Search results for: modal assurance criteria

Authors: Sudipto Sarkar

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Capital is the primary fuel for starting and running a business. Since capital is crucial for every business, entrepreneurs must successfully acquire adequate capital for executing their projects. Sources for the necessary capital for entrepreneurs include their own personal funds from existing bank accounts, or lines of credit or loans from banks or financial institutions, or equity funding from investors. The most commonly selected source of capital is a bank loan. However, acquiring a loan by any entrepreneur requires adhering to strict guidelines, conditions and norms. Because not only they have to show evidence for viability of the project, but also the means to return the acquired loan. On the bank’s part, it requires that every loan officer performs a thorough credit appraisal of the prospective borrowers and makes decisions about whether or not to lend money, how much to lend, and what conditions should be attached to it. Moreover, these credit decisions in general were often based on biases, analytical techniques, or prior experience. A loan can either turn out to be good or poor, irrespective of what type of credit decisions were followed. However, based on prior experience, the loan officers seem to differentiate between a good and a bad loan by examining the borrower’s credit history, pattern of borrowing, volume of borrowing, frequency of borrowing, and reasons for borrowing. As per an article written by Maureen Wallenfang on postcrescent.com dated May 10, 2010, it is observed that borrowers with good credit, solid business plans and adequate collateral security were able to procure loans very easily in the Fox Valley region. Since loans are required to run businesses, and also with the propensity of loans to become bad, loan officers tend to be very critical and cautious before approving and disbursing the loans. The pressure to be critical and cautious, at least partly, is a result of increased scrutiny by the Securities and Exchange Commission. As per Wall Street Journal (Sidel & Eaglesham, March, 3 2011, online), the Securities and Exchange Commission scrutinized banks that have restructured troubled loans in order to make them appear healthier than they really are. Therefore, loan officers’ loan criteria are of immense importance for entrepreneurs and banks alike.

Keywords: entrepreneur, loans, marketing, banks

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Authors: Alireza Monzavi Chaleshtari, Maryam Aliakbari

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Objective: The aim of this study was to investigate the prediction of child attachment style based on a positive and safe combination parenting method mediated by maternal attachment styles in children with attention deficit hyperactivity disorder. Method: The design of the present study was descriptive of correlation and structural equations and applied in terms of purpose. The population of this study includes all children with attention deficit hyperactivity disorder living in Chaharmahal and Bakhtiari province and their mothers. The sample size of the above study includes 165children with attention deficit hyperactivity disorder in Chaharmahal and Bakhtiari province with their mothers, who were selected by purposive sampling method based on the inclusion criteria. The obtained data were analyzed in two sections of descriptive and inferential statistics. In the descriptive statistics section, statistical indices of mean, standard deviation, frequency distribution table and graph were used. In the inferential section, according to the nature of the hypotheses and objectives of the research, the data were analyzed using Pearson correlation coefficient tests, Bootstrap test and structural equation model. findings:The results of structural equation modeling showed that the research models fit and showed a positive and safe combination parenting style mediated by the mother attachment style has an indirect effect on the child attachment style. Also, a positive and safe combined parenting style has a direct relationship with child attachment style, and She has a mother attachment style. Conclusion:The results and findings of the present study show that there is a significant relationship between positive and safe combination parenting methods and attachment styles of children with attention deficit hyperactivity disorder with maternal attachment style mediation. Therefore, it can be expected that parents using a positive and safe combination232 parenting method can effectively lead to secure attachment in children with attention deficit hyperactivity disorder.

Keywords: child attachment style, positive and safe parenting, maternal attachment style, ADHD

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Authors: Marianys Fernandez

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Gastronomic experiences generate a positive impact on the dynamization of the economy when they are managed in a sustainable manner, given that they value the identity of the destination, strengthen cooperation between stakeholders in the sector, contribute to the preservation of gastronomic heritage, and encourage the implementation of competitive and sustainable public policies. Having as its main aim the analysis of sustainable management of gastronomic experiences, this study analyses different elements associated with the promotion of the local economy. For this purpose, a systematic literature review was carried out to identify, select, synthesise, and evaluate the studies that respond to the research objectives in order to select more reliable articles for research and reduce the potential for bias within the review of literature. To obtain reliable, updated and relevant sources for scientific research, the Web of Science and Scopus databases were used, taking into account the following key words: (1) experiential tourism, (2) gastronomy experience, (3) sustainable destination management, (4) sustainable gastronomy, (5) sustainable economy, in which we obtained a final list of 76 articles. The analysis of the literature allowed us to identify the most pertinent elements referring to the objective of the study: (a) need for competitive policies in the gastronomic sector to promote sustainable local economic development, (b) incentive for cooperation between stakeholders in the gastronomic sector, to guarantee the competitiveness of the destination, (c) propose sustainable standards in the gastronomic tourism sector that link the local economy. Gastronomic experiences constitute a dynamic element of the local economy and promote sustainable tourism. We can highlight that sustainability is a mechanism for the preservation of regional identity in the gastronomic sector through the valuation of the attributes of gastronomy, promotion of the local economy, strengthening of strategic alliances between the stakeholders of the gastronomic sector and its relevant contribution to the competitiveness of the destination. The theoretical implications of the study are focused on suggesting planning, management, and policy criteria to promote the sustainable management of gastronomic experiences in order to promote the local economy. In the practical context, research integrates different approaches, tools, and methods to encourage the active participation of local actors in the promotion of the local economy through the sustainable management of gastronomic tourism.

Keywords: experiential tourism, gastronomy experience, sustainable destination management, sustainable economy, sustainable gastronomy

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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Authors: Mateusz Wielopolski, Asia Guerreschi

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Circular Economy, as the counterargument to the ‘make-take-dispose’ linear model, is an approach that includes a variety of schools of thought looking at environmental, economic, and social sustainability. This, in turn, leads to a variety of strategies and often confusion when it comes to choosing the right one to make a circular transition as effective as possible. Due to the close interplay of circular product design, business model and social responsibility, companies often struggle to develop strategies that comply with all three triple-bottom-line criteria. Hence, to transition to circularity effectively, product design approaches must become more inclusive. In a case study conducted with the University of Bayreuth and the ISPO, we correlated aspects of material choice in product design, labeling and technological innovation with customer preferences and education about specific material and technology features. The study revealed those attributes of the consumers’ environmental awareness that directly translate into an increase of purchase power - primarily connected with individual preferences regarding sports activity and technical knowledge. Based on this outcome, we constituted a product development approach that incorporates the consumers’ individual preferences towards sustainable product features as well as their awareness about materials and technology. It allows deploying targeted customer education campaigns to raise the willingness to pay for sustainability. Next, we implemented the customer preference and education analysis into a circularity assessment tool that takes into account inherent company assets as well as subjective parameters like customer awareness. The outcome is a detailed but not cumbersome scoring system, which provides guidance for material and technology choices for circular product design while considering business model and communication strategy to the attentive customers. By including customer knowledge and complying with corresponding labels, companies develop more effective circular design strategies, while simultaneously increasing customers’ trust and loyalty.

Keywords: circularity, sustainability, product design, material choice, education, awareness, willingness to pay

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Authors: Per Blomqvist

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This study is part of a larger research project on creativity and writing cultures in upper secondary schools in Sweden, with the purpose of exploring how formative assessment practices can be developed to better support students' writing of subject-specific texts. The purpose of the study is to shed light on how writing has changed over time in the subjects of Social Studies and Swedish, especially regarding changes in the formative assessment practice in relation to students opportunities to take part in creative writing processes that can develop their subject specific-writing. Theoretically, the study is based on concepts and models concerning creativity, writing instructions and formative assessment, especially regarding scaffolding in relation to the development of students' subject-specific writing. The empirical data consists of video recordings of teacher groups' conversations from five upper secondary schools in Sweden, compromising a total of twenty teachers. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how writing assessment has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers in each group. The result highlights two different assessment practices that are described as giving students different opportunities to take part in creative writing processes to develop their writing of subject-specific texts. One of the assessment practices is characterized by teachers focusing on explaining to the students what the grading criteria mean and showing sample texts that correspond to a certain grade. The teachers describe that this assessment practice has led to a formalized, instrumental and product-oriented writing culture that has negative consequences for the student's development of their subject-specific writing, which often lacks independent reasoning, own conclusions and understanding of concepts. The other assessment practice is characterized by students examining text qualities and discussing a variety of sample texts to understand what different texts require. These teachers describe the assessment practice as an exploratory work that leads to more creative writing processes where the students gradually deepen their understanding of subject-specific texts and develop their writing.

Keywords: teaching for creativity, writing processes, formative assessment, subject-specific writing

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Authors: Yutong Wan, John N. Wood

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Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.

Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review

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Authors: Arij Yehya, Suhaila Ghuloum, Abdlmoneim Abdulhakam, Azza Al-Mujalli, Mark Opler, Samer Hammoudeh, Yahya Hani, Sundus Mari, Reem Elsherbiny, Ziyad Mahfoud, Hassen Al-Amin

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Introduction: The Positive and Negative Syndrome Scale (PANSS) is a valid instrument developed by Kay and colleagues6 to assess symptoms of patients with schizophrenia. It consists of 30 items that factor the symptoms into three subscales: positive, negative and general psychopathology. This scale has been translated and validated in several languages. Objective: This study aims to determine the validity and psychometric properties of the Arabic version of the PANSS. Methods: A standardized translation and cultural adaptation method was adopted. Patients diagnosed with schizophrenia (n=98), according to psychiatrist’s diagnosis based on DSM-IV criteria, were recruited from the Psychiatry Department at Rumailah Hospital, Qatar. A first rater confirmed the diagnosis using the Arabic version of Mini International Neuropsychiatric Interview (MINI 6). A second and independent rater-administered the Arabic version of PANSS. Also, a control group (n=101), with no history of psychiatric disorder was recruited from the family and friends of the patients and from primary health care centers in Qatar. Results: There were more males than females in our sample of patients with schizophrenia (68.9% and 31.6%, respectively). On the other hand, in the control group the number of females outweighed that of males (58.4% and 41.6% respectively). The scale had a good internal consistency with Cronbach’s alpha 0.91. There was a significant difference between the scores on the three subscales of the PANSS. Patients with schizophrenia scored significantly higher (p<.0001) than the control subjects on subscales for positive symptoms 20.01(SD=7.21) and 7.30(SD=1.38), negative symptoms 18.89(SD=8.88) and 7.37(SD=2.38) and general psychopathology 34.41 (SD=11.56) and 16.93 (SD=3.93), respectively. Factor analysis and ROC curve were carried out to further test the psychometrics of the scale. Conclusions: The Arabic version of PANSS is a reliable and valid tool to assess both positive and negative symptoms of patients with schizophrenia in a balanced manner. In addition to providing the Arab population with a standardized tool to monitor symptoms of schizophrenia, this version provides a gateway to compare the prevalence of positive and negative symptoms in the Arab world which can be compared to others done elsewhere.

Keywords: Arabic version, assessment, diagnosis, schizophrenia, validation

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Authors: K. Caban-Piaskowska

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The aim of the article is to show how the role of a designer has changed, from the point of view of human resources management and thanks to the increased importance of design management, and is to present how a rehabilitation product, through technology approach to designing, becomes a universal product. Designing for the disabled is a very undiscovered area on the pattern-designing market, most often because it is associated with devices which support rehabilitation. In consequence, it means that the realizations have a limited group of receivers and are not that attractive for designers. The relation between using modern design in building rehabilitation devices and increasing the efficiency of treatment and physiotherapy. Using modern technology can have marketing significance. Rehabilitation products designed and produced in a modern way makes an impression that experts and professionals are involved in the lives of the user – patient. In order to illustrate the problem presented above i.e. Creating a rehabilitation product as an example of design management, the case study method was used in the research. The analysis of the case was created on the basis of an interview conducted by the author with a designer who took part in meetings with people who use rehabilitation and their physiotherapists, and created universal products in Poland in the years of 2012 to 2017. Usually, engineers and constructors deal with creating products which remind us of old torture devices, however, they are indestructible in construction. Such image of those products for the disabled clearly indicates that it is a wonderful niche for designers and emphasizes the need to make those products more attractive and innovative. Products for the disabled cannot be limited to rehabilitation equipment only e.g. wheelchairs or standing frames. Introducing the idea of universal designing can significantly broaden the circle of pattern-designing receivers – everyday-use items – with the disabled people. Fulfilling these criteria will decide about the advantage on the competitive market. It is possible due to the usage of the design management concept in the functioning of an organization. Using modern technology and materials in the production of equipment, and changing the role of a designer broadening the circle of receivers by designing a wide use process which makes it possible to use the product by people with various needs. What is more, introducing rehabilitation functions in everyday-use items can also become an innovative accent in designing. In the reality of the market, each group of users can and should be treated as a problem and a realization task.

Keywords: design management, innovation, rehabilitation product, universal product

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Authors: Panagiotis Platanitis

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Purpose: This research paper seeks to review the empirical studies in the field of expatriate adjustment in East Asia in order to produce a thematic understanding of the current adjustment challenges, thus enabling practitioners to enrich their knowledge. Background: Learning to live, work, and function in a country and culture vastly different from that of one’s upbringing can pose some unique challenges in terms of adaptation and adjustment. This has led to a growing body of research about the adjustment of expatriate workers. Adjustment itself has been posited as a three-dimensional construct; work adjustment, interaction adjustment and general or cultural adjustment. Methodology: This qualitative systematic review has been conducted on all identified peer-reviewed empirical studies related to expatriate adjustment in East Asia. Five electronic databases (PsychInfo, Emerald, Scopus, EBSCO and JSTOR) were searched to December 2015. Out of 625 identified records, thorough evaluation for eligibility resulted in 15 relevant studies being subjected to data analysis. The quality of the identified research was assessed according to the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. The data were analysed by means of thematic synthesis for systematic reviews of qualitative research. Findings: Data analysis revealed five key themes. The themes developed were: (1) personality traits (2) types of adjustment, (3) language, (4) culture and (5) coping strategies. Types of adjustment included subthemes such as: Interaction, general, work, psychological, sociocultural and cross-cultural adjustment. Conclusion: The present review supported previous literature on the different themes of adjustment and it takes the focus from work and general adjustment to the psychological challenges and it introduces the psychological adjustment. It also gives a different perspective about the use of cross-cultural training and the coping strategies expatriates use when they are abroad. This review helps counselling psychologists to understand the importance of a multicultural approach when working with expatriates and also to be aware of what expatriates might face when working and living in East Asia.

Keywords: adjustment, counselling psychology, East Asia, expatriates

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Authors: Bahor Bahriddinovna Turaeva

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The article provides a structural analysis of the titles of the famous Kyrgyz writer Chingiz Aitmatov’s creative works “The Day Lasts More Than a Hundred Years”, “Doomsday”. The author’s creative purpose in naming the work of art, the role of the elements of the plot, and the composition of the novels in revealing the essence of the title are explained. The criteria that are important in naming the author’s works in different genres are classified, and the titles that mean artistic time and artistic space are studied separately. Chronotope is being concerned as the literary-aesthetic category in world literary studies, expressing the scope of the universe interpretation, the author’s outlook and imagination regarding the world foundation, defining personages, and the composition means of expressing the sequence and duration of the events. A creative comprehension of the chronotope as a means of arranging the work composition, structure and constructing an epic field of the text demands a special approach to understanding the aesthetic character of the work. Since the chronotope includes all the elements of a fictional work, it is impossible to present the plot, composition, conflict, system of characters, feelings, and mood of the characters without the description of the chronotope. In the following development of the scientific-theoretical thought in the world, the chronotope is accepted to be one of the poetic means to demonstrate reality as well as to be a literary process that is basic for the expression of reality in the compositional construction and illustration of the plot relying on the writer’s intention and the ideological conception of the literary work. Literary time enables one to cognate the literary world picture created by the author in terms of the descriptive subject and object of the work. Therefore, one of the topical tasks of modern Uzbek literary studies is to describe historical evidence, event, the life of outstanding people, the chronology of the near past based on the literary time; on the example of the creative works of a certain period, creators or an individual writer are analyzed in separate or comparative-typological aspect.

Keywords: novel, title, chronotope, motive, epigraph, analepsis, structural analysis, plot line, composition

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Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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Authors: Hamdy Khamis Korayem, Manal Yehia Tayel, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Shimaa Badr Abdelnaby Badr

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The aim of the current study was to demonstrate whether serum Interleukin-18 (IL-18) is increased in rheumatoid arthritis (RA) and its correlation with disease activity, functional disability and quality of life in RA patients. The study included 30 RA patients and 20 healthy normal control subjects. The RA patients were diagnosed according to the 2010 ACR/EULAR classification criteria for RA with the exclusion of those who had diabetes mellitus, endocrine disorders, associated rheumatologic diseases, viral hepatitis B or C and other diseases with increased serum IL-18 level. All patients were subjected to clinical evaluation of the musculoskeletal system. Disease activity was assessed by disease activity score 28 with 4 variables (DAS 28). Functional disability was assessed by health assessment questionnaire disability index (HAQ-DI). The quality of life was assessed by Short form-36 (SF-36) questionnaire. Radiological assessment of both hands and feet by Sharp/van der Heijde (SvH) scoring method. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were assessed in patients and serum level of IL-18 in both patients and control subjects. There was no statistically significant difference between patient and control group as regards age and sex. Among patients, 29 % were females and the age range was between 25 to 55 years. Extra-articular manifestations were presented in 56.7% of the patients. The mean of DAS 28 score was 5.73±1.46 and that of HAQ-DI was 1.22±0.72 while that of SF-36 was 40.03±13.96. The level of serum IL-18 was significantly higher in patients than in the control subjects (P= 0.030). Serum IL-18 was correlated with ACPA among the patient group. There were no statistically significant correlations between serum IL-18 and DAS28, HAQ-DI, SF-36, total SvH score and the other laboratory results. In conclusion, IL-18 is significantly higher in RA patient than in healthy control subjects and positively correlated with ACPA level. IL-18 is associated with extra-articular manifestations. However, it is not correlated with other laboratory parameters, disease activity, functional disability, quality of life nor radiological severity.

Keywords: disease activity score, Interleukin-18, quality of life assessment, rheumatoid arthritis

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Authors: Zdzislaw Kaminski, Zbigniew Czyz

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The paper discusses the results of the research into a wind turbine with a vertical axis of rotation which was performed with the open return wind tunnel, Gunt HM 170, at the laboratory of the Department of Thermodynamics, Fluid Mechanics and Propulsion Aviation Systems of Lublin University of Technology. Wind tunnel experiments are a necessary step to construct any new type of wind turbine, to validate design assumptions and numerical results. This research focused on the rotor with the blades capable of modifying their working surfaces, i.e. absorbing wind kinetic energy. The operation of this rotor is based on adjusting angular aperture α of the top and bottom parts of the blades mounted on an axis. If this angle α increases, the working surface which absorbs wind kinetic energy also increases. The study was performed on scaled and geometrically similar models with the criteria of similarity relevant for the type of research preserved. The rotors with varied angular apertures of their blades were printed for the research with a powder 3D printer, ZPrinter® 450. This paper presents the research results for the selected flow speed of 6.5 m/s for the three angular apertures of the rotor blades, i.e. 30°, 60°, 90° at varied speeds. The test stand enables the turbine rotor to be braked to achieve the required speed and airflow speed and torque to be recorded. Accordingly, the torque and power as a function of airflow were plotted. The rotor with its adjustable blades enables turbine power to be adjusted within a wide range of wind speeds. A variable angular aperture of blade working surfaces α in a wind turbine enables us to control the speed of the turbine and consequently its output power. Reducing the angular aperture of working surfaces results in reduced speed, and if a special current generator applied, electrical output power is reduced, too. Speed adjusted by changing angle α enables the maximum load acting on rotor blades to be controlled. The solution under study is a kind of safety against a damage of a turbine due to possible high wind speed.

Keywords: drive torque, renewable energy, power, wind turbine, wind tunnel

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Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Dipanshu Sur, Ratnabali Chakravorty, Rimi Pal, Siddhartha Chatterjee, Joyshree Chaterjee, Amal Mallik

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Background: Women with polycystic ovary disease (PCOD) frequently suffer from metabolic disturbances. PCOD is a common ovulatory disorder in young women, which affects 5-10% of the population and results in infertility due to anovulation. Importantly, aromatase in ovarian granulosa and luteinized granulosa cells plays an important role for women of reproductive age. Generation and metabolism of androgen is directly related to aromatase activity. The E2/T ratio provides important information about aromatase activity because conversion of androgens to estrogens is mediated by CYP19, suggesting that the E2/T ratio may be a direct marker of aromatase activity. The nature of the interaction between ovarian aromatase activity and PCOD in women has been controversial, and the impact of weight gain on aromatase activity as well as E2 levels is unknown. Aim: The objective of this study was to investigate the association and relation between aromatase activity and levels of body mass index (BMI) from a reproductive hormone perspective in a group of women with or without PCOD. Methods: We designed a cohort study which included 200 individuals. It enrolled 100 cases of PCOD based on 2006 Rotterdam criteria and 100 ovulatory normal- non PCOD, healthy, age-matched controls. Plasma sex hormones viz. estradiol (E2), testosterone (T), follicle stimulating hormone (FSH), and luteinizing hormone (LH) were measured by ELISA on the second day of the menstrual cycle, together with BMI and E2/T were calculated. Aromatase activity in PCOD patients with different BMI, T and E2 levels were compared. Results: PCOD patients showed significantly increased levels of BMI, E2 (P=0.004), T and LH, while their E2/T (P= <0.001), FSH and FSH/LH values were decreased compared with the control group. Higher E2 levels correlated with a relatively enhanced E2/T as well as T and LH levels but reduced BMI, FSH and FSH/LH levels in women with PCOD. Hyperandrogenic PCOD patients had increased E2 levels but their aromatase activity was markedly inhibited independent of their BMI values. Conclusions: We found a significant decrease of ovarian aromatase activity in women with PCOD as compared to controls. Our study showed that ovarian aromatase activity in PCOD was decreased which was independent of BMI. Enhancing aromatase activity may become an optimized strategy for developing therapies for PCOD women, especially those with obesity.

Keywords: aromatase activity, polycystic ovary disease, obesity, body mass index

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Authors: Ezil Sam Leni, Shalen S.

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Transport service monitoring and upkeep are essential components of smart city initiatives. The main risks to the relevant departments and authorities are the ever-increasing vehicular traffic and the conditions of the roads. In India, the economy is greatly impacted by the road transport sector. In 2021, the Ministry of Road Transport and Highways Transport, Government of India, produced a report with statistical data on traffic accidents. The data included the number of fatalities, injuries, and other pertinent criteria. This study proposes a distributed infrastructure for the monitoring, detection, and reporting of potholes to the appropriate authorities. In a distributed environment, the nodes are the edge devices, and local edge servers, and global servers. The edge devices receive the initial model to be employed from the global server. The YOLOv8 model for pothole detection is used in the edge devices. The edge devices run the pothole detection model, gather the pothole images on their path, and send the updates to the nearby edge server. The local edge server selects the clients for its aggregation process, aggregates the model updates and sends the updates to the global server. The global server collects the updates from the local edge servers, performs aggregation and derives the updated model. The updated model has the information about the potholes received from the local edge servers and notifies the updates to the local edge servers and concerned authorities for monitoring and maintenance of road conditions. The entire process is implemented in FedCV distributed environment with the implementation using the client-server model and aggregation entities. After choosing the clients for its aggregation process, the local edge server gathers the model updates and transmits them to the global server. After gathering the updates from the regional edge servers, the global server aggregates them and creates the updated model. Performance indicators and the experimentation environment are assessed, discussed, and presented. Accelerometer data may be taken into consideration for improved performance in the future development of this study, in addition to the images captured from the transportation routes.

Keywords: federated Learning, pothole detection, distributed framework, federated averaging

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Authors: Sandra Pietri, Helene Dubout, Sabrina Ena, Candice Hoste, Enrico Bastianelli

Abstract:

Bone Therapeutics is a bone cell therapy company addressing high unmet medical needs in the field of bone fracture repair, more specifically in non-union and delayed-union fractures where the bone repair process is impaired. The company has developed a unique allogeneic osteoblastic cell product (ALLOB®) derived from bone marrow which is currently tested in humans in the indication of delayed-union fractures. The purpose of our study was to directly compare ALLOB® vs. non-differentiated mesenchymal stem cells (MSC) for their in vitro osteogenic characteristics and their in vivo osteogenic potential in order to determine which cellular type would be the most adapted for bone fracture repair. Methods: Healthy volunteers’ bone marrow aspirates (n=6) were expended (i) into BM-MSCs using a complete MSC culture medium or (ii) into ALLOB® cells according to its manufacturing process. Cells were characterized in vitro by morphology, immunophenotype, gene expression and differentiation potential. Additionally, their osteogenic potential was assessed in vivo in the subperiosteal calvaria bone formation model in nude mice. Results: The in vitro side-by-side comparison studies showed that although ALLOB® and BM-MSC shared some common general characteristics such as the 3 minimal MSC criteria, ALLOB® expressed significantly higher levels of chondro/osteoblastic genes such as BMP2 (fold change (FC) > 100), ALPL (FC > 12), CBFA1 (FC > 3) and differentiated significantly earlier than BM-MSC toward the osteogenic lineage. Moreover the bone formation model in nude mice demonstrated that used at the same cellular concentration, ALLOB® was able to induce significantly more (160% vs.107% for control animals) bone formation than BM-MSC (118% vs. 107 % for control animals) two weeks after administration. Conclusion: Our side-by-side comparison studies demonstrated that in vitro and in vivo, ALLOB® displays superior osteogenic capacity to BM-MScs and is therefore a better candidate for the treatment of bone fractures.

Keywords: gene expression, histomorphometry, mesenchymal stem cells, osteogenic differentiation potential, preclinical

Procedia PDF Downloads 330

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

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Authors: Emre Ozaslan, Bulent Acar, Mehmet Ali Guler

Abstract:

Unidirectional composites are very popular structural materials used in aerospace, marine, energy and automotive industries thanks to their superior material properties. However, the mechanical behavior of composite materials is more complicated than isotropic materials because of their anisotropic nature. Also, a stress concentration availability on the structure, like a hole, makes the problem further complicated. Therefore, enormous number of tests require to understand the mechanical behavior and strength of composites which contain stress concentration. Accurate finite element analysis and analytical models enable to understand mechanical behavior and predict the strength of composites without enormous number of tests which cost serious time and money. In this study, unidirectional Carbon/Epoxy composite specimens with central circular hole were investigated in terms of stress concentration factor and strength prediction. The composite specimens which had different specimen wide (W) to hole diameter (D) ratio were tested to investigate the effect of hole size on the stress concentration and strength. Also, specimens which had same specimen wide to hole diameter ratio, but varied sizes were tested to investigate the size effect. Finite element analysis was performed to determine stress concentration factor for all specimen configurations. For quasi-isotropic laminate, it was found that the stress concentration factor increased approximately %15 with decreasing of W/D ratio from 6 to 3. Point stress criteria (PSC), inherent flaw method and progressive failure analysis were compared in terms of predicting the strength of specimens. All methods could predict the strength of specimens with maximum %8 error. PSC was better than other methods for high values of W/D ratio, however, inherent flaw method was successful for low values of W/D. Also, it is seen that increasing by 4 times of the W/D ratio rises the failure strength of composite specimen as %62.4. For constant W/D ratio specimens, all the strength prediction methods were more successful for smaller size specimens than larger ones. Increasing the specimen width and hole diameter together by 2 times reduces the specimen failure strength as %13.2.

Keywords: failure, strength, stress concentration, unidirectional composites

Procedia PDF Downloads 156

Authors: Enes Caliskan, Hatice Camgoz Akdag

Abstract:

There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

Abstract:

Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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Authors: Gabriel Dolabella, Henrique Rangel, Stella Araújo, Carlos Bolonha, Igor de Lazari

Abstract:

Public security is a common subject on the Brazilian political agenda. The seventh largest economy in the world has high crime and insecurity rates. Specialists try to explain this social picture based on poverty, inequality or public policies addressed to drug trafficking. This excerpt approaches State measures to handle that picture. Therefore, the public security - law enforcement institutions - is at the core of this paper, particularly the relationship among federal and state law enforcement agencies, mainly ruled by a system of urgency. The problems are informal changes on law enforcement management and public opinion collaboration to these changes. Whenever there were huge international events, Brazilian armed forces occupied streets to assure law enforcement - ensuring the order. This logic, considered in the long time, could impact the federal structure of the country. The post-madisonian theorists verify that urgency is often associated to delegation of powers, which is true for Brazilian law enforcement, but here there is a different delegation: States continuously delegate law enforcement powers to the federal government throughout the use of Armed Forces. Therefore, the hypothesis is: Brazil is under a political process of federalization of public security. The political framework addressed here can be explained by the disrespect of legal constraints and the failure of rule of law theoretical models. The methodology of analysis is based on general criteria. Temporally, this study investigates events from 2003, when discussions about the disarmament statute begun. Geographically, this study is limited to Brazilian borders. Materially, the analysis result from the observation of legal resources and political resources (pronouncements of government officials). The main parameters are based on post-madisonianism and federalization of public security can be assessed through credibility and popularity that allow evaluation of this political process of constitutional change. The objective is to demonstrate how the Military Forces are used in public security, not as a random fact or an isolated political event, in order to understand the political motivations and effects that stem from that use from an institutional perspective.

Keywords: public security, governability, rule of law, federalism

Procedia PDF Downloads 677

Authors: C. Hernandez-Garcia, P. Adderley, D. Bullard, J. Grames, M. A. Mamun, G. Palacios-Serrano, M. Poelker, M. Stutzman, R. Suleiman, Y. Wang, , S. Zhang

Abstract:

High-energy nuclear physics experiments performed at the Jefferson Lab (JLab) Continuous Electron Beam Accelerator Facility require a beam of spin-polarized ps-long electron bunches. The electron beam is generated when a circularly polarized laser beam illuminates a GaAs semiconductor photocathode biased at hundreds of kV dc inside an ultra-high vacuum chamber. The photocathode is mounted on highly polished stainless steel electrodes electrically isolated by means of a conical-shape ceramic insulator that extends into the vacuum chamber, serving as the cathode electrode support structure. The assembly is known as a dc photogun, which has to simultaneously meet the following criteria: high voltage to manage space charge forces within the electron bunch, ultra-high vacuum conditions to preserve the photocathode quantum efficiency, no field emission to prevent gas load when field emitted electrons impact the vacuum chamber, and finally no voltage breakdown for robust operation. Over the past decade, JLab has tested and implemented the use of inverted geometry ceramic insulators connected to commercial high voltage cables to operate a photogun at 200kV dc with a 10 cm long insulator, and a larger version at 300kV dc with 20 cm long insulator. Plans to develop a third photogun operating at 400kV dc to meet the stringent requirements of the proposed International Linear Collider are underway at JLab, utilizing even larger inverted insulators. This contribution describes approaches that have been successful in solving challenging problems related to breakdown and field emission, such as triple-point junction screening electrodes, mechanical polishing to achieve mirror-like surface finish and high voltage conditioning procedures with Kr gas to extinguish field emission.

Keywords: electron guns, high voltage techniques, insulators, vacuum insulation

Procedia PDF Downloads 113

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

Procedia PDF Downloads 198

Authors: Sisira Edirippulige

Abstract:

Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

Procedia PDF Downloads 282

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

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Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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Authors: Sharadha G., Suresh Kanakkanavar

Abstract:

Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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Authors: Kalina Alina Aidarovna, Khayrullina Yulia Sergeevna

Abstract:

The question of forming quality housing and living environment remains a vexed problem in the current situation of high-rise apartment building in big cities of Russia. At this start up stage of the modern so-called "mass housing" market it needs to identify key quality characteristics on a different scale from apartments to the district. This paper describes the methodology of qualitative assessment of modern mass housing construction, made on the basis of the ITMO university in cooperation with the institute of spatial planning "Urbanika," based on the case study of St. Petersburg’s residential mass housing built in 2011-2014. The methodology of the study of housing and living environment goes back to the native and foreign urbanists of 60s - 80s, such Jane Jacobs, Jan Gehl, Oscar Newman, Krasheninnikov, as well as Sommer, Stools, Kohnen and Sherrod, Krasilnikova, Sychev, Zhdanov, Tinyaeva considering spatial features of living environment in a wide range of its characteristics (environmental control, territorial and personalization, privacy, etc.). Assessment is carrying out on the proposed system of criteria developed for each residential environment scale-district, quarter, courtyard, building surrounding grounds, houses, and flats. Thus the objects of study are planning unit of residential development areas (residential area, neighborhood, quarter) residential units areas (living artist, a house), and households (apartments) consisting of residential units. As a product of identified methodology, after the results of case studies of more than 700 residential complexes in St. Petersburg, we intend the creation of affordable online resource that would allow conducting a detailed qualitative evaluation or comparative characteristics of residential complexes for all participants of the construction market-developers, designers, realtors and buyers. Thereby the main objective of the rating may be achieved to improve knowledge, requirements, and demand for quality housing and living environment among the major stakeholders of the construction market.

Keywords: methodology of living environment, qualitative assessment of mass housing, scale-district, vexed problem

Procedia PDF Downloads 459