Search results for: clinical assessment tools

Authors: Belén Vinaixa Kinnear, Arturo Hidalgo López, Bernardo Elembo Wilasi, Pablo Fernández Pérez, Cecilia Hernández Fuentealba

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The expanded use of risk assessment in legislative and corporate decision-making has increased the role of expert judgement in giving data for security-related decision-making. Expert judgements are required in most steps of risk assessment: danger recognizable proof, hazard estimation, risk evaluation, and examination of choices. This paper presents a fault tree analysis (FTA), which implies a probabilistic failure analysis applied to leakage of oil in a subsea production system. In standard FTA, the failure probabilities of items of a framework are treated as exact values while evaluating the failure probability of the top event. There is continuously insufficiency of data for calculating the failure estimation of components within the drilling industry. Therefore, fuzzy hypothesis can be used as a solution to solve the issue. The aim of this paper is to examine the leaks from the Zafiro West subsea oil facility by using fuzzy fault tree analysis (FFTA). As a result, the research has given theoretical and practical contributions to maritime safety and environmental protection. It has been also an effective strategy used traditionally in identifying hazards in nuclear installations and power industries.

Keywords: expert judgment, probability assessment, fault tree analysis, risk analysis, oil pipelines, subsea production system, drilling, quantitative risk analysis, leakage failure, top event, off-shore industry

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Authors: Hala A. Hassan, Vasiliki K. Tsiouri, Konstantinos E. Konstantinos

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Fugitive particulate matter (PM) is a major source of airborne pollution in the Middle East countries. The meteorological conditions and topography of the area make it highly susceptible to wind-blown particles which raise many air quality concerns. Air quality tools such as field monitoring, emission factors, and dispersion modeling have been used in previous research studies to analyze the release and impacts of fugitive PM in the region. However, these tools have been originally developed based on experiments made for European and North American regions. In this work, an experimental campaign was conducted on April-May 2014 in a construction site in Doha city, Qatar. The ultimate goal is to evaluate the applicability of the existing emission factors for construction sites in dry and arid areas like the Middle East. This publication was made possible by a NPRP award [NPRP 7-649-2-241] from the Qatar National Research Fund (a member of The Qatar Foundation). The statements made herein are solely the responsibility of the authors.

Keywords: particulate matter, emissions, fugitive, construction, air pollution

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Authors: Marina Sousa, Célia Barreto Carvalho, Carolina da Motta, Joana Cabral, Vera Pereira, Suzana Nunes Caldeira, Ermelindo Peixoto

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Paranoid ideation is a common thought process that constitutes a defense against perceived social threats. The current study aimed at the characterization of paranoid ideation in youths and to explore the possible predictors involved in the development of paranoid ideations. Paranoid ideation, shame, submission, early childhood memories and current depressive, anxious and stress symptomatology was assessed in a sample of 1516 Portuguese youths. Higher frequencies of paranoid ideation were observed, particularly in females and youths from lower socio-economic status. The main predictors identified relates to submissive behaviors and adverse childhood experiences, and especially to shame feelings. The current study emphasizes that the these predictors are similar to findings in adults and clinical populations, and future implications to research and clinical practice aiming at paranoid ideations are discussed, as well as the pertinence of the study of mediating factors that allow a wider understanding of this thought process in younger populations and the prevention of psychopathology in adulthood.

Keywords: adolescence, early memories, paranoid ideation, parenting styles, shame, submissiveness

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Authors: Naheed Niaz, Nimra Naeem, Bushra Uzair, Riffat Tahira

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Antibacterial activity of different traditional plants essential oils against clinical isolates of Methicillin-resistant Staphylococcus aureus (MRSA) through disk diffusion method was evaluated. All the tested essential oils, in different concentrations, inhibited growth of S. aureus to varying degrees. Cinnamon and Thyme essential oils were observed to be the “best” against test pathogen. Even at lowest concentration of these essential oils i.e. 25 µl/ml, clear zone of inhibition was recorded 9+0.085mm and 8+0.051mm respectively, and at higher concentrations there was a total reduction in growth of MRSA. The study also focused on analyzing the synergistic effects of essential oils in combination with amoxicillin. Results showed that oregano and pennyroyal mint essential oils which were not very effective alone turned out to be strong synergistic enhancers. The activity increased with increase in concentration of the essential oils. It may be concluded from present results that cinnamon and thyme essential oils could be used as potential antimicrobial source for the treatment of infections caused by Methicillin-resistant Staphylococcus aureus (MRSA).

Keywords: Staphylococcus aureus, essential oils, antibiotics, combination therapy, minimum inhibitory concentration

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Authors: S. Zolghadri, M. Naderi, H. Yousefnia, A. Ramazani, A. R. Jalilian

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The aim of this work was to evaluate the values of absorbed dose of 68Ga-DOTATOC in numerous human organs. 68Ga-DOTATOC was prepared with the radiochemical purity of higher than 98% and by specific activity of 39.6 MBq/nmol. The complex demonstrated great stability at room temperature and in human serum at 37° C at least 2 h after preparation. Significant uptake was observed in somatostatin receptor-positive tissues such as pancreas and adrenal. The absorbed dose received by human organs was evaluated based on biodistribution studies in Syrian rats by the radiation absorbed dose assessment resource (RADAR) method. Maximum absorbed dose was obtained in the pancreas, kidneys, and adrenal with 0.105, 0.074, and 0.010 mGy/MBq, respectively. The effective absorbed dose was 0.026 mSv/MBq for 68Ga-DOTATOC. The results showed that 68Ga-DOTATOC can be considered as a safe and effective agent for clinically PET imaging applications.

Keywords: effective absorbed dose, Ga-68, octreotide, MIRD

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Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

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Authors: Suraj Sharma

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Green infrastructure (GI) offers a contemporary approach for reducing the risk of flooding, improve water quality, and harvesting stormwater for sustainable use. GI promotes landscape planning to enhance sustainable development and urban resilience. However, the existing literature is lacking in ensuring the comprehensive assessment of GI performance in terms of ecosystem function and services for social, ecological, and economical system resilience. We propose a robust indicator set and fuzzy comprehensive evaluation (FCE) for quantitative and qualitative analysis for sustainable water management to assess the capacity of urban resilience. Green infrastructure in urban resilience water management system (GIUR-WMS) supports decision-making for GI planning through scenario comparisons with urban resilience capacity index. To demonstrate the GIUR-WMS, we develop five scenarios for five sectors of Chandigarh (12, 26, 14, 17, and 34) to test common type of GI (rain barrel, rain gardens, detention basins, porous pavements, and open spaces). The result shows the open spaces achieve the highest green infrastructure urban resilience index of 4.22/5. To implement the open space scenario in urban sites, suitable vacant can be converted to green spaces (example: forest, low impact recreation areas, and detention basins) GIUR-WMS is easy to replicate, customize and apply to cities of different sizes to assess environmental, social and ecological dimensions.

Keywords: green infrastructure, assessment, urban resilience, water management system, fuzzy comprehensive evaluation

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Ben Levenger

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Social life revolves around a central meeting place or gathering space. It is where the community integrates, earns social skills, and ultimately becomes part of the community. Following this premise, public spaces are one of the most important spaces that downtowns offer, providing locations for people to be witnessed, heard, and most importantly, seamlessly integrate into the downtown as part of the community. To facilitate this, these local spaces must be envisioned and designed to meet the changing needs of a downtown, offering a space and purpose for everyone. This paper will dive deep into analyzing, designing, and implementing public space design for small plazas or gathering spaces. These spaces often require a detailed level of study, followed by a broad stroke of design implementation, allowing for adaptability. This paper will highlight how to assess needs, define needed types of spaces, outline a program for spaces, detail elements of design to meet the needs, assess your new space, and plan for change. This study will provide participants with the necessary framework for conducting a grass-roots-level assessment of public space and programming, including short-term and long-term improvements. Participants will also receive assessment tools, sheets, and visual representation diagrams. Urbanism, for the sake of urbanism, is an exercise in aesthetic beauty. An economic improvement or benefit must be attained to solidify these efforts' purpose further and justify the infrastructure or construction costs. We will deep dive into case studies highlighting economic impacts to ground this work in quantitative impacts. These case studies will highlight the financial impact on an area, measuring the following metrics: rental rates (per sq meter), tax revenue generation (sales and property), foot traffic generation, increased property valuations, currency expenditure by tenure, clustered development improvements, cost/valuation benefits of increased density in housing. The economic impact results will be targeted by community size, measuring in three tiers: Sub 10,000 in population, 10,001 to 75,000 in population, and 75,000+ in population. Through this classification breakdown, the participants can gauge the impact in communities similar to their work or for which they are responsible. Finally, a detailed analysis of specific urbanism enhancements, such as plazas, on-street dining, pedestrian malls, etc., will be discussed. Metrics that document the economic impact of each enhancement will be presented, aiding in the prioritization of improvements for each community. All materials, documents, and information will be available to participants via Google Drive. They are welcome to download the data and use it for their purposes.

Keywords: downtown, economic development, planning, strategic

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Authors: P. Amarnath, Albert Thomas

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Buildings qualify to be the major consumer of energy and resources thereby urging the designers, architects and policy makers to place a great deal of effort in achieving and implementing sustainable building strategies in construction. Green building rating systems help a great deal in this by measuring the effectiveness of these strategies along with the escalation of building performance in social, environmental and economic perspective, and construct new sustainable buildings. However, for a country like India, enormous population and its rapid rate of growth impose an increasing burden on the country's limited and continuously degrading natural resource base, which also includes the land available for construction. In general, the number of sustainable rated buildings in India is very minimal primarily due to the complexity and obstinate nature of the assessment systems/regulations that restrict the stakeholders and designers in proper implementation and utilization of these rating systems. This paper aims to introduce a data driven and user-friendly framework which cross compares the present prominent green building rating systems such as LEED, BREEAM, and GRIHA and subsequently help the users to rate their proposed building design as per the regulations of these assessment frameworks. This framework is validated using the input data collected from green buildings constructed globally. The proposed system has prospects to encourage the users to test the efficiency of various sustainable construction practices and thereby promote more sustainable buildings in the country.

Keywords: BREEAM, GRIHA, green building rating systems, LEED, sustainable buildings

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Authors: Junaid Mahmood Alam

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Revalidating and harmonizing clinical chemistry analytical principles and optimizing methods through quality control programs and assessments is the preeminent means to attain optimal outcome within the clinical laboratory services. Present study reports revalidation of our existing IFCC regularized analytical methods, particularly hepatic and thyroid function tests, by optimization of precision analyses and processing through external and internal quality assessments and regression determination. Parametric components of hepatic (Bilirubin ALT, γGT, ALP), cardiac (LDH, AST, Trop I) and thyroid/pituitary (T3, T4, TSH, FT3, FT4) function tests were used to validate analytical techniques on automated chemistry and immunological analyzers namely Hitachi 912, Cobas 6000 e601, Cobas c501, Cobas e411 with UV kinetic, colorimetric dry chemistry principles and Electro-Chemiluminescence immunoassay (ECLi) techniques. Process of validation and revalidation was completed with evaluating and assessing the precision analyzed Preci-control data of various instruments plotting against each other with regression analyses R2. Results showed that: Revalidation and optimization of respective parameters that were accredited through CAP, CLSI and NEQAPP assessments depicted 99.0% to 99.8% optimization, in addition to the methodology and instruments used for analyses. Regression R2 analysis of BilT was 0.996, whereas that of ALT, ALP, γGT, LDH, AST, Trop I, T3, T4, TSH, FT3, and FT4 exhibited R2 0.998, 0.997, 0.993, 0.967, 0.970, 0.980, 0.976, 0.996, 0.997, 0.997, and R2 0.990, respectively. This confirmed marked harmonization of analytical methods and instrumentations thus revalidating optimized precision standardization as per IFCC recommended guidelines. It is concluded that practices of revalidating and harmonizing the existing or any new services should be followed by all clinical laboratories, especially those associated with tertiary care hospital. This is will ensure deliverance of standardized, proficiency tested, optimized services for prompt and better patient care that will guarantee maximum patients’ confidence.

Keywords: revalidation, standardized, IFCC, CAP, harmonized

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Authors: Liana Gomide, Juliana Rodrigues

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The morphology of the foot defines its mode of operation and a biomechanical reform indispensable for a symmetrical distribution of plantar pressures in order not to overload some of its components in isolation. High plantar pressures at specific points in the foot may be a causal factor in several orthopedic disorders that affect the feet such as pain and stress fracture. With digital baro-podometry equipment one can observe an intensity of pressures along the entire foot and quantify some of the movements, such as a subtalar pronation present in the midfoot region. Although, they are involved in microtraumas. In clinical practice, excessive movement has been limited with the use of different taping techniques applied on the plantar arch. Thus, the objective of the present study was to analyze and compare the influence of the inelastic and elastic taping on the distribution of plantar pressure of runners pronators. This is a randomized clinical trial and blind-crossover. Twenty (20) male subjects, mean age 33 ± 7 years old, mean body mass of 71 ± 7 kg, mean height of 174 ± 6 cm, were included in the study. A data collection was carried out by a single research through barop-odometry equipment - Tekscan, model F-scan mobile. The tests were performed at three different times. In the first, an initial barop-odometric evaluation was performed, without a bandage application, with edges at a speed of 9.0 km/h. In the second and third moments, the inelastic or elastic taping was applied consecutively, according to the definition defined in the randomization. As results, it was observed that both as inelastic and elastic taping, provided significant reductions in contact pressure and peak pressure values when compared to the moment without a taping. However, an elastic taping was more effective in decreasing contact pressure (no bandage = 714 ± 201, elastic taping = 690 ± 210 and inelastic taping = 716 ± 180) and no peak pressure in the midfoot region (no bandage = 1490 ± 42, elastic taping = 1273 ± 323 and inelastic taping = 1487 ± 437). It is possible to conclude that it is an elastic taping provided by pressure in the middle region, thereby reducing the subtalar pronunciation event during the run.

Keywords: elastic taping, inelastic taping, running, subtalar pronation

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Authors: Derick Shi-Chen Ou, Liang-Yu Chen

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Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

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Authors: Arefeh Hesaraki

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The application of photovoltaic-thermal hybrids (PVT), which delivers both electricity and heat simultaneously from the same system, has become more popular during the past few years. This study addresses techno-economic and environmental impacts assessment of photovoltaic/thermal systems combined with a ground-source heat pump (GSHP) for three single-family houses located in Stockholm, Sweden. Three case studies were: (1) A renovated building built in 1936, (2) A renovated building built in 1973, and (3) A new building built-in 2013. Two simulation programs of SimaPro 9.1 and IDA Indoor Climate and Energy 4.8 (IDA ICE) were applied to analyze environmental impacts and energy usage, respectively. The cost-effectiveness of the system was evaluated using net present value (NPV), internal rate of return (IRR), and discounted payback time (DPBT) methods. In addition to cost payback time, the studied PVT system was evaluated using the energy payback time (EPBT) method. EPBT presents the time that is needed for the installed system to generate the same amount of energy which was utilized during the whole lifecycle (fabrication, installation, transportation, and end-of-life) of the system itself. Energy calculation by IDA ICE showed that a 5 m² PVT was sufficient to create a balance between the maximum heat production and the domestic hot water consumption during the summer months for all three case studies. The techno-economic analysis revealed that combining a 5 m² PVT with GSHP in the second case study possess the smallest DPBT and the highest NPV and IRR among the three case studies. It means that DPBTs (IRR) were 10.8 years (6%), 12.6 years (4%), and 13.8 years (3%) for the second, first, and the third case study, respectively. Moreover, environmental assessment of embodied energy during cradle- to- grave life cycle of the studied PVT, including fabrication, delivery of energy and raw materials, manufacture process, installation, transportation, operation phase, and end of life, revealed approximately two years of EPBT in all cases.

Keywords: life-cycle cost, life-cycle assessment, photovoltaic/thermal, IDA ICE, net present value

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Authors: Ivan Balázs, Jindřich Melcher

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Metal thin-walled members have been widely used in building industry. Usually they are utilized as purlins, girts or ceiling beams. Due to slenderness of thin-walled cross-sections these structural members are prone to stability problems (e.g. flexural buckling, lateral torsional buckling). If buckling is not constructionally prevented their resistance is limited by buckling strength. In practice planar members of roof or wall cladding can be attached to thin-walled members. These elements reduce displacement of thin-walled members and therefore increase their buckling strength. If this effect is taken into static assessment more economical sections of thin-walled members might be utilized and certain savings of material might be achieved. This paper focuses on problem of determination of critical load of steel thin-walled beams with lateral continuous restraint which is crucial for lateral torsional buckling assessment.

Keywords: beam, buckling, numerical analysis, stability, steel

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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Authors: Juan Li, Jiawen Qiu, Yuchuan Chu, Tianping Zhang, Wei Meng, Yanhui Jia, Xiaohui Liu

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This article developed an ion thruster optic system sputter erosion depth numerical 3D model by IFE-PIC (Immersed Finite Element-Particle-in-Cell) and Mont Carlo method, and calculated the downstream surface sputter erosion rate of accelerator grid; Compared with LIPS-200 life test data, the results of the numerical model are in reasonable agreement with the measured data. Finally, we predict the lifetime of the 20cm diameter ion thruster via the erosion data obtained with the model. The ultimate result demonstrates that under normal operating condition, the erosion rate of the grooves wears on the downstream surface of the accelerator grid is 34.6μm⁄1000h, which means the conservative lifetime until structural failure occurring on the accelerator grid is 11500 hours.

Keywords: ion thruster, accelerator gird, sputter erosion, lifetime assessment

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Authors: G. Schuh, S. Woelk, D. Schraknepper, A. Such

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The systematic evaluation of manufacturing technologies with regard to the potential for product designing constitutes a major challenge. Until now, conventional evaluation methods primarily consider the costs of manufacturing technologies. Thus, the potential of manufacturing technologies for achieving additional product design features is not completely captured. To compensate this deficit, final evaluations of new technologies are mainly intuitive in practice. Therefore, an additional evaluation dimension is needed which takes the potential of manufacturing technologies for specific realizable product designs into account. In this paper, we present the approach of an evaluation method for selecting manufacturing technologies with regard to their potential for product designing. This research is done within the Fraunhofer innovation cluster »AdaM« (Adaptive Manufacturing) which targets the development of resource efficient and adaptive manufacturing technology processes for complex turbo machinery components.

Keywords: manufacturing, product design, production, technology assessment, technology management

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Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

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Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

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Authors: Valentina Milanova, Kalina Mihaylova, Iva Lazarova

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The mechanisms by which female genital infections are detected are varied and include clinician-collected high vaginal swabs, clinician-collected endocervical swabs, patient-collected vaginal swabs, and first-pass urine samples. Vaginal health screening has chronically low rates of uptake. This highlights the unmet need for a screening tool with comparable diagnostic accuracy which is familiar, convenient and easy to use for people. The Daye™ medical grade tampon offers an alternative to traditional sampling methods with the potential of increasing screening uptake among people previously too embarrassed or busy to attend gynecological appointments. In this white paper, the results of stability studies and a comparative clinical trial are discussed to assess the suitability of the device for the collection of vaginal samples for various clinical assessments. The tampon has demonstrated good sample stability and comparable sample quality compared to a self-collected vaginal swab and a clinician-collected cervical swab.

Keywords: vaginal microbiome, vaginal infections, gynaecological infections, female health, menstrual tampons, in vitro diagnostics

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Authors: Jasmin Cowin, Amany Alkhayat

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This paper will concentrate on a comparative analysis of both the advantages and limitations of using digital learning resources (DLRs). DLRs covered will be Virtual Reality (VR), Mobile Learning (M-learning) and Computer-Assisted Language Learning (CALL) together with their subset, Mobile Assisted Language Learning (MALL) in language education. In addition, best practices for language teaching and the application of established language teaching methodologies such as Communicative Language Teaching (CLT), the audio-lingual method, or community language learning will be explored. Education has changed dramatically since the eruption of the pandemic. Traditional face-to-face education was disrupted on a global scale. The rise of distance learning brought new digital tools to the forefront, especially web conferencing tools, digital storytelling apps, test authoring tools, and VR platforms. Language educators raced to vet, learn, and implement multiple technology resources suited for language acquisition. Yet, questions remain on how to harness new technologies, digital tools, and their ubiquitous availability while using established methods and methodologies in language learning paired with best teaching practices. In M-learning language, learners employ portable computing devices such as smartphones or tablets. CALL is a language teaching approach using computers and other technologies through presenting, reinforcing, and assessing language materials to be learned or to create environments where teachers and learners can meaningfully interact. In VR, a computer-generated simulation enables learner interaction with a 3D environment via screen, smartphone, or a head mounted display. Research supports that VR for language learning is effective in terms of exploration, communication, engagement, and motivation. Students are able to relate through role play activities, interact with 3D objects and activities such as field trips. VR lends itself to group language exercises in the classroom with target language practice in an immersive, virtual environment. Students, teachers, schools, language institutes, and institutions benefit from specialized support to help them acquire second language proficiency and content knowledge that builds on their cultural and linguistic assets. Through the purposeful application of different language methodologies and teaching approaches, language learners can not only make cultural and linguistic connections in DLRs but also practice grammar drills, play memory games or flourish in authentic settings.

Keywords: language teaching methodologies, computer-assisted language learning, mobile learning, virtual reality

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Authors: Yueying Chen

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A city can be developed through memory, and memory is one of the most important elements for urban contexts. Collective memory is a collection of personal memories that can be preserved with objects, places, and events of heritage, expressing culture through spatial changes. These preserved forms can evoke a sense of community and certain emotions. Collective memory in cities reflects urban spatial alterations and historical developments. It can be preserved and reflected by revitalisation projects. A major current focus in collective memory research is how to identify and preserve memory in an intangible way. The influential elements within the preservation of collective memory mainly include institutions and objects. However, current research lacks the assessment of the collective memory after alterations of urban heritage. The assessment of urban heritage lacks visualization and qualitative methods. The emergence of the application of space syntax can fill in this gap. Hengshan Mansions was a new project in 2015. The original residential area has been replaced with a comprehensive commercial area integrating boutique shopping, upscale restaurants, and creative offices. Hengshan Mansions is located in the largest historic area in Shanghai, and its development is the epitome of the traditional culture in Shanghai. Its alteration is the newest project in this area and presents the new concept of revitalisation of urban heritage. For its physical parts, modern vitality is created, and historical information is preserved at the same time. However, most of the local people are moved away, and its functions are altered a lot. The preservation of its collective memory needs to discuss furtherly. Thus, the article builds a framework to assess the collective memory of urban heritage, including spatial configuration, spatial interaction, and cultural cognition. Then, it selects Hengshan Mansions in Shanghai as a case to analyse the assessed framework. Space syntax can be applied to visualize the assessment. Based on the analysis, the article will explore the influential reasons for the collective memory after alterations and proposes relevant advice for the preservation of the collective memory of urban heritage.

Keywords: collective memory, alternation of urban heritage, space syntax, Hengshan Mansions

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Authors: Hafsa Qabool, Rashna Sukhia, Mubassar Fida

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Introduction: Success of orthodontic mechanotherapy is highly dependent upon patient cooperation and compliance throughout the duration of treatment. This study was conducted to assess the cooperation and compliance of adult orthodontic patients during the leveling and alignment, space closure/molar correction, and finishing stages of tooth movement. Materials and Methods: Patient cooperation and compliance among three stages of orthodontic treatment were assessed using the Orthodontic Patient Cooperation Scale (OPCS) and Clinical Compliance Evaluation (CCE) form. A sample size of 38 was calculated for each stage of treatment; therefore, 114 subjects were included in the study. Shapiro-Wilk test identified that the data were normally distributed. One way ANOVA was used to evaluate the percentage cooperation and compliance among the three stages. Pair-wise comparisons between the three stages were performed using Post-hoc Tukey. Results: Statistically significant difference was seen for scores of patient compliance using CCE (p = 0.01); however, the results of the OPCS showed a non-significant difference for patient cooperation (p = 0.16) among the three stages of treatment. Post-hoc analysis showed significant differences (p = 0.01) in patient cooperation and compliance between space closure and the finishing stage. Highly significant (p < 0.001) decline in oral hygiene was found with the progression of orthodontic treatment. Conclusions: Improvement in the cooperation and compliance levels for adult orthodontic patients was observed during space closure & molar correction stage, which then showed a decline as treatment progressed. Oral hygiene was progressively compromised as orthodontic treatment progressed.

Keywords: patient compliance, adult orthodontics, orthodontic motivation, orthodontic patient adherence

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Authors: Aber Aboalgasm, Rupert Ward, Ruth Taylor, Jonathan Glazzard

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Teaching art by digital means is a big challenge for the majority of teachers of art and artistic design courses in primary education schools. These courses can clearly identify relationships between art, technology, and creativity in the classroom .The aim of this article is to present a modern way of teaching art, using digital tools in the art classroom in order to improve creative ability in pupils aged between 9 and 11 years; it also presents a conceptual model for creativity based on digital art. The model could be useful for pupils interested in learning drawing and using an e-drawing package, and for teachers who are interested in teaching their students modern digital art, and improving children’s creativity. This model is designed to show the strategy of teaching art through technology, in order for children to learn how to be creative. This will also help education providers to make suitable choices about which technological approaches they should choose to teach students and enhance their creative ability. It is also expected that use of this model will help to develop social interactive qualities that may improve intellectual ability.

Keywords: digital tools, motivation, creative activity, education

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: J. Carlos Frutos Dordelly, M. Coillot, M. El Mankibi, R. Enríquez Miranda, M. José Jimenez, J. Arce Landa

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Natural ventilation systems have increasingly been the subject of research due to rising energetic consumption within the building sector and increased environmental awareness. In the last two decades, the mounting concern of greenhouse gas emissions and the need for an efficient passive ventilation system have driven the development of new alternative passive technologies such as ventilated facades, trombe walls or solar chimneys. The objective of the study is the assessment of PCM panels in an in situ solar chimney for the establishment of a numerical model. The PCM integrated solar chimney shows slight performance improvement in terms of mass flow rate and external temperature and outlet temperature difference. An increase of 11.3659 m³/h can be observed during low wind speed periods. Additionally, the surface temperature across the chimney goes beyond 45 °C and allows the activation of PCM panels.

Keywords: energy storage, natural ventilation, phase changing materials, solar chimney, solar energy

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Zama Mahmood

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The increasing demand of food management, monitoring of the crop growth and forecasting its yield well before harvest is very important. These days, yield assessment together with monitoring of crop development and its growth are being identified with the help of satellite and remote sensing images. Studies using remote sensing data along with field survey validation reported high correlation between vegetation indices and yield. With the development of remote sensing technique, the detection of crop and its mechanism using remote sensing data on regional or global scales have become popular topics in remote sensing applications. Punjab, specially the southern Punjab region is extremely favourable for wheat production. But measuring the exact amount of wheat production is a tedious job for the farmers and workers using traditional ground based measurements. However, remote sensing can provide the most real time information. In this study, using the Normalized Differentiate Vegetation Index (NDVI) indicator developed from Landsat satellite images, the yield of wheat has been estimated during the season of 2013-2014 for the agricultural area around Bahawalpur. The average yield of the wheat was found 35 kg/acre by analysing field survey data. The field survey data is in fair agreement with the NDVI values extracted from Landsat images. A correlation between wheat production (ton) and number of wheat pixels has also been calculated which is in proportional pattern with each other. Also a strong correlation between the NDVI and wheat area was found (R2=0.71) which represents the effectiveness of the remote sensing tools for crop monitoring and production estimation.

Keywords: landsat, NDVI, remote sensing, satellite images, yield

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Authors: Sasikala Govindaraj, P. Palanisamy, G. M. Natarajan

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Domestic sewage poses major threats to the aquatic environment in third world countries due to lack of technical and economic sources which can have significant impacts on fish. The tolerance limits to toxicants found in domestic effluents vary among species and their integrative effects may lead to reproductive failure and reduction of survival and growth of the more sensitive fish species. The mechanism of action of toxic substances upon various concentrations of sewage was taken aiming to evaluate locomotory, physiological, neurological and morbidity response of fish. The rapid biomonitoring assessment technique for qualitative evaluation of various industrial pollutants, behavioral responses of an air-breathing fish Pangasius pangasius were used as biomarkers for water quality assessment. The present investigation concluded that sewage is highly toxic to the fish and severely affects their physiology and behavior.

Keywords: air-breathing organs, behavioral, locomotory, morbidity, neurological, physiological, sewage

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