Search results for: dynamic method

Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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Authors: Shiau-Fang Chao, Yu-Chih Chen

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Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

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Authors: Qian Sun, Dannie Dai, Vivian Lou

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Background: Changes in population structure and modernization have left traditional channels of achieving intergenerational solidarity in crisis. Policies and projects purposefully structuring intergenerational interaction are regarded as effective ways to enhance positive attitude changes between generations. However, few inter-generational interaction program has put equal emphasis on promoting positive changes on both attitude and behavior across generational groups. Objective: This study evaluated the effectiveness of an intergenerational interaction program which aims to facilitate positive attitude and behavioral interaction between both young and old individuals in Hong Kong. Method: A quasi-experimental design was adopted with the sample of 150 older participants and 161 young participants. Among 73 older and 78 young participants belong to experiment groups while 77 older participants and 84 young participants belong to control groups. The Age Group Evaluation and Description scale (AGED) was adopted to measure attitude toward young people by older participants and the Chinese version of Kogan’s Attitude towards Older People (KAOP) as well as Polizzi’s refined version of the Ageing Semantic Differential Scale (ASD) were used to measure attitude toward older people by the younger generation. The interpersonal behaviour of participants was assessed using Beglgrave’s behavioural observation tool. Six primary verbal or non-verbal interpersonal behaviours including smiles, looks, touches, encourages, initiated conversations and assists were identified and observed. Findings Effectiveness of attitude and behavior changes on both younger and older participants was confirmed in results. Compared with participants from the control group, experimental participants of elderly showed significant positive changes of attitudes toward the younger generation as assessed by AGED (F=138.34, p < .001). Moreover, older participants showed significant positive changes on three out of six behaviours (visual attention: t=2.26, p<0.05; initiate conversation: t=3.42, p<0.01; and touch: t=2.28, p<0.05). For younger participants, participants from experimental group showed significant positive changes in attitude toward older people (with F-score of 47.22 for KAOP and 72.75 for ASD, p<.001). Young participants also showed significant positive changes in two out of six behaviours (visual attention: t=3.70, p<0.01; initiate conversation: t=2.04, p<0.001). There is no significant relationship between attitude change and behaviour change in both older (p=0.86) and younger (p=0.22) groups. Conclusion: This study has brought practical implications for social work. The effective model of this program could assist social workers and allied professionals to design relevant projects for nurture intergenerational solidarity. Furthermore, insignificant results between attitude and behavior changes revealed that attitude change was not a strong predictor for behavior change, hence, intergenerational programs against age-stereotype should put equal emphasis on both attitudinal and behavioral aspects.

Keywords: attitude and behaviour changes, intergenerational interaction, intergenerational solidarity, program design

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Authors: Elif Erdem, Nalan Kaya, Gonca Ozan, Durrin Ozlem Dabak, Enver Ozan

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This study was carried out to determine the histological and biochemical changes in the lungs of the rat pups exposed to tobacco smoke during pregnancy period and to investigate the protective effects of alpha lipoic acid, which is administered during pregnancy, on these changes. In our study, 24 six-week old Spraque-Dawley female rats weighing 160 ± 10 g were used (n:7). Rats were randomly divided into four equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + alpha lipoic acid) and group IV (alpha lipoic acid). Rats in the group II, group III were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group III. Only alpha lipoic acid was administered to the rats in the group IV. Once after the delivery, all administrations were stopped. On the 7 and 21th days, the seven pups of all groups were decapitated. A portion of the lung was taken and stained with HE, PAS and Masson. In addition to immunohistochemical staining of surfactant protein A, vascular endothelial growth factor, caspase-3, TUNEL method was also used to determine apoptosis. Biochemical analyzes were performed with some part of the lung tissue specimens. In the histological evaluations performed under light microscopy, inflammatory cell increase, hemorrhagic areas, edema, interalveolar septal thickening, alveolar numbers decrease, degeneration of some bronchi and bronchial epithelium, epithelial cells that were fallen into the lumen and hyaline membrane formation were observed in tobacco smoke group. These findings were ameliorated in tobacco smoke + ALA group. Hyaline membrane formation was not detected in this group. The TUNEL positive cell numbers a significant increase was detected in the tobacco smoke group, whereas a significant decrease was detected in the tobacco smoke + ALA group. In terms of the immunoreactivity of both SP-A and VEGF, a significant decrease was observed in the tobacco smoke group, and a significant increase was observed in the tobacco smoke + ALA group. Regarding the immunoreactivity of caspase-3, there was a significant increase in the group of tobacco smoke and a significant decrease in the group of tobacco smoke + ALA. The malondialdehyde levels were determined to be significantly increased in the tobacco smoke group, and a significant decreased in the tobacco smoke + ALA. Glutathione and superoxide dismutase enzyme activities showed a significant decrease in the group of tobacco smoke and a significant increase in the tobacco smoke + ALA group. In conclusion, we suggest that the exposure to tobacco smoke during pregnancy leads to morphological, histopathological and functional changes on lung development by causing oxidative damage in lung tissues of neonatal rats and the maternal use of alpha lipoic acid can provide a protective effect on the neonatal lung development against this oxidative stress originating from tobacco smoke.

Keywords: alpha lipoic acid, lung, neonate, tobacco smoke, pregnancy

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Authors: Ciprian Briciu-Burghina, Brendan Heery, Dermot Brabazon, Fiona Regan

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Good quality bathing water is a highly desirable natural resource which can provide major economic, social, and environmental benefits. Both in Ireland and Europe, such water bodies are managed under the European Directive for the management of bathing water quality (BWD). The BWD aims mainly: (i) to improve health protection for bathers by introducing stricter standards for faecal pollution assessment (E. coli, enterococci), (ii) to establish a more pro-active approach to the assessment of possible pollution risks and the management of bathing waters, and (iii) to increase public involvement and dissemination of information to the general public. Standard methods for E. coli and enterococci quantification rely on cultivation of the target organism which requires long incubation periods (from 18h to a few days). This is not ideal when immediate action is required for risk mitigation. Municipalities that oversee the bathing water quality and deploy appropriate signage have to wait for laboratory results. During this time, bathers can be exposed to pollution events and health risks. Although forecasting tools exist, they are site specific and as consequence extensive historical data is required to be effective. Another approach for early detection of faecal pollution is the use of marker enzymes. β-glucuronidase (GUS) is a widely accepted biomarker for E. coli detection in microbiological water quality control. GUS assay is particularly attractive as they are rapid, less than 4 h, easy to perform and they do not require specialised training. A method for on-site detection of GUS from environmental samples in less than 75 min was previously demonstrated. In this study, the capability of ColiSense as an early warning system for faecal pollution in freshwater is assessed. The system successfully detected GUS activity in all of the 45 freshwater samples tested. GUS activity was found to correlate linearly with E. coli (r2=0.53, N=45, p < 0.001) and enterococci (r2=0.66, N=45, p < 0.001) Although GUS is a marker for E. coli, a better correlation was obtained for enterococci. For this study water samples were collected from 5 rivers in the Dublin area over 1 month. This suggests a high diversity of pollution sources (agricultural, industrial, etc) as well as point and diffuse pollution sources were captured in the sample size. Such variety in the source of E. coli can account for different GUS activities/culturable cell and different ratios of viable but not culturable to viable culturable bacteria. A previously developed protocol for the recovery and detection of E. coli was coupled with a miniaturised fluorometer (ColiSense) and the system was assessed for the rapid detection FIB in freshwater samples. Further work will be carried out to evaluate the system’s performance on seawater samples.

Keywords: faecal pollution, β-glucuronidase (GUS), bathing water, E. coli

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Authors: Deborah Bailey-Rodriguez, Maria Paula Valdivieso Rueda, Gemma Reynolds

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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counseling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues, with 94% of HE institutions recently reporting an increase in the need for counseling services. One way of improving the well-being and mental health of HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group was required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group was required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15 minutes per day for four consecutive days. Baseline mental health and well-being measures were taken before the intervention via a battery of standardized questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. Preliminary findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity mean it can be easily implemented and can be freely available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: expressive writing, higher education, psychology in education, mixed-methods, mental health, academic stress

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Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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Authors: Felicia Orah Rein Moshe

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Soil erosion has become a priority global concern, impairing water quality and degrading ecosystem services. In Mediterranean climates, following a long dry period, the onset of rain occurs when agricultural soils are often bare and most vulnerable to erosion. Early storms transport sediments and sediment-bound pollutants into streams, along with dissolved chemicals. This results in loss of valuable topsoil, water quality degradation, and potentially expensive dredged-material disposal costs. Information on the provenance of fine sediment and priority sources of adsorbed pollutants represents a critical need for developing effective control strategies aimed at source reduction. Modifying sediment traps designed for marine systems, this study tested a cost-effective method to collect suspended sediments on a catchment scale to characterize stream water quality during first-flush storm events in a flashy Eastern Mediterranean coastal perennial stream. This study investigated the Kishon Basin, deploying sediment traps in 23 locations, including 4 in the mainstream and one downstream in each of 19 tributaries, enabling the characterization of sediment as a vehicle for transporting chemicals. Further, it enabled direct comparison of sediment-bound pollutants transported during the first-flush winter storms of 2020 from each of 19 tributaries, allowing subsequent ecotoxicity ranking. Sediment samples were successfully captured in 22 locations. Pesticides, pharmaceuticals, nutrients, and metal concentrations were quantified, identifying a total of 50 pesticides, 15 pharmaceuticals, and 22 metals, with 16 pesticides and 3 pharmaceuticals found in all 23 locations, demonstrating the importance of this transport pathway. Heavy metals were detected in only one tributary, identifying an important watershed pollution source with immediate potential influence on long-term dredging costs. Simultaneous sediment sampling at first flush storms enabled clear identification of priority tributaries and their chemical contributions, advancing a new national watershed monitoring approach, facilitating strategic plan development based on source reduction, and advancing the goal of improving the farm-stream interface, conserving soil resources, and protecting water quality.

Keywords: adsorbed pollution, dredged material, heavy metals, suspended sediment, water quality monitoring

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Authors: Hiromi Kawai

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This study investigates the nature of EFL older children’s L2 perceptive and productive abilities using classroom data, in order to find a pedagogical solution to the teaching of L2 sounds at an early stage of learning in a formal school setting. It is still inconclusive whether older children with only EFL formal school instruction at the initial stage of L2 learning are able to attain native-like perception and production in English within the very limited amount of exposure to the target language available. Based on the notion of the lack of study of EFL Japanese children’s acquisition of English segments, the researcher uses a model of L1 speech processing which was developed for investigating L1 English children’s speech and literacy difficulties using a psycholinguistic framework. The model is composed of input channel, output channel, and lexical representation, and examines how a child receives information from spoken or written language, remembers and stores it within the lexical representations and how the child selects and produces spoken or written words. Concerning language universality and language specificity in the language acquisitional process, the aim of finding any sound errors in L1 English children seemed to conform to the author’s intention to find abilities of English sounds in older Japanese children at the novice level of English in an EFL setting. 104 students in Grade 5 (between the ages of 10 and 11 years old) of an elementary school in Tokyo participated in this study. Four tests to measure their perceptive ability and three oral repetition tests to measure their productive ability were conducted with/without reference to lexical representation. All the test items were analyzed to calculate item facility (IF) indices, and correlational analyses and Structural Equation Modeling (SEM) were conducted to examine the relationship between the receptive ability and the productive ability. IF analysis showed that (1) the participants were better at perceiving a segment than producing a segment, (2) they had difficulty in auditory discrimination of paired consonants when one of them does not exist in the Japanese inventory, (3) they had difficulty in both perceiving and producing English vowels, and (4) their L1 loan word knowledge had an influence on their ability to perceive and produce L2 sounds. The result of the Multiple Regression Modeling showed that the two production tests could predict the participants’ auditory ability of real words in English. The result of SEM showed that the hypothesis that perceptive ability affects productive ability was supported. Based on these findings, the author discusses the possible explicit method of teaching English segments to EFL older children in a formal school setting.

Keywords: EFL older children, english segments, perception, production, speech processing system

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Authors: Sayem Zafar, Mahmood Rahi

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Rigorous international maritime regulations are in place to limit boat and ship hydrocarbon emissions. The global sustainability goals are reducing the fuel consumption and minimizing the emissions from the ships and boats. These maritime sustainability goals have attracted a lot of research interest. Energy harvesting and storage system is designed in this study based on hybrid renewable and conventional energy systems. This energy harvesting and storage system is designed for marine applications, such as, boats and small ships. These systems can be utilized for mobile use or off-grid remote electrification. This study analyzed the use of micro power generation for boats and small ships. The energy harvesting and storage system has two distinct systems i.e. dockside shore-based system and on-board system. The shore-based system consists of a small wind turbine, photovoltaic (PV) panels, small gas turbine, hydrogen generator and high-pressure hydrogen storage tank. This dockside system is to provide easy access to the boats and small ships for supply of hydrogen. The on-board system consists of hydrogen storage tanks and fuel cells. The wind turbine and PV panels generate electricity to operate electrolyzer. A small gas turbine is used as a supplementary power system to contribute in case the hybrid renewable energy system does not provide the required energy. The electrolyzer performs the electrolysis on distilled water to produce hydrogen. The hydrogen is stored in high-pressure tanks. The hydrogen from the high-pressure tank is filled in the low-pressure tanks on-board seagoing vessels to operate the fuel cell. The boats and small ships use the hydrogen fuel cell to provide power to electric propulsion motors and for on-board auxiliary use. For shore-based system, a small wind turbine with the total length of 4.5 m and the disk diameter of 1.8 m is used. The small wind turbine dimensions make it big enough to be used to charge batteries yet small enough to be installed on the rooftops of dockside facility. The small dimensions also make the wind turbine easily transportable. In this paper, PV, sizing and solar flux are studied parametrically. System performance is evaluated under different operating and environmental conditions. The parametric study is conducted to evaluate the energy output and storage capacity of energy storage system. Results are generated for a wide range of conditions to analyze the usability of hybrid energy harvesting and storage system. This energy harvesting method significantly improves the usability and output of the renewable energy sources. It also shows that small hybrid energy systems have promising practical applications.

Keywords: energy harvesting, fuel cell, hybrid energy system, hydrogen, wind turbine

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Authors: Gómez S. Jennifer, Méndez V. Camila, Moncayo M. Diana, Vega M. Lizeth

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The cape gooseberry is a climacteric fruit; Colombia is one of the principal exporters in the world. The environmental condition of temperature and relative moisture decreases the titratable acidity and pH. These conditions and fruit maturation result in the fungal proliferation of Botrytis cinerea disease. Plastic packaging for fresh cape gooseberries was used for mechanical damage protection but created a suitable atmosphere for fungal growth. Beta-cyclodextrins are currently implemented as coatings for the encapsulation of hydrophobic compounds, for example, with bioactive compounds from essential oils such as cinnamaldehyde, which has a high antimicrobial capacity. However, it is a volatile substance. In this article, the casting method was used to obtain a polylactic acid (PLA) polymer film containing the beta-cyclodextrin-cinnamaldehyde inclusion complex, generating an insert that allowed the controlled release of the antifungal substance in packed cape gooseberries to decrease contamination by Botrytis cinerea in a latent state during storage. For the encapsulation technique, three ratios for the cinnamaldehyde: beta-cyclodextrin inclusion complex were proposed: (25:75), (40:60), and (50:50). Spectrophotometry, colorimetry in L*a*b* coordinate space and scanning electron microscopy (SEM) were made for the complex characterization. Subsequently, two ratios of tween and water (40:60) and (50:50) were used to obtain the polylactic acid (PLA) film. To determine mechanical and physical parameters of colourimetry in L*a*b* coordinate space, atomic force microscopy and stereoscopy were done to determine the transparency and flexibility of the film; for both cases, Statgraphics software was used to determine the best ratio in each of the proposed phases, where for encapsulation it was (50:50) with an encapsulation efficiency of 65,92%, and for casting the ratio (40:60) obtained greater transparency and flexibility that permitted its incorporation into the polymeric packaging. A liberation assay was also developed under ambient temperature conditions to evaluate the concentration of cinnamaldehyde inside the packaging through gas chromatography for three weeks. It was found that the insert had a controlled release. Nevertheless, a higher cinnamaldehyde concentration is needed to obtain the minimum inhibitory concentration for the fungus Botrytis cinerea (0.2g/L). The homogeneity of the cinnamaldehyde gas phase inside the packaging can be improved by considering other insert configurations. This development aims to impact emerging food preservation technologies with the controlled release of antifungals to reduce the affectation of the physico-chemical and sensory properties of the fruit as a result of contamination by microorganisms in the postharvest stage.

Keywords: antifungal, casting, encapsulation, postharvest

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Authors: Munenari Inoguchi, Keiko Tamura

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In Japan, we were suffered by earthquake, typhoon, and flood disaster in 2019. Especially, 38 of 47 prefectures were affected by typhoon #1919 occurred in October 2019. By this disaster, 99 people were dead, three people were missing, and 484 people were injured as human damage. Furthermore, 3,081 buildings were totally collapsed, 24,998 buildings were half-collapsed. Once disaster occurs, local responders have to inspect damage level of each building by themselves in order to certificate building damage for survivors for starting their life reconstruction process. At that disaster, the total number to be inspected was so high. Based on this situation, Cabinet Office of Japan approved the way to detect building damage level efficiently, that is collectively detection. However, they proposed a just guideline, and local responders had to establish the concrete and infallible method by themselves. Against this issue, we decided to establish the effective and efficient methodology to detect building damage level collectively with flood depth. Besides, we thought that the flood depth was relied on the land height, and we decided to utilize GIS (Geographic Information System) for analyzing the elevation spatially. We focused on the analyzing tool of spatial interpolation, which is utilized to survey the ground water level usually. In establishing the methodology, we considered 4 key-points: 1) how to satisfy the condition defined in the guideline approved by Cabinet Office for detecting building damage level, 2) how to satisfy survivors for the result of building damage level, 3) how to keep equitability and fairness because the detection of building damage level was executed by public institution, 4) how to reduce cost of time and human-resource because they do not have enough time and human-resource for disaster response. Then, we proposed a methodology for detecting building damage level collectively with flood depth utilizing GIS with five steps. First is to obtain the boundary of flooded area. Second is to collect the actual flood depth as sampling over flooded area. Third is to execute spatial analysis of interpolation with sampled flood depth to detect two-dimensional flood depth extent. Fourth is to divide to blocks by four categories of flood depth (non-flooded, over the floor to 100 cm, 100 cm to 180 cm and over 180 cm) following lines of roads for getting satisfaction from survivors. Fifth is to put flood depth level to each building. In Koriyama city of Fukushima prefecture, we proposed the methodology of collectively detection for building damage level as described above, and local responders decided to adopt our methodology at typhoon #1919 in 2019. Then, we and local responders detect building damage level collectively to over 1,000 buildings. We have received good feedback that the methodology was so simple, and it reduced cost of time and human-resources.

Keywords: building damage inspection, flood, geographic information system, spatial interpolation

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Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke

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Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.

Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants

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Authors: Seyed Hamed Mousavi, Juha M. Hijmans, Reza Rajabi, Ron Diercks, Johannes Zwerver, Henk van der Worp

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Introduction: Running is one of the most popular sports activity among people. Improper sagittal plane ankle, knee and hip kinematics are considered to be associated with the increase of injury risk in runners. Motion assessing smart-phone applications are increasingly used to measure kinematics both in the field and laboratory setting, as they are cheaper, more portable, accessible, and easier to use relative to 3D motion analysis system. The aims of this study are 1) to compare the results of 3D gait analysis system and CE; 2) to evaluate the test-retest and intra-rater reliability of coach’s eye (CE) app for the sagittal plane hip, knee, and ankle angles in the touchdown and toe-off while running. Method: Twenty subjects participated in this study. Sixteen reflective markers and cluster markers were attached to the subject’s body. Subjects were asked to run at a self-selected speed on a treadmill. Twenty-five seconds of running were collected for analyzing kinematics of interest. To measure sagittal plane hip, knee and ankle joint angles at touchdown (TD) and toe off (TO), the mean of first ten acceptable consecutive strides was calculated for each angle. A smartphone (Samsung Note5, android) was placed on the right side of the subject so that whole body was simultaneously filmed with 3D gait system during running. All subjects repeated the task with the same running speed after a short interval of 5 minutes in between. The CE app, installed on the smartphone, was used to measure the sagittal plane hip, knee and ankle joint angles at touchdown and toe off the stance phase. Results: Intraclass correlation coefficient (ICC) was used to assess test-retest and intra-rater reliability. To analyze the agreement between 3D and 2D outcomes, the Bland and Altman plot was used. The values of ICC were for Ankle at TD (TRR=0.8,IRR=0.94), ankle at TO (TRR=0.9,IRR=0.97), knee at TD (TRR=0.78,IRR=0.98), knee at TO (TRR=0.9,IRR=0.96), hip at TD (TRR=0.75,IRR=0.97), hip at TO (TRR=0.87,IRR=0.98). The Bland and Altman plots displaying a mean difference (MD) and ±2 standard deviation of MD (2SDMD) of 3D and 2D outcomes were for Ankle at TD (MD=3.71,+2SDMD=8.19, -2SDMD=-0.77), ankle at TO (MD=-1.27, +2SDMD=6.22, -2SDMD=-8.76), knee at TD (MD=1.48, +2SDMD=8.21, -2SDMD=-5.25), knee at TO (MD=-6.63, +2SDMD=3.94, -2SDMD=-17.19), hip at TD (MD=1.51, +2SDMD=9.05, -2SDMD=-6.03), hip at TO (MD=-0.18, +2SDMD=12.22, -2SDMD=-12.59). Discussion: The ability that the measurements are accurately reproduced is valuable in the performance and clinical assessment of outcomes of joint angles. The results of this study showed that the intra-rater and test-retest reliability of CE app for all kinematics measured are excellent (ICC ≥ 0.75). The Bland and Altman plots display that there are high differences of values for ankle at TD and knee at TO. Measuring ankle at TD by 2D gait analysis depends on the plane of movement. Since ankle at TD mostly occurs in the none-sagittal plane, the measurements can be different as foot progression angle at TD increases during running. The difference in values of the knee at TD can depend on how 3D and the rater detect the TO during the stance phase of running.

Keywords: reliability, running, sagittal plane, two dimensional

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Authors: Gustavo Axel Elizalde-Velázquez

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Metformin is the first line of oral therapy to treat type II diabetes and is also employed as a treatment for other indications, such as polycystic ovary syndrome, cancer, and COVID-19. Recent data suggest it is the aspirin of the 21st century due to its antioxidant and anti-aging effects. However, increasingly current articles indicate its long-term consumption generates mitochondrial impairment. Up to date, it is known metformin increases the biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcription, but further information related to brain damage after its consumption is missing. Bearing in mind the above, this work aimed to establish whether or not chronic exposure to metformin may alter swimming behavior and induce neurotoxicity in Danio rerio adults. For this purpose, 250 Danio rerio grown-ups were assigned to six tanks of 50 L of capacity. Four of the six systems contained 50 fish, while the remaining two had 25 fish (≈1 male:1 female ratio). Every system with 50 fish was allocated one of the three metformin treatment concentrations (1, 20, and 40 μg/L), with one system as the control treatment. Systems with 25 fish, on the other hand, were used as positive controls for acetylcholinesterase (10 μg/L of Atrazine) and oxidative stress (3 μg/L of Atrazine). After four months of exposure, a mean of 32 fish (S.D. ± 2) per group of MET treatment survived, which were used for the evaluation of behavior with the Novel Tank test. Moreover, after the behavioral assessment, we aimed to collect the blood and brains of all fish from all treatment groups. For blood collection, fish were anesthetized with an MS-222 solution (150 mg/L), while for brain gathering, fish were euthanized using the hypothermic shock method (2–4 °C). Blood was employed to determine CASP3 activity and the percentage of apoptotic cells with the TUNEL assay, and brains were used to evaluate acetylcholinesterase activity, oxidative damage, and gene expression. After chronic exposure, MET-exposed fish exhibited less swimming activity when compared to control fish. Moreover, compared with the control group, MET significantly inhibited the activity of AChE and induced oxidative damage in the brain of fish. Concerning gene expression, MET significantly upregulated the expression of Nrf1, Nrf2, BAX, p53, BACE1, APP, PSEN1, and downregulated CASP3 and CASP9. Although MET did not overexpress the CASP3 gene, we saw a meaningful rise in the activity of this enzyme in the blood of fish exposed to MET compared to the control group, which we then confirmed by a high number of apoptotic cells in the TUNEL assay. To the best of our understanding, this is the first study that delivers evidence of oxidative impairment, apoptosis, AChE alteration, and overexpression of B- amyloid-related genes in the brain of fish exposed to metformin.

Keywords: AChE inhibition, CASP3 activity, NovelTank test, oxidative damage, TUNEL assay

Procedia PDF Downloads 86

Authors: Qiuhu Shao

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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.

Keywords: data envelopment analysis, home-based care, performance management, social organization

Procedia PDF Downloads 269

Authors: Flora Takayindisa, Tsoaledi Thobejane, Thizwilondi Mudau

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This study highlights what people in polygamous marriages face on a daily basis. It argues that there are more disadvantages for women in polygamous marriages than their counterparts in monogamous relationships. The study further suggests that the patriarchal power structure seems to take a powerful and effective role on polygamous marriages in our societies, particularly in Zimbabwe where this study took place. The study explored the intricacies of polygamous marriages and how these dominances can be resolved. The research is therefore presented through the ‘lived realities’ of the affected women in polygamous marriages in Gutu District located in Masvingo Province of Zimbabwe. Polygamous marriages are practised in different societies. Some women who are practising a polygamous lifestyle are emotionally and physically abused in their relationships. Evidence also suggests children from polygamous marriages also suffer psychologically when their fathers take other wives. Relationships within the family are very difficult because of the husband’s seeming favouritism for one wife. Children are mostly affected by disputes between co-wives and they often lack quality time with their fathers. There are mixed feelings about polygamous marriages. There are some people who condemn it saying inhumane. However, considerations must be made of what it might mean to other people who do not have choices of any other form of marriage. The other factor that has to be noted is that polygamous marriages are not always negative. There are some positive things that result from the polygamous marriages. The study was conducted in a village called Matizha. In the study, a qualitative research approach was employed to stimulate awareness of the social, cultural, religious and the effect of economic factors in polygamous marriages. This approach facilitates a unique understanding of the experiences of women in polygamous marriages, their experiences being both negative and positive. The qualitative type of research method enabled the respondents to have an open minded when they were being asked questions. The researcher utilised the feminist theory in the study. The researcher employed guide interviews to acquire information from the participants. The chapter focuses on the participants who took part in the study, how the participants were selected, ethical considerations, data collection, the interview process, the research instruments and the summary. The data was obtained using a guided interview for all the respondents ranging from all ages who are in polygamous marriages. The researcher presented the demographic information of the participants. Thereafter, the researcher presented other aspects of the data collection like social factors, economic factors and also religious affiliation. The conclusions and recommendations are made from the four main themes that came up from the discussions. The recommendations were made for the women, the policies and laws affecting women, and finally, recommendations for future research. It is believed that the overall objectives of the study have been met and research questions have been answered based on the findings of the study discussed.

Keywords: co-wives, egalitarianism, experiences, polyandry, polygamy, woman

Procedia PDF Downloads 262

Authors: Satria B. Mahathma, Asri Hendrawati

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Background: Diabetes mellitus (DM) is a metabolic disorder syndrome characterized by chronic hyperglycemia. The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014. In general, almost 90% of the prevalence of DM is type 2 DM which marked by insulin resistance and decreased receptor sensitivity. Aside from conventional antidiabetic therapy, the utilization of medicinal plants as alternative medicine has beneficial effects in diabetic patients. Flavonoid contents in radish leaves such as quercetin, pelargonidin, and kaempferol are thought to have antidiabetic activity on decreasing blood glucose levels by tricyclic nucleotide modulation of pancreatic beta cells and ameliorating insulin resistance. This study aimed to determine the effect of variant concentration of radish leaves ethanol extract on blood glucose levels in diabetic rats. Method: This study used pretest-posttest control group design by using 16 male Wistar rats which were induced type-2 diabetic by streptozotocin 60 mg/kg BW-nicotinamide 120 mg/kg BW intraperitoneally. Rats who had developed type-2 DM later divided randomly into 4 groups; negative control received placebo, positive control received glibenclamide 5 mg/kg BW/day, rats intervention I and intervention II received 100% and 50% of radish leaves ethanol extract, respectively. Treatments were administered orally for four weeks. The blood glucose levels were measured using the Enzymatic Colorimetric Test “GOD-PAP”. Data were analyzed by the dependent t-test for pretest-posttest intervention difference and one-way ANOVA followed by post hoc test to determine the significant difference of each treatment to obtain the significant data. Result: The result revealed that intervention group had lower blood glucose levels mean than control group which the lowest was intervention II group (negative control: 540,9 ± 191,7 mg/dl, positive control: 494, 97 ± 64,91 mg/dl, intervention I: 301,92 ± 165,70 mg/dl, and intervention II group: 276,1 ± 139,02 mg/dl. Intervention II group had the highest antidiabetic activity, followed by the intervention I group with the amount of decrease in blood glucose levels were -151,85 ± 77,43 mg/dl and -11,08 ± 186,62 mg/dl, however negative and positive control group didn’t have antidiabetic activity. The dependent t-test result showed there is a significant difference in decreasing blood glucose levels in the intervention II pretest-posttest intervention (p=0,03) while the other group didn’t. Data analyzed by one-way ANOVA also revealed the intervention II group significantly declined blood glucose levels compared to the negative and positive control group (p = 0,033 and p=0,032, respectively). Conclusion: There is a significant effect of radish leaves ethanol extract on blood glucose levels in streptozotocin-nicotinamide-induced diabetic rats with the optimal therapeutic effect at a concentration of 50%.

Keywords: blood glucose levels, medicinal plant, radish leaves, type-2 diabetes mellitus

Procedia PDF Downloads 135

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

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People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

Procedia PDF Downloads 114

Authors: Rensson Homero Celiz Ygnacio, Marco Aurélio Schiavo Novaes, Lucy Vanessa Sulca Ñaupas, Ana Paula Ribeiro Rodrigues

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The cryopreservation of testicular tissue emerges as an alternative for the preservation of the reproductive potential of individuals who still cannot produce sperm; however, they will undergo treatments that may affect their fertility (e.g., chemotherapy). Therefore, the present work aims to compare two cryopreservation methods (slow freezing and vitrification) in testicular tissue of prepubertal lambs. For that, to obtain the testicular tissue, the animals were castrated and the testicles were collected immediately in a physiological solution supplemented with antibiotics. In the laboratory, the testis was split into small pieces. The total size of the testicular fragments was 3×3x1 mm³ and was placed in a dish contained in Minimum Essential Medium (MEM-HEPES). The fragments were distributed randomly into non-cryopreserved (fresh control), slow freezing (SF), and vitrified. To SF procedures, two fragments from a given male were then placed in a 2,0 mL cryogenic vial containing 1,0 mL MEM-HEPES supplemented with 20% fetal bovine serum (FBS) and 20% dimethylsulfoxide (DMSO). Tubes were placed into a Mr. Frosty™ Freezing container with isopropyl alcohol and transferred to a -80°C freezer for overnight storage. On the next day, each tube was plunged into liquid nitrogen (NL). For vitrification, the ovarian tissue cryosystem (OTC) device was used. Testicular fragments were placed in the OTC device and exposed to the first vitrification solution composed of MEM-HEPES supplemented with 10 mg/mL Bovine Serum Albumin (BSA), 0.25 M sucrose, 10% Ethylene glycol (EG), 10% DMSO and 150 μM alpha-lipoic acid for four min. The VS1 was discarded and then the fragments were submerged into a second vitrification solution (VS2) containing the same composition of VS1 but 20% EG and 20% DMSO. VS2 was then discarded and each OTC device containing up to four testicular fragments was closed and immersed in NL. After the storage period, the fragments were removed from the NL, kept at room temperature for one min and then immersed at 37 °C in a water bath for 30 s. Samples were warmed by sequentially immersing in solutions of MEM-HEPES supplemented with 3 mg/mL BSA and decreasing concentrations of sucrose. Hematoxylin-eosin staining to analyze the tissue architecture was used. The score scale used was from 0 to 3, classified with a score 0 representing normal morphologically, and 3 were considered a lot of alteration. The histomorphological evaluation of the testicular tissue shows that when evaluating the nuclear alteration (distinction of nucleoli and condensation of nuclei), there are no differences when using slow freezing with respect to the control. However, vitrification presents greater damage (p <0.05). On the other hand, when evaluating the epithelial alteration, we observed that the freezing showed scores statistically equal to the control in variables such as retraction of the basement membrane, formation of gaps and organization of the peritubular cells. The results of the study demonstrated that cryopreservation using the slow freezing method is an excellent tool for the preservation of pubertal testicular tissue.

Keywords: cryopreservation, slow freezing, vitrification, testicular tissue, lambs

Procedia PDF Downloads 174

Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

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Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

Procedia PDF Downloads 60

Authors: D. Kakulia, L. Shoshiashvili, G. Sapharishvili

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The results of the study are related to the direction of plastic mine detection research using electromagnetic induction, the development of appropriate equipment, and the evaluation of expected results. Electromagnetic induction sensing is effectively used in the detection of metal objects in the soil and in the discrimination of unexploded ordnances. Metal objects interact well with a low-frequency alternating magnetic field. Their electromagnetic response can be detected at the low-frequency range even when they are placed in the ground. Detection of plastic things such as plastic mines by electromagnetic induction is associated with difficulties. The interaction of non-conducting bodies or low-conductive objects with a low-frequency alternating magnetic field is very weak. At the high-frequency range where already wave processes take place, the interaction increases. Interactions with other distant objects also increase. A complex interference picture is formed, and extraction of useful information also meets difficulties. Sensing by electromagnetic induction at the intermediate MHz frequency range is the subject of research. The concept of detecting plastic mines in this range can be based on the study of the electromagnetic response of non-conductive cavity in a low-conductivity environment or the detection of small metal components in plastic mines, taking into account constructive features. The detector node based on the amplitude and phase detector 'Analog Devices ad8302' has been developed for experimental studies. The node has two inputs. At one of the inputs, the node receives a sinusoidal signal from the generator, to which a transmitting coil is also connected. The receiver coil is attached to the second input of the node. The additional circuit provides an option to amplify the signal output from the receiver coil by 20 dB. The node has two outputs. The voltages obtained at the output reflect the ratio of the amplitudes and the phase difference of the input harmonic signals. Experimental measurements were performed in different positions of the transmitter and receiver coils at the frequency range 1-20 MHz. Arbitrary/Function Generator Tektronix AFG3052C and the eight-channel high-resolution oscilloscope PICOSCOPE 4824 were used in the experiments. Experimental measurements were also performed with a low-conductive test object. The results of the measurements and comparative analysis show the capabilities of the simple detector node and the prospects for its further development in this direction. The results of the experimental measurements are compared and analyzed with the results of appropriate computer modeling based on the method of auxiliary sources (MAS). The experimental measurements are driven using the MATLAB environment. Acknowledgment -This work was supported by Shota Rustaveli National Science Foundation (SRNSF) (Grant number: NFR 17_523).

Keywords: EM induction sensing, detector, plastic mines, remote sensing

Procedia PDF Downloads 149

Authors: Irsa Wolfram, Boruch Lorenz

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Innovative solutions with additive manufacturing applying material extrusion for functional parts necessitate innovative filaments with persistent quality. Uniform homogeneity and a consistent dispersion of particles embedded in filaments generally require multiple cycles of extrusion or well-prepared primal matter by injection molding, kneader machines, or mixing equipment. These technologies commit to dedicated equipment that is rarely at the disposal in production laboratories unfamiliar with research in polymer materials. This stands in contrast to laboratories that investigate complex material topics and technology science to leverage the potential of 3-D printing. Consequently, scientific studies in labs are often constrained to compositions and concentrations of fillersofferedfrom the market. Therefore, we introduce a prototypal laboratory methodology scalable to tailoredprimal matter for extruding ceramic composite filaments with fused filament fabrication (FFF) technology. - A desktop single-screw extruder serves as a core device for the experiments. Custom-made filaments encapsulate the ceramic fillers and serve with polylactide (PLA), which is a thermoplastic polyester, as primal matter and is processed in the melting area of the extruder, preserving the defined concentration of the fillers. Validated results demonstrate that this approach enables continuously produced and uniform composite filaments with consistent homogeneity. Itis 3-D printable with controllable dimensions, which is a prerequisite for any scalable application. Additionally, digital microscopy confirms the steady dispersion of the ceramic particles in the composite filament. - This permits a 2D reconstruction of the planar distribution of the embedded ceramic particles in the PLA matrices. The innovation of the introduced method lies in the smart simplicity of preparing the composite primal matter. It circumvents the inconvenience of numerous extrusion operations and expensive laboratory equipment. Nevertheless, it deliversconsistent filaments of controlled, predictable, and reproducible filler concentration, which is the prerequisite for any industrial application. The introduced prototypal laboratory methodology seems capable for other polymer matrices and suitable to further utilitarian particle types beyond and above ceramic fillers. This inaugurates a roadmap for supplementary laboratory development of peculiar composite filaments, providing value for industries and societies. This low-threshold entry of sophisticated preparation of composite filaments - enabling businesses to create their own dedicated filaments - will support the mutual efforts for establishing 3D printing to new functional devices.

Keywords: additive manufacturing, ceramic composites, complex filament, industrial application

Procedia PDF Downloads 106

Authors: Şefika Dilek Güven, Gülden Küçükakça

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Objective: Learning the process of interaction with patient occurs within the process of nursing education. For this reason, it is considered to provide an opportunity for questioning and rearrangement of nursing education programs by assessing attitudes of nursing students towards caring nurse-patient interaction. Method: This is a descriptive study conducted in order to assess attitudes of nursing students towards caring nurse-patient interaction. The study was conducted with 318 students who were studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in 2015-2016 academic year and agreed to participate in the study. “Personal Information Form” prepared by the researchers utilizing the literature and “Caring Nurse-Patient Interaction Scale (CNPIS)”, who Turkish validity and reliability were conducted by Atar and Aştı, were used in the study. The Cronbach α coefficient of CNPIS was found as 0.973 in the study. Permissions of the institution and participants were received before starting to conduct study. Significance test of the difference between two means, analysis of variance, and correlation analysis were used to assess the data. Results: Average age of nursing students participating in the study was 20.72±1.91 and 74.8% were female, and 28.0% were the fourth-year students. 52.5% of the nursing students stated that they chose nursing profession willingly, 80.2% did not have difficulty in their interactions with patients, and 84.6% did not have difficulty in their social relationships. CNPIS total mean score of nursing students was found to be 295.31±40.95. When the correlation between total CNPIS mean score of the nursing students in terms of some variables was examined; it was determined there was a significant positive correlation between ages of the nursing students and total mean score of CNPIS (r=0.184, p=0.001). CNPIS total mean score was found to be higher in female students compared to male students, in 3rd–year students compared to students studying at other years, in those choosing their profession willingly compared to those choosing their profession unwillingly, in those not having difficulty in relations with the patients compared to those having difficulty, and in those not having difficulty in social relationships compared to those having difficulty. It was determined there was a significant difference between CNPIS total mean scores in terms of the year and state of having difficulty in social relationships (p<0,005). Conclusion: Nursing students had positive attitudes towards caring nurse-patient interactions, attitudes of nursing students, who were female, studying at 3rd year, chose nursing profession willingly, did not have difficulty in patient relations, and did not have difficulty in social relationships, towards caring nurse-patient interaction were found to be more positive. In the line with these results; it can be recommended to organize activities for introducing nursing profession to the youth preparing for the university, to use methods that will increase further communication skills to nursing students during their education, to support students in terms of communication skills, and to involve activities that will strengthen their social relationships.

Keywords: nurse-patient interaction, nursing student, patient, communication

Procedia PDF Downloads 223

Authors: Antoni Grau, Yolanda Bolea, Alberto Sanfeliu

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Mobile robots can be used in many different applications, including mapping, search, rescue, reconnaissance, hazard detection, and carpet cleaning, exploration, etc. However, they are limited due to their reliance on traditional energy sources such as electricity and oil which cannot always provide a convenient energy source in all situations. In an ever more eco-conscious world, solar energy offers the most environmentally clean option of all energy sources. Electricity presents threats of pollution resulting from its production process, and oil poses a huge threat to the environment. Not only does it pose harm by the toxic emissions (for instance CO2 emissions), it produces the combustion process necessary to produce energy, but there is the ever present risk of oil spillages and damages to ecosystems. Solar energy can help to mitigate carbon emissions by replacing more carbon intensive sources of heat and power. The challenge of this work is to propose the design and the implementation of electric battery recharge stations. Those recharge docks are based on the use of renewable energy such as solar energy (with photovoltaic panels) with the object to reduce the CO2 emissions. In this paper, a comparative study of the CO2 emission productions (from the use of different energy sources: natural gas, gas oil, fuel and solar panels) in the charging process of the Segway PT batteries is carried out. To make the study with solar energy, a photovoltaic panel, and a Buck-Boost DC/DC block has been used. Specifically, the STP005S-12/Db solar panel has been used to carry out our experiments. This module is a 5Wp-photovoltaic (PV) module, configured with 36 monocrystalline cells serially connected. With those elements, a battery recharge station is made to recharge the robot batteries. For the energy storage DC/DC block, a series of ultracapacitors have been used. Due to the variation of the PV panel with the temperature and irradiation, and the non-integer behavior of the ultracapacitors as well as the non-linearities of the whole system, authors have been used a fractional control method to achieve that solar panels supply the maximum allowed power to recharge the robots in the lesser time. Greenhouse gas emissions for production of electricity vary due to regional differences in source fuel. The impact of an energy technology on the climate can be characterised by its carbon emission intensity, a measure of the amount of CO2, or CO2 equivalent emitted by unit of energy generated. In our work, the coal is the fossil energy more hazardous, providing a 53% more of gas emissions than natural gas and a 30% more than fuel. Moreover, it is remarkable that existing fossil fuel technologies produce high carbon emission intensity through the combustion of carbon-rich fuels, whilst renewable technologies such as solar produce little or no emissions during operation, but may incur emissions during manufacture. The solar energy thus can help to mitigate carbon emissions.

Keywords: autonomous robots, CO2 emissions, DC/DC buck-boost, solar energy

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Authors: R. Abdulrahman, A. Eardley, A. Soliman

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The proliferation in the development of mobile learning (m-learning) has played a vital role in the rapidly growing electronic learning market. This relatively new technology can help to encourage the development of in learning and to aid knowledge transfer a number of areas, by familiarizing students with innovative information and communications technologies (ICT). M-learning plays a substantial role in the deployment of learning methods for nursing students by using the Internet and portable devices to access learning resources ‘anytime and anywhere’. However, acceptance of m-learning by students is critical to the successful use of m-learning systems. Thus, there is a need to study the factors that influence student’s intention to use m-learning. This paper addresses this issue. It outlines the outcomes of a study that evaluates the unified theory of acceptance and use of technology (UTAUT) model as applied to the subject of user acceptance in relation to m-learning activity in nurse education. The model integrates the significant components across eight prominent user acceptance models. Therefore, a standard measure is introduced with core determinants of user behavioural intention. The research model extends the UTAUT in the context of m-learning acceptance by modifying and adding individual innovativeness (II) and quality of service (QoS) to the original structure of UTAUT. The paper goes on to add the factors of previous experience (of using mobile devices in similar applications) and the nursing students’ readiness (to use the technology) to influence their behavioural intentions to use m-learning. This study uses a technique called ‘convenience sampling’ which involves student volunteers as participants in order to collect numerical data. A quantitative method of data collection was selected and involves an online survey using a questionnaire form. This form contains 33 questions to measure the six constructs, using a 5-point Likert scale. A total of 42 respondents participated, all from the Nursing Institute at the Armed Forces Hospital in Saudi Arabia. The gathered data were then tested using a research model that employs the structural equation modelling (SEM), including confirmatory factor analysis (CFA). The results of the CFA show that the UTAUT model has the ability to predict student behavioural intention and to adapt m-learning activity to the specific learning activities. It also demonstrates satisfactory, dependable and valid scales of the model constructs. This suggests further analysis to confirm the model as a valuable instrument in order to evaluate the user acceptance of m-learning activity.

Keywords: mobile learning, nursing institute students’ acceptance of m-learning activity in Saudi Arabia, unified theory of acceptance and use of technology model (UTAUT), structural equation modelling (SEM)

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Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie

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Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.

Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin

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Authors: Suman Som, Abhijit Maity, Sunil B. Daschakraborty, Sujit Chaudhuri, Manik Pradhan

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Background: Helicobacter pylori is a common and important human pathogen and the primary cause of peptic ulcer disease and gastric cancer. Currently H. pylori infection is detected by both invasive and non-invasive way but the diagnostic accuracy is not up to the mark. Aim: To set up an optimal diagnostic cut-off value of 13C-Urea Breath Test to detect H. pylori infection and evaluate a novel c-PDR methodology to overcome of inconclusive grey zone. Materials and Methods: All 83 subjects first underwent upper-gastrointestinal endoscopy followed by rapid urease test and histopathology and depending on these results; we classified 49 subjects as H. pylori positive and 34 negative. After an overnight, fast patients are taken 4 gm of citric acid in 200 ml water solution and 10 minute after ingestion of the test meal, a baseline exhaled breath sample was collected. Thereafter an oral dose of 75 mg 13C-Urea dissolved in 50 ml water was given and breath samples were collected upto 90 minute for 15 minute intervals and analysed by laser based high precisional cavity enhanced spectroscopy. Results: We studied the excretion kinetics of 13C isotope enrichment (expressed as δDOB13C ‰) of exhaled breath samples and found maximum enrichment around 30 minute of H. pylori positive patients, it is due to the acid mediated stimulated urease enzyme activity and maximum acidification happened within 30 minute but no such significant isotopic enrichment observed for H. pylori negative individuals. Using Receiver Operating Characteristic (ROC) curve an optimal diagnostic cut-off value, δDOB13C ‰ = 3.14 was determined at 30 minute exhibiting 89.16% accuracy. Now to overcome grey zone problem we explore percentage dose of 13C recovered per hour, i.e. 13C-PDR (%/hr) and cumulative percentage dose of 13C recovered, i.e. c-PDR (%) in exhaled breath samples for the present 13C-UBT. We further explored the diagnostic accuracy of 13C-UBT by constructing ROC curve using c-PDR (%) values and an optimal cut-off value was estimated to be c-PDR = 1.47 (%) at 60 minute, exhibiting 100 % diagnostic sensitivity , 100 % specificity and 100 % accuracy of 13C-UBT for detection of H. pylori infection. We also elucidate the gastric emptying process of present 13C-UBT for H. pylori positive patients. The maximal emptying rate found at 36 minute and half empting time of present 13C-UBT was found at 45 minute. Conclusions: The present study exhibiting the importance of c-PDR methodology to overcome of grey zone problem in 13C-UBT for accurate determination of infection without any risk of diagnostic errors and making it sufficiently robust and novel method for an accurate and fast non-invasive diagnosis of H. pylori infection for large scale screening purposes.

Keywords: 13C-Urea breath test, c-PDR methodology, grey zone, Helicobacter pylori

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Authors: Jean-Eric Pelet, Erhard Lick, Basma Taieb

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Purpose This research bridges the gap between sensory marketing and the use of the Internet of Things (IoT) in luxury hotels. We investigated how stimulating guests’ senses through IoT devices influenced their emotions, affective experiences, eudaimonism (well-being), and, ultimately, guest behavior. We examined potential moderating effects of gender. Design/methodology/approach We adopted a mixed method approach, combining qualitative research (semi-structured interviews) to explore hotel managers’ perspectives on the potential use of IoT in luxury hotels and quantitative research (surveying hotel guests; n=357). Findings The results showed that while the senses of smell, hearing, and sight had an impact on guests’ emotions, the senses of touch, hearing, and sight impacted guests’ affective experiences. The senses of smell and taste influenced guests’ eudaimonism. The sense of smell had a greater effect on eudaimonism and behavioral intentions among women compared to men. Originality IoT can be applied in creating customized multi-sensory hotel experiences. For example, hotels may offer unique and diverse ambiences in their rooms and suites to improve guest experiences. Research limitations/implications This study concentrated on luxury hotels located in Europe. Further research may explore the generalizability of the findings (e.g., in other cultures, comparison between high-end and low-end hotels). Practical implications Context awareness and hyper-personalization, through intensive and continuous data collection (hyper-connectivity) and real time processing, are key trends in the service industry. Therefore, big data plays a crucial role in the collection of information since it allows hoteliers to retrieve, analyze, and visualize data to provide personalized services in real time. Together with their guests, hotels may co-create customized sensory experiences. For instance, if the hotel knows about the guest’s music preferences based on social media as well as their age and gender, etc. and considers the temperature and size (standard, suite, etc.) of the guest room, this may determine the playlist of the concierge-tablet made available in the guest room. Furthermore, one may record the guest’s voice to use it for voice command purposes once the guest arrives at the hotel. Based on our finding that the sense of smell has a greater impact on eudaimonism and behavioral intentions among women than men, hotels may deploy subtler scents with lower intensities, or even different scents, for female guests in comparison to male guests.

Keywords: affective experience, emotional value, eudaimonism, hospitality industry, Internet of Things, sensory marketing

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Authors: Tuula Nygard

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This study contributes to the pedagogical discussion on how to promote adolescents’ multiliteracies with the emphasis on information seeking and evaluation skills in contemporary media environments. The study is conducted in the school environment utilizing perspectives of educational sciences and information studies to health communication and teaching. The research focus is on the teacher role as a trusted person, who guides students to choose and use credible information sources. Evaluating the credibility of information may often be challenging. Specifically, children and adolescents may find it difficult to know what to believe and who to trust, for instance, in health and well-being communication. Thus, advanced multiliteracy skills are needed. In the school environment, trust is based on the teacher’s subject content knowledge, but also the teacher’s character and caring. Teacher’s benevolence and approachability generate trustworthiness, which lays the foundation for good interaction with students and further, for the teacher’s pedagogical authority. The study explores teachers’ perceptions of their pedagogical authority and the role of a trustee. In addition, the study examines what kind of multiliteracy practices teachers utilize in their teaching. The data will be collected by interviewing secondary school health education teachers during Spring 2019. The analysis method is a nexus analysis, which is an ethnographic research orientation. Classroom interaction as the interviewed teachers see it is scrutinized through a nexus analysis lens in order to expound a social action, where people, places, discourses, and objects are intertwined. The crucial social actions in this study are information seeking and evaluation situations, where the teacher and the students together assess the credibility of the information sources. The study is based on the hypothesis that a trustee’s opinions of credible sources and guidance in information seeking and evaluation affect students’, that is, trustors’ choices. In the school context, the teacher’s own experiences and perceptions of health-related issues cannot be brushed aside. Furthermore, adolescents are used to utilize digital technology for day-to-day information seeking, but the chosen information sources are often not very high quality. In the school, teachers are inclined to recommend familiar sources, such as health education textbook and web pages of well-known health authorities. Students, in turn, rely on the teacher’s guidance of credible information sources without using their own judgment. In terms of students’ multiliteracy competences, information seeking and evaluation tasks in health education are excellent opportunities to practice and enhance these skills. To distinguish the right information from a wrong one is particularly important in health communication because experts by experience are easy to find and their opinions are convincing. This can be addressed by employing the ideas of multiliteracy in the school subject health education and in teacher education and training.

Keywords: multiliteracies, nexus analysis, pedagogical authority, trust

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