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

Search results for: differential groups

6401 The Implementation of Inclusive Education in Collaboration between Teachers of Special Education Classes and Regular Classes in a Preschool

Authors: Chiou-Shiue Ko

Abstract:

As is explicitly stipulated in Article 7 of the Enforcement Rules of the Special Education Act as amended in 1998, "in principle, children with disabilities should be integrated with normal children for preschool education". Since then, all cities and counties have been committed to promoting preschool inclusive education. The Education Department, New Taipei City Government, has been actively recruiting advisory groups of professors to assist in the implementation of inclusive education in preschools since 2001. Since 2011, the author of this study has been guiding Preschool Rainbow to implement inclusive education. Through field observations, meetings, and teaching demonstration seminars, this study explored the process of how inclusive education has been successfully implemented in collaboration with teachers of special education classes and regular classes in Preschool Rainbow. The implementation phases for inclusive education in a single academic year include the following: 1) Preparatory stage. Prior to implementation, teachers in special education and regular classes discuss ways of conducting inclusive education and organize reading clubs to read books related to curriculum modifications that integrate the eight education strategies, early treatment and education, and early childhood education programs to enhance their capacity to implement and compose teaching plans for inclusive education. In addition to the general objectives of inclusive education, the objective of inclusive education for special children is also embedded into the Individualized Education Program (IEP). 2) Implementation stage. Initially, a promotional program for special education is implemented for the children to allow all the children in the preschool to understand their own special qualities and those of special children. After the implementation of three weeks of reverse inclusion, the children in the special education classes are put into groups and enter the regular classes twice a week to implement adjustments to their inclusion in the learning area and the curriculum. In 2013, further cooperation was carried out with adjacent hospitals to perform development screening activities for the early detection of children with developmental delays. 3) Review and reflection stage. After the implementation of inclusive education, all teachers in the preschool are divided into two groups to record their teaching plans and the lessons learned during implementation. The effectiveness of implementing the objective of inclusive education is also reviewed. With the collaboration of all teachers, in 2015, Preschool Rainbow won New Taipei City’s “Preschool Light” award as an exceptional model for inclusive education. Its model of implementing inclusive education can be used as a reference for other preschools.

Keywords: collaboration, inclusive education, preschool, teachers, special education classes, regular classes

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6400 Mathematical Models for Drug Diffusion Through the Compartments of Blood and Tissue Medium

Authors: M. A. Khanday, Aasma Rafiq, Khalid Nazir

Abstract:

This paper is an attempt to establish the mathematical models to understand the distribution of drug administration in the human body through oral and intravenous routes. Three models were formulated based on diffusion process using Fick’s principle and the law of mass action. The rate constants governing the law of mass action were used on the basis of the drug efficacy at different interfaces. The Laplace transform and eigenvalue methods were used to obtain the solution of the ordinary differential equations concerning the rate of change of concentration in different compartments viz. blood and tissue medium. The drug concentration in the different compartments has been computed using numerical parameters. The results illustrate the variation of drug concentration with respect to time using MATLAB software. It has been observed from the results that the drug concentration decreases in the first compartment and gradually increases in other subsequent compartments.

Keywords: Laplace transform, diffusion, eigenvalue method, mathematical model

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6399 Youth and Radicalization: Main Causes Who Lead Young People to Radicalize in a Context with Background of Radicalization

Authors: Zineb Emrane

Abstract:

This abstract addresses the issue of radicalization of young people in a context with background of radicalization, in North of Morocco, 5 terrorist of Madrid's Attacts on 11th March, were coming from this context. It were developed a study pilot that describing young people perception about the main causes that lead and motivate for radicalization. Whenever we talk about this topic, we obtain information from studies and investigations by specialists in field, but we don’t give voice to the protagonists who in many cases are victims, specifically, young people at social risk because of social factors. Extremist radicalization is an expanding phenomenon, that affect young people, in north of Morocco. They live in a context with radical background and at risk of social exclusion, their social, economic and familiar needs make them vulnerable. The extremist groups take advantage of this vulnerability to involve them in a process of radicalization, offering them an alternative environment where they can found all they are looking for. This study pilot approaches the main causes that lead and motivates young people to become radicals, analyzing their context with emphasis on influencing factors, and bearing in mind the analysis of young people about how the radical background affect them and their opinion this phenomenon. The pilot study was carried out through the following actions: - Group dynamics with young people to analyze the process of violent radicalization of young people. -A participatory workshop with members of organizations that work directly with young people at risk of radicalization. -Interviews with institutional managers -Participant observation. The implementation of actions has led to the conclusion that young people define violent radicalization as a sequential process, depending on the stage, it can be deconstructed. Young people recognize that they stop feeling belonging to their family, school and neighborhood when they see behavior contrary to what they consider good and evil. The emotional rupture and the search for references outside their circle, push them to sympathize with groups that have an extremist ideology and that offer them what they need. The radicalization is a process with different stages, the main causes and the factors which lead young people to use extremist violence are related their low level of belonging feeling to their context, and lack of critical thinking about important issues. The young people are in a vulnerable stage, searching their identity, a space in which they can be accepted, and when they don't find it they are easily manipulated and susceptible to being attracted by extremist groups.

Keywords: exclusion, radicalization, vulnerability, youth

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6398 Development of 3D Particle Method for Calculating Large Deformation of Soils

Authors: Sung-Sik Park, Han Chang, Kyung-Hun Chae, Sae-Byeok Lee

Abstract:

In this study, a three-dimensional (3D) Particle method without using grid was developed for analyzing large deformation of soils instead of using ordinary finite element method (FEM) or finite difference method (FDM). In the 3D Particle method, the governing equations were discretized by various particle interaction models corresponding to differential operators such as gradient, divergence, and Laplacian. The Mohr-Coulomb failure criterion was incorporated into the 3D Particle method to determine soil failure. The yielding and hardening behavior of soil before failure was also considered by varying viscosity of soil. First of all, an unconfined compression test was carried out and the large deformation following soil yielding or failure was simulated by the developed 3D Particle method. The results were also compared with those of a commercial FEM software PLAXIS 3D. The developed 3D Particle method was able to simulate the 3D large deformation of soils due to soil yielding and calculate the variation of normal and shear stresses following clay deformation.

Keywords: particle method, large deformation, soil column, confined compressive stress

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6397 Out-of-Plane Free Vibrations of Circular Rods

Authors: Faruk Firat Çalim, Nurullah Karaca, Hakan Tacettin Türker

Abstract:

In this study, out-of-plane free vibrations of a circular rods is investigated theoretically. The governing equations for naturally twisted and curved spatial rods are obtained using Timoshenko beam theory and rewritten for circular rods. Effects of the axial and shear deformations are considered in the formulations. Ordinary differential equations in scalar form are solved analytically by using transfer matrix method. The circular rods of the mass matrix are obtained by using straight rod of consistent mass matrix. Free vibrations frequencies obtained by solving eigenvalue problem. A computer program coded in MATHEMATICA language is prepared. Circular beams are analyzed through various examples for free vibrations analysis. Results are compared with ANSYS results based on finite element method and available in the literature.

Keywords: circular rod, out-of-plane free vibration analysis, transfer matrix method

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6396 Impact of 6-Week Brain Endurance Training on Cognitive and Cycling Performance in Highly Trained Individuals

Authors: W. Staiano, S. Marcora

Abstract:

Introduction: It has been proposed that acute negative effect of mental fatigue (MF) could potentially become a training stimulus for the brain (Brain endurance training (BET)) to adapt and improve its ability to attenuate MF states during sport competitions. Purpose: The aim of this study was to test the efficacy of 6 weeks of BET on cognitive and cycling tests in a group of well-trained subjects. We hypothesised that combination of BET and standard physical training (SPT) would increase cognitive capacity and cycling performance by reducing rating of perceived exertion (RPE) and increase resilience to fatigue more than SPT alone. Methods: In a randomized controlled trial design, 26 well trained participants, after a familiarization session, cycled to exhaustion (TTE) at 80% peak power output (PPO) and, after 90 min rest, at 65% PPO, before and after random allocation to a 6 week BET or active placebo control. Cognitive performance was measured using 30 min of STROOP coloured task performed before cycling performance. During the training, BET group performed a series of cognitive tasks for a total of 30 sessions (5 sessions per week) with duration increasing from 30 to 60 min per session. Placebo engaged in a breathing relaxation training. Both groups were monitored for physical training and were naïve to the purpose of the study. Physiological and perceptual parameters of heart rate, lactate (LA) and RPE were recorded during cycling performances, while subjective workload (NASA TLX scale) was measured during the training. Results: Group (BET vs. Placebo) x Test (Pre-test vs. Post-test) mixed model ANOVA’s revealed significant interaction for performance at 80% PPO (p = .038) or 65% PPO (p = .011). In both tests, groups improved their TTE performance; however, BET group improved significantly more compared to placebo. No significant differences were found for heart rate during the TTE cycling tests. LA did not change significantly at rest in both groups. However, at completion of 65% TTE, it was significantly higher (p = 0.043) in the placebo condition compared to BET. RPE measured at ISO-time in BET was significantly lower (80% PPO, p = 0.041; 65% PPO p= 0.021) compared to placebo. Cognitive results in the STROOP task showed that reaction time in both groups decreased at post-test. However, BET decreased significantly (p = 0.01) more compared to placebo despite no differences accuracy. During training sessions, participants in the BET showed, through NASA TLX questionnaires, constantly significantly higher (p < 0.01) mental demand rates compared to placebo. No significant differences were found for physical demand. Conclusion: The results of this study provide evidences that combining BET and SPT seems to be more effective than SPT alone in increasing cognitive and cycling performance in well trained endurance participants. The cognitive overload produced during the 6-week training of BET can induce a reduction in perception of effort at a specific power, and thus improving cycling performance. Moreover, it provides evidence that including neurocognitive interventions will benefit athletes by increasing their mental resilience, without affecting their physical training load and routine.

Keywords: cognitive training, perception of effort, endurance performance, neuro-performance

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6395 Polymer Dispersed Liquid Crystals Based on Poly Vinyl Alcohol Boric Acid Matrix

Authors: Daniela Ailincai, Bogdan C. Simionescu, Luminita Marin

Abstract:

Polymer dispersed liquid crystals (PDLC) represent an interesting class of materials which combine the ability of polymers to form films and their mechanical strength with the opto-electronic properties of liquid crystals. The proper choice of the two components - the liquid crystal and the polymeric matrix - leads to materials suitable for a large area of applications, from electronics to biomedical devices. The objective of our work was to obtain PDLC films with potential applications in the biomedical field, using poly vinyl alcohol boric acid (PVAB) as a polymeric matrix for the first time. Presenting all the tremendous properties of poly vinyl alcohol (such as: biocompatibility, biodegradability, water solubility, good chemical stability and film forming ability), PVAB brings the advantage of containing the electron deficient boron atom, and due to this, it should promote the liquid crystal anchoring and a narrow liquid crystal droplets polydispersity. Two different PDLC systems have been obtained, by the use of two liquid crystals, a nematic commercial one: 4-cyano-4’-penthylbiphenyl (5CB) and a new smectic liquid crystal, synthesized by us: buthyl-p-[p’-n-octyloxy benzoyloxy] benzoate (BBO). The PDLC composites have been obtained by the encapsulation method, working with four different ratios between the polymeric matrix and the liquid crystal, from 60:40 to 90:10. In all cases, the composites were able to form free standing, flexible films. Polarized light microscopy, scanning electron microscopy, differential scanning calorimetry, RAMAN- spectroscopy and the contact angle measurements have been performed, in order to characterize the new composites. The new smectic liquid crystal has been characterized using 1H-NMR and single crystal X-ray diffraction and its thermotropic behavior has been established using differential scanning calorimetry and polarized light microscopy. The polarized light microscopy evidenced the formation of round birefringent droplets, anchored homeotropic in the first case and planar in the second, with a narrow dimensional polydispersity, especially for the PDLC containing the largest amount of liquid crystal, fact evidenced by SEM, also. The obtained values for the water to air contact angle showed that the composites have a proper hydrophilic-hydrophobic balance, making them potential candidates for bioapplications. More than this, our studies demonstrated that the water to air contact angle varies as a function of PVAB matrix crystalinity degree, which can be controled as a function of time. This fact allowed us to conclude that the use of PVAB as matrix for PDLCs obtaining offers the possibility to modulate their properties for specific applications.

Keywords: 4-cyano-4’-penthylbiphenyl, buthyl-p-[p’-n-octyloxy benzoyloxy] benzoate, contact angle, polymer dispersed liquid crystals, poly vinyl alcohol boric acid

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6394 Relationship Salt Sensitivity and с825т Polymorphism of gnb3 Gene in Patients with Essential Hypertension

Authors: Aleksandr Nagay, Gulnoz Khamidullayeva

Abstract:

It is known that an unbalanced intake of salt (NaCI), lifestyle and genetic predisposition to pathology is a key component of the risk and the development of essential hypertension (EH). Purpose: To study the relationship between salt-sensitivity and blood pressure (BP) on systolic (SBP) and diastolic (DBP) blood pressure, depending on the C825T polymorphism of GNB3 in individuals of Uzbek nationality with EH. Method: studied 148 healthy and 148 patients with EH with I-II degree (WHO/ISH, 2003) with disease duration 6,5±1,3 years. Investigation of the gene GNB3 was produced by PCR-RFLP method. Determination of salt-sensitivity was performed by the method of R. Henkin. Results: For a comparative analysis of BP, the groups with carriage of CТ and TT genotypes were combined. The analysis showed that carriers of CC genotype and low salt-sensitivity were determined by higher levels of SBP compared with carriers of CT and TT genotypes, and low salt-sensitivity of SBP: 166,2±4,3 against 158,2±9,1 mm Hg (p=0,000). A similar analysis on the values of DBP also showed significantly higher values of blood pressure in carriers of CC genotype DBP: 105,8±10,6 vs. 100,5±7,2 mm Hg, respectively (p=0,001). The average values of SBP and DBP in groups with carriers of CC genotype at medium or high salt-sensitivity in comparison with carriers of CT or TT genotype did not differ statistically SBP: 165,0±0,1 vs. 160,0±8,6 mm Hg (p=0,275) and DBP: 100,1±0,1 vs. 101,6±7,6 mm Hg (p=0,687), respectively. Conclusion: It is revealed that in patients with EH CC genotype of the gene GNB3 given salt-sensitivity has a negative effect on blood pressure profile. Since patients with EH with the CC genotype of GNB3 gene with low-salt taste sensitivity is determined by a higher level of blood pressure, both on SBP and DBP.

Keywords: salt sensitivity, essential hypertension EH, blood pressure BP, genetic predisposition

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6393 Implementing Critical Friends Groups in Schools

Authors: S. Odabasi Cimer, A. Cimer

Abstract:

Recently, the poor quality of education, low achieving students, low international exam performances and little or no effect of the education reforms on the teaching in the classrooms are the main problems of education discussed in Turkey. Research showed that the quality of an education system can not exceed the quality of its teachers and teaching. Therefore, in-service training (INSET) courses are important to improve teacher quality, thereby, the quality of education. However, according to the research conducted on the evaluation of the INSET courses in Turkey, they are not effective in improving the quality of teaching in the classroom. The main reason for this result is because INSET courses are conducted and delivered in limited time and presented theoretically, which does not meet the needs of teachers and as a result, the knowledge and skills taught are not used in the classrooms. Recently, developed countries have been using Critical Friends Groups (CFGs) successfully for the purpose of school-based training of teachers. CFGs are the learning groups which contain 6-10 teachers aimed at fostering their capacities to undertake instructional and personal improvement and schoolwide reform. CFGs have been recognized as a critical feature in school reform, improving teaching practice and improving student achievement. In addition, in the USA, teachers have named CFGs one of the most powerful professional development activities in which they have ever participated. Whereas, in Turkey, the concept is new. This study aimed to investigate the implications of application, evaluation, and promotion of CFGs which has the potential to contribute to teacher development and student learning in schools in Turkey. For this purpose, the study employed a qualitative approach and case study methodology to implement the model in high schools. The research was conducted in two schools and 13 teachers working in these schools participated. The study lasted two years and the data were collected through various data collection tools including interviews, meeting transcripts, questionnaires, portfolios, and diaries. The results of the study showed that CFGs contributed professional development of teachers and their students’ learning. It also contributed to a culture of collaborative work in schools. A number of barriers and challenges which prevent effective implementation were also determined.

Keywords: critical friends group, education reform, science learning, teacher education

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6392 Chronological Skin System Aging: Improvements in Reversing Markers with Different Routes of Green Tea Extract Administration

Authors: Aliaa Mahmoud Issa

Abstract:

Green tea may provide an alternative treatment for many skin system disorders. Intrinsic or chronological aging represents the structural, functional, and metabolic changes in the skin, which depend on the passage of time per se. The aim of the present study is to compare the effect of green tea extract administration, in drinking water or topically, on the chronological changes of the old Swiss albino mice skin. A total number of forty Swiss albino female mice (Mus musculus) were used; thirty were old females, 50-52 weeks old and the remaining ten young females were about 10 weeks old. The skin of the back of all the studied mice was dehaired with a topical depilatory cream. Treatment with green tea extract was applied in two different ways: in the drinking water (0.5mg/ml/day) or topically, applied to the skin of the dorsal side (6mg/ml water). They were divided into four main groups each of 10 animals: Group I: young untreated, Group II: old untreated groups, Group III: tea-drinking (TD) group, and Group IV: topical tea (TT) group. The animals were euthanized after 3 and 6 weeks from the beginning of green tea extract treatment. The skin was subject to morphometric (epidermal, dermal, and stratum corneum thicknesses; collagen and elastin content) studies. The skin ultrastructure of the groups treated for 6 weeks with the green tea extract was also examined. The old mouse skin was compared to the young one to investigate the chronological changes of the tissue. The results revealed that the skin of mice treated with green tea extract, either topically or to less extent in drinking water, showed a reduction in the aging features manifested by a numerical but statistically insignificant improvement in the morphometric measurements. A remarkable amelioration in the ultrastructure of the old skin was also observed. Generally, green tea extract in the drinking water revealed inconsistent results. The topical application of green tea extract to the skin revealed that the epidermal, dermal and stratum corneum thicknesses and the elastin content, that were statistically significant, approach those of the young group. The ultrastructural study revealed the same observations. The disjunction of the lower epidermal keratinocytes was reduced. It could be concluded that the topical application of green tea extract to the skin of old mice showed improvement in reversing markers of skin system aging more than using the extract in the drinking water.

Keywords: aging, green tea extract, morphometry, skin, ultrastructure

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6391 Effect of Thermal Radiation on Flow, Heat, and Mass Transfer of a Nanofluid over a Stretching Horizontal Cylinder Embedded in a Porous Medium with Suction/Injection

Authors: Elsayed M. A. Elbashbeshy, T. G. Emam, M. S. El-Azab, K. M. Abdelgaber

Abstract:

The effect of thermal radiation on flow, heat and mass transfer of an incompressible viscous nanofluid over a stretching horizontal cylinder embedded in a porous medium with suction/injection is discussed numerically. The governing boundary layer equations are reduced to a system of ordinary differential equations. Mathematica has been used to solve such system after obtaining the missed initial conditions. Comparison of obtained numerical results is made with previously published results in some special cases, and found to be in a good agreement.

Keywords: laminar flow, boundary layer, stretching horizontal cylinder, thermal radiation, suction/injection, nanofluid

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6390 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy

Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan

Abstract:

Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.

Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery

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6389 Microstructural and Magnetic Properties of Ni50Mn39Sn11 and Ni50Mn36Sn14 Heusler Alloys

Authors: Mst Nazmunnahar, Juan del Val, Alena Vimmrova, Blanca Hernando, Julian González

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We report the microstructural and magnetic properties of Ni50Mn39Sn11 and Ni50Mn36Sn14 ribbon Heusler alloys. Experimental results were obtained by differential scanning calorymetry, X-ray diffraction and vibrating sample magnetometry techniques. The Ni-Mn-Sn system undergoes a martensitic structural transformation in a wide temperature range. For example, for Ni50Mn39Sn11 the start and finish temperatures of the martensitic and austenite phase transformation for ribbon alloy were Ms = 336K , Mf = 328K, As = 335K and Af = 343K whereas no structural transformation is observed for Ni50Mn36Sn14 alloys. Magnetic measurements show the typical ferromagnetic behavior with Curie temperature 207K at low applied field of 50 Oe. The complex behavior exhibited by these Heusler alloys should be ascribed to the strong coupling between magnetism and structure, being their magnetic behavior determined by the distance between Mn atoms.

Keywords: as-cast ribbon, Heusler alloys, magnetic properties, structural transformation

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6388 Investigation of Dynamic Mechanical Properties of Jute/Carbon Reinforced Composites

Authors: H. Sezgin, O. B. Berkalp, R. Mishra, J. Militky

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In the last few decades, due to their advanced properties, there has been an increasing interest in hybrid composite materials. In this study, the effect of different stacking sequences of jute and carbon fabric plies on dynamic mechanical properties of composite laminates were investigated. Vacuum bagging system was used to fabricate the composite samples. Each composite laminate was reinforced with two plies of jute fabric and two plies of carbon fabric by varying the position of layers. Dynamic mechanical analyzer (DMA) was used to examine the dynamic mechanical properties of composite laminates with increasing temperature. Results showed that the composite sample, which has carbon fabric at the outer layers, has the highest storage and loss modulus. Besides, it was observed that glass transition temperature (Tg) of samples are close to each other and at about 75 °C.

Keywords: differential scanning calorimetry dynamic mechanical analysis, textile reinforced composites, thermogravimetric analysis

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6387 One-Stage Conversion of Adjustable Gastric Band to One-Anastomosis Gastric Bypass Versus Sleeve Gastrectomy : A Single-Center Experience With a Short and Mid-term Follow-up

Authors: Basma Hussein Abdelaziz Hassan, Kareem Kamel, Philobater Bahgat Adly Awad, Karim Fahmy

Abstract:

Background: Laparoscopic adjustable gastric band was one of the most applied and common bariatric procedures in the last 8 years. However; the failure rate was very high, reaching approximately 60% of the patients not achieving the desired weight loss. Most patients sought another revisional surgery. In which, we compared two of the most common weight loss surgeries performed nowadays: the laparoscopic sleeve gastrectomy and laparoscopic one- anastomosis gastric bypass. Objective: To compare the weight loss and postoperative outcomes among patients undergoing conversion laparoscopic one-anastomosis gastric bypass (cOAGB) and laparoscopic sleeve gastrectomy (cSG) after a failed laparoscopic adjustable gastric band (LAGB). Patients and Methods: A prospective cohort study was conducted from June 2020 to June 2022 at a single medical center, which included 77 patients undergoing single-stage conversion to (cOAGB) vs (cSG). Patients were reassessed for weight loss, comorbidities remission, and post-operative complications at 6, 12, and 18 months. Results: There were 77 patients with failed LAGB in our study. Group (I) was 43 patients who underwent cOAGB and Group (II) was 34 patients who underwent cSG. The mean age of the cOAGB group was 38.58. While in the cSG group, the mean age was 39.47 (p=0.389). Of the 77 patients, 10 (12.99%) were males and 67 (87.01%) were females. Regarding Body mass index (BMI), in the cOAGB group the mean BMI was 41.06 and in the cSG group the mean BMI was 40.5 (p=0.042). The two groups were compared postoperative in relation to EBWL%, BMI, and the co-morbidities remission within 18 months follow-up. The BMI was calculated post-operative at three visits. After 6 months of follow-up, the mean BMI in the cOAGB group was 34.34, and the cSG group was 35.47 (p=0.229). In 12-month follow-up, the mean BMI in the cOAGB group was 32.69 and the cSG group was 33.79 (p=0.2). Finally, the mean BMI after 18 months of follow-up in the cOAGB group was 30.02, and in the cSG group was 31.79 (p=0.001). Both groups had no statistically significant values at 6 and 12 months follow-up with p-values of 0.229, and 0.2 respectively. However, patients who underwent cOAGB after 18 months of follow-up achieved lower BMI than those who underwent cSG with a statistically significant p-value of 0.005. Regarding EBWL% there was a statistically significant difference between the two groups. After 6 months of follow-up, the mean EBWL% in the cOAGB group was 35.9% and the cSG group was 33.14%. In the 12-month follow-up, the EBWL % mean in the cOAGB group was 52.35 and the cSG group was 48.76 (p=0.045). Finally, the mean EBWL % after 18 months of follow-up in the cOAGB group was 62.06 ±8.68 and in the cSG group was 55.58 ±10.87 (p=0.005). Regarding comorbidities remission; Diabetes mellitus remission was found in 22 (88%) patients in the cOAGB group and 10 (71.4%) patients in the cSG group with (p= 0.225). Hypertension remission was found in 20 (80%) patients in the cOAGB group and 14 (82.4%) patients in the cSG group with (p=1). In addition, dyslipidemia remission was found in 27(87%) patients in cOAGB group and 17(70%) patients in the cSG group with (p=0.18). Finally, GERD remission was found in about 15 (88.2%) patients in the cOAGB group and 6 (60%) patients in the cSG group with (p=0.47). There are no statistically significant differences between the two groups in the post-operative data outcomes. Conclusion: This study suggests that the conversion of LAGB to either cOAGB or cSG could be feasibly performed in a single-stage operation. cOAGB had a significant difference as regards the weight loss results than cSG among the mid-term follow-up. However, there is no significant difference in the postoperative complications and the resolution of the co-morbidities. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

Keywords: laparoscopic, gastric banding, one-anastomosis gastric bypass, Sleeve gastrectomy, revisional surgery, weight loss

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6386 Inclusion of Children with Disabilities in Early Childhood Development Programs in Nepal: Construction of a Stakeholder Informed Framework

Authors: Divya Dawadi, Kerry Bissaker

Abstract:

Inclusion of children with a disability (CwD) in Early Childhood Education and Development (ECED) programs in Nepal while viewed as desirable is not widespread. Even though the ECED program is currently providing access to ECED services for one million young children, with the aim to improve children's school readiness by equipping them with the necessary knowledge and skills to succeed more effectively in their primary schooling, access to early year's education in inclusive settings for CwD is challenging. Using a heuristic qualitative design, this research aims to construct a framework by analyzing the perspectives of parents and professionals through interviews and focus group discussions, with a view to recommending a new policy to address the rights of CwD and their families. Several school-based and/or organizational and contextual factors interact to contribute to CwD becoming victims of multiple layers of exclusion. The school-based factors include policy, attitudes, teacher efficacy, resources, coordination and parental engagement. The contextual factors are spirituality, caste ethnicity, language, economic status, and geographic location. However, there is a varied effect of the interaction between school-based and contextual factors on different groups of CwD. A policy needs to recognize the multiplicity of the interactions between these factors that inhibit the inclusion of varied groups of CwD in ECED programs and address them separately.

Keywords: children with a disability, early childhood education and development, framework, inclusion

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6385 The Effects of Prebiotic, Probiotic and Synbiotic Diets Containing Bacillus coagulans and Inulin on Serum Lipid Profile in the Rat

Authors: Khadijeh Abhari, Seyed Shahram Shekarforoush, Saeid Hosseinzadeh

Abstract:

An in vivo trial was conducted to evaluate the effects of Bacillus coagulans, and inulin, either separately or in combination, on lipid profile using a rat model. Thirty-two male Wistar rats were randomly divided into four groups (n=8) and fed as follows: standard diet (control), standard diet with 5% w/w long chain inulin (prebiotic), standard diet with 109 spores/day spores of B. coagulans by orogastric gavage (probiotic), and standard diet with 5% w/w long chain inulin and 109 spores/day of B. coagulans (synbiotic). Rats were fed the treatments for 30 days. Serum samples were collected 10, 20 and 30 days following onset of treatment. Total cholesterol, HDL and LDL cholesterol and triglycerides concentrations were analyzed. Results of this study showed that inulin potentially affected the lipid profile. An obvious decrease in serum total cholesterol and LDL-cholestrol of rats fed with inulin in synbiotic and prebiotic groups was seen in all sampling days. Inulin fed rats also demonstrated higher levels of HDL-cholesterol concentration; however this value in probiotic and control fed rats remains without significant change. According to the results of this study, B. coagulans did not contribute to any lipid profile changes after 30 days. Thus, further in vitro investigations on the characteristic of these bacteria could be useful to gain insights into understanding the treatment of probiotics in order to achieve the maximum beneficial effect.

Keywords: bacillus coagulans, inulin, rat, lipid profile, synbiotic diet

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6384 E-Immediacy in Saudi Higher Education Context: Female Students’ Perspectives

Authors: Samar Alharbi, Yota Dimitriadi

Abstract:

The literature on educational technology in Saudi Arabia reveals female learners’ unwillingness to study fully online courses in higher education despite the fact that Saudi universities have offered a variety of online degree programmes to undergraduate students in many regions of the country. The root causes keeping female students from successfully learning in online environments are limited social interaction, lack of motivation and difficulty with the use of e-learning platforms. E-immediacy remains an important method of online teaching to enhance students’ interaction and support their online learning. This study explored Saudi female students’ perceptions, as well as the experiences of lecturers’ immediacy behaviours in online environments, who participate in fully online courses using Blackboard at a Saudi university. Data were collected through interviews with focus groups. The three focus groups included five to seven students each. The female participants were asked about lecturers’ e-immediacy behaviours and which e-immediacy behaviours were important for an effective learning environment. A thematic analysis of the data revealed three main themes: the encouragement of student interaction, the incorporation of social media and addressing the needs of students. These findings provide lecturers with insights into instructional designs and strategies that can be adopted in using e-immediacy in effective ways, thus improving female learners’ interactions as well as their online learning experiences.

Keywords: e-learning, female students, higher education, immediacy

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6383 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

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6382 A Mixed Methodology of the Social and Spatial Fragmentation of the City of Beirut Leading to the Creation of Internal Boundaries

Authors: Hala Obeid

Abstract:

Among the cities that have been touched by hard events and have been experiencing this polemic of existence, one can quote Beirut. A city that defies and confronts itself for its own existence. Beirut materialized all the social complexity; it has also preserved the memory of a society that has been able to build and reflect a certain unique identity. In spite of its glory, Lebanon’s civil war has marked a turning point in Beirut’s history. It has caused many deaths and opposed religious communities. Once this civil war has ended, the reconstruction of the city center, however, saw the spatial exclusion of manual labor, small local commerce, and middle-class residences. The urban functions that characterized the pre-war center were removed, and the city’s spontaneous evolutions were replaced by a historical urban planning, which neglected the city’s memory and identity. The social and spatial fragmentation that has erupted since the war has led to a breakdown of spatial and social boundaries within the city. The aim of this study is to evaluate the impact of fragmentation and boundaries on the city of Beirut in spatial, social, religious and ethnic terms. The method used in this research is what we call the mixed method which is a combination between the quantitative method and the qualitative one. These two approaches, in this case, do not oppose but complement each other in order to study the city of Beirut physically and socially. The main purpose of the qualitative approach is to describe and analyze the social phenomenon of the fragmentation of the city; this method can be summarized by the field observation and study. While the quantitative approach is based on filling out questionnaires that leads to statistics analyzes. Together, these two approaches will mark the course of the research. As a result, Beirut is not only a divided city but is fragmented spatially into many fragments and socially into many groups. This fragmentation is creating immaterial boundaries between fragments and therefore between groups. These urban and social boundaries are specifically religious and ethnic limits. As a conclusion, one of the most important and discussed boundary in Beirut is a spatial and religious boundary called ‘the green line’ or the demarcation line, a true caesura within the city. It marks the opposition of two urban groups and the aggravated fragmentation between them. This line divided Beirut into two compartments: East Beirut (for Christians) and West Beirut (for Muslims). This green line has become an urban void that holds the past in suspension. Finally, to think of Beirut as an urban unit becomes an insoluble problem.

Keywords: Beirut, boundaries, fragmentation, identity

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6381 Rhythm-Reading Success Using Conversational Solfege

Authors: Kelly Jo Hollingsworth

Abstract:

Conversational Solfege, a research-based, 12-step music literacy instructional method using the sound-before-sight approach, was used to teach rhythm-reading to 128-second grade students at a public school in the southeastern United States. For each step, multiple scripted techniques are supplied to teach each skill. Unit one was the focus of this study, which is quarter note and barred eighth note rhythms. During regular weekly music instruction, students completed method steps one through five, which includes aural discrimination, decoding familiar and unfamiliar rhythm patterns, and improvising rhythmic phrases using quarter notes and barred eighth notes. Intact classes were randomly assigned to two treatment groups for teaching steps six through eight, which was the visual presentation and identification of quarter notes and barred eighth notes, visually presenting and decoding familiar patterns, and visually presenting and decoding unfamiliar patterns using said notation. For three weeks, students practiced steps six through eight during regular weekly music class. One group spent five-minutes of class time on steps six through eight technique work, while the other group spends ten-minutes of class time practicing the same techniques. A pretest and posttest were administered, and ANOVA results reveal both the five-minute (p < .001) and ten-minute group (p < .001) reached statistical significance suggesting Conversational Solfege is an efficient, effective approach to teach rhythm-reading to second grade students. After two weeks of no instruction, students were retested to measure retention. Using a repeated-measures ANOVA, both groups reached statistical significance (p < .001) on the second posttest, suggesting both the five-minute and ten-minute group retained rhythm-reading skill after two weeks of no instruction. Statistical significance was not reached between groups (p=.252), suggesting five-minutes is equally as effective as ten-minutes of rhythm-reading practice using Conversational Solfege techniques. Future research includes replicating the study with other grades and units in the text.

Keywords: conversational solfege, length of instructional time, rhythm-reading, rhythm instruction

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6380 Review of Consecutive Patients Treated with a Combination of Vancomycin and Rifaximin for Diarrhea Predominant Irritable Bowel Syndrome (IBS-D)

Authors: Portia Murphy, Danica Vasic, Anoja W. Gunaratne, Encarnita Sitchon, Teresita Tugonon, Marou Ison, Antoinette Le Busque, Christelle Pagonis, Thomas J. Borody

Abstract:

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of the population globally with the most predominant symptoms being abdominal pain, bloating and altered bowel movements. All age groups suffer from IBS although the prevalence of IBS decreases for age groups over 50 years. Women are more likely to suffer from IBS than men. IBS can be categorized into 3 groups based on the type of altered bowel movement: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). The contribution of the gut microbiome to the etiology of IBS is becoming increasingly recognized with rising use of anti-microbial agents. Previous studies on vancomycin and rifaximin used as monotherapy or in combination have been conducted mainly on IBS-C and showed marked improvements in the symptoms. According to our knowledge, no studies reported using these two combinations of antibiotics for IBS-D. Here, we report a consecutive cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients ages were between 24-74 years (mean 44 years) and 9 were female. Baseline all patients had diarrhea, 4 with mucus and one with blood. Patients reported other symptoms were abdominal pain (n=11) bloating (n=9), flatulence (n=7), fatigue (n=4) and nausea (n=3). Patients treatments were personalized according to their symptom severity and tolerability and were treated with combination of rifaximin (500 - 3000mg/d) and vancomycin (500mg - 1500mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks’ time. Of all patients, 89% patients reported improvement of the symptoms, 1 reported no change and 1 patient’s symptoms got worse. The mechanism of action for both vancomycin and rifaximin involves the inhibition of bacterial cell wall and protein synthesis respectively. The role of these medications in improving the symptoms of this cohort suggests that IBS-D may be microbiome infection driven. In this cohort, similar patient presentations to Clostridium difficile, as well as symptom improvement with the use of rifaximin and particularly vancomycin, suggest that the infectious agent may be an unidentified Clostridium. These preliminary results offer an alternative etiology for IBS-D not previously considered and open the avenue for new research.

Keywords: clostridium deficile, diarrhea predominant Irritable Bowel Syndrome, microbiome, vancomycin/rifaximin combination

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6379 Strengthening Functional Community-Provider Linkages: Lessons from the Challenge Initiative for Healthy Cities Program in Indore, India

Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

Abstract:

Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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6378 The Effect of Aromatherapy Candle as Insecticide from Citrus Extract of Lemongrass (Cymbopogon) to Increase Ae. aegypti Mortality

Authors: Nurul Hidayah, Farida Rahmatika, Fathimah Azzahra, Nesty Herennadia

Abstract:

Aromatherapy candles are one of the insecticide media that have not been much researched. The active ingredient that is proven to have the effect of insecticide is a citrus extract from lemongrass oil (Cymbopogon). Aromatherapy candles are added by citrus compounds to be insecticidal for Ae. aegypti mosquito that was related to the infectious disease such as dengue fever. This research aims to find out if aromatherapy candles of citrus compounds have an insecticidal effect on Ae. aegypti mosquito. We used true experimental design including posttest only with control group design. The samples are 20 male and female Ae. aegypti mosquitos with aged 1-7 days belong to the inclusion criteria. The subjects were divided into 6 groups, consisting of 1 negative control group and 5 treatment groups with variation concentration are 1%; 2%; 3%; 4%; 5%. Each group will be treated for 2 hours and observed death after 24 hours. Replication in each group is done 4 times. The results were then tested statistically using Kruskal-Wallis and probit test. Mean of death in negative control group, and treatment group 1%; 2%; 3%; 4%; 5% respectively 0; 1; 0.25; 0; 1 and 1 mosquito. The Kruskal-Wallis test in the study group found no significant difference (p = 0.178). The probit analysis showed that LC50 and LC90 were 20.069% and 31.557%. The aromatherapy candle of a citrus compound has an insecticidal effect on the Ae aegypti mosquito.

Keywords: Ae. aegypti insecticide, aromatherapy candle, citrus compound, lemongrass oil (Cymbopogon)

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6377 Analysis of Exponential Nonuniform Transmission Line Parameters

Authors: Mounir Belattar

Abstract:

In this paper the Analysis of voltage waves that propagate along a lossless exponential nonuniform line is presented. For this analysis the parameters of this line are assumed to be varying function of the distance x along the line from the source end. The approach is based on the tow-port networks cascading presentation to derive the ABDC parameters of transmission using Picard-Carson Method which is a powerful method in getting a power series solution for distributed network because it is easy to calculate poles and zeros and solves differential equations such as telegrapher equations by an iterative sequence. So the impedance, admittance voltage and current along the line are expanded as a Taylor series in x/l where l is the total length of the line to obtain at the end, the main transmission line parameters such as voltage response and transmission and reflexion coefficients represented by scattering parameters in frequency domain.

Keywords: ABCD parameters, characteristic impedance exponential nonuniform transmission line, Picard-Carson's method, S parameters, Taylor's series

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6376 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

Abstract:

Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1-L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: obesity, trabecular bone score, bone mineral density, women

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6375 Performance of Bimetallic Catalyst in the Oxidation of Volatile Organic Compounds

Authors: Faezeh Aghazadeh

Abstract:

The catalytic activity of Pt/γ-Al₂O₃ and Pt-Fe/γ-Al₂O₃ catalysts was investigated to bring about the complete oxidation of 2-Propanol. Among them, Pt-Fe/γ-Al₂O₃ was found to be the most promising catalyst based on activity. The catalysts were characterized by (XRD), (SEM), (TEM) and ICP-AES techniques. Iron loadings on Pt/γ-Al₂O₃ had a great effect on catalytic activity, and Pt-Fe/γ-Al₂O₃ (1.75 wt% Fe) catalyst at calcination temperature 300°C was observed to be the most active, which might be contributed to the favorable synergetic effects between Pt and Fe, high activity and the well-dispersed bimetallic phase. The combustion of 2-Propanol in the vapor phase was carried out in a conventional flow U-shape glass reactor used in the differential mode at atmospheric pressure. 2-Propanol was analyzed by a gas chromatograph VARIAN 3800 CX equipped with an FID. As observed, better performance and activity were observed for Pt-Fe/Al₂O₃ bimetallic catalyst. These results indicate that the high dispersion on support gives a positive effect on catalytic activity.

Keywords: volatile organic compounds, bimetallic catalyst, catalytic activity, low temperature

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6374 A Method for Evaluating Gender Equity of Cycling from Rawls Justice Perspective

Authors: Zahra Hamidi

Abstract:

Promoting cycling, as an affordable environmentally friendly mode of transport to replace private car use has been central to sustainable transport policies. Cycling is faster than walking and combined with public transport has the potential to extend the opportunities that people can access. In other words, cycling, besides direct positive health impacts, can improve people mobility and ultimately their quality of life. Transport literature well supports the close relationship between mobility, quality of life, and, well being. At the same time inequity in the distribution of access and mobility has been associated with the key aspects of injustice and social exclusion. The pattern of social exclusion and inequality in access are also often related to population characteristics such as age, gender, income, health, and ethnic background. Therefore, while investing in transport infrastructure it is important to consider the equity of provided access for different population groups. This paper proposes a method to evaluate the equity of cycling in a city from Rawls egalitarian perspective. Since this perspective is concerned with the difference between individuals and social groups, this method combines accessibility measures and Theil index of inequality that allows capturing the inequalities ‘within’ and ‘between’ groups. The paper specifically focuses on two population characteristics as gender and ethnic background. Following Rawls equity principles, this paper measures accessibility by bikes to a selection of urban activities that can be linked to the concept of the social primary goods. Moreover, as growing number of cities around the world have launched bike-sharing systems (BSS) this paper incorporates both private and public bikes networks in the estimation of accessibility levels. Additionally, the typology of bike lanes (separated from or shared with roads), the presence of a bike sharing system in the network, as well as bike facilities (e.g. parking racks) have been included in the developed accessibility measures. Application of this proposed method to a real case study, the city of Malmö, Sweden, shows its effectiveness and efficiency. Although the accessibility levels were estimated only based on gender and ethnic background characteristics of the population, the author suggests that the analysis can be applied to other contexts and further developed using other properties, such as age, income, or health.

Keywords: accessibility, cycling, equity, gender

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6373 Comparison of Early Post-operative Outcomes of Cardiac Surgery Patients Who Have Had Blood Transfusion Based on Fixed Cut-off Point versus of Change in Percentage of Basic Hematocrit Levels

Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

Abstract:

Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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6372 Breast Cancer Survivability Prediction via Classifier Ensemble

Authors: Mohamed Al-Badrashiny, Abdelghani Bellaachia

Abstract:

This paper presents a classifier ensemble approach for predicting the survivability of the breast cancer patients using the latest database version of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The system consists of two main components; features selection and classifier ensemble components. The features selection component divides the features in SEER database into four groups. After that it tries to find the most important features among the four groups that maximizes the weighted average F-score of a certain classification algorithm. The ensemble component uses three different classifiers, each of which models different set of features from SEER through the features selection module. On top of them, another classifier is used to give the final decision based on the output decisions and confidence scores from each of the underlying classifiers. Different classification algorithms have been examined; the best setup found is by using the decision tree, Bayesian network, and Na¨ıve Bayes algorithms for the underlying classifiers and Na¨ıve Bayes for the classifier ensemble step. The system outperforms all published systems to date when evaluated against the exact same data of SEER (period of 1973-2002). It gives 87.39% weighted average F-score compared to 85.82% and 81.34% of the other published systems. By increasing the data size to cover the whole database (period of 1973-2014), the overall weighted average F-score jumps to 92.4% on the held out unseen test set.

Keywords: classifier ensemble, breast cancer survivability, data mining, SEER

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