Search results for: medical education design

Authors: Morgan Johansson, Joosef Leppanen, Mathias Flansbjer, Fabio Lozano, Josef Makdesi

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Concrete is commonly used for protective structures and how impact loading affects different types of concrete structures is an important issue. Often the knowledge gained from static loading is also used in the design of impulse loaded structures. A large plastic deformation capacity is essential to obtain a large energy absorption in an impulse loaded structure. However, the structural response of an impact loaded concrete beam may be very different compared to a statically loaded beam. Consequently, the plastic deformation capacity and failure modes of the concrete structure can be different when subjected to dynamic loads; and hence it is not sure that the observations obtained from static loading are also valid for dynamic loading. The aim of this paper is to investigate the residual plastic deformation capacity in reinforced concrete beams subjected to drop weight impact tests. A test-series consisting of 18 simply supported beams (0.1 x 0.1 x 1.18 m, ρs = 0.7%) with a span length of 1.0 m and subjected to a point load in the beam mid-point, was carried out. 2x6 beams were first subjected to drop weight impact tests, and thereafter statically tested until failure. The drop in weight had a mass of 10 kg and was dropped from 2.5 m or 5.0 m. During the impact tests, a high-speed camera was used with 5 000 fps and for the static tests, a camera was used with 0.5 fps. Digital image correlation (DIC) analyses were conducted and from these the velocities of the beam and the drop weight, as well as the deformations and crack propagation of the beam, were effectively measured. Additionally, for the static tests, the applied load and midspan deformation were measured. The load-deformation relations for the beams subjected to an impact load were compared with 6 reference beams that were subjected to static loading only. The crack pattern obtained were compared using DIC, and it was concluded that the resulting crack formation depended much on the test method used. For the static tests, only bending cracks occurred. For the impact loaded beams, though, distinctive diagonal shear cracks also formed below the zone of impact and less wide shear cracks were observed in the region half-way to the support. Furthermore, due to wave propagation effects, bending cracks developed in the upper part of the beam during initial loading. The results showed that the plastic deformation capacity increased for beams subjected to drop weight impact tests from a high drop height of 5.0 m. For beams subjected to an impact from a low drop height of 2.5 m, though, the plastic deformation capacity was in the same order of magnitude as for the statically loaded reference beams. The beams tested were designed to fail due to bending when subjected to a static load. However, for the impact tested beams, one beam exhibited a shear failure at a significantly reduced load level when it was tested statically; indicating that there might be a risk of reduced residual load capacity for impact loaded structures.

Keywords: digital image correlation (DIC), drop weight impact, experiments, plastic deformation capacity, reinforced concrete

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Authors: Nabila Ihaddadene, Razika Ihaddadene, Abdelwahaab Betka

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1973 energy crisis (rising oil prices) pushed the world to consider other alternative energy resources to existing conventional energies consisting predominantly of hydrocarbons. Renewable energies such as solar, the wind and geothermal have received renewed interest, especially to preserve nature ( the low-temperature rise of global environmental problems). Solar energy as an available, cheap and environmental friendly alternative source has various applications such as heating, cooling, drying, power generation, etc. In short, there is no life on earth without this enormous nuclear reactor, called the sun. Among available solar collector designs, flat plate collector (FPC) is low-temperature applications (heating water, space heating, etc.) due to its simple design and ease of manufacturing. Flat plate collectors are permanently fixed in position and do not track the sun (non-concentrating collectors). They operate by converting solar radiation into heat and transferring that heat to a working fluid (usually air, water, water plus antifreeze additive) flowing through them. An FPC generally consists of the main following components: glazing, absorber plate of high absorptivity, fluid tubes welded to or can be an integral part of the absorber plate, insulation and container or casing of the above-mentioned components. Insulation is of prime importance in thermal applications. There are three main families of insulation: mineral insulation; vegetal insulation and synthetic organic insulation. The old houses of the inhabitants of North Africa were built of brick made of composite material that is clay and straw. These homes are characterized by their thermal comfort; i.e. the air inside these houses is cool in summer and warm in winter. So, the material composed from clay and straw act as a thermal insulation. In this research document, the polystyrene used as insulation in the ET200 flat plate solar collector is replaced by the cheapest natural material which is clay and straw. Trials were carried out on a solar energy demonstration system (ET 200). This system contains a solar collector, water storage tank, a high power lamp simulating solar energy and a control and command cabinet. In the experimental device, the polystyrene is placed under the absorber plate and in the edges of the casing containing the components of the solar collector. In this work, we have replaced the polystyrene of the edges by the composite material. The use of the clay and straw as insulation instead of the polystyrene increases temperature difference (T2-T1) between the inlet and the outlet of the absorber by 0.9°C; thus increases the useful power transmitted to water in the solar collector. Tank Water is well heated when using the clay and straw as insulation. However, it is less heated when using the polystyrene as insulation. Clay and straw material improves also the performance of the solar collector by 5.77%. Thus, it is recommended to use this cheapest non-polluting material instead of synthetic insulation to improve the performance of the solar collector.

Keywords: clay, insulation material, polystyrene, solar collector, straw

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Authors: Brandy Yee, Dianne Yee

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Through the exploration of the lived experiences, beliefs and values of instructional leaders, teachers and students in Finland, Germany and Canada, we investigated the factors which contribute to developmentally responsive, intellectually engaging middle-level learning environments for early adolescents. Student-centred leadership dimensions, effective instructional practices and student agency were examined through the lens of current policy and research on middle-level learning environments emerging from the Canadian province of Manitoba. Consideration of these three research perspectives in the context of early adolescent learning, placed against an international backdrop, provided a previously undocumented perspective on leading, teaching and learning in the middle years. Aligning with a social constructivist, qualitative research paradigm, the study incorporated collective case study methodology, along with constructivist grounded theory methods of data analysis. Data were collected through semi-structured individual and focus group interviews and document review, as well as direct and participant observation. Three case study narratives were developed to share the rich stories of study participants, who had been selected using maximum variation and intensity sampling techniques. Interview transcript data were coded using processes from constructivist grounded theory. A cross-case analysis yielded a conceptual framework highlighting key factors that were found to be significant in the establishment of developmentally responsive, intellectually engaging middle-level learning environments. Seven core categories emerged from the cross-case analysis as common to all three countries. Within the visual conceptual framework (which depicts the interconnected nature of leading, teaching and learning in middle-level learning environments), these seven core categories were grouped into Essential Factors (student agency, voice and choice), Contextual Factors (instructional practices; school culture; engaging families and the community), Synergistic Factors (instructional leadership) and Cornerstone Factors (education as a fundamental cultural value; preservice, in-service and ongoing teacher development). In addition, sub-factors emerged from recurring codes in the data and identified specific characteristics and actions found in developmentally responsive, intellectually engaging middle-level learning environments. Although this study focused on 12 schools in Finland, Germany and Canada, it informs the practice of educators working with early adolescent learners in middle-level learning environments internationally. The authentic voices of early adolescent learners are the most important resource educators have to gauge if they are creating effective learning environments for their students. Ongoing professional dialogue and learning is essential to ensure teachers are supported in their work and develop the pedagogical practices needed to meet the needs of early adolescent learners. It is critical to balance consistency, coherence and dependability in the school environment with the necessary flexibility in order to support the unique learning needs of early adolescents. Educators must intentionally create a school culture that unites teachers, students and their families in support of a common purpose, as well as nurture positive relationships between the school and its community. A large, urban school district in Canada has implemented a school cohort-based model to begin to bring developmentally responsive, intellectually engaging middle-level learning environments to scale.

Keywords: developmentally responsive learning environments, early adolescents, middle level learning, middle years, instructional leadership, instructional practices, intellectually engaging learning environments, leadership dimensions, student agency

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Authors: Richa Sharma, Uma Nahar, Sadhna Sharma, Indu Verma

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Counteracting the deadly pathogen Mycobacterium tuberculosis (M. tb) effectively is still a global challenge. Scrutinizing alternative weapons like antimicrobial peptides to strengthen existing tuberculosis artillery is urgently required. Considering the antimycobacterial potential of Human Beta Defensin 1 (HBD-1) along with isoniazid, the present study was designed to explore the ability of HBD-1 to act against active and dormant M. tb. HBD-1 was screened in silico using antimicrobial peptide prediction servers to identify its short antimicrobial motif. The activity of both HBD-1 and its selected motif (Pep B) was determined at different concentrations against actively growing M. tb in vitro and ex vivo in monocyte derived macrophages (MDMs). Log phase M. tb was grown along with HBD-1 and Pep B for 7 days. M. tb infected MDMs were treated with HBD-1 and Pep B for 72 hours. Thereafter, colony forming unit (CFU) enumeration was performed to determine activity of both peptides against actively growing in vitro and intracellular M. tb. The dormant M. tb models were prepared by following two approaches and treated with different concentrations of HBD-1 and Pep B. Firstly, 20-22 days old M. tbH37Rv was grown in potassium deficient Sauton media for 35 days. The presence of dormant bacilli was confirmed by Nile red staining. Dormant bacilli were further treated with rifampicin, isoniazid, HBD-1 and its motif for 7 days. The effect of both peptides on latent bacilli was assessed by colony forming units (CFU) and most probable number (MPN) enumeration. Secondly, human PBMC granuloma model was prepared by infecting PBMCs seeded on collagen matrix with M. tb(MOI 0.1) for 10 days. Histopathology was done to confirm granuloma formation. The granuloma thus formed was incubated for 72 hours with rifampicin, HBD-1 and Pep B individually. Difference in bacillary load was determined by CFU enumeration. The minimum inhibitory concentrations of HBD-1 and Pep B restricting growth of mycobacteria in vitro were 2μg/ml and 20μg/ml respectively. The intracellular mycobacterial load was reduced significantly by HBD-1 and Pep B at 1μg/ml and 5μg/ml respectively. Nile red positive bacterial population, high MPN/ low CFU count and tolerance to isoniazid, confirmed the formation of potassium deficienybaseddormancy model. HBD-1 (8μg/ml) showed 96% and 99% killing and Pep B (40μg/ml) lowered dormant bacillary load by 68.89% and 92.49% based on CFU and MPN enumeration respectively. Further, H&E stained aggregates of macrophages and lymphocytes, acid fast bacilli surrounded by cellular aggregates and rifampicin resistance, indicated the formation of human granuloma dormancy model. HBD-1 (8μg/ml) led to 81.3% reduction in CFU whereas its motif Pep B (40μg/ml) showed only 54.66% decrease in bacterial load inside granuloma. Thus, the present study indicated that HBD-1 and its motif are effective antimicrobial players against both actively growing and dormant M. tb. They should be further explored to tap their potential to design a powerful weapon for combating tuberculosis.

Keywords: antimicrobial peptides, dormant, human beta defensin 1, tuberculosis

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Authors: Kantha Siddhanth Gujjari, Shaani Singhal, Robert Andrew Danks, Adrian Praeger

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Background: Trigeminal neuralgia (TN) is a heterogenous pain syndrome characterised by short paroxysms of lancinating facial pain in the distribution of the trigeminal nerve, often triggered by usually innocuous stimuli. TN has a low prevalence of less than 0.1%, of which 80% to 90% is caused by compression of the trigeminal nerve from an adjacent artery or vein. The root entry zone of the trigeminal nerve is most sensitive to neurovascular conflict (NVC), causing dysmyelination. Whilst microvascular decompression (MVD) is an effective treatment for TN with NVC, all patients do not achieve long-term pain relief. Pre-operative scoring systems by Panczykowski and Hardaway have been proposed but have not been externally validated. These pre-operative scoring systems are composite scores calculated according to a subtype of TN, presence and degree of neurovascular conflict, and response to medical treatments. There is discordance in the assessment of NVC identified on pre-operative magnetic resonance imaging (MRI) between neurosurgeons and radiologists. To our best knowledge, the prognostic impact for MVD of this difference of interpretation has not previously been investigated in the form of a composite scoring system such as those suggested by Panczykowski and Hardaway. Aims: This study aims to identify prognostic factors and externally validate the proposed scoring systems by Panczykowski and Hardaway for TN. A secondary aim is to investigate the prognostic difference between a neurosurgeon's interpretation of NVC on MRI compared with a radiologist’s. Methods: This retrospective cohort study included 95 patients who underwent de novo MVD in a single neurosurgical unit in Melbourne. Data was recorded from patients’ hospital records and neurosurgeon’s correspondence from perioperative clinic reviews. Patient demographics, type of TN, distribution of TN, response to carbamazepine, neurosurgeon, and radiologist interpretation of NVC on MRI, were clearly described prospectively and preoperatively in the correspondence. Scoring systems published by Panczykowski et al. and Hardaway et al. were used to determine composite scores, which were compared with the recurrence of TN recorded during follow-up over 1-year. Categorical data analysed using Pearson chi-square testing. Independent numerical and nominal data analysed with logistical regression. Results: Logistical regression showed that a Panczykowski composite score of greater than 3 points was associated with a higher likelihood of pain-free outcome 1-year post-MVD with an OR 1.81 (95%CI 1.41-2.61, p=0.032). The composite score using neurosurgeon’s impression of NVC had an OR 2.96 (95%CI 2.28-3.31, p=0.048). A Hardaway composite score of greater than 2 points was associated with a higher likelihood of pain-free outcome 1 year post-MVD with an OR 3.41 (95%CI 2.58-4.37, p=0.028). The composite score using neurosurgeon’s impression of NVC had an OR 3.96 (95%CI 3.01-4.65, p=0.042). Conclusion: Composite scores developed by Panczykowski and Hardaway were validated for the prediction of response to MVD in TN. A composite score based on the neurosurgeon’s interpretation of NVC on MRI, when compared with the radiologist’s had a greater correlation with pain-free outcomes 1 year post-MVD.

Keywords: de novo microvascular decompression, neurovascular conflict, prognosis, trigeminal neuralgia

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Authors: Emre Kara, Şura Karakuzu, Ahmet Fatih Geylan, Metehan Demir, Kadir Koç, Halil Aykul

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The material selection in the design of the sandwich structures is very crucial aspect because of the positive or negative influences of the base materials to the mechanical properties of the entire panel. In the literature, it was presented that the selection of the skin and core materials plays very important role on the behavior of the sandwich. Beside this, the use of the correct adhesive can make the whole structure to show better mechanical results and behavior. By this way, the sandwich structures realized in the study were obtained with the combination of aluminum foam core and three different glass fiber reinforced polymer (GFRP) skins using two different commercial adhesives which are based on flexible polyurethane and toughened epoxy. The static and dynamic tests were already applied on the sandwiches with different types of adhesives. In the present work, the static three-point bending tests were performed on the sandwiches having an aluminum foam core with the thickness of 15 mm, the skins with three different types of fabrics ([0°/90°] cross ply E-Glass Biaxial stitched, [0°/90°] cross ply E-Glass Woven and [0°/90°] cross ply S-Glass Woven which have same thickness value of 1.75 mm) and two different commercial adhesives (flexible polyurethane and toughened epoxy based) at different values of support span distances (L= 55, 70, 80, 125 mm) by aiming the analyses of their flexural performance. The skins used in the study were produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique and were easily bonded onto the aluminum foam core with flexible and toughened adhesives under a very low pressure using press machine with the alignment tabs having the total thickness of the whole panel. The main results of the flexural loading are: force-displacement curves obtained after the bending tests, peak force values, absorbed energy, collapse mechanisms, adhesion quality and the effect of the support span length and adhesive type. The experimental results presented that the sandwiches with epoxy based toughened adhesive and the skins made of S-Glass Woven fabrics indicated the best adhesion quality and mechanical properties. The sandwiches with toughened adhesive exhibited higher peak force and energy absorption values compared to the sandwiches with flexible adhesive. The core shear mode occurred in the sandwiches with flexible polyurethane based adhesive through the thickness of the core while the same mode took place in the sandwiches with toughened epoxy based adhesive along the length of the core. The use of these sandwich structures can lead to a weight reduction of the transport vehicles, providing an adequate structural strength under operating conditions.

Keywords: adhesive and adhesion, aluminum foam, bending, collapse mechanisms

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Authors: Tamas Dani

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The author’s research explores the geo-economical role and importance of some small and medium sized states, reviews their adaption strategies in foreign trade and also in foreign affairs in the course of changing into a multipolar world, uses international background. With these, the paper analyses the recent years and the future of ‘Opening towards Eastern foreign economic policies’ from East-Central Europe and parallel with that the ‘Western foreign economy policies’ from Asia, as the Chinese One Belt One Road new silk route plans (so far its huge part is an infrastructural development plan to reach international trade and investment aims). It can be today’s question whether these ideas will reshape the global trade or not. How does the new silk road initiatives and the Eurasian Union reflect the effect of globalization? It is worth to analyse that how did Central and Eastern European countries open to Asia; why does China have the focus of the opening policies in many countries and why could China be seen as the ‘winner’ of the world economic crisis after 2008. The research is based on the following methodologies: national and international literature, policy documents and related design documents, complemented by processing of international databases, statistics and live interviews with leaders from East-Central European countries’ companies and public administration, diplomats and international traders. The results also illustrated by mapping and graphs. The research will find out as major findings whether the state decision-makers have enough margin for manoeuvres to strengthen foreign economic relations. This work has a hypothesis that countries in East-Central Europe have real chance to diversify their relations in foreign trade, focus beyond their traditional partners. This essay focuses on the opportunities of East-Central-European countries in diversification of foreign trade relations towards China and Russia in terms of ‘Eastern Openings’. The effects of the new silk road initiatives and the Eurasian Union to Hungary’s economy with a comparing outlook on East-Central European countries and exploring common regional cooperation opportunities in this area. The essay concentrate on the changing trade relations between East-Central-Europe and China as well as Russia, try to analyse the effects of the new silk road initiatives and the Eurasian Union also. In the conclusion part, it shows how the cooperation is necessary for the East-Central European countries if they want to have a non-asymmetric trade with Russia, China or some Chinese regions (Pearl River Delta, Hainan, …). The form of the cooperation for the East-Central European nations can be Visegrad 4 Cooperation (V4), Central and Eastern European Countries (CEEC16), 3 SEAS Cooperation (or BABS – Baltic, Adriatic, Black Seas Initiative).

Keywords: China, East-Central Europe, foreign trade relations, geoeconomics, geopolitics, Russia

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Authors: Victoria Molina, Wendy Franco, Sergio Benavides, José M. Troncoso, Ricardo Luna, Jose R. PéRez-Correa

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Emamectin Benzoate (EB) is a crystal antiparasitic that belongs to the avermectin family. It is one of the most common treatments used in Chile to control Caligus rogercresseyi in Atlantic salmon. However, the sea lice acquired resistance to EB when it is exposed at sublethal EB doses. The low solubility rate of EB and its degradation at the acidic pH in the fish digestive tract are the causes of the slow absorption of EB in the intestine. To protect EB from degradation and enhance its absorption, specific microencapsulation technologies must be developed. Amorphous Solid Dispersion techniques such as Spray Drying (SD) and Ionic Gelation (IG) seem adequate for this purpose. Recently, Soluplus® (SOL) has been used to increase the solubility rate of several drugs with similar characteristics than EB. In addition, alginate (ALG) is a widely used polymer in IG for biomedical applications. Regardless of the encapsulation technique, the quality of the obtained microparticles is evaluated with the following responses, yield (Y%), encapsulation efficiency (EE%) and loading capacity (LC%). In addition, it is important to know the percentage of EB released from the microparticles in gastric (GD%) and intestinal (ID%) digestions. In this work, we microencapsulated EB with SOL (EB-SD) and with ALG (EB-IG) using SD and IG, respectively. Quality microencapsulation responses and in vitro gastric and intestinal digestions at pH 3.35 and 7.8, respectively, were obtained. A central composite design was used to find the optimum microencapsulation variables (amount of EB, amount of polymer and feed flow). In each formulation, the behavior of these variables was predicted with statistical models. Then, the response surface methodology was used to find the best combination of the factors that allowed a lower EB release in gastric conditions, while permitting a major release at intestinal digestion. Two approaches were used to determine this. The desirability approach (DA) and multi-objective optimization (MOO) with multi-criteria decision making (MCDM). Both microencapsulation techniques allowed to maintain the integrity of EB in acid pH, given the small amount of EB released in gastric medium, while EB-IG microparticles showed greater EB release at intestinal digestion. For EB-SD, optimal conditions obtained with MOO plus MCDM yielded a good compromise among the microencapsulation responses. In addition, using these conditions, it is possible to reduce microparticles costs due to the reduction of 60% of BE regard the optimal BE proposed by (DA). For EB-GI, the optimization techniques used (DA and MOO) yielded solutions with different advantages and limitations. Applying DA costs can be reduced 21%, while Y, GD and ID showed 9.5%, 84.8% and 2.6% lower values than the best condition. In turn, MOO yielded better microencapsulation responses, but at a higher cost. Overall, EB-SD with operating conditions selected by MOO seems the best option, since a good compromise between costs and encapsulation responses was obtained.

Keywords: microencapsulation, multiple decision-making criteria, multi-objective optimization, Soluplus®

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Authors: Alberto Sanchidrián, José A. Parra, Jesús Alonso, Julián Pecharromán, Antonia Pacios, Consuelo Huerta

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Glass is a commonly used material in building; there is not a unique design solution as plates with a different number of layers and interlayers may be used. In most façades, a security glazing have to be used according to its performance in the impact pendulum. The European Standard EN 12600 establishes an impact test procedure for classification under the point of view of the human security, of flat plates with different thickness, using a pendulum of two tires and 50 kg mass that impacts against the plate from different heights. However, this test does not replicate the actual dimensions and border conditions used in building configurations and so the real stress distribution is not determined with this test. The influence of different boundary conditions, as the ones employed in construction sites, is not well taking into account when testing the behaviour of safety glazing and there is not a detailed procedure and criteria to determinate the glass resistance against human impact. To reproduce the actual boundary conditions on site, when needed, the pendulum test is arranged to be used "in situ", with no account for load control, stiffness, and without a standard procedure. Fracture stress of small and large glass plates fit a Weibull distribution with quite a big dispersion so conservative values are adopted for admissible fracture stress under static loads. In fact, test performed for human impact gives a fracture strength two or three times higher, and many times without a total fracture of the glass plate. Newest standards, as for example DIN 18008-4, states for an admissible fracture stress 2.5 times higher than the ones used for static and wing loads. Now two working areas are open: a) to define a standard for the ‘in situ’ test; b) to prepare a laboratory procedure that allows testing with more real stress distribution. To work on both research lines a laboratory that allows to test medium size specimens with different border conditions, has been developed. A special steel frame allows reproducing the stiffness of the glass support substructure, including a rigid condition used as reference. The dynamic behaviour of the glass plate and its support substructure have been characterized with finite elements models updated with modal tests results. In addition, a new portable impact machine is being used to get enough force and direction control during the impact test. Impact based on 100 J is used. To avoid problems with broken glass plates, the test have been done using an aluminium plate of 1000 mm x 700 mm size and 10 mm thickness supported on four sides; three different substructure stiffness conditions are used. A detailed control of the dynamic stiffness and the behaviour of the plate is done with modal tests. Repeatability of the test and reproducibility of results prove that procedure to control both, stiffness of the plate and the impact level, is necessary.

Keywords: glass plates, human impact test, modal test, plate boundary conditions

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Authors: Budur Almutairi

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Introduction: There is an alarming increase in the number of diabetic patients in Saudi Arabia during the last twenty years. The World Health Organization (WHO) reports that the country ranks seventh in the world for the rate of diabetes. It is also estimated that around 7 million of the population are diabetic and almost around 3 million have pre-diabetes. The prevalence is more in urban area than in rural and more in women than in men and it is closely associated with the parallel rise in obesity rates. Diabetes is found to be contributing to the increasing mortality, morbidity and vascular complications and becoming a significant cause of medical complications and even death. The trends shown by the numbers are worrying as the prevalence is steadily doubling every two decades and particularly in Saudi Arabia, this could soon reach 50% in those over 50 years of age. The economic growth and prosperity have shown notable changes in the lifestyle of the people. Most importantly, along with an increased consumption of fast foods and sugar-rich carbonated soft drinks, eating habits became less healthy and the level of physical activity is decreased. The simultaneous technological advancement and the introduction of new mechanical devices like, elevators, escalators, remotes and vehicles pushed people to a situation of leading a more sedentary life. This study is attempting to evaluate the success of the campaign that introduced through popular social media in the country. Methodology: The Ministry of Health (MoH) has initiated a novel method of campaign activity to generate discussion among public about diabetes. There were mythical monsters introduced through popular social media with disguised messages about the condition of diabetes has generated widespread discussions about the disease among the general public. The characters that started appearing in social media About 600 retweets of the original post was testimonial for the success of the Twitter campaign. The second most successful form of campaign was a video that adopted a very popular approach of using Dark Comedy in which, the diabetes was represented through a twisted negative character that talks about his meticulous plans of how he is going to take the common people into his clutches. This fictional character gained more popularity when introduced into twitter and people started interacting with him raising various questions and challenging his anti-social activities. Major findings: The video generated more than 3,200,000 views ranking 9th in You Tube’s most popular video in Saudi Arabia and was shared 7000 times in a single week. Also, the hashtag got over 4,500,000impressions and over one million visits. Conclusion: Diabetes mellitus in Saudi Arabia is emerging as an epidemic of massive proportions, threatening to negate the benefits of modernization and economic revival. It is highly possible that healthy practices connected with the prevention and management of DM can easily be implemented in a manner that does not conflict with the cultural milieu of Saudi Arabia.

Keywords: campaign, diabetes, Saudi, social media

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: André Augusto Ceballos Melo

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Design to facilitate the recognition of congruent prosthetic movements, context-to-motion translations guided by image, verbal prompt, users nonverbal communication such as facial expressions, gestures, paralinguistics, scene context, and object recognition contributes to this process though it can also be applied to other tasks, such as walking, Prosthetic limbs as assistive technology through gestures, sound codes, signs, facial, body expressions, and scene context The context-to-motion model is a machine learning approach that is designed to improve the control and dexterity of prosthetic limbs. It works by using sensory input from the prosthetic limb to learn about the dynamics of the environment and then using this information to generate smooth, stable movements. This can help to improve the performance of the prosthetic limb and make it easier for the user to perform a wide range of tasks. There are several key benefits to using the context-to-motion model for prosthetic limb control. First, it can help to improve the naturalness and smoothness of prosthetic limb movements, which can make them more comfortable and easier to use for the user. Second, it can help to improve the accuracy and precision of prosthetic limb movements, which can be particularly useful for tasks that require fine motor control. Finally, the context-to-motion model can be trained using a variety of different sensory inputs, which makes it adaptable to a wide range of prosthetic limb designs and environments. Stable diffusion is a machine learning method that can be used to improve the control and stability of movements in robotic and prosthetic systems. It works by using sensory feedback to learn about the dynamics of the environment and then using this information to generate smooth, stable movements. One key aspect of stable diffusion is that it is designed to be robust to noise and uncertainty in the sensory feedback. This means that it can continue to produce stable, smooth movements even when the sensory data is noisy or unreliable. To implement stable diffusion in a robotic or prosthetic system, it is typically necessary to first collect a dataset of examples of the desired movements. This dataset can then be used to train a machine learning model to predict the appropriate control inputs for a given set of sensory observations. Once the model has been trained, it can be used to control the robotic or prosthetic system in real-time. The model receives sensory input from the system and uses it to generate control signals that drive the motors or actuators responsible for moving the system. Overall, the use of the context-to-motion model has the potential to significantly improve the dexterity and performance of prosthetic limbs, making them more useful and effective for a wide range of users Hand Gesture Body Language Influence Communication to social interaction, offering a possibility for users to maximize their quality of life, social interaction, and gesture communication.

Keywords: stable diffusion, neural interface, smart prosthetic, augmenting

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Authors: Constantinos S. Mammas, Andreas Lazaris, Adamantia S. Mamma-Graham, Georgia Kostopanagiotou, Chryssa Lemonidou, John Mantas, Eustratios Patsouris

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The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the evaluation of the grafts. Α high percentage of solid organs arrive at the recipient hospitals and are considered as injured or improper for transplantation in the UK. Digital microscopy adds information on a microscopic level about the grafts (G) in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G will arrive at the recipient hospital for implantation. Aim: The aim of this study is to analyze the ergonomics of digital microscopy (DM) based on virtual slides, on telemedicine systems (TS) for tele-pathological evaluation (TPE) of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of renal graft (RG), liver graft (LG) and pancreatic graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying virtual slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included the development of an OTE-TS similar experimental telemedicine system (Exp.-TS) for simulating the integrated VS based microscopic TPE of RG, LG and PG Simulation of DM on TS based TPE performed by 2 specialists on a total of 238 human renal graft (RG), 172 liver graft (LG) and 108 pancreatic graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to accurately diagnose the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a desktop, followed by the ES of the applied Exp.-TS. Tablet and mobile-phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and awareness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval, seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: digital microscopy, organ transplantation, tele-pathology, virtual slides

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Authors: Carolina N. França, Jônatas B. do Amaral, Maria C.O. Izar, Ighor L. Teixeira, Francisco A. Fonseca

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Introduction: Atherosclerosis is a progressive disease, characterized by lipid and fibrotic element deposition in large-caliber arteries. Conditions related to the development of atherosclerosis, as dyslipidemia, hypertension, diabetes, and smoking are associated with endothelial dysfunction. There is a frequent recurrence of cardiovascular outcomes after acute myocardial infarction and, at this sense, cycles of mobilization of monocyte subtypes (classical, intermediate and nonclassical) secondary to myocardial infarction may determine the colonization of atherosclerotic plaques in different stages of the development, contributing to early recurrence of ischemic events. The recruitment of different monocyte subsets during inflammatory process requires the expression of chemokine receptors CCR2, CCR5, and CX3CR1, to promote the migration of monocytes to the inflammatory site. The aim of this study was to evaluate the effect of lipid-lowering treatment by six months in the monocyte phenotype and chemokine receptor levels of patients after Acute Myocardial Infarction (AMI). Methods: This is a PROBE (prospective, randomized, open-label trial with blinded endpoints) study (ClinicalTrials.gov Identifier: NCT02428374). Adult patients (n=147) of both genders, ageing 18-75 years, were randomized in a 2x2 factorial design for treatment with rosuvastatin 20 mg/day or simvastatin 40 mg/day plus ezetimibe 10 mg/day as well as ticagrelor 90 mg 2x/day and clopidogrel 75 mg, in addition to conventional AMI therapy. Blood samples were collected at baseline, after one month and six months of treatment. Monocyte subtypes (classical - inflammatory, intermediate - phagocytic and nonclassical – anti-inflammatory) were identified, quantified and characterized by flow cytometry, as well as the expressions of the chemokine receptors (CCR2, CCR5 and CX3CR1) were also evaluated in the mononuclear cells. Results: After six months of treatment, there was an increase in the percentage of classical monocytes and reduction in the nonclassical monocytes (p=0.038 and p < 0.0001 Friedman Test), without differences for intermediate monocytes. Besides, classical monocytes had higher expressions of CCR5 and CX3CR1 after treatment, without differences related to CCR2 (p < 0.0001 for CCR5 and CX3CR1; p=0.175 for CCR2). Intermediate monocytes had higher expressions of CCR5 and CX3CR1 and lower expression of CCR2 (p = 0.003; p < 0.0001 and p = 0.011, respectively). Nonclassical monocytes had lower expressions of CCR2 and CCR5, without differences for CX3CR1 (p < 0.0001; p = 0.009 and p = 0.138, respectively). There were no differences after the comparison between the four treatment arms. Conclusion: The data suggest a time-dependent modulation of classical and nonclassical monocytes and chemokine receptor levels. The higher percentage of classical monocytes (inflammatory cells) suggest a residual inflammatory risk, even under preconized treatments to AMI. Indeed, these changes do not seem to be affected by choice of the lipid-lowering strategy.

Keywords: acute myocardial infarction, chemokine receptors, lipid-lowering treatment, monocyte subtypes

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Authors: Polina Trusova

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The majority of young enterprises is founded and run by teams and develops new, innovative products or services. While problems within the team are considered to be an important reason for the failure of young enterprises, effective teamwork on innovation may be a key success factor. It may require special teamwork design or members’ creativity not needed during work routine. However, little is known about how young enterprises develop innovative solutions in teams, what makes their teamwork special and what influences its effectivity. Extending this knowledge is essential for understanding the success and failure factors for young enterprises. Previous research focused on working on innovation or professional teams in general. Rare studies combining these issues usually concentrate on homogenous groups like IT expert teams in innovation projects of big, well-established firms. The transferability of those studies’ findings to the entrepreneurial context is doubtful because of several reasons why teamwork should differ significantly between big, well-established firms and young enterprises. First, teamwork is conducted by team members, e.g., employees. The personality of employees in young enterprises, in contrast to that of employees in established firms, has been shown to be more similar to the personality of entrepreneurs. As entrepreneurs were found to be more open to experience and show less risk aversion, it may have a positive impact on their teamwork. Persons open to novelty are more likely to develop or accept a creative solution, which is especially important for teamwork on innovation. Secondly, young enterprises are often characterized by a flat hierarchy, so in general, teamwork should be more participative there. It encourages each member (and not only the founder) to produce and discuss innovative ideas, increasing their variety and enabling the team to select the best idea from the larger idea pool. Thirdly, teams in young enterprises are often multidisciplinary. It has some advantages but also increases the risk of internal conflicts making teamwork less effective. Despite the key role of teamwork on innovation and presented barriers for transferring existing evidence to the context of young enterprises, only a few researchers have addressed this issue. In order to close the existing research gap, to explore and understand how innovations are developed in teams of young enterprises and which factors influencing teamwork may be especially relevant for such teams, a qualitative study has been developed. The study consisting of 20 half-structured interviews with (co-)founders of young innovative enterprises in the UK and USA started in September 2017. The interview guide comprises but is not limited to teamwork dimensions discussed in literature like members’ skill or authority differentiation. Data will be evaluated following the rules of qualitative content analysis. First results indicate some factors which may be relevant especially for teamwork in young innovative enterprises. They will enrich the scientific discussion and provide the evidence needed to test a possible causality between identified factors and teamwork effectivity in future research on young innovative enterprises. Results and their discussion can be presented at the conference.

Keywords: innovation, qualitative study, teamwork, young enterprises

Procedia PDF Downloads 197

Authors: A. Dudek, P. Tylec, G. Torbicz, P. Duda, K. Proniewska, P. Major, M. Pedziwiatr

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Background: Conservative treatments of obesity, based only on a proper diet and physical activity, without the support of an interdisciplinary team of specialist does not bring satisfactory bariatric results. Long-term maintenance of a proper metabolic results after rapid weight loss due to bariatric surgery requires engagement from patients. Mobile health tool may offer alternative model that enhance participant engagement in keeping the therapy. Objective: We aimed to assess the influence of constant monitoring and subsequent motivational alerts in perioperative period and on post-operative effects in the bariatric patients. As well as the study was designed to identify factors conductive urge to change lifestyle after surgery. Methods: This prospective clinical control study was based on a usage of a designed prototype of bariatric mHealth system. The prepared application comprises central data management with a comprehensible interface dedicated for patients and data transfer module as a physician’s platform. Motivation system of a platform consist of motivational alerts, graphic outcome presentation, and patient communication center. Generated list of patients requiring urgent consultation and possibility of a constant contact with a specialist provide safety zone. 31 patients were enrolled in continuous monitoring program during a 6-month period along with typical follow-up visits. After one year follow-up, all patients were examined. Results: There were 20 active users of the proposed monitoring system during the entire duration of the study. After six months, 24 patients took a part in a control by telephone questionnaires. Among them, 75% confirmed that the application concept was an important element in the treatment. Active users of the application indicated as the most valuable features: motivation to continue treatment (11 users), graphical presentation of weight loss, and other parameters (7 users), the ability to contact a doctor (3 users). The three main drawbacks are technical errors (9 users), tedious questionnaires inside the application (5 users), and time-consuming tasks inside the system (2 users). Conclusions: Constant monitoring and successive motivational alerts to continue treatment is an appropriate tool in the treatment after bariatric surgery, mainly in the early post-operative period. Graphic presentation of data and continuous connection with a clinical staff seemed to be an element of motivation to continue treatment and a sense of security.

Keywords: bariatric surgery, mHealth, mobile health tool, obesity

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Denis A. Sokolov, Andrey V. Mazurkevich

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In the modern world, there is an increasing demand for highly precise measurements in various fields, such as aircraft, shipbuilding, and rocket engineering. This has resulted in the development of appropriate measuring instruments that are capable of measuring the coordinates of objects within a range of up to 100 meters, with an accuracy of up to one micron. The calibration process for such optoelectronic measuring devices (trackers and total stations) involves comparing the measurement results from these devices to a reference measurement based on a linear or spatial basis. The reference used in such measurements could be a reference base or a reference range finder with the capability to measure angle increments (EDM). The base would serve as a set of reference points for this purpose. The concept of the EDM for replicating the unit of measurement has been implemented on a mobile platform, which allows for angular changes in the direction of laser radiation in two planes. To determine the distance to an object, a high-precision interferometer with its own design is employed. The laser radiation travels to the corner reflectors, which form a spatial reference with precisely known positions. When the femtosecond pulses from the reference arm and the measuring arm coincide, an interference signal is created, repeating at the frequency of the laser pulses. The distance between reference points determined by interference signals is calculated in accordance with recommendations from the International Bureau of Weights and Measures for the indirect measurement of time of light passage according to the definition of a meter. This distance is D/2 = c/2nF, approximately 2.5 meters, where c is the speed of light in a vacuum, n is the refractive index of a medium, and F is the frequency of femtosecond pulse repetition. The achieved uncertainty of type A measurement of the distance to reflectors 64 m (N•D/2, where N is an integer) away and spaced apart relative to each other at a distance of 1 m does not exceed 5 microns. The angular uncertainty is calculated theoretically since standard high-precision ring encoders will be used and are not a focus of research in this study. The Type B uncertainty components are not taken into account either, as the components that contribute most do not depend on the selected coordinate measuring method. This technology is being explored in the context of laboratory applications under controlled environmental conditions, where it is possible to achieve an advantage in terms of accuracy. In general, the EDM tests showed high accuracy, and theoretical calculations and experimental studies on an EDM prototype have shown that the uncertainty type A of distance measurements to reflectors can be less than 1 micrometer. The results of this research will be utilized to develop a highly accurate mobile absolute range finder designed for the calibration of high-precision laser trackers and laser rangefinders, as well as other equipment, using a 64 meter laboratory comparator as a reference.

Keywords: femtosecond laser, pulse correlation, interferometer, laser absolute range finder, coordinate measurement

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Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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Authors: Hamed Khosravi, Reza Eslami-Farsani

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Increased interest in lightweight and efficient structural components has created the need for selecting materials with improved mechanical properties. To do so, composite materials are being widely used in many applications, due to durability, high strength and modulus, and low weight. Among the various composite structures, grid-stiffened structures are extensively considered in various aerospace and aircraft applications, because of higher specific strength and stiffness, higher impact resistance, superior load-bearing capacity, easy to repair, and excellent energy absorption capability. Although there are a good number of publications on the design aspects and fabrication of grid structures, little systematic work has been reported on their material modification to improve their properties, to our knowledge. Therefore, the aim of this research is to study the reinforcing effect of silica nanoparticles on the flexural properties of epoxy/E-glass isogrid panels under three-point bending test. Samples containing 0, 1, 3, and 5 wt.% of the silica nanoparticles, with 44 and 48 vol.% of the glass fibers in the ribs and skin components respectively, were fabricated by using a manual filament winding method. Ultrasonic and mechanical routes were employed to disperse the nanoparticles within the epoxy resin. To fabricate the ribs, the unidirectional fiber rovings were impregnated with the matrix mixture (epoxy + nanoparticles) and then laid up into the grooves of a silicone mold layer-by-layer. At once, four plies of woven fabrics, after impregnating into the same matrix mixture, were layered on the top of the ribs to produce the skin part. In order to conduct the ultimate curing and to achieve the maximum strength, the samples were tested after 7 days of holding at room temperature. According to load-displacement graphs, the bellow trend was observed for all of the samples when loaded from the skin side; following an initial linear region and reaching a load peak, the curve was abruptly dropped and then showed a typical absorbed energy region. It would be worth mentioning that in these structures, a considerable energy absorption was observed after the primary failure related to the load peak. The results showed that the flexural properties of the nanocomposite samples were always higher than those of the nanoparticle-free sample. The maximum enhancement in flexural maximum load and energy absorption was found to be for the incorporation of 3 wt.% of the nanoparticles. Furthermore, the flexural stiffness was continually increased by increasing the silica loading. In conclusion, this study suggested that the addition of nanoparticles is a promising method to improve the flexural properties of grid-stiffened fibrous composite structures.

Keywords: grid-stiffened composite structures, nanocomposite, three point flexural test , energy absorption

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Authors: Ana Cristina García-Luna Romero

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This document seeks to reflect on the urban project from its conceptual identity root. In the first instance, a proposal is made on how the city project is sustained from the conceptual root, from the logos: it opens a way to assimilate the imagination; what we imagine becomes a reality. In this way, firstly, the need to use language as a vehicle for transmitting the stories that sustain us as humanity can be deemed as an important social factor that enables us to social behavior. Secondly, the need to attend to the written language as a mechanism of power, as a means to consolidate a dominant ideology or a political position, is raised; as it served to carry out the modernization project, it is therefore addressed differences between the real and the literate city. Thus, the consolidated urban-architectural project is based on logos, the project, and planning. Considering the importance of materiality and its relation to subjective well-being contextualized from a socio-urban approach, we question ourselves into how we can look at something that is doubtful. From a philosophy perspective, the truth is considered to be nothing more than a matter of correspondence between the observer and the observed. To understand beyond the relative of the gaze, it is necessary to expose different perspectives since it depends on the understanding of what is observed and how it is critically analyzed. Therefore, the analysis of materiality, as a political field, takes a proposal based on this research in the principles in transgenesis: principle of communication, representativeness, security, health, malleability, availability of potentiality or development, conservation, sustainability, economy, harmony, stability, accessibility, justice, legibility, significance, consistency, joint responsibility, connectivity, beauty, among others. The (urban) human being acts because he wants to live in a certain way: in a community, in a fair way, with opportunity for development, with the possibility of managing the environment according to their needs, etc. In order to comply with this principle, it is necessary to design strategies from the principles in transgenesis, which must be named, defined, understood, and socialized by the urban being, the companies, and from themselves. In this way, the technical status of the city in the neoliberal present determines extraordinary conditions for reflecting on an almost emergency scenario created by the impact of cities that, far from being limited to resilient proposals, must aim at the reflection of the urban process that the present social model has generated. Therefore, can we rethink the paradigm of the perception of life quality in the current neoliberal model in the production of the character of public space related to the practices of being urban. What we are trying to do within this document is to build a framework to study under what logic the practices of the social system that make sense of the public space are developed, what the implications of the phenomena of the inscription of action and materialization (and its results over political action between the social and the technical system) are and finally, how we can improve the quality of life of individuals from the urban space.

Keywords: cities, nature, society, urban quality of life

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Authors: Mariam Mtunguja, Henry Laswai, Yasinta Muzanilla, Joseph Ndunguru

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Starchy tuberous roots of cassava provide food for people but also find application in various industries. Recently there has been the focus of concentrated research efforts to fully exploit its potential as a sustainable multipurpose crop. High starch yield is the important trait for commercial cassava production for the starch industries. Furthermore, cyanide present in cassava root poses a health challenge in the use of cassava for food. Farming communities where cassava is a staple food, prefer bitter (high cyanogenic) varieties as protection from predators and thieves. As a result, food insecure farmers prefer growing bitter cassava. This has led to cyanide intoxication to this farming communities. Cassava farmers can benefit from marketing cassava to starch producers thereby improving their income and food security. This will decrease dependency on cassava as staple food as a result of increased income and be able to afford other food sources. To achieve this, adequate information is required on the right cassava cultivars and appropriate harvesting period so as to maximize cassava production and profitability. This study aimed at identifying suitable cassava cultivars and optimum time of harvest to maximize starch production. Six commonly grown cultivars were identified and planted in a complete random block design and further analysis was done to assess variation in physicochemical characteristics, starch yield and cyanogenic potentials across three environments. The analysis showed that there is a difference in physicochemical characteristics between landraces (p ≤ 0.05), and can be targeted to different industrial applications. Among landraces, dry matter (30-39%), amylose (11-19%), starch (74-80%) and reducing sugars content (1-3%) varied when expressed on a dry weight basis (p ≤ 0.05); however, only one of the six genotypes differed in crystallinity and mean starch granule particle size, while glucan chain distribution and granule morphology were the same. In contrast, the starch functionality features measured: swelling power, solubility, syneresis, and digestibility differed (p ≤ 0.05). This was supported by Partial least square discriminant analysis (PLS-DA), which highlighted the divergence among the cassavas based on starch functionality, permitting suggestions for the targeted uses of these starches in diverse industries. The study also illustrated genotypic difference in starch yield and cyanogenic potential. Among landraces, Kiroba showed potential for maximum starch yield (12.8 t ha-1) followed by Msenene (12.3 t ha-1) and third was Kilusungu (10.2 t ha-1). The cyanide content of cassava landraces was between 15 and 800 ppm across all trial sites. GGE biplot analysis further confirmed that Kiroba was a superior cultivar in terms of starch yield. Kilusungu had the highest cyanide content and average starch yield, therefore it can also be suitable for use in starch production.

Keywords: cyanogen, cassava starch, food security, starch yield

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Authors: Sajana Suwal, Ganesh R. Nhemafuki

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Evaluation of ground response under earthquake shaking is crucial in geotechnical earthquake engineering. Damage due to seismic excitation is mainly correlated to local geological and geotechnical conditions. It is evident from the past earthquakes (e.g. 1906 San Francisco, USA, 1923 Kanto, Japan) that the local geology has strong influence on amplitude and duration of ground motions. Since then significant studies has been conducted on ground motion amplification revealing the importance of influence of local geology on ground. Observations from the damaging earthquakes (e.g. Nigata and San Francisco, 1964; Irpinia, 1980; Mexico, 1985; Kobe, 1995; L’Aquila, 2009) divulged that non-uniform damage pattern, particularly in soft fluvio-lacustrine deposit is due to the local amplification of seismic ground motion. Non-uniform damage patterns are also observed in Kathmandu Valley during 1934 Bihar Nepal earthquake and recent 2015 Gorkha earthquake seemingly due to the modification of earthquake ground motion parameters. In this study, site effects resulting from amplification of soft soil in Kathmandu are presented. A large amount of subsoil data was collected and used for defining the appropriate subsoil model for the Kathamandu valley. A comparative study of one-dimensional total-stress equivalent linear and non-linear site response is performed using four strong ground motions for six sites of Kathmandu valley. In general, one-dimensional (1D) site-response analysis involves the excitation of a soil profile using the horizontal component and calculating the response at individual soil layers. In the present study, both equivalent linear and non-linear site response analyses were conducted using the computer program DEEPSOIL. The results show that there is no significant deviation between equivalent linear and non-linear site response models until the maximum strain reaches to 0.06-0.1%. Overall, it is clearly observed from the results that non-linear site response model perform better as compared to equivalent linear model. However, the significant deviation between two models is resulted from other influencing factors such as assumptions made in 1D site response, lack of accurate values of shear wave velocity and nonlinear properties of the soil deposit. The results are also presented in terms of amplification factors which are predicted to be around four times more in case of non-linear analysis as compared to equivalent linear analysis. Hence, the nonlinear behavior of soil prevails the urgent need of study of dynamic characteristics of the soft soil deposit that can specifically represent the site-specific design spectra for the Kathmandu valley for building resilient structures from future damaging earthquakes.

Keywords: deep soil, equivalent linear analysis, non-linear analysis, site response

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Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

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Authors: Amanda Gregorim Fernandes, Lorena Cardoso Cintra, Rosalia Santos Amorim Jesuino, Fabricia Paula De Faria, Marcio José Poças Fonseca

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Bioethanol is one of the most promising biofuels and able to replace fossil fuels and reduce its different environmental impacts and can be generated from various agroindustrial waste. The Brazil is in first place in bioethanol production to be the largest producer of sugarcane. The bagasse sugarcane (SCB) has lignocellulose which is composed of three major components: cellulose, hemicellulose and lignin. Cellulose is a homopolymer of glucose units connected by glycosidic linkages. Among all species of Penicillium, Penicillium echinulatum has been the focus of attention because they produce high quantities of cellulase and the mutant strain 9A02S1 produces higher enzyme levels compared to the wild. Among the cellulases, the cellobiohydrolases enzymes are the main components of the cellulolytic system of fungi, and are also responsible for most of the potential hydrolytic in enzyme cocktails for the industrial processing of plant biomass and several cellobiohydrolases Penicillium had higher specific activity against cellulose compared to CBH I from Trichoderma reesei. This fact makes it an interesting pattern for higher yields in the enzymatic hydrolysis, and also they are important enzymes in the hydrolysis of crystalline regions of cellulose. Therefore, finding new and more active enzymes become necessary. Meanwhile, β-glycosidases act on soluble substrates and are highly dependent on cellobiohydrolases and endoglucanases action to provide the substrate in the hydrolysis of the biomass, but the cellobiohydrolases and endoglucanases are highly dependent β-glucosidases to maintain efficient hydrolysis. Thus, there is a need to understand the structure-function relationships that govern the catalytic activity of cellulolytic enzymes to elucidate its mechanism of action and optimize its potential as industrial biocatalysts. To evaluate the enzyme β-glucosidase of Penicillium echinulatum (PeBGL1) the gene was synthesized from the assembly sequence from a library in induction conditions and then the PeBGL1 gene was cloned in the vector pPICZαA and transformed into P. pastoris GS115. After processing, the producers of PeBGL1 were analyzed for enzyme activity and protein profile where a band of approximately 100 kDa was viewed. It was also carried out the zymogram. In partial characterization it was determined optimum temperature of 50°C and optimum pH of 6,5. In addition, to increase the secreted recombinant PeBGL1 production by Pichia pastoris, three parameters of P. pastoris culture medium were analysed: methanol, nitrogen source concentrations and the inoculum size. A 23 factorial design was effective in achieving the optimum condition. Altogether, these results point to the potential application of this P. echinulatum β-glucosidase in hydrolysis of cellulose for the production of bioethanol.

Keywords: bioethanol, biotechnology, beta-glucosidase, penicillium echinulatum

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Authors: Robert Wimmer, Soeren Eikemeier, Michael Berger, Anita Preisler

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A relatively large percentage of energy and resource consumption occurs in the building sector. This concerns the production of building materials, the construction of buildings and also the energy consumption during the use phase. Therefore, the overall objective of this EU LIFE project “LIFE Cycle Habitation” (LIFE13 ENV/AT/000741) is to demonstrate innovative building concepts that significantly reduce CO₂emissions, mitigate climate change and contain a minimum of grey energy over their entire life cycle. The project is being realised with the contribution of the LIFE financial instrument of the European Union. The ultimate goal is to design and build prototypes for carbon-neutral and “LIFE cycle”-oriented residential buildings and make energy-efficient settlements the standard of tomorrow in line with the EU 2020 objectives. To this end, a resource and energy-efficient building compound is being built in Böheimkirchen, Lower Austria, which includes 6 living units and a community area as well as 2 single family houses with a total usable floor surface of approximately 740 m². Different innovative straw bale construction types (load bearing and pre-fabricated non loadbearing modules) together with a highly innovative energy-supply system, which is based on the maximum use of thermal energy for thermal energy services, are going to be implemented. Therefore only renewable resources and alternative energies are used to generate thermal as well as electrical energy. This includes the use of solar energy for space heating, hot water and household appliances like dishwasher or washing machine, but also a cooking place for the community area operated with thermal oil as heat transfer medium on a higher temperature level. Solar collectors in combination with a biomass cogeneration unit and photovoltaic panels are used to provide thermal and electric energy for the living units according to the seasonal demand. The building concepts are optimised by support of dynamic simulations. A particular focus is on the production and use of modular prefabricated components and building parts made of regionally available, highly energy-efficient, CO₂-storing renewable materials like straw bales. The building components will be produced in collaboration by local SMEs that are organised in an efficient way. The whole building process and results are monitored and prepared for knowledge transfer and dissemination including a trial living in the residential units to test and monitor the energy supply system and to involve stakeholders into evaluation and dissemination of the applied technologies and building concepts. The realised building concepts should then be used as templates for a further modular extension of the settlement in a second phase.

Keywords: energy-efficiency, green architecture, renewable resources, sustainable building

Procedia PDF Downloads 148

Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

Procedia PDF Downloads 96

Authors: S. D. Zalepugin, A. E. Murzich, D. G. Satskevich, A. B. Palivanov

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Introduction. The incidence of spinal injuries in patients under 18 years of age has increased significantly in recent years, which represents a significant economic, social and medical problem. The most common method of surgical stabilization of spinal fractures in pediatric patients is transpedicular posterior spinal fusion, which is widely used by spinal neurosurgeons in adult patients. Purpose of the study: This study evaluates the results of treatment of thoracolumbar spine lesions in children using the transpedicular screw fixation method. Materials and methods. From 2019 to 2024, 35 children with injuries to the thoracic and lumbar spine underwent surgical treatment using the transpedicular screw fixation method. Among the injured, girls prevailed (21 cases, 60%). The age of the victims ranged from 9 to 17 years. The main causes of damage were: catatrauma (19 cases), road accident (5 cases), sports injury (6 cases), and other reasons - 5 cases. In 5 cases, suicidal attempts occurred. Co-injury was observed in most cases (20 patients, or 57%), which is natural for high-energy injury. Vertebral-spinal injury with neurological disorders was observed in 13 patients, the disorders ranged from mild inferior (4 children) to moderate/severe paraparesis (5 patients) and inferior paraplegia (4 children). 6 children had pelvic organ dysfunction in the form of urinary and fecal retention or incontinence. All thirty-five patients, within a period of 1 to 57 days after the injury, underwent several surgical interventions from the posterior surgical access using a screw fixation method (posterior decompression + spinal fusion). In 12 cases, it was necessary to perform the second stage of surgical treatment - anterior decompression of the spinal cord or its roots. Verticalization of patients was carried out within 1 to 5 days after surgery. Results. In all patients, the nearest, up to 1 year, results were evaluated. In children operated in 2019-2021, the results were studied in terms of 3 to 5 years. The procedures used, clinical results and the quality of the fixative installation were assessed. All patients managed to achieve positive results. The use of internal fixation made it possible to carry out early verticalization of children, eliminate pain syndrome and achieve a regression of neurological disorders in most patients (especially in cases when the operation was performed early after injury - from 1 to 3 days). Within the first month, the ability to self-care was fully restored. Bone fusion was observed within 6-12 months after surgery. There were no complications after surgery. The analysis of postoperative radiographs, CT and MRI images revealed the correct standing of the screws in all cases. Conclusion. The posterior spinal fusion using the new method of screw fixation in pediatric patients allows to achieve durable stabilization of damage, begins early rehabilitation of patients and reduces the duration of hospital treatment by 2-3 times. Thus, we recommend the use of a transpedicular fixator in children as a reliable, technically feasible method for restoring spinal stability with a low risk of intra- and postoperative complications.

Keywords: pediatric patients, spinal injuries, transpedicular stabilization, operative treatment

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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The present study was aimed to find out the prevalence of DD's in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different DD's including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Among 26,423 cases, children with birth defects are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80 %) and a small number of children were affected with goiter (1.70%). Among the diseases, dental carriers (67.97%) are mostly found and these cases were at peak during the years 2016 and 2019. From disabilities, children with vision impairment (20.55%) have mostly approached the center. Over the past 5 years, the admission rate of down's syndrome and congenital deafness cases showed a rising trend up to 2019 and then declined. Hearing impairment, motor delay, and learning disorder showed a steep rise and gradual decline trend, whereas severe anemia, vitamin-D deficiency, otitis media, reactive airway disease, and attention deficit hyperactivity disorder showed a declining trend. However, congenital heart diseases, dental caries, and vision impairment admission rates showed a zigzag pattern over the past 5 years. This center had inadequate diagnostic facilities related to genetic disease management. For advanced confirmation, the cases are referred to a district government hospital or private diagnostic laboratories in the city for genetic tests. Information regarding the overall burden and pattern of admissions in the health center is obtained by the review of DEIC records. Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.

Keywords: child health screening, developmental delays, district early intervention center, genetic disease management, infrastructural facility, Visakhapatnam district

Procedia PDF Downloads 212

Authors: Jamil Lane, Jason Freeman

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Background: The role of interpersonal relationships is vital predictors of adolescents’ eating habits, exercise activity, and health problems including obesity. The effect of interpersonal relationships (i.e. family, friends, and intimate partners) on individual health behaviors and development have gained considerable attention during the past 10 years. Teenagers eating habits and exercise activities are established through a dynamic course involving internal and external factors such as food preferences, body weight perception, and parental and peer influence. When conceptualizing one’s interpersonal relationships, it is important to understand that how one relates to others is shaped by their culture. East-Asian culture has been characterized as collectivistic, which describes the significant role intergroup relationships play in their construction of the self. Cultures found in North America, on the other hand, can be characterized as individualistic, meaning that these cultures encourage individuals to prioritize their interest over the needs and want of their compatriots. Individuals from collectivistic cultures typically have stronger boundaries between in-group and out-group membership, whereas those from individualistic cultures see themselves as distinct and separate from strangers as well as family or friends. Objective: The purpose of this study is to examine the effect of collectivism and individualism on interpersonal relationships that shapes eating patterns and physical activity among Asian-American and European-American adolescents. Design/Methods: Analyses were based on data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in the United States who were surveyed from 1994 through 2008. This data will be used to examine interpersonal relationship factors that shape dietary intake and physical activity patterns within the Asian-American and European-American population in the United States. Factors relating to relationship strength, eating, and exercise behaviors were reported by participants in this first wave of data collection (1995). We plan to analyze our data using intragroup comparisons among those who identified as 'Asian-American' (n = 270) and 'White or European American' (n = 4,294) among the domains of positivity of peer influence and level of physical activity / healthy eating. Further, intergroup comparisons of these relationships will be made to extricate how the role positive peer influence in maintaining healthy eating and exercise habits differs with cultural variation. Results: We hypothesize that East-Asian participants with a higher degree of positivity in their peer and family relationships will experience a significantly greater rise in healthy eating and exercise behaviors than European-American participants with similar degrees of relationship positivity.

Keywords: interpersonal relationships, eating patterns, physical activity, adolescent health

Procedia PDF Downloads 196