. The Preparatory stage, 2. The reading comprehension stage, 3. The writing stage, 4. The evaluation stage. Our lecture will introduce a detailed description of the model with illustrations and samples from the units that we built through highlighting some aspects of the uniqueness and innovation that are specific to this model and the different integrated tools and techniques that we developed. One of the most significant conclusions of this research is that teaching languages through the employment of new computerized strategies is very likely to get the Arabic speaking pupils out of the circle of passive reception into active and serious action and interaction. The study also emphasizes the argument that the computerized model of teaching can change the role of the pupil's mind from being a store of knowledge for a short time into a partner in producing knowledge and storing it in a coherent way that prevents its forgetfulness and keeping it in memory for a long period of time. Consequently, the learners also turn into partners in evaluation by expressing their views, giving their notes and observations, and application of the method of peer-teaching and learning.

Keywords: classical poetry, computerization, diglossia, writing skill

Procedia PDF Downloads 204

Authors: Varun Agarwal

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Introduction: With the advent of personalized medicine, histopathological review of whole slide images (WSIs) for cancer diagnosis presents an exceedingly time-consuming, complex task. Specifically, detecting metastatic regions in WSIs of sentinel lymph node biopsies necessitates a full-scanned, holistic evaluation of the image. Thus, digital pathology, low-level image manipulation algorithms, and machine learning provide significant advancements in improving the efficiency and accuracy of WSI analysis. Using Camelyon16 data, this paper proposes a deep learning pipeline to automate and ameliorate breast cancer metastasis localization and WSI classification. Methodology: The model broadly follows five stages -region of interest detection, WSI partitioning into image tiles, convolutional neural network (CNN) image-segment classifications, probabilistic mapping of tumor localizations, and further processing for whole WSI classification. Transfer learning is applied to the task, with the implementation of Inception-ResNetV2 - an effective CNN classifier that uses residual connections to enhance feature representation, adding convolved outputs in the inception unit to the proceeding input data. Moreover, in order to augment the performance of the transfer learning CNN, a stack of convolutional denoising autoencoders (CDAE) is applied to produce embeddings that enrich image representation. Through a saliency-detection algorithm, visual training segments are generated, which are then processed through a denoising autoencoder -primarily consisting of convolutional, leaky rectified linear unit, and batch normalization layers- and subsequently a contrast-normalization function. A spatial pyramid pooling algorithm extracts the key features from the processed image, creating a viable feature map for the CNN that minimizes spatial resolution and noise. Results and Conclusion: The simplified and effective architecture of the fine-tuned transfer learning Inception-ResNetV2 network enhanced with the CDAE stack yields state of the art performance in WSI classification and tumor localization, achieving AUC scores of 0.947 and 0.753, respectively. The convolutional feature retention and compilation with the residual connections to inception units synergized with the input denoising algorithm enable the pipeline to serve as an effective, efficient tool in the histopathological review of WSIs.

Keywords: breast cancer, convolutional neural networks, metastasis mapping, whole slide images

Procedia PDF Downloads 107

Authors: Jaroslav Kraus

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Spatial information about demographic processes are a standard part of outputs in the Czech Republic. That was also the case of Population and Housing Census which was held on 2011. This is a starting point for a follow up study devoted to two basic types of households: single person households and households of one completed family. Single person households and one family households create more than 80 percent of all households, but the share and spatial structure is in long-term changing. The increase of single households is results of long-term fertility decrease and divorce increase, but also possibility of separate living. There are regions in the Czech Republic with traditional demographic behavior, and regions like capital Prague and some others with changing pattern. Population census is based - according to international standards - on the concept of currently living population. Three types of geospatial approaches will be used for analysis: (i) firstly measures of geographic distribution, (ii) secondly mapping clusters to identify the locations of statistically significant hot spots, cold spots, spatial outliers, and similar features and (iii) finally analyzing pattern approach as a starting point for more in-depth analyses (geospatial regression) in the future will be also applied. For analysis of this type of data, number of households by types should be distinct objects. All events in a meaningful delimited study region (e.g. municipalities) will be included in an analysis. Commonly produced measures of central tendency and spread will include: identification of the location of the center of the point set (by NUTS3 level); identification of the median center and standard distance, weighted standard distance and standard deviational ellipses will be also used. Identifying that clustering exists in census households datasets does not provide a detailed picture of the nature and pattern of clustering but will be helpful to apply simple hot-spot (and cold spot) identification techniques to such datasets. Once the spatial structure of households will be determined, any particular measure of autocorrelation can be constructed by defining a way of measuring the difference between location attribute values. The most widely used measure is Moran’s I that will be applied to municipal units where numerical ratio is calculated. Local statistics arise naturally out of any of the methods for measuring spatial autocorrelation and will be applied to development of localized variants of almost any standard summary statistic. Local Moran’s I will give an indication of household data homogeneity and diversity on a municipal level.

Keywords: census, geo-demography, households, the Czech Republic

Procedia PDF Downloads 82

Authors: Shahid Razzaq

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The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

Procedia PDF Downloads 116

Authors: Sajeli A. Begum, Ameer Basha, Kirti Hira, Rukaiyya Khan

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Cyclic dipeptides are simple diketopiperazine derivatives being investigated by several scientists for their biological effects which include anticancer, antimicrobial, haematological, anticonvulsant, immunomodulatory effect, etc. They are potentially active microbial metabolites having been synthesized too, for developing into drug candidates. Cultures of Pseudomonas species have earlier been reported to produce cyclic dipeptides, helping in quorum sensing signals and bacterial–host colonization phenomena during infections, causing cell anti-proliferation and immunosuppression. Fluorescing Pseudomonas species have been identified to secrete lipid derivatives, peptides, pyrroles, phenazines, indoles, aminoacids, pterines, pseudomonic acids and some antibiotics. In the present work, results of investigation on the cyclic dipeptide metabolites secreted by the culture broth of Pseudomonas species as potent pro-inflammatory cytokine inhibitors are discussed. The bacterial strain was isolated from the rhizospheric soil of groundnut crop and identified as Pseudomonas aeruginosa by 16S rDNA sequence (GenBank Accession No. KT625586). Culture broth of this strain was prepared by inoculating into King’s B broth and incubating at 30 ºC for 7 days. The ethyl acetate extract of culture broth was prepared and lyophilized to get a dry residue (EEPA). Lipopolysaccharide (LPS)-induced ELISA assay proved the inhibition of tumor necrosis factor-alpha (TNF-α) secretion in culture supernatant of RAW 264.7 cells by EEPA (IC50 38.8 μg/mL). The effect of oral administration of EEPA on plasma TNF-α level in rats was tested by ELISA kit. The LPS mediated plasma TNF-α level was reduced to 45% with 125 mg/kg dose of EEPA. Isolation of the chemical constituents of EEPA through column chromatography yielded ten cyclic dipeptides, which were characterized using nuclear magnetic resonance and mass spectroscopic techniques. These cyclic dipeptides are biosynthesized in microorganisms by multifunctional assembly of non-ribosomal peptide synthases and cyclic dipeptide synthase. Cyclo (Gly-L-Pro) was found to be more potentially (IC50 value 4.5 μg/mL) inhibiting TNF-α production followed by cyclo (trans-4-hydroxy-L-Pro-L-Phe) (IC50 value 14.2 μg/mL) and the effect was equal to that of standard immunosuppressant drug, prednisolone. Further, the effect was analyzed by determining mRNA expression of TNF-α in LPS-stimulated RAW 264.7 macrophages using quantitative real-time reverse transcription polymerase chain reaction. EEPA and isolated cyclic dipeptides demonstrated diminution of TNF-α mRNA expression levels in a dose-dependent manner under the tested conditions. Also, they were found to control the expression of other pro-inflammatory cytokines like IL-1β and IL-6, when tested through their mRNA expression levels in LPS-stimulated RAW 264.7 macrophages under LPS-stimulated conditions. In addition, significant inhibition effect was found on Nitric oxide production. Further all the compounds exhibited weak toxicity to LPS-induced RAW 264.7 cells. Thus the outcome of the study disclosed the effectiveness of EEPA and the isolated cyclic dipeptides in down-regulating key cytokines involved in pathophysiology of autoimmune diseases.In another study led by the investigators, microbial cyclic dipeptides were found to exhibit excellent antimicrobial effect against Fusarium moniliforme which is an important causative agent of Sorghum grain mold disease. Thus, cyclic dipeptides are emerging small molecular drug candidates for various autoimmune diseases.

Keywords: cyclic dipeptides, cytokines, Fusarium moniliforme, Pseudomonas, TNF-alpha

Procedia PDF Downloads 185

Authors: Aysen Celen Ozturk, Hatice Dulger

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University may be defined as a teaching institution consisting of faculties, institutes, colleges, and units that have undergraduate and graduate education, scientific research and publications. It has scientific autonomy and public legal personality. Today, universities are not only the institutions in which students and lecturers experience education, training and scientific work. They also offer social, cultural and artistic activities that strengthen the link with the city. This also incorporates all city users into the campus borders. Thus, universities contribute to social and individual development of the country by providing science, art, socio-cultural development, communication and socialization with people of different cultural and social backgrounds. Moreover, universities provide an active social life, where the young population is the majority. This enables the sense of belonging to the users to develop, to increase the interaction between academicians and students, and to increase the learning / producing community by continuing academic sharing environments outside the classrooms. For this reason, besides academic spaces in university campuses, the users also need closed and open spaces where they can socialize, spend time together and relax. Public open spaces are the most important social spaces that individuals meet, express themselves and share. Individuals belonging to different socio-cultural structures and ethnic groups maintain their social experiences with the physical environment they are in, the outdoors, and their actions and sharing in these spaces. While university campuses are being designed for their individual and social development roles, user needs must be determined correctly and design should be realized in this direction. While considering that requirements may change over time, user satisfaction should be questioned at certain periods and new arrangements should be made in existing applications in the direction of current demands. This study aims to determine the user requirements through the case of Eskişehir Osmangazi University, Meşelik Campus / Turkey. Post Occupancy Evaluation (POE) questionnaire, cognitive mapping and deep interview methods are used in the research process. All these methods show that the students, academicians and other officials in the Meşelik Campus of Eskişehir Osmangazi University find way finding elements insufficient and are in need of efficient landscape design and social spaces. This study is important in terms of determining the needs of the users as a design input. This will help improving the quality of common space in Eskişehir Osmangazi University and in other similar universities.

Keywords: university campuses, public open space, user requirement, post occupancy evaluation

Procedia PDF Downloads 218

Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

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Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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Authors: Natsuki Kishizawa, Keiko Nakano, Hussam Organji, Amer Shaiban, Mohammad Albeirutty

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One of the most important tasks in operating desalination plants using a reverse osmosis (RO) method is preventing RO membrane fouling caused by foulants found in seawater. Optimal design of the pre-treatment process of RO process for plants enables the reduction of foulants. Therefore, a quantitative evaluation of the fouling risk in pre-treated water, which is fed to RO, is required for optimal design. Some measurement methods for water quality such as silt density index (SDI) and total organic carbon (TOC) have been conservatively applied for evaluations. However, these methods have not been effective in some situations for evaluating the fouling risk of RO feed water. Furthermore, stable management of plants will be possible by alerts and appropriate control of the pre-treatment process by using the method if it can be applied to the inline monitoring system for the fouling risk of RO feed water. The purpose of this study is to develop a method to evaluate the fouling risk of RO feed water. We applied a quartz crystal microbalance (QCM) to measure the amount of foulants found in seawater using a sensor whose surface is coated with polyamide thin film, which is the main material of a RO membrane. The increase of the weight of the sensor after a certain length of time in which the sample water passes indicates the fouling risk of the sample directly. We classified the values as “FP: Fouling Potential”. The characteristics of the method are to measure the very small amount of substances in seawater in a short time: < 2h, and from a small volume of the sample water: < 50mL. Using some RO cell filtration units, a higher correlation between the pressure increase given by RO fouling and the FP from the method than SDI and TOC was confirmed in the laboratory-scale test. Then, to establish the correlation in the actual bench-scale RO membrane module, and to confirm the feasibility of the monitoring system as a control tool for the pre-treatment process, we have started a long-term test at an experimental desalination site by the Red Sea in Jeddah, Kingdom of Saudi Arabia. Implementing inline equipment for the method made it possible to measure FP intermittently (4 times per day) and automatically. Moreover, for two 3-month long operations, the RO operation pressure among feed water samples of different qualities was compared. The pressure increase through a RO membrane module was observed at a high FP RO unit in which feed water was treated by a cartridge filter only. On the other hand, the pressure increase was not observed at a low FP RO unit in which feed water was treated by an ultra-filter during the operation. Therefore, the correlation in an actual scale RO membrane was established in two runs of two types of feed water. The result suggested that the FP method enables the evaluation of the fouling risk of RO feed water.

Keywords: fouling, monitoring, QCM, water quality

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Authors: Mohammad Emamjome Kashan, Alan S. Fung

Abstract:

In Canada, more than 32% of the total energy demand is related to the building sector. Therefore, there is a great opportunity for Greenhouse Gases (GHG) reduction by integrating solar collectors to provide building heating load and domestic hot water (DHW). Despite the cold winter weather, Canada has a good number of sunny and clear days that can be considered for diurnal solar thermal energy storage. Due to the energy mismatch between building heating load and solar irradiation availability, relatively big storage tanks are usually needed to store solar thermal energy during the daytime and then use it at night. On the other hand, water tanks occupy huge space, especially in big cities, space is relatively expensive. This project investigates the possibility of using a specific building construction material (ICF – Insulated Concrete Form) as diurnal solar thermal energy storage that is integrated with a heat pump and microchannel solar thermal collector (MCST). Not much literature has studied the application of building pre-existing walls as active solar thermal energy storage as a feasible and industrialized solution for the solar thermal mismatch. By using ICF walls that are integrated into the building envelope, instead of big storage tanks, excess solar energy can be stored in the concrete of the ICF wall that consists of EPS insulation layers on both sides to store the thermal energy. In this study, two solar-based systems are designed and simulated inTransient Systems Simulation Program(TRNSYS)to compare ICF wall thermal storage benefits over the system without ICF walls. In this study, the heating load and DHW of a Canadian single-family house located in London, Ontario, are provided by solar-based systems. The proposed system integrates the MCST collector, a water-to-water HP, a preheat tank, the main tank, fan coils (to deliver the building heating load), and ICF walls. During the day, excess solar energy is stored in the ICF walls (charging cycle). Thermal energy can be restored from the ICF walls when the preheat tank temperature drops below the ICF wall (discharging process) to increase the COP of the heat pump. The evaporator of the heat pump is taking is coupled with the preheat tank. The provided warm water by the heat pump is stored in the second tank. Fan coil units are in contact with the tank to provide a building heating load. DHW is also delivered is provided from the main tank. It is investigated that the system with ICF walls with an average solar fraction of 82%- 88% can cover the whole heating demand+DHW of nine months and has a 10-15% higher average solar fraction than the system without ICF walls. Sensitivity analysis for different parameters influencing the solar fraction is discussed in detail.

Keywords: net-zero building, renewable energy, solar thermal storage, microchannel solar thermal collector

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Authors: J. Manuel Bello-López, Julieta Rojo-Medina

Abstract:

Introduction: The transplant of Umbilical Cord Blood Units (UCBU) are a therapeutic possibility for patients with oncohaematological disorders, especially in children. In Mexico, 48.5% of oncological diseases in children 1-4 years old are leukemias; whereas in patients 5-14 and 15-24 years old, lymphomas and leukemias represent the second and third cause of death in these groups respectively. Therefore it is necessary to have more registries of UCBU in order to ensure genetic diversity in the country; the above because the search for appropriate a UCBU is increasingly difficult for patients of mixed ethnicity. Objective: To estimate the genetic diversity (polymorphisms) of Human Leucocyte Antigen (HLA) Class I (A, B) and Class II (DRB1) in UCBU cryopreserved for transplant at Cord Blood Bank of the NCBT. Material and Methods: HLA typing of 533 UCBU for transplant was performed from 2003-2012 at the Histocompatibility Laboratory from the Research Department (evaluated by Los Angeles Ca. Immunogenetics Center) of the NCBT. Class I HLA-A, HLA-B and Class II HLA-DRB1 typing was performed using medium resolution Sequence-Specific Primer (SSP). In cases of an ambiguity detected by SSP; Sequence-Specific Oligonucleotide (SSO) method was carried out. A strict analysis of populations genetic parameters were done in 5 representative UCBU populations. Results: 46.5% of UCBU were collected from Mexico City, State of Mexico (30.95%), Puebla (8.06%), Morelos (6.37%) and Veracruz (3.37%). The remaining UCBU (4.75%) are represented by other states. The identified genotypes correspond to Amerindian origins (HLA-A*02, 31; HLA-B*39, 15, 48), Caucasian (HLA-A*02, 68, 01, 30, 31; HLA-B*35, 15, 40, 44, 07 y HLA-DRB1*04, 08, 07, 15, 03, 14), Oriental (HLA-A*02, 30, 01, 31; HLA-B* 35, 39, 15, 40, 44, 07,48 y HLA-DRB1*04, 07,15, 03) and African (HLA-A*30 y HLA-DRB1*03). The genetic distances obtained by Cavalli-Sforza analysis of the five states showed significant genetic differences by comparing genetic frequencies. The shortest genetic distance exists between Mexico City and the state of Puebla (0.0039) and the largest between Veracruz and Morelos (0.0084). In order to identify significant differences between this states, the ANOVA test was performed. This demonstrates that UCBU is significantly different according to their origin (P <0.05). This is shown by the divergence between arms at the Dendogram of Neighbor-Joining. Conclusions: The NCBT provides UCBU in patients with oncohaematological disorders in all the country. There is a group of patients for which not compatible UCBU can be find due to the mixed ethnic origin. For example, the population of northern Mexico is mostly Caucasian. Most of the NCBT donors are of various ethnic origins, predominantly Amerindians and Caucasians; although some ethnic minorities like Oriental, African and pure Indian ethnics are not represented. The NCBT is, therefore, establishing agreements with different states of Mexico to promote the altruistic donation of Umbilical Cord Blood in order to enrich the genetic diversity in its files.

Keywords: cord blood, genetic diversity, human leucocyte antigen, transplant

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Authors: Jayashree Aanand, Gajjam

Abstract:

The grammatical tradition in Sanskrit literature emphasizes the importance of the correct use of Sanskrit words or linguistic units (sādhu śabda) that brings the meritorious values, denying the attribution of the same religious merit to the incorrect use of Sanskrit words (asādhu śabda) or the vernacular or corrupt forms (apa-śabda or apabhraṁśa), even though they may help in communication. The current research, the culmination of the doctoral research on sentence definition, studies the difference among the comprehension of both correct and incorrect word forms in Sanskrit and Marathi languages in India. Based on the total of 19 experiments (both web-based and classroom-controlled) on approximately 900 Indian readers, it is found that while the incorrect forms in Sanskrit are comprehended with lesser accuracy than the correct word forms, no such difference can be seen for the Marathi language. It is interpreted that the incorrect word forms in the native language or in the language which is spoken daily (such as Marathi) will pose a lesser cognitive load as compared to the language that is not spoken on a daily basis but only used for reading (such as Sanskrit). The theoretical base for the research problem is as follows: among the three main schools of Language Science in ancient India, the Vaiyākaraṇas (Grammarians) hold that the corrupt word forms do have their own expressive power since they convey meaning, while as the Mimāṁsakas (the Exegesists) and the Naiyāyikas (the Logicians) believe that the corrupt forms can only convey the meaning indirectly, by recalling their association and similarity with the correct forms. The grammarians argue that the vernaculars that are born of the speaker’s inability to speak proper Sanskrit are regarded as degenerate versions or fallen forms of the ‘divine’ Sanskrit language and speakers who could not use proper Sanskrit or the standard language were considered as Śiṣṭa (‘elite’). The different ideas of different schools strictly adhere to their textual dispositions. For the last few years, sociolinguists have agreed that no variety of language is inherently better than any other; they are all the same as long as they serve the need of people that use them. Although the standard form of a language may offer the speakers some advantages, the non-standard variety is considered the most natural style of speaking. This is visible in the results. If the incorrect word forms incur the recall of the correct word forms in the reader as the theory suggests, it would have added one extra step in the process of sentential cognition leading to more cognitive load and less accuracy. This has not been the case for the Marathi language. Although speaking and listening to the vernaculars is the common practice and reading the vernacular is not, Marathi readers have readily and accurately comprehended the incorrect word forms in the sentences, as against the Sanskrit readers. The primary reason being Sanskrit is spoken and also read in the standard form only and the vernacular forms in Sanskrit are not found in the conversational data.

Keywords: experimental sociolinguistics, grammaticality and meaningfulness, Marathi, Sanskrit

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