Search results for: balance in patient

Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos

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Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.

Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure

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Authors: Karina Guimaraes, Lilian Santos

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This study has the purpose of planning and instituting monitoring actions as a way of knowing the scenario of assistance to the patient with stoma, treated in the public health network in Brazil, from January to November of the year 2016, from the elaboration of a technical document containing the survey of the number of procedures offered and the value of the ostomy services, accredited in the Unified Health System-SUS. The purpose of this document is to improve the quality of these services in the efficient management of available financial resources, making it indispensable for the creation of strategies for the implementation and implementation of care services for people with stomata as a strategic tool in the promotion, prevention, qualification and efficiency in health care.

Keywords: health economic, management, ostomy, unified health system

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Authors: Haiqiao Du, Qian Wang, Shuwei Wang, Jianan Li

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Purpose: The aim is to evaluate the effect of cochlear implantation (CI) in patients with unilateral hearing loss, with a view to providing data support for the selection of therapeutic interventions for patients with single-sided deafness (SSD)/asymmetric hearing loss (AHL) and the broadening of the indications for CI. Methods: The study subjects were patients with unilateral hearing loss who underwent cochlear implantation surgery in our hospital in August 2022 and were willing to cooperate with the test and were divided into 2 groups: SSD group and AHL group. The enrolled patients were followed up for hearing level, tinnitus changes, speech recognition ability, sound source localization ability, and quality of life at five-time points: preoperatively, and 1, 3, 6, and 12 months after postoperative start-up. Results: As of June 30, 2024, a total of nine patients completed follow-up, including four in the SSD group and five in the AHL group. The mean postoperative hearing aid thresholds on the CI side were 31.56 dB HL and 34.75 dB HL in the two groups, respectively. Of the four patients with preoperative tinnitus symptoms (three patients in the SSD group and one patient in the AHL group), all showed a degree of reduction in Tinnitus Handicap Inventory (THI) scores, except for one patient who showed no change. In both the SSD and AHL groups, the sound source localization results (expressed as RMS error values, with smaller values indicating better ability) were 66.87° and 77.41° preoperatively and 29.34° and 54.60° 12 months after postoperative start-up, respectively, which showed that the ability to localize the sound source improved significantly with longer implantation time. The level of speech recognition was assessed by 3 test methods: speech recognition rate of monosyllabic words in a quiet environment and speech recognition rate of different sound source directions at 0° and 90° (implantation side) in a noisy environment. The results of the 3 tests were 99.0%, 72.0%, and 36.0% in the preoperative SSD group and 96.0%, 83.6%, and 73.8% in the AHL group, respectively, whereas they fluctuated in the postoperative period 3 months after start-up, and stabilized at 12 months after start-up to 99.0%, 100.0%, and 100.0% in the SSD group and 99.5%, 96.0%, and 99.0%. Quality of life was subjectively evaluated by three tests: the Speech Spatial Quality of Sound Auditory Scale (SSQ-12), the Quality-of-Life Bilateral Listening Questionnaire (QLBHE), and the Nijmegen Cochlear Implantation Inventory (NCIQ). The results of the SSQ-12 (with a 10-point score out of 10) showed that the scores of preoperative and postoperative 12 months after start-up were 6.35 and 6.46 in the SSD group, while they were 5.61 and 9.83 in the AHL group. The QLBHE scores (100 points out of 100) were 61.0 and 76.0 in the SSD group and 53.4 and 63.7 in the AHL group for the preoperative versus the postoperative 12 months after start-up. Conclusion: Patients with unilateral hearing loss can benefit from cochlear implantation: CI implantation is effective in compensating for the hearing on the affected side and reduces the accompanying tinnitus symptoms; there is a significant improvement in sound source localization and speech recognition in the presence of noise; and the quality of life is improved.

Keywords: single-sided deafness, asymmetric hearing loss, cochlear implant, unilateral hearing loss

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Authors: Prashant Verma

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Commercial banks are facing immense pressure, including financial disintermediation, interest rate volatility and digital ways of finance. Retaining an existing customer is 5 to 25 less expensive than acquiring a new one. This paper explores customer churn prediction, based on various statistical & machine learning models and uses under-sampling, to improve the predictive power of these models. The results show that out of the various machine learning models, Random Forest which predicts the churn with 78% accuracy, has been found to be the most powerful model for the scenario. Customer vintage, customer’s age, average balance, occupation code, population code, average withdrawal amount, and an average number of transactions were found to be the variables with high predictive power for the churn prediction model. The model can be deployed by the commercial banks in order to avoid the customer churn so that they may retain the funds, which are kept by savings bank (SB) customers. The article suggests a customized campaign to be initiated by commercial banks to avoid SB customer churn. Hence, by giving better customer satisfaction and experience, the commercial banks can limit the customer churn and maintain their deposits.

Keywords: savings bank, customer churn, customer retention, random forests, machine learning, under-sampling

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Authors: Avinash Kumar Ranjan, Akash Anand

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The Land Surface Temperature (LST) is an essential factor accompanying to rise urban heat and climate warming within a city in micro level. It is also playing crucial role in global change study as well as radiation budgets measuring in heat balance studies. The information of LST is very substantial to recognize the urban climatology, ecological changes, anthropological and environmental interactions etc. The Chief motivation of present study focus on time series of ANN model that taken a sequence of LST values of 2000, 2008 and 2016, realize the pattern of variation within the data set and predict the LST values for 2024 and 2032. The novelty of this study centers on evaluation of LST using series of multi-temporal MODIS (MOD 11A2) satellite data by Maximum Value Composite (MVC) techniques. The results derived from this study endorse the proficiency of Geoinformatics Technology with integration of ANN to gain knowledge, understanding and building of precise forecast from the complex physical world database. This study will also focus on influence of Land Use/ Land Cover (LU/LC) variation on Land Surface Temperature.

Keywords: LST, geoinformatics technology, ANN, MODIS satellite imagery, MVC

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Authors: Sean Hall

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Prior to COVID-19, the world was preoccupied with opioids, effectiveness versus risk, and specifically toxicity versus abuse. Historically underpinning opioid use was a concept of safety. As use over time and real-world data evolved, a pursuit for efficacy associated with non-opioid alternatives became mainstream. On January 8, 2021, the US signed back into the opioid problem, with these two fundamental questions still unresolved. The author will share the current progression of a lead non-opioid cancer bone pain candidate, NanaBis™. NanaBis™ represents two innovative factors: The active ingredients are from cannabinoids; these ingredients are in a proprietary sub-micron delivery platform, NanoCelle®. The author will offer an opinion piece, potentiating the future role of delivery platforms in medicine to increase both patient safety and compliance.

Keywords: NanaBis, nanoCelle, opioids, toxicity

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Authors: Xinke Huang, Huan Wang, Lidong Guo, Changbin Ju, Runbiao Liu, Shanshan Meng, Yibo Wang, Honghua Xu

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Large-scale photovoltaic (PV) generation system connected to HVDC grid has many advantages compared to its counterpart of AC grid. DC connection can solve many problems that AC connection faces, such as the grid-connection and power transmission, and DC connection is the tendency. DC/DC converter as the most important device in the system has become one of the hot spots recently. The paper proposes a centralized DC/DC converter which uses Boost Full Bridge Isolated DC/DC Converter(BFBIC) topology and combination through input parallel output series(IPOS) method to improve power capacity and output voltage to match with the HVDC grid voltage. Meanwhile, it adopts input current sharing control strategy to realize input current and output voltage balance. A ±30kV/1MW system is modeled in MATLAB/SIMULINK, and a downscaled ±10kV/200kW DC/DC converter platform is built to verify the proposed topology and control strategy.

Keywords: photovoltaic generation, cascaded dc/dc converter, galvanic isolation, high-voltage, direct current (HVDC)

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Authors: D. Gåsvaer, L. Stålberg, A. Fundin, M. Jackson, P. Johansson

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Exploration and exploitation capabilities are both important within Operations as means for improvement when managed separately, and for establishing dynamic improvement capabilities when combined in balance. However, it is unclear what exploration and exploitation capabilities imply in improvement and development work within an operations context. So in order to better understand how to develop exploration and exploitation capabilities within operations, the main characteristics of these constructs needs to be identified and further understood. Thus, the objective of this research is to increase the understanding about exploitation and exploration characteristics, to concretize what they translates to within the context of improvement and development work in an operations unit, and to identify practical challenges. A literature review and a case study are presented. In the literature review, different interpretations of exploration and exploitation are portrayed, key characteristics have been identified, and a deepened understanding of exploration and exploitation characteristics is described. The case in the study is an operations unit, and the aim is to explore to what extent and in what ways exploration and exploitation activities are part of the improvement structures and processes. The contribution includes an identification of key characteristics of exploitation and exploration, as well as an interpretation of the constructs. Further, some practical challenges are identified. For instance, exploration activities tend to be given low priority, both in daily work as in the manufacturing strategy. Also, the overall understanding about the concepts of exploitation and exploration (or any similar aspect of dynamic improvement capabilities) is very low.

Keywords: exploitation, exploration, improvement, lean production, manufacturing

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Authors: Yahia Massinissa, Melakhessou Med Akram, Mezahdia Mehdi, Marref Salah Eddine

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Cytokines are natural proteins which act as true intercellular communication signals in immune and inflammatory responses. Reverse signaling pathways that activate cytokines help to regulate different functions at the target cell, causing its activation, its proliferation, the differentiation, its survival or death. It was shown that malfunctioning of the cytokine regulation, particularly over-expression, contributes to the onset and development of certain serious diseases such as chronic rheumatoid arthritis, Crohn's disease, psoriasis, lupus. The action mode of Kinoid® technology is based on the principle vaccine: The patient's immune system is activated so that it neutralizes itself and the factor responsible for the disease. When applied specifically to autoimmune diseases, therapeutic vaccination allows the body to neutralize cytokines (proteins) overproduced through a highly targeted stimulation of the immune system.

Keywords: cytokines, Kinoid tech, auto-immune diseases, vaccination

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Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

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Authors: Fan Zhang

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In the process of urbanization in China, the new rural construction is in the ascendant, which is becoming more and more popular. Under the driving effect of rural urbanization, the house pattern and tectonic methods of traditional vernacular houses have shown great differences from the family structure and values of contemporary peasant families. Therefore, it is particularly important to find a prototype, form and strategy, to make a balance between the traditional memory and modern functional requirements. In order for research to combine the regional culture with modern life, under the situation of the current batch production of new rural residence, Badie village, in Linhai, Zhejiang province, is taken as the case. This paper aims to put forward a prototype which can not only meet the demand of modern life but also ensure the continuation of traditional culture and historical context for the new rural dwellings design. This research not only helps to extend the local context in the construction of the new site but also contributes to the fusion of old and new rural dwellings in the old site construction. Through the study and research of this case, the research methodology and results can be drawn as reference for the new rural construction in other areas.

Keywords: badie village, design strategy, new rural dwellings, regional context, regional expression

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

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Authors: Fátima Farinha, Miguel J. Oliveira, Gina Matias, Armando Inverno, Jânio Monteiro, Cristiano Cabrita

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In the last decades, the construction of swimming pools for recreational activities has grown exponentially in southern Europe. Swimming pools are used both for private use in villas and for collective use in hotels or condominiums. However, they have a high environmental impact, mainly in terms of water and energy consumption, being used for a short period of time, depending significantly on favorable atmospheric conditions. Contrary to what would be expected, not enough research has been conducted to reduce the negative impact of this equipment. In this context, this work proposes and analyses technological measures to reduce the environmental impacts of swimming pools, such as thermal insulation of the tank, water balance in order to detect leaks and optimize the backwash process, integration of renewable energy generation, and a smart control system that meets the requirements of the user. The work was developed within the scope of the Ecopool+++ project, which aims to create innovative heated pools with reduced thermal losses and integration of SMART energy plus water management systems. The project is in the final phase of its development, with very encouraging results.

Keywords: swimming pools, sustainability, thermal losses, water management system

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Ivan Tolj

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Water produced during electrochemical reaction in Proton Exchange Membrane (PEM) fuel cell can be used for internal humidification of reactant gases; hydrogen and air. On such a way it is possible to eliminate expensive external humidifiers and simplify fuel cell balance-of-plant (BoP). When fuel cell operates at constant temperature (usually between 60 °C and 80 °C) relatively cold and dry ambient air heats up quickly upon entering channels which cause further drop in relative humidity (below 20%). Low relative humidity of reactant gases dries up polymer membrane and decrease its proton conductivity which results in fuel cell performance drop. It is possible to maintain such temperature profile throughout fuel cell cathode channel which will result in close to 100 % RH. In order to achieve this, passive heat exchanger was designed using commercial CFD software (ANSYS Fluent). Such passive heat exchanger (with variable surface area) is suitable for small scale PEM fuel cells. In this study, passive heat exchanger for single PEM fuel cell segment (with 20 x 1 cm active area) was developed. Results show close to 100 % RH of air throughout cathode channel with increased fuel cell performance (mainly improved polarization curve) and improved durability.

Keywords: PEM fuel cell, passive heat exchange, relative humidity, thermal management

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Authors: Widya Anggraini Pamungkas, Rosana Budi Setyawati, Awaludin Fitroh Rifai, Candra Pangesti Setiawan, Anatta Wahyu Budiiman, Inayati, Joko Waluyo, Sunu Herwi Pranolo

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The increase in LPG consumption in Indonesia is not balanced with the amount of supply. The high demand for LPG due to the success of the government's kerosene-to-LPG conversion program and the Covid-19 pandemic in 2020 led to an increase in LPG consumption in the household sector and caused Indonesia's trade balance to experience a deficit. The high consumption of LPG encourages the need for alternative fuels as a substitute or which aims to substitute LPG; one of the materials that can be used is Dimethyl Ether (DME). Dimethyl ether (DME) is an organic compound with the chemical formula CH 3. OCH 3 has a high cetane number and has characteristics similar to LPG. DME can be produced from various sources, such as coal, biomass and natural gas. Based on the economic analysis conducted at 10% IRR, coal has the largest NPV of Rp. 20,034,837,497,241 with a payback period of 3.86 years, then biomass with an NPV of Rp. 10,401,526,072,850 and a payback period of 5.16. the latter is natural gas with an NPV of IDR 7,401,272,559,191 and a payback period of 6.17 years. Of the three sources of raw materials used, if the sensitivity is calculated using the selling price of DME equal to the selling price of LPG, it will get an NPV value that is greater than the NPV value when using the current DME price. The advantages of coal as a raw material for DME are not only because it is profitable, namely: low price and abundant resources, but has high greenhouse gas emissions.

Keywords: LPG, DME, coal, biomass, natural gas

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Authors: Robin Becker, Maike Eilers, Nane Roetmann, Manfred Helmus

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The shortage of junior staff in the construction industry is a problem that will be further exacerbated in the coming years by the retirement of the baby-boom generations (1955-1969) from employment. In addition, the current working conditions in the field of construction management are not attractive for young professionals. A survey of students revealed a desire for an increase in flexibility and an improved work-life balance in everyday working life. Students of civil engineering and architecture are basically interested in a career in construction management but have reservations due to the image of the profession and the current working conditions. A survey among experts from the construction industry shows that the profession can become more attractive. This report provides recommendations for action in the form of working modules to improve the working conditions of employees. If these are taken into account, graduates can be attracted to the profession of construction management, and existing staff can be retained more effectively. The aim of this report is to show incentives for employers to respond to the wishes and needs of their current and future employees to the extent that can be implemented.

Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model

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Authors: Ankur Chauhan, Amol Singh

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The increasing human resource has led to the rapid increment in the generation of healthcare waste across the world. Since, this waste consists of the infectious and hazardous components emerged from the patient care activities in different healthcare facilities; therefore, its proper management becomes vital for mitigating its negative impact on society and environment. The present research work focuses on the identification of the key success factors for developing a successful healthcare waste management plan. In addition, the key success factors have been studied by developing a causal diagram with the help of a decision making trial and evaluation (DEMATEL) approach. The findings of the study would help in the filtration of dominant key success factors which would further help in making a comparative assessment of the waste management plan of different hospitals.

Keywords: healthcare waste disposal, environment and society, multi-criteria decision making, DEMATEL

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Authors: Talip Turkmen

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From the moment the first beats, the first step into the world mankind finds him in a struggle to survive. Most important case to win this fight is power. Power is one of the most common concepts which we encounter in our life. Mainly power is ability to reach desired results on someone else or ability to penetrate into the behavior of others. Throughout history merging technology and changing political trade-offs caused the change of concept of power. Receiving a state of multipolar new world order in the 21st century and increasing impacts of media have narrowed the limits of military power. With increasing globalization and peaceful diplomacy this gap, left by military power, has filled by soft power which has ability to persuade and attract. As concepts of power soft power also has not compromised yet. For that reason it is important to specify, sources of soft power, soft power strategies and limits of soft power. The purpose of this study was to analyze concept of soft power and importance of soft power in foreign relations. This project focuses on power, hard power and soft power relations, sources of soft power and strategies to gain soft power. Datas in this project was acquired from other studies on soft power and foreign relations. This paper was prepared in terms of concept and research techniques. As a result of data gained in this study the one of important topics in international relations is balance between soft power.

Keywords: soft power, foreign policy, national power, hard power

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Authors: Ioana G. Turcan

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reimagined rituals towards unattachment wants to look at an ambiguous loss through the perspective of caregivers, those that accompany us at the beginning and possibly the end of life, those that observe, accumulate, and are impacted by our behavior and needs, but also those that are the witnesses of the human vulnerability. Someone taking care of a patient with dementia experiences ambiguous loss, being in a present of a person partially present, partially absent. The one offering care needs care, not isolation and the aim of the project is to consolidate existing communities or engage other possible ones using performance, storytelling, and other artistic methods. The long-term aim is that with community work, we will manage to co-create rituals in order to help us live with this kind of loss. Looking at them through the lens of different cultures and individuals exercises both the ability to extract the universal essence of a ritual, but also the need and freedom to express the specificity of each situation. To be seen and acknowledged by others, but more importantly, to see oneself from outside with dignity, is very powerful. Oftentimes we forget to express, look and appreciate our own stories, and instead, we choose to outcast them.

Keywords: grief, socio-politics of loss, ambiguous loss, rituals

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Authors: Leila Noori, Rosario Barone, Francesca Rappa, Antonella Marino Gammazza, Alessandra Maria Vitale, Giuseppe Donato Mangano, Giusy Sentiero, Filippo Macaluso, Kathryn H. Myburgh, Francesco Cappello, Federica Scalia

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The neuromuscular system controls, directs, and allows movement of the body through the action of neural circuits, which include motor neurons, sensory neurons, and skeletal muscle fibers. Protein homeostasis of the involved cytotypes appears crucial to maintain the correct and prolonged functions of the neuromuscular system, and both neuronal cells and skeletal muscle fibers express significant quantities of protein chaperones, the molecular machinery responsible to maintain the protein turnover. Genetic mutations or defective post-translational modifications of molecular chaperones (i.e., genetic or acquired chaperonopathies) may lead to neuromuscular disorders called as neurochaperonopathies. The limited knowledge of the effects of the defective chaperones on skeletal muscle fibers and neurons impedes the progression of therapeutic approaches. A distinct genetic variation of CCT5 gene encoding for the subunit 5 of the chaperonin CCT (Chaperonin Containing TCP1; also known as TRiC, TCP1 Ring Complex) was recently described associated with severe distal motor neuropathy by our team. In this study, we investigated the histopathological abnormalities of the skeletal muscle biopsy of the pediatric patient affected by the mutation Leu224Val in the CCT5 subunit. We provide molecular and structural features of the diseased skeletal muscle tissue that we believe may be useful to identify undiagnosed cases of this rare genetic disorder. We investigated the histological abnormalities of the affected tissue via hematoxylin and eosin staining. Then we used immunofluorescence and qPCR techniques to explore the expression and distribution of CCT5 in diseased and healthy skeletal muscle tissue. Immunofluorescence and immunohistochemistry assays were performed to study the sarcomeric and structural proteins of skeletal muscle, including actin, myosin, tubulin, troponin-T, telethonin, and titin. We performed Western blot to examine the protein expression of CCT5 and some heat shock proteins, Hsp90, Hsp60, Hsp27, and α-B crystallin, along with the main client proteins of the CCT5, actin, and tubulin. Our findings revealed muscular atrophy, abnormal morphology, and different sizes of muscle fibers in affected tissue. The swollen nuclei and wide interfiber spaces were seen. Expression of CCT5 had been decreased and showed a different distribution pattern in the affected tissue. Altered expression, distribution, and bandage pattern were detected by confocal microscopy for the interested muscular proteins in tissue from the patient compared to the healthy control. Protein levels of the studied Hsps normally located at the Z-disk were reduced. Western blot results showed increased levels of the actin and tubulin proteins in the diseased skeletal muscle biopsy compared to healthy tissue. Chaperones must be expressed at high levels in skeletal muscle to counteract various stressors such as mechanical, oxidative, and thermal crises; therefore, it seems relevant that defects of molecular chaperones may result in damaged skeletal muscle fibers. So far, several chaperones or cochaperones involved in neuromuscular disorders have been defined. Our study shows that alteration of the CCT5 subunit is associated with the damaged structure of skeletal muscle fibers and alterations of chaperone system components and paves the way to explore possible alternative substrates of chaperonin CCT. However, further studies are underway to investigate the CCT mechanisms of action to design applicable therapeutic strategies.

Keywords: molecular chaperones, neurochaperonopathy, neuromuscular system, protein homeostasis

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: Ghandehari-Motlagh, Mohammad

Abstract:

Purpose: To evaluate of the effect of an ideal fit of RGPs on HOA and keratoconus indices. Methods: In this cohort study, 65 keratoconus eyes with more than 3 lines(Snellen)improvement between BSCVA and BCVA(RGP) were imaged with Pentacam HR and their topometric and Zernike analysis findings without RGP were recorded. After 6 months or later of RGP fitting (Rose-K,Boston XO2), imaging with pentacam was repeated and the above information were recorded. Results: 65 different grades of keratoconus eyes with mean age of 27.32 yrs/old(SD +_5.51)enrolled including M 28(43.1%) and F 37(56.9%). 44(67.7%) with family Hx of Kc and 21(31.25%)without any Kc in their families. 54 (83.1%) with and 11 (16.9%) without any ocular allergy Hx. Maximum percent of age of onset of kc was 15 ys/old(29.2%).This study showed there are meaningful correlations between with and without RGP Pentacam indices and HOA in each grade of Kc.92.3% of patients had foreign body sensation but 96.9% had 11-20 hours/day RGP wear that confirms on psychologic effect of an ideal fit on patient’s motivation. Conclusion: With the three points touch principle of RGP fitting in Kc corneas, the patients will have a decrease in HOA and so delayed need for PK or LK.

Keywords: keratoconus, rigid gas permeable lens, aberration, fitting

Procedia PDF Downloads 415

Authors: Tanhao Gao, Hongtao Zhou

Abstract:

With the COVID-19 pandemic spreading worldwide, people are facing more significant mental pressure. The government and social groups are sparing no effort to find ways to heal people's emotions and return to normal life. Therefore, research on emotional healing has urgency and practical significance. From the perspective of urban planning, street furniture has the potential to become "emotional healing touchpoints." This study first analyzed the suitable places for adding emotional healing street furniture in the background of urban micro-renewal and combined the fifteen-minute living circle, the leftover space, and urban acupuncture theories, then used the 5W analysis method to show the main characteristics of emotionally healing street furniture. Finally, the research discovers four design strategies, which can be summarized as: A. Exploring the renewal potential of the leftover space; B. Integrating with local culture and the surrounding environment; C. Discovering quick and straightforward ways of interaction; D. Finding a delicate balance between artistry and functionality. Then, the author takes one emotional healing street furniture located on Chifeng Road as an example to show the design strategies vividly.

Keywords: emotional healing, street furniture, urban micro-renewal, urban acupuncture

Procedia PDF Downloads 192

Authors: Pritha Niraj Arya

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Education plays a crucial role in societal evolution by promoting economic expansion and creativity. The varied demands of students in India’s higher education setting signify inclusive and efficient teaching methods. The present study examined how teaching styles, self-efficacy, and personality traits interact among Indian higher education faculty members and how these factors collectively affect pedagogical practices. Specifically, the research explored differences in personality traits -agreeableness, conscientiousness, neuroticism, openness, and extraversion- between teachers with high and low self-efficacy and examined how these traits shape teaching strategies, either student-focused or teacher-focused. Data collection took place for three months, ensuring confidentiality and ethical compliance. 268 faculty members from Indian higher education institutions participated in this comparative study. An online questionnaire was used to gather data in which participants completed three well-established tools: the approaches to teaching inventory, which measures teaching styles; the teacher self-efficacy questionnaire, which measures self-efficacy levels; and the big five inventory, which measures personality traits. The results showed that while teachers with low self-efficacy had higher levels of neuroticism, those with high self-efficacy scored much higher on traits such as agreeableness, conscientiousness, openness, and extraversion. Despite the traditional belief that high self-efficacy is only associated with student-focused teaching, the findings suggest that teachers with high self-efficacy have cognitive flexibility, which enables them to skillfully use both teacher-focused and student-focused approaches to cater to a wide range of classroom needs. Teachers with low self-efficacy, on the other hand, are less flexible and adopt fewer different strategies in their teaching practice. The findings challenge simplistic associations between self-efficacy and teaching strategies, emphasising that high self-efficacy promotes adaptability rather than a fixed preference for specific teaching methods. This adaptability is crucial in India’s diverse educational settings, where teachers must balance standardised curricula with the varied learning needs of students. This study highlights the importance of integrating personality traits and self-efficacy into teacher training programs. By promoting self-efficacy and tailoring professional development to consider individual personality traits, institutions can enhance teachers’ teaching flexibility, hence improving student engagement and learning outcomes. These findings have practical implications for teacher education, suggesting that adopting cognitive flexibility among teachers can improve instructional quality and classroom dynamics. To gain a deeper knowledge of how personality traits and self-efficacy impact teaching practices over time, future research should investigate causal relationships using longitudinal studies. Examining external factors like institutional policies, availability of resources, and cultural settings will help to clarify the dynamics at play. Furthermore, this study emphasises the need to strike a balance between teacher-focused and student-focused approaches to provide a comprehensive education that covers both conceptual understanding and the delivery of key information. This study offers insights into how the Indian educational system is changing and how, to achieve global standards, effective teaching techniques are becoming increasingly important. This study promotes the larger objective of educational excellence by exploring the interaction of internal and external factors impacting teaching styles and providing practical policy and practice recommendations.

Keywords: higher education, personality traits, self-efficacy, teaching styles

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Authors: Vinay P., Srinivas K. S.

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Low Light Image Enhancement is of utmost impor- tance in computer vision based tasks. Applications include vision systems for autonomous driving, night vision devices for defence systems, low light object detection tasks. Many of the existing deep learning methods are resource intensive during the inference step and take considerable time for processing. The algorithm should take considerably less than 41 milliseconds in order to process a real-time video feed with 24 frames per second and should be even less for a video with 30 or 60 frames per second. The paper presents a fast and efficient solution which has two main advantages, it has the potential to be used for a real-time video feed, and it can be used in low compute environments because of the lightweight nature. The proposed solution is a pipeline of three steps, the first one is the use of a simple function to map input RGB values to output RGB values, the second is to balance the colors and the final step is to adjust the contrast of the image. Hence a custom dataset is carefully prepared using images taken in low and bright lighting conditions. The preparation of the dataset, the proposed model, the processing time are discussed in detail and the quality of the enhanced images using different methods is shown.

Keywords: low light image enhancement, real-time video, computer vision, machine learning

Procedia PDF Downloads 206

Authors: Mary Isobelle Mullaney

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The maxim "an unexamined life is not worth living," attributed to Socrates, prompts a contemplative reflection spanning over 32 years as a teacher educator in the Republic of Ireland. Taking time to contemplate the changes that have occurred and the current landscape provides valuable insights into the dynamic terrain of teacher preparation. The reflective journey traverses the impacts of global and societal shifts, responding to challenges, embracing advancements, and navigating the delicate balance between responsiveness to the world and the active shaping of it. The transformative events of the COVID-19 pandemic spotlighted the indispensable role of teachers in Ireland, reinforcing the critical nature of education for the well-being of pupils. Research solidifies the understanding that teachers matter and so it is worth exploring the pivotal role of the teacher educator. This reflective piece examines the changes in teacher education and explores the juxtapositions that have emerged in response to three decades of profound change. The attractiveness of teaching as a career is juxtaposed against the reality of the demands of the job, with conditions for public servants in Ireland undergoing a shift. High-level strategic discussions about increasing teacher numbers now contrast with a previous oversupply. The delicate balance between the imperative to increase enrolment (getting "bums on seats") and the gatekeeper role of teacher educators is explored, raising questions about maintaining high standards amid changing student profiles. Another poignant dichotomy involves the high demand for teachers versus the hurdles candidates face in becoming teachers. The rising cost and duration of teacher education courses raise concerns about attracting quality candidates. The perceived attractiveness of teaching as a career contends with the reality of increased demands on educators. One notable juxtaposition centres around the rapid evolution of Irish initial teacher education versus the potential risk of change overload. The Teaching Council of Ireland has spearheaded considerable changes, raising questions about the timing and evaluation of these changes. This reflection contemplates the vision of a professional teaching council versus its evolving reality and the challenges posed by the value placed on school placement in teacher preparation. The juxtapositions extend to the classroom, where theory may not seamlessly align with the lived experience. Inconsistencies between college expectations and the classroom reality prompt reflection on the effectiveness of teacher preparation programs. Addressing the changing demographic landscape of society and schools, there is a persistent incongruity between the diversity of Irish society and the profile of second-level teachers. As education undergoes a digital revolution, the enduring philosophies of education confront technological advances. This reflection highlights the tension between established practices and contemporary demands, acknowledging the irreplaceable value of face-to-face interaction while integrating technology into teacher training programs. In conclusion, this reflective journey encapsulates the intricate web of juxtapositions in Irish Initial Teacher Education. It emphasises the enduring commitment to fostering education, recognising the profound influence educators wield, and acknowledging the challenges and gratifications inherent in shaping the minds and futures of generations to come.

Keywords: Irish post primary teaching, juxtapositions, reflection, teacher education

Procedia PDF Downloads 55

Authors: Srushti Bhatt, M. B. Kiran

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Two-sided assembly line balancing problem is yet to be addressed simply to compete for the global market for manufacturers. The task assigned in an ordered sequence to get optimum performance of the system is known as assembly line balancing problem mainly classified as single and two sided. It is very challenging in manufacturing industries to balance two-sided assembly line, wherein the set of sequential workstations the task operations are performed in two sides of the line. The conflicting major objective in two-sided assembly line balancing problem is either to maximize /minimize the performance parameters. The present study emphases on combining different evolutionary algorithm; ant colony, Tabu search and petri net method; and compares their results of an algorithm for solving two-sided assembly line balancing problem. The concept of multi objective optimization of performance parameters is now a day adopted to make a decision involving more than one objective function to be simultaneously optimized. The optimum result can be expected among the selected methods using multi-objective optimization. The performance parameters considered in the present study are a number of workstation, slickness and smoothness index. The simulation of the assembly line balancing problem provides optimal results of classical and practical problems.

Keywords: Ant colony, petri net, tabu search, two sided ALBP

Procedia PDF Downloads 278

Authors: Ratima Damkham, Natasha Dejdumrong, Priyakorn Pusawiro

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This paper explored the solution in game design to help game designers in the educational game designing using digital educational game model canvas (DEGMC) and digital educational game form (DEGF) based on Outcome-based Education program. DEGMC and DEGF can help designers develop an overview of the game while designing and planning their own game. The way to clearly assess players’ ability from learning outcomes and support their game learning design is by using the tools. Designers can balance educational content and entertainment in designing a game by using the strategies of the Business Model Canvas and design the gameplay and players’ ability assessment from learning outcomes they need by referring to the Constructive Alignment. Furthermore, they can use their design plan in this research to write their Game Design Document (GDD). The success of the research was evaluated by four experts’ perspectives in the education and computer field. From the experiments, the canvas and form helped the game designers model their game according to the learning outcomes and analysis of their own game elements. This method can be a path to research an educational game design in the future.

Keywords: constructive alignment, constructivist theory, educational game, outcome-based education

Procedia PDF Downloads 354

Authors: Hammad Khan, Wookeun Bae

Abstract:

The objective of this study was to optimize and control the highly loaded and efficient nitrite production having suitability for autotrophic and heterotrophic denitritation. A lab scale CSTR for partial and full nitritation was operated to treat the livestock manure digester liquor having an ammonium concentration of ~2000 mg-NH4+-N/L and biodegradable contents of ~0.8 g-COD/L. The experiments were performed at 30°C, pH: 8.0 DO: 1.5 mg/L and SRT ranging from 7-20 days. After 125 days operation, >95% nitrite buildup having the ammonium loading rate of ~3.2 kg-NH4+-N/m3-day was seen with almost complete ammonium conversion. On increasing the loading rate further (i.e. from 3.2-6.2 kg-NH4+-N/m3-day), stability of the system remained unaffected. On decreasing the pH from 8 to7.5 and further 7.2, removal rate can be easily controlled as 95%, 75% and even 50%. Results demonstrated that nitritation stability and desired removal rates are controlled by a balance of simultaneous inhibition by FA and FNA, pH affect and DO limitation. These parameters proved to be effective even to produce an appropriate influent for anammox. In addition, a mathematical model, identified through the occurring biological reactions, is proposed to optimize the full and partial nitritation process. The proposed model presents relationship between pH, ammonium and produced nitrite for full and partial nitritation under the varying concentrations of DO, and simultaneous inhibition by FA and FNA.

Keywords: stable nitritation, high loading, autrophic denitritation, hetrotrophic denitritation

Procedia PDF Downloads 327