Search results for: project management methods
Commenced in January 2007
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Edition: International
Paper Count: 25241

Search results for: project management methods

5231 Sensitivity and Uncertainty Analysis of One Dimensional Shape Memory Alloy Constitutive Models

Authors: A. B. M. Rezaul Islam, Ernur Karadogan

Abstract:

Shape memory alloys (SMAs) are known for their shape memory effect and pseudoelasticity behavior. Their thermomechanical behaviors are modeled by numerous researchers using microscopic thermodynamic and macroscopic phenomenological point of view. Tanaka, Liang-Rogers and Ivshin-Pence models are some of the most popular SMA macroscopic phenomenological constitutive models. They describe SMA behavior in terms of stress, strain and temperature. These models involve material parameters and they have associated uncertainty present in them. At different operating temperatures, the uncertainty propagates to the output when the material is subjected to loading followed by unloading. The propagation of uncertainty while utilizing these models in real-life application can result in performance discrepancies or failure at extreme conditions. To resolve this, we used probabilistic approach to perform the sensitivity and uncertainty analysis of Tanaka, Liang-Rogers, and Ivshin-Pence models. Sobol and extended Fourier Amplitude Sensitivity Testing (eFAST) methods have been used to perform the sensitivity analysis for simulated isothermal loading/unloading at various operating temperatures. As per the results, it is evident that the models vary due to the change in operating temperature and loading condition. The average and stress-dependent sensitivity indices present the most significant parameters at several temperatures. This work highlights the sensitivity and uncertainty analysis results and shows comparison of them at different temperatures and loading conditions for all these models. The analysis presented will aid in designing engineering applications by eliminating the probability of model failure due to the uncertainty in the input parameters. Thus, it is recommended to have a proper understanding of sensitive parameters and the uncertainty propagation at several operating temperatures and loading conditions as per Tanaka, Liang-Rogers, and Ivshin-Pence model.

Keywords: constitutive models, FAST sensitivity analysis, sensitivity analysis, sobol, shape memory alloy, uncertainty analysis

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5230 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders

Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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5229 Induction of Adaptive Response in Yeast Cells under Influence of Extremely High Frequency Electromagnetic Field

Authors: Sergei Voychuk

Abstract:

Introduction: Adaptive response (AR) is a manifestation of radiation hormesis, which deal with the radiation resistance that may be increased with the pretreatment with small doses of radiation. In the current study, we evaluated the potency of radiofrequency EMF to induce the AR mechanisms and to increase a resistance to UV light. Methods: Saccharomyces cerevisiae yeast strains, which were created to study induction of mutagenesis and recombination, were used in the study. The strains have mutations in rad2 and rad54 genes, responsible for DNA repair: nucleotide excision repair (PG-61), postreplication repair (PG-80) and mitotic (crossover) recombination (T2). An induction of mutation and recombination are revealed due to the formation of red colonies on agar plates. The PG-61 and T2 are UV sensitive strains, while PG-80 is sensitive to ionizing radiation. Extremely high frequency electromagnetic field (EHF-EMF) was used. The irradiation was performed in floating mode and frequency changed during exposure from 57 GHz to 62 GHz. The power of irradiation was 100 mkW, and duration of exposure was 10 and 30 min. Treatment was performed at RT and then cells were stored at 28° C during 1 h without any exposure but after that they were treated with UV light (254nm) for 20 sec (strain T2) and 120 sec (strain PG-61 and PG-80). Cell viability and quantity of red colonies were determined after 5 days of cultivation on agar plates. Results: It was determined that EHF-EMF caused 10-20% decrease of viability of T2 and PG-61 strains, while UV showed twice stronger effect (30-70%). EHF-EMF pretreatment increased T2 resistance to UV, and decreased it in PG-61. The PG-80 strain was insensitive to EHF-EMF and no AR effect was determined for this strain. It was not marked any induction of red colonies formation in T2 and PG-80 strain after EHF or UV exposure. The quantity of red colonies was 2 times more in PG-61 strain after EHF-EMF treatment and at least 300 times more after UV exposure. The pretreatment of PG-61 with EHF-EMF caused at least twice increase of viability and consequent decrease of amount of red colonies. Conclusion: EHF-EMF may induce AR in yeast cells and increase their viability under UV treatment.

Keywords: Saccharomyces cerevisiae, EHF-EMF, UV light, adaptive response

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5228 Evaluating the Learning Outcomes of Physical Therapy Clinical Fieldwork Course

Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

Abstract:

Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

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5227 Three-Dimensional Computer Graphical Demonstration of Calcified Tissue and Its Clinical Significance

Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

Abstract:

Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

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5226 Different Types of Amyloidosis Revealed with Positive Cardiac Scintigraphy with Tc-99M DPD-SPECT

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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5225 Microfabrication and Non-Invasive Imaging of Porous Osteogenic Structures Using Laser-Assisted Technologies

Authors: Irina Alexandra Paun, Mona Mihailescu, Marian Zamfirescu, Catalin Romeo Luculescu, Adriana Maria Acasandrei, Cosmin Catalin Mustaciosu, Roxana Cristina Popescu, Maria Dinescu

Abstract:

A major concern in bone tissue engineering is to develop complex 3D architectures that mimic the natural cells environment, facilitate the cells growth in a defined manner and allow the flow transport of nutrients and metabolic waste. In particular, porous structures of controlled pore size and positioning are indispensable for growing human-like bone structures. Another concern is to monitor both the structures and the seeded cells with high spatial resolution and without interfering with the cells natural environment. The present approach relies on laser-based technologies employed for fabricating porous biomimetic structures that support the growth of osteoblast-like cells and for their non-invasive 3D imaging. Specifically, the porous structures were built by two photon polymerization –direct writing (2PP_DW) of the commercially available photoresists IL-L780, using the Photonic Professional 3D lithography system. The structures consist of vertical tubes with micrometer-sized heights and diameters, in a honeycomb-like spatial arrangement. These were fabricated by irradiating the IP-L780 photoresist with focused laser pulses with wavelength centered at 780 nm, 120 fs pulse duration and 80 MHz repetition rate. The samples were precisely scanned in 3D by piezo stages. The coarse positioning was done by XY motorized stages. The scanning path was programmed through a writing language (GWL) script developed by Nanoscribe. Following laser irradiation, the unexposed regions of the photoresist were washed out by immersing the samples in the Propylene Glycol Monomethyl Ether Acetate (PGMEA). The porous structures were seeded with osteoblast like MG-63 cells and their osteogenic potential was tested in vitro. The cell-seeded structures were analyzed in 3D using the digital holographic microscopy technique (DHM). DHM is a marker free and high spatial resolution imaging tool, where the hologram acquisition is performed non-invasively i.e. without interfering with the cells natural environment. Following hologram recording, a digital algorithm provided a 3D image of the sample, as well as information about its refractive index, which is correlated with the intracellular content. The axial resolution of the images went down to the nanoscale, while the temporal scales ranged from milliseconds up to hours. The hologram did not involve sample scanning and the whole image was available in one frame recorded going over 200μm field of view. The digital holograms processing provided 3D quantitative information on the porous structures and allowed a quantitative analysis of the cellular response in respect to the porous architectures. The cellular shape and dimensions were found to be influenced by the underlying micro relief. Furthermore, the intracellular content gave evidence on the beneficial role of the porous structures in promoting osteoblast differentiation. In all, the proposed laser-based protocol emerges as a promising tool for the fabrication and non-invasive imaging of porous constructs for bone tissue engineering. Acknowledgments: This work was supported by a grant of the Romanian Authority for Scientific Research and Innovation, CNCS-UEFISCDI, project PN-II-RU-TE-2014-4-2534 (contract 97 from 01/10/2015) and by UEFISCDI PN-II-PT-PCCA no. 6/2012. A part of this work was performed in the CETAL laser facility, supported by the National Program PN 16 47 - LAPLAS IV.

Keywords: biomimetic, holography, laser, osteoblast, two photon polymerization

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5224 Analysis of Human Toxicity Potential of Major Building Material Production Stage Using Life Cycle Assessment

Authors: Rakhyun Kim, Sungho Tae

Abstract:

Global environmental issues such as abnormal weathers due to global warming, resource depletion, and ecosystem distortions have been escalating due to rapid increase of population growth, and expansion of industrial and economic development. Accordingly, initiatives have been implemented by many countries to protect the environment through indirect regulation methods such as Environmental Product Declaration (EPD), in addition to direct regulations such as various emission standards. Following this trend, life cycle assessment (LCA) techniques that provide quantitative environmental information, such as Human Toxicity Potential (HTP), for buildings are being developed in the construction industry. However, at present, the studies on the environmental database of building materials are not sufficient to provide this support adequately. The purpose of this study is to analysis human toxicity potential of major building material production stage using life cycle assessment. For this purpose, the theoretical consideration of the life cycle assessment and environmental impact category was performed and the direction of the study was set up. That is, the major material in the global warming potential view was drawn against the building and life cycle inventory database was selected. The classification was performed about 17 kinds of substance and impact index, such as human toxicity potential, that it specifies in CML2001. The environmental impact of analysis human toxicity potential for the building material production stage was calculated through the characterization. Meanwhile, the environmental impact of building material in the same category was analyze based on the characterization impact which was calculated in this study. In this study, establishment of environmental impact coefficients of major building material by complying with ISO 14040. Through this, it is believed to effectively support the decisions of stakeholders to improve the environmental performance of buildings and provide a basis for voluntary participation of architects in environment consideration activities.

Keywords: human toxicity potential, major building material, life cycle assessment, production stage

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5223 Identifying the Barriers behind the Lack of Six Sigma Use in Libyan Manufacturing Companies

Authors: Osama Elgadi, Martin Birkett, Wai Ming Cheung

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This paper investigates the barriers behind the underutilisation of six sigma in Libyan manufacturing companies (LMCs). A mixed-method methodology is proposed, starting by conducting interviews to collect qualitative data followed by the development of a questionnaire to obtain quantitative data. The focus of this paper is on discussing the findings of the interview stage and how these can be used to further develop the questionnaire stage. The interview results showed that only four key barriers were highlighted as being encountered by LMCs. With a difference in terms of their significance, these factors were identified, and placed in descending order according to their importance, namely: “Lack of top management commitment”, “Lack of training”, “Lack of knowledge about six sigma”, and “Culture effect”. The findings also showed that some barriers which, were found in previous studies of six sigma implementation were not considered as barriers to LMCs but can, in fact, be considered as success factors or enablers for six sigma adoption. These factors were identified as: “sufficiency of time and financial resources”; “customers unsatisfied”; “good communication between all departments in the company”; “we are certain about its results and benefits to our company and unhappy with the current quality system”. These results suggest that LMCs face fewer barriers to adopting six sigma than many well-established global companies operating in other countries and could take advantage of these successful factors by developing and implementing a six sigma framework to improve their product quality and competitiveness.

Keywords: six sigma, barriers, Libyan manufacturing companies, interview

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5222 Esthetic Rehabilitation of White and Brown Spot Lesions with Ceramic Veneers: A Clinical Report

Authors: Rania E. Ramadan

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Dental esthetics is subjective, can be reported by the dentist and not noticed by the patient. However, if there is any imperfection seen by both the dentist and the patient, it is considered as an unesthetic like white and/or brown spot lesions. Many patients nowadays have been concerned about dental esthetics. Esthetic rehabilitation of anterior teeth and even maxillary premolars aid a lot in patients’ satisfaction of their smile consequently, gaining positive psychological impact for the patients. Many cases need esthetic rehabilitation such as diastema closure, spaced teeth and masking discolored teeth. Dental fluorosis and enamel hypo calcification can be presented as white and/or brown spot lesions. There are many treatment options for the management of these spotted teeth. Treatment options range from bleaching, microabrasion, direct composite restorations, porcelain veneers, and complete coverage crowns. The selection of certain options depends on many factors: the patient’s age, socioeconomic status and the severity of the lesion. In this clinical report, a 22-year-old male patient has been presented to the Department of Prosthodontics in Alexandria University, Egypt. His chief complaint was, “I was unpleased by white and brown spots in my teeth and I want to close the space between the two maxillary central.” Upon medical history, clinical examination, diagnostic photographs, and digital smile design by Exocad software, lithium disilicate veneers were chosen as the treatment of choice in maxillary anterior and first premolars.

Keywords: flourosis, ceramic veneers, case report, diastema closure

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5221 Treatment with RRx-001, a Minimally Toxic NLRP3 Inhibitor in Phase 3 Clinical Trials, Improves Exercise and Skeletal Muscle Oxidative Capacity in Untrained Mice

Authors: Pedro Cabrales, Scott Caroen, Tony R. Reid, Bryan Oronsky

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Introduction and Purpose RRx-001 is an NLRP3 inhibitor and Nrf2 agonist in Phase 3 trials for the treatment of cancer. The purpose of this study was to examine whether treatment with RRx-001, given itsanti-inflammatory and antioxidant properties, improvedexercise and skeletal muscle oxidative capacity in mice on the generalpremiss that better health outcomes correlatewith more activity. Material and Methods Male and female adult mice (n=6 per group) were subjected to an endurance exercise capacity (EEC)test until exhaustion on a motorized treadmill after 3 once weekly doses of either RRx-001 5 mg/kg, RRx-001 2 mg/kg, or vehicle. The EEC protocol consisted of a treadmill velocity of 30meters per min at an uphill inclination (slope of 10%) until the mice reached fatigue, which was defined as the inability of the mice to maintain the appropriate pace despitecontinuous hand stimulation for 1 min. The concentration of malondialdehyde (MDA), an indicator of lipid peroxidation, and creatine kinase (CK), an indicator of muscle damage, in the blood samples collected immediately after the acute exercise was determined with a commercial ELISA assay kit. ResultsThe exhaustive exercise times of the RRx-001 groups were significantly longer than that of the vehicle group (p<0.05) by weeks 2 and 3. In addition, MDA levels in the gastrocnemius, soleus, and extensor digitorum longus muscles were significantly lower than those of the vehicle group were (p<0.05), as were the serum CK levels(p<0.05). ConclusionsIn conclusion, this study found that RRx-001 has anti-fatigue properties, as evidenced by an increase in exercise capacity with RRx-001 treatment, and protects against strenuous exercise-induced muscle damage and lipid peroxidation. This data potentially supports the use of RRx-001 in the clinic to improve exercise performance and reduce physical fatigue.

Keywords: RRx-001, anti-fatigue, muscle protection, increased exercise tolerance, lipid peroxidation

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5220 Revisiting Classic Triad of Japanese Spotted Fever: A Case Series of Forty-Three Patients

Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

Abstract:

Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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5219 Kinetics of Inhibition of Xanthine Oxidase by Lycium Arabicum and Its Protective Effect against Oxonate-Induced Hyperuricemia and Renal Dysfunction in Mice

Authors: Naouel Boussoualim, Hayat Trabsa, Imane Krache, Seddik Khennouf, Noureddine Charef, Lekhmici Arrar, Abderrahmane Baghiani

Abstract:

Purpose: To evaluate the in-vitro inhibition of xanthine oxidase (purified from bovine milk) by extracts of Lycium arabicum, as well as it is in vivo hypouricemic and renal protective effects. Methods: Four extracts of Lycium arabicum, methanol (CrE), chloroform (ChE), ethyl acetate (EaE) and aqueous (AqE) extracts, were screened for their total phenolics and potential inhibitory effects on purified bovine milk xanthine oxidase (XO) activity by measuring the formation of uric acid or superoxide radical. The mode of inhibition was investigated and compared with the standard drugs, allopurinol, quercitin, and catechin. To evaluate their hypouricemic effect, the extracts were administered to potassium oxonate-induced hyperuricemic mice at a dose of 50 mg/kg body weight. Results: The results showed that EaE had the highest content of phenolic compounds and was the most potent inhibitor of uric acid formation (IC50 = 0.017 ± 0.001 mg/mL) and formation of superoxide (IC50 = 0.035 ± 0.001 mg/ml). Lineweaver-Burk analysis showed that CrE and EaE inhibited XO competitively, whereas the inhibitory activities exerted by ChE and AqE were of a mixed type. Intraperetoneal injection of L. arabicum extracts (50 mg/kg) elicited hypouricemic actions in hyperuricemic mice. Hyperuricemic mice presented a serum uric acid concentration of 4.71 ± 0.29 mg/L but this was reduced to 1.78 ± 0.11 mg/L by EaE, which was the most potent hyporuricemic extract. Conclusion: L. arabicum fractions have a strong inhibitory effect on xanthine oxidase and and also have a significantly lowering effect on serum and liver creatinine and urea levels in hyperuricemic mice.

Keywords: lycium arabicum, uric acid, creatinine, superoxide, phenolic compounds, flavonoids, hyperuricemia

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5218 Application of Fuzzy Analytical Hierarchical Process in Evaluation Supply Chain Performance Measurement

Authors: Riyadh Jamegh, AllaEldin Kassam, Sawsan Sabih

Abstract:

In modern trends of market, organizations face high-pressure environment which is characterized by globalization, high competition, and customer orientation, so it is very crucial to control and know the weak and strong points of the supply chain in order to improve their performance. So the performance measurements presented as an important tool of supply chain management because it's enabled the organizations to control, understand, and improve their efficiency. This paper aims to identify supply chain performance measurement (SCPM) by using Fuzzy Analytical Hierarchical Process (FAHP). In our real application, the performance of organizations estimated based on four parameters these are cost parameter indicator of cost (CPI), inventory turnover parameter indicator of (INPI), raw material parameter (RMPI), and safety stock level parameter indicator (SSPI), these indicators vary in impact on performance depending upon policies and strategies of organization. In this research (FAHP) technique has been used to identify the importance of such parameters, and then first fuzzy inference (FIR1) is applied to identify performance indicator of each factor depending on the importance of the factor and its value. Then, the second fuzzy inference (FIR2) also applied to integrate the effect of these indicators and identify (SCPM) which represent the required output. The developed approach provides an effective tool for evaluation of supply chain performance measurement.

Keywords: fuzzy performance measurements, supply chain, fuzzy logic, key performance indicator

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5217 Sustainable Environmental Management through the Comparative Study of Two Recreational Parks in Nigeria

Authors: Oluwagbemiga Paul Agboola, Cornelius Olatunji Omojola, Dayo Martins Oyeshomo

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The role of a recreational park in human and environmental development has attracted much interest in the recent time. Recreation parks' development could act as an effective planning strategy to enhance environmental sustainability, social cohesiveness, and users' quality of life. Similarly, parks enhance neighbourhood's aesthetics, refresh the air and enhance humans' contact with nature. In this connection, recreation parks create natural surroundings of rural areas for leisure, relaxation, recreation, psychological and physical comfort of the people. The purpose of this paper is to investigate the effectiveness of the two recreational parks' development as a strategy for neighbourhood's environmental improvement, sustainability and the recreationists' cohesiveness. A total number of 158 survey questionnaires were distributed to the tourists at Ikogosi cold and warm spring in Ekiti state as well as Olumirin waterfalls, Erin-Ijesa, Osun State, in South-West, Nigeria. The quantitative results of the analyzed data with Relative Importance Index (RII) revealed that recreation parks provide optimum opportunities for users' social cohesiveness and well-being while parks' sustainable environment could be enhanced base on the provision of essential facilities, services, and future developmental plans. It is recommended that for recreation parks to realize their full potential in environmental sustainability, adequate maintenance and provision of essential facilities becomes imperative.

Keywords: environmental sustainability, neighbourhood development, recreational park, Nigeria

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5216 Correlation between Flexible Flatfoot and Lumbosacral Angle

Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

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5215 Comparative Evaluation of a Dynamic Navigation System Versus a Three-Dimensional Microscope in Retrieving Separated Endodontic Files: An in Vitro Study

Authors: Mohammed H. Karim, Bestoon M. Faraj

Abstract:

Introduction: This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused minimal change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: separated instruments retrieval, dynamic navigation system, 3D video microscope, trephine burs, extractor

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5214 Application of Digital Technologies as Tools for Transformative Agricultural Science Instructional Delivery in Secondary Schools

Authors: Cajethan U. Ugwuoke

Abstract:

Agriculture is taught in secondary schools to develop skills in students which will empower them to contribute to national economic development. Unfortunately, our educational system emphasizes the application of conventional teaching methods in delivering instructions, which fails to produce students competent enough to carry out agricultural production. This study was therefore aimed at examining the application of digital technologies as tools for transformative instructional delivery. Four specific purposes, research questions and hypotheses guided the study. The study adopted a descriptive survey research design where 80 subjects representing 64 teachers of agriculture and 16 principals in the Udenu local government area of Enugu State, Nigeria, participated in the study. A structured questionnaire was used to collect data. The assumption of normality was ascertained by subjecting the data collected to a normality test. Data collected were later subjected to mean, Pearson product-moment correlation, ANOVA and t-test to answer the research questions and test the hypotheses at a 5% significant level. The result shows that the application of digital technologies helps to reduce learners’ boredom (3.52.75), improves learners’ performance (3.63.51), and is used as a visual aid for learners (3.56.61), among others. There was a positive, strong and significant relationship between the application of digital technologies and effective instructional delivery (+.895, p=.001<.05, F=17.73), competency of teachers to the application of digital technologies and effective instructional delivery (+998, p=.001<0.5, F=16263.45), and frequency of the application of digital technologies and effective instructional delivery (+.999, p=.001<.05, F=31436.14). There was no evidence of autocorrelation and multicollinearity in the regression models between the application of digital technologies and effective instructional delivery (2.03, Tolerance=1.00, VIF=1.00), competency of teachers in the application of digital technologies and effective instructional delivery (2.38, Tolerance=1.00, VIF=1.00) and frequency of the application of digital technologies and effective instructional delivery (2.00, Tolerance=1.00, VIF=1.00). Digital technologies should be therefore applied in teaching to facilitate effective instructional delivery in agriculture.

Keywords: agricultural science, digital technologies, instructional delivery, learning

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5213 Correlation of Hematological Indices with Fasting Blood Glucose Level and Anthropometric Measurements in Geriatric Diabetes Mellitus Subjects in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

Abstract:

Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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5212 Implementation Status of Industrial Training for Production Engineering Technology Diploma Inuniversity Kuala Lumpur Malaysia Spanish Institute (Unikl Msi)

Authors: M. Sazali Said, Rahim Jamian, Shahrizan Yusoff, Shahruzaman Sulaiman, Jum'Azulhisham Abdul Shukor

Abstract:

This case study focuses on the role of Universiti Kuala Lumpur Malaysian Spanish Institute (UniKL MSI) to produce technologist in order to reduce the shortage of skilled workers especially in the automotive industry. The purpose of the study therefore seeks to examine the effectiveness of Technical Education and Vocational Training (TEVT) curriculum of UniKL MSI to produce graduates that could immediately be productively employed by the automotive industry. The approach used in this study is through performance evaluation of students attending the Industrial Training Attachment (INTRA). The sample of study comprises of 37 students, 16 university supervisors and 26 industrial supervisors. The research methodology involves the use of quantitative and qualitative methods of data collections through the triangulation approach. The quantitative data was gathered from the students, university supervisors and industrial supervisors through the use of questionnaire. Meanwhile, the qualitative data was obtained from the students and university supervisors through the use of interview and observation. Both types of data have been processed and analyzed in order to summarize the results in terms of frequency and percentage by using a computerized spread sheet. The result shows that industrial supervisors were satisfied with the students’ performance. Meanwhile, university supervisors rated moderate effectiveness of the UniKL MSI curriculum in producing graduates with appropriate skills and in meeting the industrial needs. During the period of study, several weaknesses in the curriculum have been identified for further continuous improvements. Recommendations and suggestions for curriculum improvement also include the enhancement of technical skills and competences of students towards fulfilling the needs and demand of the automotive industries.

Keywords: technical education and vocational training (TEVT), industrial training attachment (INTRA), curriculum improvement, automotive industry

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5211 A Study on Eliteathletes and Coaches' Attitude towards Sport Psychologyi the Areas of Sports

Authors: Mahdi PourAsghar, Abbas Mas'udzadeh, Abdulhakim Tirgari, Saeed Dabiri Roushan, Hooman Rashidi, Fariba Salehi

Abstract:

Objective: One of the major objectives in sports areas is to achieve maximum athletic performance. Physical and psychological preparations are the basic factors for achieving maximum performance in athletes. Unfortunately, in the field of physical preparation, we can see maximum attention and planning of trainers and sports officials. But despite the importance of psychological preparation of athletes and its serious and profound effect on athletic performance, the results of sports competitions show that less attention is paid to this topic, and it is less under the control of counselors and psychologists in different areas of our sport. Therefore, this study aimed to evaluate the attitude of athletes and coaches to sport psychology. Materials and methods: A descriptive study with a sample size of 234 elite athletes and 216 skilled coaches was conducted in different areas of sports, in Sari, Mazandaran in 2015.The instrument was a questionnaire consisting of two parts of demographic data and Martin questionnaire, assessing the attitude to sport psychology. The data from this study were analyzed using Spss version 18, descriptive statistics tests, and Chi-square test. Results: In this study, positive attitudes of participants in need and confidence towards sport psychology consultation in athletes and coaches group were 55/1 and 56/5 percent, respectively. The positive attitude of female athletes in belief to psychology consultation was more than male athletes. Athletes with higher education had more positive attitude towards the presence of psychologists and psychiatrists in fields of sports. Conclusion: According to the findings based on the need to the psychology consultation in different areas of sports, it is recommended that through training of specialists in the field of sport psychology and review of sports programs in different fields of sports, the presence of these counselors to maintain the psychological preparation of athletes to achieve maximum athletic performance and reduce anxiety and stress be used.

Keywords: Keywords: Athletes, Eliteathletes, Coaches, Attitude, Sport psychology.

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5210 Risk Factors for Diabetic Foot: Upper Egypt Experience

Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

Abstract:

Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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5209 Rational Memory Therapy: The Counselling Technique to Control Psychological and Psychosomatic Illnesses

Authors: Sachin Deshmukh

Abstract:

Mind and body synchronization occurs through memory and sensation production. Sensations are the guiding language of subconscious mind for conscious mind to take a proper action. Mind-mechanism is based upon memories collected so far since intrauterine life. There are three universal triggers for memory creation; they are persons, situations and objects. Memory is created as sensations experienced by special senses. Based upon experiencing comfort or discomfort, the triggers are categorized as safe or unsafe triggers. A memory comprises of ‘safe or unsafe feeling for triggers, and actions taken for that feeling’. Memories for triggers are created slowly, thoughtfully and consciously by the conscious mind, and archived in the subconscious mind for future references. Later on, similar triggers can come in contact with the individual. Subconscious mind uses these stored feelings to decide whether these triggers are safe or unsafe. It produces comfort or discomfort sensations as emotions accordingly and reacts in the same way as has been recorded in memory. Speed of sensing and processing the triggers, and reacting by subconscious mind is that of the speed of bioelectricity. Hence, formula for human emotions has been designed in this paper as follows: Emotion (Stress or Peace) = Trigger (Person or Situation or object) x Mass of feelings (stressful or peaceful) associated with the Trigger x Speed of Light². We also establish modern medical scientific facts about relationship between reflex activity and memory. This research further develops the ‘Rational Memory Therapy’ focusing on therapeutic feelings conversion techniques, for stress prevention and management.

Keywords: memory, sensations, feelings, emotions, rational memory therapy

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5208 Synthesis of Liposomal Vesicles by a Novel Supercritical Fluid Process

Authors: Wen-Chyan Tsai, Syed S. H. Rizvi

Abstract:

Organic solvent residues are always associated with liposomes produced by the traditional techniques like the thin film hydration and reverse phase evaporation methods, which limit the applications of these vesicles in the pharmaceutical, food and cosmetic industries. Our objective was to develop a novel and benign process of liposomal microencapsulation by using supercritical carbon dioxide (SC-CO2) as the sole phospholipid-dissolving medium and a green substitute for organic solvents. This process consists of supercritical fluid extraction followed by rapid expansion via a nozzle and automatic cargo suction. Lecithin and cholesterol mixed in 10:1 mass ratio were dissolved in SC-CO2 at 20 ± 0.5 MPa and 60 oC. After at least two hours of equilibrium, the lecithin/cholesterol-laden SC-CO2 was passed through a 1000-micron nozzle and immediately mixed with the cargo solution to form liposomes. Liposomal micro-encapsulation was conducted at three pressures (8.27, 12.41, 16.55 MPa), three temperatures (75, 83 and 90 oC) and two flow rates (0.25 ml/sec and 0.5 ml/sec). Liposome size, zeta potential and encapsulation efficiency were characterized as functions of the operating parameters. The average liposomal size varied from 400-500 nm to 1000-1200 nm when the pressure was increased from 8.27 to 16.55 MPa. At 12.41 MPa, 90 oC and 0.25 ml per second of 0.2 M glucose cargo loading rate, the highest encapsulation efficiency of 31.65 % was achieved. Under a confocal laser scanning microscope, large unilamellar vesicles and multivesicular vesicles were observed to make up a majority of the liposomal emulsion. This new approach is a rapid and continuous process for bulk production of liposomes using a green solvent. Based on the results to date, it is feasible to apply this technique to encapsulate hydrophilic compounds inside the aqueous core as well as lipophilic compounds in the phospholipid bilayers of the liposomes for controlled release, solubility improvement and targeted therapy of bioactive compounds.

Keywords: liposome, micro encapsulation, supercritical carbon dioxide, non-toxic process

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5207 Emerging Social Media Presence of International Organisations - Challenges and Opportunities

Authors: Laura Hervai

Abstract:

One of the most significant phenomena of the 2000s was the emergence of social media sites and web 2.0 that revolutionized communication processes. Social networking platforms have fundamentally changed social and political participation of the public, which require organisations in the public and non-profit sector not only to adapt to these new trends but also to actively engage their audiences. Opportunity for interaction, freer expression of opinion and the proliferation of user generated content are major changes brought by web 2.0 technologies. Furthermore, due to the wide penetration of mobile technologies, social media sites are capable of connecting underdeveloped regions to the global flow of information. Taking advantage of these characteristics, organisations have the opportunity to engage much wider audiences, exploit new ways to raise awareness or reach out to regions that are difficult to access. The early adopters of these new communication tools soon recognized the need of developing social media guidelines for their organisations as well as the increased workload that they require. While ten years ago communication officers could handle their organisation’s social media presence, today it is a separate profession. International organisations face several challenges related to their social media presence. Early adopters have contributed to the development of best practices among which the ethics of social media usage still remained problematic. Another challenge for international organisations is to adapt to country-specific social media trends while they have to comply with the requirements of their parent organisation as well. However in the 21st century social media presence can be crucial to the successful operation of international organisations, their importance is still not taken seriously enough. The measurement of the effects and influence of social networking on the organisations’ productivity is an unsolved problem thus further research should focus on this matter. Research methods included primary research of major IGOs’ and NGOs’ social media presence and guidelines along with secondary research of social media statistics and scientific articles in the topic.

Keywords: international organisations, non-profit sector, NGO, social media, social network

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5206 Exploring Academic Writing Challenges of First Year English as an Additional Language Students at an ODeL Institution in South Africa

Authors: Tumelo Jaquiline Ntsopi

Abstract:

This study explored the academic writing challenges of first-year students who use English as an Additional Language (EAL) registered in the EAW101 module at an ODeL institution. Research shows that academic writing is a challenge for EAL teaching and learning contexts across the globe in higher education institutions (HEIs). Academic writing is an important aspect of academic literacy in any institution of higher learning, more so in an ODeL institution. This has probed research that shows that academic writing is and continues to pose challenges for EAL teaching and learning contexts in higher education institutions. This study stems from the researcher’s experience in teaching academic writing to first-year students in the EAW101 module. The motivation for this study emerged from the fact that EAW101 is a writing module that has a high number of students in the Department of English Studies with an average of between 50-80 percent pass rate. These statistics elaborate on the argument that most students registered in this module struggle with academic writing, and they need intervention to assist and support them in achieving competence in the module. This study is underpinned by Community of Inquiry (CoI) framework and Transactional distance theory. This study adopted a qualitative research methodology and utilised a case study approach as a research design. Furthermore, the study gathered data from first year students and the EAW101 module’s student support initiatives. To collect data, focus group discussions, structured open-ended evaluation questions, and an observation schedule were used to gather data. The study is vital towards exploring academic writing challenges that first-year students in EAW101 encounter so that lecturers in the module may consider re-evaluating their methods of teaching to improve EAL students’ academic writing skills. This study may help lecturers towards enhancing academic writing in a ODeL context by assisting first year students through using student support interventions.

Keywords: academic writing, academic writing challenge, ODeL, EAL

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5205 Exclusive Breastfeeding Abandonment among Adolescent Mothers: A Cohort Study

Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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5204 Modeling Operating Theater Scheduling and Configuration: An Integrated Model in Health-Care Logistics

Authors: Sina Keyhanian, Abbas Ahmadi, Behrooz Karimi

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We present a multi-objective binary programming model which considers surgical cases are scheduling among operating rooms and the configuration of surgical instruments in limited capacity hospital trays, simultaneously. Many mathematical models have been developed previously in the literature addressing different challenges in health-care logistics such as assigning operating rooms, leveling beds, etc. But what happens inside the operating rooms along with the inventory management of required instruments for various operations, and also their integration with surgical scheduling have been poorly discussed. Our model considers the minimization of movements between trays during a surgery which recalls the famous cell formation problem in group technology. This assumption can also provide a major potential contribution to robotic surgeries. The tray configuration problem which consumes surgical instruments requirement plan (SIRP) and sequence of surgical procedures based on required instruments (SIRO) is nested inside the bin packing problem. This modeling approach helps us understand that most of the same-output solutions will not be necessarily identical when it comes to the rearrangement of surgeries among rooms. A numerical example has been dealt with via a proposed nested simulated annealing (SA) optimization approach which provides insights about how various configurations inside a solution can alter the optimal condition.

Keywords: health-care logistics, hospital tray configuration, off-line bin packing, simulated annealing optimization, surgical case scheduling

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5203 Terahertz Glucose Sensors Based on Photonic Crystal Pillar Array

Authors: S. S. Sree Sanker, K. N. Madhusoodanan

Abstract:

Optical biosensors are dominant alternative for traditional analytical methods, because of their small size, simple design and high sensitivity. Photonic sensing method is one of the recent advancing technology for biosensors. It measures the change in refractive index which is induced by the difference in molecular interactions due to the change in concentration of the analyte. Glucose is an aldosic monosaccharide, which is a metabolic source in many of the organisms. The terahertz waves occupies the space between infrared and microwaves in the electromagnetic spectrum. Terahertz waves are expected to be applied to various types of sensors for detecting harmful substances in blood, cancer cells in skin and micro bacteria in vegetables. We have designed glucose sensors using silicon based 1D and 2D photonic crystal pillar arrays in terahertz frequency range. 1D photonic crystal has rectangular pillars with height 100 µm, length 1600 µm and width 50 µm. The array period of the crystal is 500 µm. 2D photonic crystal has 5×5 cylindrical pillar array with an array period of 75 µm. Height and diameter of the pillar array are 160 µm and 100 µm respectively. Two samples considered in the work are blood and glucose solution, which are labelled as sample 1 and sample 2 respectively. The proposed sensor detects the concentration of glucose in the samples from 0 to 100 mg/dL. For this, the crystal was irradiated with 0.3 to 3 THz waves. By analyzing the obtained S parameter, the refractive index of the crystal corresponding to the particular concentration of glucose was measured using the parameter retrieval method. Refractive indices of the two crystals decreased gradually with the increase in concentration of glucose in the sample. For 1D photonic crystals, a gradual decrease in refractive index was observed at 1 THz. 2D photonic crystal showed this behavior at 2 THz. The proposed sensor was simulated using CST Microwave studio. This will enable us to develop a model which can be used to characterize a glucose sensor. The present study is expected to contribute to blood glucose monitoring.

Keywords: CST microwave studio, glucose sensor, photonic crystal, terahertz waves

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5202 Early Hypothyroidism after Radiotherapy for Nasopharyngeal Carcinoma

Authors: Nejla Fourati, Zied Fessi, Fatma Dhouib, Wicem Siala, Leila Farhat, Afef Khanfir, Wafa Mnejja, Jamel Daoud

Abstract:

Purpose: Radiation induced hypothyroidism in nasopharyngeal cancer (NPC) ranged from 15% to 55%. In reported data, it is considered as a common late complication of definitive radiation and is mainly observed 2 years after the end of treatment. The aim of this study was to evaluate the incidence of early hypothyroidism within 6 months after radiotherapy. Patients and methods: From June 2017 to February 2020, 35 patients treated with concurrent chemo-radiotherapy (CCR) for NPC were included in this prospective study. Median age was 49 years [23-68] with a sex ratio of 2.88. All patients received intensity modulated radiotherapy (IMRT) at a dose of 69.96 Gy in 33 daily fractions with weekly cisplatin (40mg/m²) chemotherapy. Thyroid stimulating hormone (TSH) and Free Thyroxine 4 (FT4) dosage was performed before the start of radiotherapy and 6 months after. Different dosimetric parameters for the thyroid gland were reported: the volume (cc); the mean dose (Dmean) and the %age of volume receiving more than 45 Gy (V45Gy). Wilcoxon Test was used to compare these different parameters between patients with or without hypothyroidism. Results: At baseline, 5 patients (14.3%) had hypothyroidism and were excluded from the analysis. For the remaining 30 patients, 9 patients (30%) developed a hypothyroidism 6 months after the end of radiotherapy. The median thyroid volume was 10.3 cc [4.6-23]. The median Dmean and V45Gy were 48.3 Gy [43.15-55.4] and 74.8 [38.2-97.9] respectively. No significant difference was noted for all studied parameters. Conclusion: Early hypothyroidism occurring within 6 months after CCR for NPC seems to be a common complication (30%) that should be screened. Good patient monitoring with regular dosage of TSH and FT4 makes it possible to treat hypothyroidism in asymptomatic phase. This would be correlated with an improvement in the quality of life of these patients. The results of our study do not show a correlation between the thyroid doses and the occurrence of hypothyroidism. This is probably related to the high doses received by the thyroid in our series. These findings encourage more optimization to limit thyroid doses and then the risk of radiation-induced hypothyroidism

Keywords: nasopharyngeal carcinoma, hypothyroidism, early complication, thyroid dose

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