Search results for: differential groups
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8351

Search results for: differential groups

6491 Effect of Erythropoietin Hormone Supplementation on Hypoxia-Inducible Factor1-Alpha in Rat Kidneys with Experimental Diabetic Nephropathy

Authors: Maha Deif, Alaa Eldin Hassan, Eman Shaat, Nesrine Elazhary, Eman Magdy

Abstract:

Background: Erythropoietin (EPO) is a hematopoietic factor with multiple protective effects. The aim of the present study was to investigate the potential effect of EPO administration on renal functions and hypoxia inducible factor 1-alpha (HIF-1a) in diabetic rat kidneys. Methodology: The current study was carried out on 40 male albino rats divided into four groups (n= 10 in each). Group I served as normal control, group II was the diabetic control, group III rats received EPO on the same day of diagnosis of diabetes mellitus (DM), while group IV received the first dose of EPO 2 weeks after the diagnosis of DM. Results: The results showed that EPO supplementation leads to a significant decrease in serum urea, urinary protein and creatinine clearance as well as a significant increase in renal HIF-1a in group III and IV rats compared to the diabetic control group (group II). However, fasting blood glucose was significantly decreased in group III as compared to the diabetic control group in the third week, but no significant difference was reported in the fourth week among groups II, III and IV. Conclusion: EPO administration leads to the improvement of renal functions and increased levels of HIF-1a in diabetic rats.

Keywords: erythropoietin, diabetic nephropathy, hypoxia-inducible factor1-alpha, renal functions

Procedia PDF Downloads 278
6490 Low Cost Surface Electromyographic Signal Amplifier Based on Arduino Microcontroller

Authors: Igor Luiz Bernardes de Moura, Luan Carlos de Sena Monteiro Ozelim, Fabiano Araujo Soares

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The development of a low cost acquisition system of S-EMG signals which are reliable, comfortable for the user and with high mobility shows to be a relevant proposition in modern biomedical engineering scenario. In the study, the sampling capacity of the Arduino microcontroller Atmel Atmega328 with an A/D converter with 10-bit resolution and its reconstructing capability of a signal of surface electromyography are analyzed. An electronic circuit to capture the signal through two differential channels was designed, signals from Biceps Brachialis of a healthy man of 21 years was acquired to test the system prototype. ARV, MDF, MNF and RMS estimators were used to compare de acquired signals with physiological values. The Arduino was configured with a sampling frequency of 1.5 kHz for each channel, and the tests with the circuit designed offered a SNR of 20.57dB.

Keywords: electromyography, Arduino, low-cost, atmel atmega328 microcontroller

Procedia PDF Downloads 351
6489 Assessment of Academic Knowledge Transfer Channels in Field of Environment

Authors: Jagul Huma Lashari, Arabella Bhutto

Abstract:

Last few years have shown increased an interest of researchers in knowledge and technology transfer. However, facts show fewer types of knowledge transfer practices in the developing countries. This article focuses on assessment transfer channels of academic research produced by highly qualified academicians working in universities in Sindh offering degrees in field of an Environment in Sindh Pakistan. The academic field has been chosen because in field of the environment there is alarming need of research into practice for sustainable development. Using case study approach; in this research qualitative interviews have been conducted from PhD faculty members working in the universities offering degrees in field of environment. Obtained data is analyzed using descriptive statistics and chi-square test with the help of statistical packages for social sciences (SPSS). Research explored 31 channels of academic knowledge transfer from detailed review of literature and exploratory interviews with participants. Identified knowledge transfer channels have been grouped together in 6 groups of knowledge transfer channels; As knowledge transfer through publications, networking, mobility of researchers, joint research, intellectual property and co-operations. Results revealed that academic knowledge have been transferred through publications, networking, and co-operation. However, less number of academic knowledge has been transferred through groups of knowledge transfer channels such as Intellectual Property and joint research.

Keywords: environment, research knowledge, transfer channels, universities

Procedia PDF Downloads 325
6488 Association of the Frequency of the Dairy Products Consumption by Students and Health Parameters

Authors: Radyah Ivan, Khanferyan Roman

Abstract:

Milk and dairy products are an important component of a balanced diet. Dairy products represent a heterogeneous food group of solid, semi-solid and liquid, fermented or non-fermented foods, each differing in nutrients such as fat and micronutrient content. Deficiency of milk and dairy products contributes a impact on the main health parameters of the various age groups of the population. The goal of this study was to analyze of the frequency of the consumption of milk and various groups of dairy products by students and its association with their body mass index (BMI), body composition and other physiological parameters. 388 full-time students of the Medical Institute of RUDN University (185 male and 203 female, average age was 20.4+2.2 and 21.9+1.7 y.o., respectively) took part in the cross-sectional study. Anthropometric measurements, estimation of BMI and body composition were analyzed by bioelectrical impedance analysis. The frequency of consumption of the milk and various groups of dairy products was studied using a modified questionnaire on the frequency of consumption of products. Due to the questionnaire data on the frequency of consumption of the diary products, it have been demonstrated that only 11% of respondents consume milk daily, 5% - cottage cheese, 4% and 1% - fermented natural and with fillers milk products, respectively, hard cheese -4%. The study demonstrated that about 16% of the respondents did not consume milk at all over the past month, about one third - cottage cheese, 22% - natural sour-milk products and 18% - sour-milk products with various fillers. hard cheeses and pickled cheeses didn’t consume 9% and 26% of respondents, respectively. We demonstrated the gender differences in the characteristics of consumer preferences were revealed. Thus female students are less likely to use cream, sour cream, soft cheese, milk comparing to male students. Among female students the prevalence of persons with overweight was higher (25%) than among male students (19%). A modest inverse relationship was demonstrated between daily milk intake, BMI, body composition parameters and diary products consumption (r=-0.61 and r=-0.65). The study showed daily insufficient milk and dairy products consumption by students and due to this it have been demonstrated the relationship between the low and rare consumption of diary products and main parameters of indicators of physical activity and health indicators.

Keywords: frequency of consumption, milk, dairy products, physical development, nutrition, body mass index.

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6487 Synthesis of New Analogs of IPS-339, and Study of Their Cardiovascular in Dogs

Authors: Elham Zarenezhad, Ali Zarenezhad, Mehdi Mardkhoshnood

Abstract:

We described the synthesis and biological study of O-oxime ethers having a-amino acid residues as new analogs of IPS-339. In this synthesis, the reaction of fluorene O-oxime with epichlorohydrin or epibromohydrin afforded the corresponding O-oxime ether adducts. The N-alkylation of valine amino acid with O-oxime ether adducts led to the synthesis of new analogs of IPS-339. The cardiovascular properties of the compound have been studied. In this regard, six clinically healthy same sex mongrel dogs were examined. The dogs were randomly divided into 3 groups of two members. 1 groups received 2 mg kg-1 body weight of compound (2-(3-(9H-fluoren-9-ylideneaminooxy)-2- hydroxypropylamino)-3-methylbutanoic acid) intravenously, whereas group 2 and 3 received only DMSO–water (distil.) and propranolol (Inderal) (2 mg kg-1), respectively. The electrocardiograph (ECG) was recorded with lead II. The recording was run successively by 5 min time interval on each dog before, simultaneously, and after compound infusion. Data after administration were taken from normal sinus beats that were closely related to the arrhythmias whenever they occurred. In general, no detectable arrhythmia was observed in all ECG records regardless of increasing the heart rate that likely caused by stress origin from invasive procedure just after infusion. Compound diminished the heart rate during study especially at 20th minute compared to propranolol as a reference drug. Compound (2-(3-(9H-fluoren-9-ylideneaminooxy)-2- hydroxypropylamino)-3-methylbutanoic acid) was the most effective compound with remarkable ability in declining of the heart rate.

Keywords: electrocardiograph (ECG), cardiovascular, IPS-339, dogs

Procedia PDF Downloads 335
6486 UV-Cured Thiol-ene Based Polymeric Phase Change Materials for Thermal Energy Storage

Authors: M. Vezir Kahraman, Emre Basturk

Abstract:

Energy storage technology offers new ways to meet the demand to obtain efficient and reliable energy storage materials. Thermal energy storage systems provide the potential to acquire energy savings, which in return decrease the environmental impact related to energy usage. For this purpose, phase change materials (PCMs) that work as 'latent heat storage units' which can store or release large amounts of energy are preferred. Phase change materials (PCMs) are being utilized to absorb, collect and discharge thermal energy during the cycle of melting and freezing, converting from one phase to another. Phase Change Materials (PCMs) can generally be arranged into three classes: organic materials, salt hydrates and eutectics. Many kinds of organic and inorganic PCMs and their blends have been examined as latent heat storage materials. PCMs have found different application areas such as solar energy storage and transfer, HVAC (Heating, Ventilating and Air Conditioning) systems, thermal comfort in vehicles, passive cooling, temperature controlled distributions, industrial waste heat recovery, under floor heating systems and modified fabrics in textiles. Ultraviolet (UV)-curing technology has many advantages, which made it applicable in many different fields. Low energy consumption, high speed, room-temperature operation, low processing costs, high chemical stability, and being environmental friendly are some of its main benefits. UV-curing technique has many applications. One of the many advantages of UV-cured PCMs is that they prevent the interior PCMs from leaking. Shape-stabilized PCM is prepared by blending the PCM with a supporting material, usually polymers. In our study, this problem is minimized by coating the fatty alcohols with a photo-cross-linked thiol-ene based polymeric system. Leakage is minimized because photo-cross-linked polymer acts a matrix. The aim of this study is to introduce a novel thiol-ene based shape-stabilized PCM. Photo-crosslinked thiol-ene based polymers containing fatty alcohols were prepared and characterized for the purpose of phase change materials (PCMs). Different types of fatty alcohols were used in order to investigate their properties as shape-stable PCMs. The structure of the PCMs was confirmed by ATR-FTIR techniques. The phase transition behaviors, thermal stability of the prepared photo-crosslinked PCMs were investigated by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). This work was supported by Marmara University, Commission of Scientific Research Project.

Keywords: differential scanning calorimetry (DSC), Polymeric phase change material, thermal energy storage, UV-curing

Procedia PDF Downloads 220
6485 The Effect of Affirmative Action in Private Schools on Education Expenditure in India: A Quasi-Experimental Approach

Authors: Athira Vinod

Abstract:

Under the Right to Education Act (2009), the Indian government introduced an affirmative action policy aimed at the reservation of seats in private schools at the entry-level and free primary education for children from lower socio-economic backgrounds. Using exogenous variation in the status of being in a lower social category (disadvantaged groups) and the year of starting school, this study investigates the effect of exposure to the policy on the expenditure on private education. It employs a difference-in-difference strategy with the help of repeated cross-sectional household data from the National Sample Survey (NSS) of India. It also exploits regional variation in exposure by combining the household data with administrative data on schools from the District Information System for Education (DISE). The study compares the outcome across two age cohorts of disadvantaged groups, starting school at different times, that is, before and after the policy. Regional variation in exposure is proxied with a measure of enrolment rate under the policy, calculated at the district level. The study finds that exposure to the policy led to an average reduction in annual private school fees of ₹223. Similarly, a 5% increase in the rate of enrolment under the policy in a district was associated with a reduction in annual private school fees of ₹240. Furthermore, there was a larger effect of the policy among households with a higher demand for private education. However, the effect is not due to fees waived through direct enrolment under the policy but rather an increase in the supply of low-fee private schools in India. The study finds that after the policy, 79,870 more private schools entered the market due to an increased demand for private education. The new schools, on average, charged a lower fee than existing schools and had a higher enrolment of children exposed to the policy. Additionally, the district-level variation in the enrolment under the policy was very strongly correlated with the entry of new schools, which not only charged a low fee but also had a higher enrolment under the policy. Results suggest that few disadvantaged children were admitted directly under the policy, but many were attending private schools, which were largely low-fee. This implies that disadvantaged households were willing to pay a lower fee to secure a place in a private school even if they did not receive a free place under the policy.

Keywords: affirmative action, disadvantaged groups, private schools, right to education act, school fees

Procedia PDF Downloads 106
6484 Voltage Controlled Ring Oscillator for RF Applications in 0.18 µm CMOS Technology

Authors: Mohammad Arif Sobhan Bhuiyan, Zainal Abidin Nordin, Mamun Bin Ibne Reaz

Abstract:

A compact and power efficient high performance Voltage Controlled Oscillator (VCO) is a must in analog and digital circuits especially in the communication system, but the best trade-off among the performance parameters is a challenge for researchers. In this paper, a design of a compact 3-stage differential voltage controlled ring oscillator (VCRO) with low phase noise, low power and higher tuning bandwidth is proposed in 0.18 µm CMOS technology. The VCRO is designed with symmetric load and positive feedback techniques to achieve higher gain and minimum delay. The proposed VCRO can operate at tuning range of 3.9-5.0 GHz at 1.6 V supply voltage. The circuit consumes only 1.0757 mW of power and produces -129 dbc/Hz. The total active area of the proposed VCRO is only 11.74 x 37.73 µm2. Such a VCO can be the best choice for compact and low-power RF applications.

Keywords: CMOS, VCO, VCRO, oscillator

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6483 Validation of a Fluid-Structure Interaction Model of an Aortic Dissection versus a Bench Top Model

Authors: K. Khanafer

Abstract:

The aim of this investigation was to validate the fluid-structure interaction (FSI) model of type B aortic dissection with our experimental results from a bench-top-model. Another objective was to study the relationship between the size of a septectomy that increases the outflow of the false lumen and its effect on the values of the differential of pressure between true lumen and false lumen. FSI analysis based on Galerkin’s formulation was used in this investigation to study flow pattern and hemodynamics within a flexible type B aortic dissection model using boundary conditions from our experimental data. The numerical results of our model were verified against the experimental data for various tear size and location. Thus, CFD tools have a potential role in evaluating different scenarios and aortic dissection configurations.

Keywords: aortic dissection, fluid-structure interaction, in vitro model, numerical

Procedia PDF Downloads 261
6482 An Approach for Thermal Resistance Prediction of Plain Socks in Wet State

Authors: Tariq Mansoor, Lubos Hes, Vladimir Bajzik

Abstract:

Socks comfort has great significance in our daily life. This significance even increased when we have undergone a work of low or high activity. It causes the sweating of our body with different rates. In this study, plain socks with differential fibre composition were wetted to saturated level. Then after successive intervals of conditioning, these socks are characterized by thermal resistance in dry and wet states. Theoretical thermal resistance is predicted by using combined filling coefficients and thermal conductivity of wet polymers instead of dry polymer (fibre) in different models. By this modification, different mathematical models could predict thermal resistance at different moisture levels. Furthermore, predicted thermal resistance by different models has reasonable correlation range between (0.84 -0.98) with experimental results in both dry (lab conditions moisture) and wet states. "This work is supported by Technical University of Liberec under SGC-2019. Project number is 21314".

Keywords: thermal resistance, mathematical model, plain socks, moisture loss rate

Procedia PDF Downloads 184
6481 Use of Didactic Bibliographic Resources to Improve the Teaching and Learning Processes of Animal Reproduction in Veterinary Science

Authors: Yasser Y. Lenis, Amy Jo Montgomery, Diego F. Carrillo-Gonzalez

Abstract:

Introduction: The use of didactic instruments in different learning environments plays a pivotal role in enhancing the level of knowledge in veterinary science students. The direct instruction of basic animal reproduction concepts in students enrolled in veterinary medicine programs allows them to elucidate the biological and molecular mechanisms that perpetuate the animal species in an ecosystem. Therefore, universities must implement didactic strategies that facilitate the teaching and learning processes for students and, in turn, enrich learning environments. Objective: to evaluate the effect of the use of a didactic textbook on the level of theoretical knowledge in embryo-maternal recognition for veterinary medicine students. Methods: the participants (n=24) were divided into two experimental groups: control (Ctrl) and treatment (Treat). Both groups received 4 hours of theoretical training regarding the basic concepts in bovine embryo-maternal recognition. However, the Treat group was also exposed to a guided lecture and the activity play-to-learn from a cow reproduction didactic textbook. A pre-test and a post-test were applied to assess the prior and subsequent knowledge in the participants. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, a repeated measures model was applied where the effect of the intervention was considered. Results: no significant difference (p>0,05) was observed in the number of right answers for groups Ctrl (54,2%±12,7) and Treat (40,8%±16,8) in the pre-test. There was no difference (p>0,05) compering the number of right answers in Ctrl pre-test (54,2%±12,7) and post-test (60,8±18,8). However, the Treat group showed a significant (p>0,05) difference in the number of right answers when comparing pre-test (40,8%±16,8) and post-test (71,7%±14,7). Finally, after the theoretical training and the didactic activity in the Treat group, an increase of 10.9% (p<0,05) in the number of right answers was found when compared with the Ctrl group. Conclusion: the use of didactic tools that include guided lectures and activities like play-to-learn from a didactic textbook enhances the level of knowledge in an animal reproduction course for veterinary medicine students.

Keywords: animal reproduction, pedagogic, level of knowledge, learning environment

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6480 Modified Graphene Oxide in Ceramic Composite

Authors: Natia Jalagonia, Jimsher Maisuradze, Karlo Barbakadze, Tinatin Kuchukhidze

Abstract:

At present intensive scientific researches of ceramics, cermets and metal alloys have been conducted for improving materials physical-mechanical characteristics. In purpose of increasing impact strength of ceramics based on alumina, simple method of graphene homogenization was developed. Homogeneous distribution of graphene (homogenization) in pressing composite became possible through the connection of functional groups of graphene oxide (-OH, -COOH, -O-O- and others) and alumina superficial OH groups with aluminum organic compounds. These two components connect with each other with -O-Al–O- bonds, and by their thermal treatment (300–500°C), graphene and alumina phase are transformed. Thus, choosing of aluminum organic compounds for modification is stipulated by the following opinion: aluminum organic compounds fragments fixed on graphene and alumina finally are transformed into an integral part of the matrix. By using of other elements as modifier on the matrix surface (Al2O3) other phases are transformed, which change sharply physical-mechanical properties of ceramic composites, for this reason, effect caused by the inclusion of graphene will be unknown. Fixing graphene fragments on alumina surface by alumoorganic compounds result in new type graphene-alumina complex, in which these two components are connected by C-O-Al bonds. Part of carbon atoms in graphene oxide are in sp3 hybrid state, so functional groups (-OH, -COOH) are located on both sides of graphene oxide layer. Aluminum organic compound reacts with graphene oxide at the room temperature, and modified graphene oxide is obtained: R2Al-O-[graphene]–COOAlR2. Remaining Al–C bonds also reacts rapidly with surface OH groups of alumina. In a result of these process, pressing powdery composite [Al2O3]-O-Al-O-[graphene]–COO–Al–O–[Al2O3] is obtained. For the purpose, graphene oxide suspension in dry toluene have added alumoorganic compound Al(iC4H9)3 in toluene with equimolecular ratio. Obtained suspension has put in the flask and removed solution in a rotary evaporate presence nitrogen atmosphere. Obtained powdery have been researched and used to consolidation of ceramic materials based on alumina. Ceramic composites are obtained in high temperature vacuum furnace with different temperature and pressure conditions. Received ceramics do not have open pores and their density reaches 99.5 % of TD. During the work, the following devices have been used: High temperature vacuum furnace OXY-GON Industries Inc (USA), device of spark-plasma synthesis, induction furnace, Electronic Scanning Microscopes Nikon Eclipse LV 150, Optical Microscope NMM-800TRF, Planetary mill Pulverisette 7 premium line, Shimadzu Dynamic Ultra Micro Hardness Tester DUH-211S, Analysette 12 Dynasizer and others.

Keywords: graphene oxide, alumo-organic, ceramic

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6479 Effects of a School-Based Mindfulness Intervention on Stress and Emotions on Students Enrolled in an Independent School

Authors: Tracie Catlett

Abstract:

Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students in particular experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial, evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences as they relate to stress and emotions revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

Procedia PDF Downloads 53
6478 The Effect of Experimentally Induced Stress on Facial Recognition Ability of Security Personnel’s

Authors: Zunjarrao Kadam, Vikas Minchekar

Abstract:

The facial recognition is an important task in criminal investigation procedure. The security guards-constantly watching the persons-can help to identify the suspected accused. The forensic psychologists are tackled such cases in the criminal justice system. The security personnel may loss their ability to correctly identify the persons due to constant stress while performing the duty. The present study aimed at to identify the effect of experimentally induced stress on facial recognition ability of security personnel’s. For this study 50, security guards from Sangli, Miraj & Jaysingpur city of the Maharashtra States of India were recruited in the experimental study. The randomized two group design was employed to carry out the research. In the initial condition twenty identity card size photographs were shown to both groups. Afterward, artificial stress was induced in the experimental group through the difficultpuzzle-solvingtask in a limited period. In the second condition, both groups were presented earlier photographs with another additional thirty new photographs. The subjects were asked to recognize the photographs which are shown earliest. The analyzed data revealed that control group has ahighest mean score of facial recognition than experimental group. The results were discussed in the present research.

Keywords: experimentally induced stress, facial recognition, cognition, security personnel

Procedia PDF Downloads 246
6477 Triple Case Phantom Tumor of Lungs

Authors: Angelis P. Barlampas

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Introduction: The term phantom lung mass describes the ovoid collection of fluid within the interlobular fissure, which initially creates the impression of a mass. The problem of correct differential diagnosis is great, especially in plain radiography. A case is presented with three nodular pulmonary foci, the shape, location, and density of which, as well as the presence of chronic loculated pleural effusions, suggest the presence of multiple phantom tumors of the lung. Purpose: The aim of this paper is to draw the attention of non-experienced and non-specialized physicians to the existence of benign findings that mimic pathological conditions and vice versa. The careful study of a radiological examination and the comparison with previous exams or further control protect against quick wrong conclusions. Methods: A hospitalized patient underwent a non-contrast CT scan of the chest as part of the general control of her situation. Results: Computed tomography revealed pleural effusions, some of them loculated, increased cardiothoracic index, as well as the presence of three nodular foci, one in the left lung and two in the right with a maximum density of up to 18 Hounsfield units and a mean diameter of approximately five centimeters. Two of them are located in the characteristical anatomical position of the major interlobular fissure. The third one is located in the area of the right lower lobe’s posterior basal part, and it presents the same characteristics as the previous ones and is likely to be a loculated fluid collection, within an auxiliary interlobular fissure or a cyst, in the context of the patient's more general pleural entrapments and loculations. The differential diagnosis of nodular foci based on their imaging characteristics includes the following: a) rare metastatic foci with low density (liposarcoma, mucous tumors of the digestive or genital system, necrotic metastatic foci, metastatic renal cancer, etc.), b) necrotic multiple primary lung tumor locations (squamous epithelial cancer, etc. ), c) hamartomas of the lung, d) fibrotic tumors of the interlobular fissures, e) lipoid pneumonia, f) fluid concentrations within the interlobular fissures, g) lipoma of the lung, h) myelolipomas of the lung. Conclusions: The collection of fluid within the interlobular fissure of the lung can give the false impression of a lung mass, particularly on plain chest radiography. In the case of computed tomography, the ability to measure the density of a lesion, combined with the provided high anatomical details of the location and characteristics of the lesion, can lead relatively easily to the correct diagnosis. In cases of doubt or image artifacts, comparison with previous or subsequent examinations can resolve any disagreements, while in rare cases, intravenous contrast may be necessary.

Keywords: phantom mass, chest CT, pleural effusion, cancer

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6476 The Effect of Musical Mobile Usage on the Physiological Parameters and Pain Level During Intestinal Stomaterapy Procedure in Infants

Authors: Hilal Keskin, Gülzade Uysal

Abstract:

This study was conducted to determine the effect of bedside music mobile use on physiological parameters and pain level during intestinal stomaterapy in infants. The study was carried out with 66 babies (music mobile group: 33, Control group: 33) who were followed in the pediatric surgery and urology unit of Kanuni Sultan Süleyman Training and Research Hospital between December 2018- October 2019. Data were collected using the “Data Collection Form” and “FLACC Pain Scale.” They were evaluated using the appropriate statistical methods in the SPSS 22.0 program. The difference between the descriptive features of music mobile and control group was not significant (p> 0.05) groups are distributed homogeneously. When the in-group results were examined; There was no significant change in the mean values of Hearth Peak Beat (HPB), SpO2 and blood pressure of the infants in the music mobile group during stomaterapy (p>0.05). Body temperature and Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale scores were found to increase immediately after stomaterapy (p<0.05). It was found that the mean scores of KTA, body temperature and FLACC pain of the babies in the control group increased significantly after the stomaterapy and SpO2 value decreased (p <0,05). After 15 minutes from stomatherapy, KTA, blood pressure, body temperature and FLACC pain scores averaged; although SpO2 value increased, it was determined that it could not reach pre-stomaterapy value. Results between groups; KTA, SpO2, systolic/diastolic blood pressure, body temperature, and FLACC pain score mean values between groups were homogeneous before stomaterapy (p> 0.05). In the control group, a significant increase was found in the mean scores of KTA, body temperature and FLACC pain after stomaterapy compared to the bedside music mobile group, and a significant decrease in SpO2 values (p <0.05). In the control group, the mean body temperature and FLACC pain scores of the infants 15 minutes after stomaterapy were significantly increased and the SpO2 values were significantly lower than the bedside music group (p <0.05). According to the results of the research; The use of bedside music mobile during intestinal stomaterapy was found to be effective in decreasing the physiological parameters and pain level. It can be recommended for use in infants during painful interventions.

Keywords: intestinal stomatherapy, infant, musical mobile, pain, physiological parameters

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6475 Androgenic and Spermatogenic Activity of Alkylamide-Rich Ethanol Solution Extract of Anacyclus Pyrethrum Dc

Authors: Vikas Sharma, V. K. Dixit

Abstract:

Anacyclus pyrethrum (A. pyrethrum) has been used as Vajikaran Rasayana (aphrodisiac) in traditional Indian ayurvedic medicine to treat male sexual dysfunction, including infertility. Aphrodisiac activity may be due to an increase in the production or effect of androgens, so this study sought to evaluate the androgenic and spermatogenic potential of the alkylamide-rich ethanol solution extract. Male Wistar strain rats weighing between 150 and 180 g were completely randomized divided into five groups. The ethanol solution extract of A. pyrethrum was administered to groups of rats in 50, 100, and 150 mg/kg doses for a period of 28 days, and the action was compared with control and testosterone-treated rats. Thirteen N-alkylamides were detected in the extract by using HPLC/UV/electrospray ionization mass spectrometry method. Extract administration at all the doses produced significant increase in body weight, sperm count, motility, and viability along with serum testosterone, luteinizing hormone, and follicle-stimulating hormone concentrations. Histoarchitecture of testis revealed increased spermatogenic activities. Seminal fructose content was also significantly increased after 28 days of treatment. Our results suggest that the ethanol solution extract of the roots of A. pyrethrum has androgenic potential and may improve male fertility by enhancing spermatogenesis.

Keywords: N-alkylamides, testosterone, Anacyclus pyrethrum, androgen

Procedia PDF Downloads 463
6474 Role of Internal and External Factors in Preventing Risky Sexual Behavior, Drug and Alcohol Abuse

Authors: Veronika Sharok

Abstract:

Research relevance on psychological determinants of risky behaviors is caused by high prevalence of such behaviors, particularly among youth. Risky sexual behavior, including unprotected and casual sex, frequent change of sexual partners, drug and alcohol use lead to negative social consequences and contribute to the spread of HIV infection and other sexually transmitted diseases. Data were obtained from 302 respondents aged 15-35 which were divided into 3 empirical groups: persons prone to risky sexual behavior, drug users and alcohol users; and 3 control groups: the individuals who are not prone to risky sexual behavior, persons who do not use drugs and the respondents who do not use alcohol. For processing, we used the following methods: Qualitative method for nominative data (Chi-squared test) and quantitative methods for metric data (student's t-test, Fisher's F-test, Pearson's r correlation test). Statistical processing was performed using Statistica 6.0 software. The study identifies two groups of factors that prevent risky behaviors. Internal factors, which include the moral and value attitudes; significance of existential values: love, life, self-actualization and search for the meaning of life; understanding independence as a responsibility for the freedom and ability to get attached to someone or something up to a point when this relationship starts restricting the freedom and becomes vital; awareness of risky behaviors as dangerous for the person and for others; self-acknowledgement. External factors (prevent risky behaviors in case of absence of the internal ones): absence of risky behaviors among friends and relatives; socio-demographic characteristics (middle class, marital status); awareness about the negative consequences of risky behaviors; inaccessibility to psychoactive substances. These factors are common for proneness to each type of risky behavior, because it usually caused by the same reasons. It should be noted that if prevention of risky behavior is based only on elimination of external factors, it is not as effective as it may be if we pay more attention to internal factors. The results obtained in the study can be used to develop training programs and activities for prevention of risky behaviors, for using values preventing such behaviors and promoting healthy lifestyle.

Keywords: existential values, prevention, psychological features, risky behavior

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6473 Managing Climate Change: Vulnerability Reduction or Resilience Building

Authors: Md Kamrul Hassan

Abstract:

Adaptation interventions are the common response to manage the vulnerabilities of climate change. The nature of adaptation intervention depends on the degree of vulnerability and the capacity of a society. The coping interventions can take the form of hard adaptation – utilising technologies and capital goods like dykes, embankments, seawalls, and/or soft adaptation – engaging knowledge and information sharing, capacity building, policy and strategy development, and innovation. Hard adaptation is quite capital intensive but provides immediate relief from climate change vulnerabilities. This type of adaptation is not real development, as the investment for the adaptation cannot improve the performance – just maintain the status quo of a social or ecological system, and often lead to maladaptation in the long-term. Maladaptation creates a two-way loss for a society – interventions bring further vulnerability on top of the existing vulnerability and investment for getting rid of the consequence of interventions. Hard adaptation is popular to the vulnerable groups, but it focuses so much on the immediate solution and often ignores the environmental issues and future risks of climate change. On the other hand, soft adaptation is education oriented where vulnerable groups learn how to live with climate change impacts. Soft adaptation interventions build the capacity of vulnerable groups through training, innovation, and support, which might enhance the resilience of a system. In consideration of long-term sustainability, soft adaptation can contribute more to resilience than hard adaptation. Taking a developing society as the study context, this study aims to investigate and understand the effectiveness of the adaptation interventions of the coastal community of Sundarbans mangrove forest in Bangladesh. Applying semi-structured interviews with a range of Sundarbans stakeholders including community residents, tourism demand-supply side stakeholders, and conservation and management agencies (e.g., Government, NGOs and international agencies) and document analysis, this paper reports several key insights regarding climate change adaptation. Firstly, while adaptation interventions may offer a short-term to medium-term solution to climate change vulnerabilities, interventions need to be revised for long-term sustainability. Secondly, soft adaptation offers advantages in terms of resilience in a rapidly changing environment, as it is flexible and dynamic. Thirdly, there is a challenge to communicate to educate vulnerable groups to understand more about the future effects of hard adaptation interventions (and the potential for maladaptation). Fourthly, hard adaptation can be used if the interventions do not degrade the environmental balance and if the investment of interventions does not exceed the economic benefit of the interventions. Overall, the goal of an adaptation intervention should be to enhance the resilience of a social or ecological system so that the system can with stand present vulnerabilities and future risks. In order to be sustainable, adaptation interventions should be designed in such way that those can address vulnerabilities and risks of climate change in a long-term timeframe.

Keywords: adaptation, climate change, maladaptation, resilience, Sundarbans, sustainability, vulnerability

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6472 Psychodidactic Strategies to Facilitate Flow of Logical Thinking in Preparation of Academic Documents

Authors: Deni Stincer Gomez, Zuraya Monroy Nasr, Luis Pérez Alvarez

Abstract:

The preparation of academic documents such as thesis, articles and research projects is one of the requirements of the higher educational level. These documents demand the implementation of logical argumentative thinking which is experienced and executed with difficulty. To mitigate the effect of these difficulties this study designed a thesis seminar, with which the authors have seven years of experience. It is taught in a graduate program in Psychology at the National Autonomous University of Mexico. In this study the authors use the Toulmin model as a mental heuristic and for the application of a set of psychodidactic strategies that facilitate the elaboration of the plot and culmination of the thesis. The efficiency in obtaining the degree in the groups exposed to the seminar has increased by 94% compared to the 10% that existed in the generations that were not exposed to the seminar. In this article the authors will emphasize the psychodidactic strategies used. The Toulmin model alone does not guarantee the success achieved. A set of actions of a psychological nature (almost psychotherapeutic) and didactics of the teacher also seem to contribute. These are actions that derive from an understanding of the psychological, epistemological and ontogenetic obstacles and the most frequent errors in which thought tends to fall when it is demanded a logical course. The authors have grouped the strategies into three groups: 1) strategies to facilitate logical thinking, 2) strategies to strengthen the scientific self and 3) strategies to facilitate the act of writing the text. In this work the authors delve into each of them.

Keywords: psychodidactic strategies, logical thinking, academic documents, Toulmin model

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6471 Impact of Chess Intervention on Cognitive Functioning of Children

Authors: Ebenezer Joseph

Abstract:

Chess is a useful tool to enhance general and specific cognitive functioning in children. The present study aims to assess the impact of chess on cognitive in children and to measure the differential impact of socio-demographic factors like age and gender of the child on the effectiveness of the chess intervention.This research study used an experimental design to study the impact of the Training in Chess on the intelligence of children. The Pre-test Post-test Control Group Design was utilized. The research design involved two groups of children: an experimental group and a control group. The experimental group consisted of children who participated in the one-year Chess Training Intervention, while the control group participated in extra-curricular activities in school. The main independent variable was training in chess. Other independent variables were gender and age of the child. The dependent variable was the cognitive functioning of the child (as measured by IQ, working memory index, processing speed index, perceptual reasoning index, verbal comprehension index, numerical reasoning, verbal reasoning, non-verbal reasoning, social intelligence, language, conceptual thinking, memory, visual motor and creativity). The sample consisted of 200 children studying in Government and Private schools. Random sampling was utilized. The sample included both boys and girls falling in the age range 6 to 16 years. The experimental group consisted of 100 children (50 from Government schools and 50 from Private schools) with an equal representation of boys and girls. The control group similarly consisted of 100 children. The dependent variables were assessed using Binet-Kamat Test of Intelligence, Wechsler Intelligence Scale for Children - IV (India) and Wallach Kogan Creativity Test. The training methodology comprised Winning Moves Chess Learning Program - Episodes 1–22, lectures with the demonstration board, on-the-board playing and training, chess exercise through workbooks (Chess school 1A, Chess school 2, and tactics) and working with chess software. Further students games were mapped using chess software and the brain patterns of the child were understood. They were taught the ideas behind chess openings and exposure to classical games were also given. The children participated in mock as well as regular tournaments. Preliminary analysis carried out using independent t tests with 50 children indicates that chess training has led to significant increases in the intelligent quotient. Children in the experimental group have shown significant increases in composite scores like working memory and perceptual reasoning. Chess training has significantly enhanced the total creativity scores, line drawing and pattern meaning subscale scores. Systematically learning chess as part of school activities appears to have a broad spectrum of positive outcomes.

Keywords: chess, intelligence, creativity, children

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6470 Rural-Urban Knowledge Transfer: Directions and Outcomes

Authors: J. Banski

Abstract:

Regardless of residence place, the type of business and the social system, an individual or groups of people use the accumulated knowledge and continuously deepen and expand its scope. Knowledge is needed by human beings to carry out certain tasks, achieve desired goals or make decisions. Knowledge is an attribute of the people of a region and is identified with the total experience and information that its residents and institutions possess, including the ability to use it. It is subject to constant development, which is the result of both the deepening and exchange of knowledge among the residents of a particular area, as well as the influx of knowledge with newly arriving residents. A good example of the aforementioned processes is in rural areas, where we are dealing with two basic groups of people between whom knowledge transfer takes place. The first group is made up of people who have lived in the village for a long time, while the second group is made up of people who migrate temporarily or permanently to the countryside. The English-language literature uses the terms oldtimers and newcomers for these groups, respectively. Newcomers, usually possessing different life experiences, cultural patterns and competencies, can be rich sources of knowledge for villagers. At the same time, the latter, with different knowledge and experience, along with knowledge of local conditions and customs, can also be an important source of knowledge for incomers to the countryside. The countryside is a particularly interesting environment for studying social interactions and the accompanying transfer of knowledge. This is because it is characterized by a high intensity of neighborly contact and a high level of trust in the private sphere. As a result of the migratory influx of new residents, the social and cultural image of the countryside is changing due to the interpenetration of urban and rural life patterns. Research on rural-urban knowledge transfer is both an opportunity to halt negative trends in the social and economic development of rural areas and support the establishment of a basis for rural renewal. This paper discusses the results of research on urban-rural knowledge transfer based on case studies carried out in a dozen villages from different regions of Poland. Their purpose was to answer three basic research questions: 1) what types of knowledge are transferred between urban and rural residents? 2) what are the main directions and intensity in knowledge transfer? And 3) what are the consequences of knowledge transfer between urban and rural residents?

Keywords: rural areas, villages, newcomers, knowledge transfer, Poland

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6469 Engagement Resources Use by Expert and Novice EFL Academic Writers

Authors: Moharram Sharifi

Abstract:

The purpose of this study was to show how expert and novice writers take positions and stances in Research Articles and Master of Art theses Introductions, so Engagement resources were investigated in 30 Research Articles and 30 Master of Art theses written by Iranian non-native speakers. Through paired samples t-test analysis, we found out that the mean occurrences of heteroglossic items in both RA and Master thesis Introductions were larger than those of monoglossic items, indicating the awareness of both groups of writers to ‘engage’ alternative positions in Introduction sections. The results also revealed that expansive choices were preferred over contractive options in both corpora, implying both groups of writers respect alternative voices cautiously by welcoming rather than closing down the possibility of different perspectives and stances. Furthermore, unlike novice academic writers who used more Attribute features than Entertainment ones in their MATs introduction sections, expert academic writers employed a balanced number of Entertainment and Attribute in their RA introduction sections. The balanced deployment of entertaining and Attribute features in RA Introductions by expert writers might be characteristics of the writers’ demonstration of politeness, which is commonly accepted as an essential feature in academic writing discourse. Finally, through qualitative analysis, it was demonstrated that MAT writers, as novice academic writers, suffered from lacking appropriate evaluative stances and authorial voices toward propositions.

Keywords: novice, expert, engagement, RA Introductions, MA Thesis

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6468 Microbial Load of Fecal Material of Broiler Birds Administered with Lagenaria Breviflora Extract

Authors: Adeleye O. O., T. M. Obuotor, A. O. Kolawole, I. O. Opowoye, M. I. Olasoju, L. T. Egbeyale, R. A. Ajadi

Abstract:

This study investigated the effect of Lagenaria breviflora on broiler poultry birds, including its effect on the microbial count of the poultry droppings. A total of 240-day-old broiler chicks were randomly assigned to six groups, with four replicates per group. The first group was the control, while the other four groups were fed water containing 300g/L and 500g/L concentrations of Lagenaria breviflora twice and thrice daily. The microbial load was determined using the plate count method. The results showed that the administration of Lagenaria breviflora in the water of broiler birds significantly improved their growth performance with an average weight gain range of 1.845g - 2.241g. Mortality rate was at 0%. The study also found that Lagenaria breviflora had a significant effect on the microbial count of the poultry droppings with colony count values from 3.5 x 10-7 - 9.9 x10-7CFU/ml, The total coliforms (Escherichia coli, and Salmonella sp.) was obtained as 1 x 10 -5CFU/ml. The reduction in microbial counts of the poultry droppings could be attributed to the antimicrobial properties of Lagenaria breviflora, which contain phytochemicals reported to possess antimicrobial activity. Therefore, the inclusion of Lagenaria breviflora in the diets of broiler poultry could be an effective strategy for improving growth performance and immune function and reducing the microbial load of poultry droppings, which can help to mitigate the risk of disease transmission to humans and other animals.

Keywords: gut microbes, bacterial count, lagenaria breviflora, coliforms

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6467 The Relation between the Organizational Trust Level and Organizational Justice Perceptions of Staff in Konya Municipality: A Theoretical and Empirical Study

Authors: Handan Ertaş

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The aim of the study is to determine the relationship between organizational trust level and organizational justice of Municipality officials. Correlational method has been used via descriptive survey model and Organizational Justice Perception Scale, Organizational Trust Inventory and Interpersonal Trust Scale have been applied to 353 participants who work in Konya Metropolitan Municipality and central district municipalities in the study. Frequency as statistical method, Independent Samples t test for binary groups, One Way-ANOVA analyses for multi-groups and Pearson Correlation analysis have been used to determine the relation in the data analysis process. It has been determined in the outcomes of the study that participants have high level of organizational trust, “Interpersonal Trust” is in the first place and there is a significant difference in the favor of male officials in terms of Trust on the Organization Itself and Interpersonal Trust. It has also been understood that officials in district municipalities have higher perception level in all dimensions, there is a significant difference in Trust on the Organization sub-dimension and work status is an important factor on organizational trust perception. Moreover, the study has shown that organizational justice implementations are important in raising trust of official on the organization, administrator and colleagues, and there is a parallel relation between Organizational Trust components and Organizational Trust dimensions.

Keywords: organizational trust level, organizational justice perceptions, staff, Konya

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6466 Synthesis, Characterization and Anti-Microbial Study of Urethanized Poly Vinyl Alcohol Metal Complexes

Authors: Maha A. Younus, Dhefaf H. Badri, Maha A. Al Abayaji, Taha M. Salih

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Polymer metal complexes of poly vinyl alcohol and Cu (II), Ni (II), Mn (II) and Co (III) were prepared from the reaction of PVA with three different percentages of urea. The compound was characterized by fourier transform infrared spectrometry (FTIR) analysis and differential scanning calorimetric (DSC) Analysis. It has been established that the polymer and its metal complexes showed good activities against nine pathogenic bacteria (Escherichia coli, Klebsiellapneumonae, Staphylococcusaureus, Staphylococcus Albus, Salmonella Typhoid, Pseudomonas Aeruginosa, Shigella Dysentery, Proteus Morgani, Brucella Militensis). The polymer metal complexes show activity higher than that of the free polymer. The increasing activities were in the order (polymer < pol-Mn< pol-Co < pol-Ni ˂ pol-Cu). The ability of these compounds to show antimicrobial properties suggests that they can be further evaluated for medicinal and/or environmental applications.

Keywords: antimicrobial activity, PVA, polymer-metal complex, urea

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6465 Protective Effects of Vitamin C and Vitamin E on Experimentally Induced Testicular Torsion and Detorsion in Rat Model

Authors: Anu Vinod Ranade

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Aim: To evaluate and compare the effects of Vitamin C and Vitamin E on experimentally induced testicular torsion and detorsion in rats. Methods: Forty Male Wistar Albino rats were divided into five groups. Animals in the Group I underwent Sham operation, Group II consisted of animals that were subjected to torsion for three hours followed by detorsion for 24 hours without any treatment. While Group III, IV and V were orally pretreated with Vitamin C (40mg/kg.bw), vitamin E (100mg/kg.bw) and a combination of Vitamin C and vitamin E respectively for a period of 30 days. The testes of the experimental groups were manually rotated to 720° clockwise for three hours and counter rotated for 24 hours to induce ischemia and reperfusion. Sequential biopsies were performed and the testes were collected at the end of 24 hours of detrosion for morphological evaluation. Result: There was a significant decrease in the standard tubular diameter and the epithelial height of the seminiferous tubules in the untreated group when compared to Sham controls. The standard tubular diameter and seminiferous epithelial height showed near normal values when animals were pretreated with Vitamin C and Vitamin E individually or in combination. Conclusion: The results showed that pretreatment of with antioxidants vitamin E and vitamin C when administered prior to testicular torsion in rats significantly reduced the torsion and detorsion induced histopathlogical injury.

Keywords: vitamin C, vitamin E, standard tubular diameter, standard epithelial height, testicular torsion

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6464 Loan Supply and Asset Price Volatility: An Experimental Study

Authors: Gabriele Iannotta

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This paper investigates credit cycles by means of an experiment based on a Kiyotaki & Moore (1997) model with heterogeneous expectations. The aim is to examine how a credit squeeze caused by high lender-level risk perceptions affects the real prices of a collateralised asset, with a special focus on the macroeconomic implications of rising price volatility in terms of total welfare and the number of bankruptcies that occur. To do that, a learning-to-forecast experiment (LtFE) has been run where participants are asked to predict the future price of land and then rewarded based on the accuracy of their forecasts. The setting includes one lender and five borrowers in each of the twelve sessions split between six control groups (G1) and six treatment groups (G2). The only difference is that while in G1 the lender always satisfies borrowers’ loan demand (bankruptcies permitting), in G2 he/she closes the entire credit market in case three or more bankruptcies occur in the previous round. Experimental results show that negative risk-driven supply shocks amplify the volatility of collateral prices. This uncertainty worsens the agents’ ability to predict the future value of land and, as a consequence, the number of defaults increases and the total welfare deteriorates.

Keywords: Behavioural Macroeconomics, Credit Cycle, Experimental Economics, Heterogeneous Expectations, Learning-to-Forecast Experiment

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6463 Microsatellite-Based Genetic Variations and Relationships among Some Farmed Nile Tilapia Populations in Ghana: Implications for Nile Tilapia Culture

Authors: Acheampong Addo, Emmanuel Odartei Armah, Seth Koranteng Agyakwah, Ruby Asmah, Emmanuel Tetteh-Doku Mensah, Rhoda Lims Diyie, Sena Amewu, Catherine Ragasa, Edward Kofi Abban, Mike Yaw Osei-Atweneboana

Abstract:

The study investigated genetic variation and relationships among populations of Nile tilapia cultured in small-scale fish farms in selected regions of Ghana. A total of 700 samples were collected. All samples were screened with five microsatellite markers and results were analyzed using (Genetic Analysis in Excel), (Molecular and Evolutionary Genetic Analysis software, and Genpop on the web for Heterozygosity and Shannon diversity, (Analysis of Molecular Variance), and (Principal Coordinate Analysis). Fish from the 16 populations (made up of 14 farms and 2 selectively bred populations) clustered into three groups: 7 populations clustered with the GIFT-derived strain, 4 populations clustered with the Akosombo strain, and three populations were in a separate cluster. The clustering pattern indicated groups of different strains of Nile tilapia cultured. Mantel correlation test also showed low genetic variations among the 16 populations hence the need to boost seed quality in order to accelerate aquaculture production in Ghana.

Keywords: microsatellites, small- scale, Nile tilapia, akosombo strain, GIFT strain

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6462 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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