Search results for: Jung Ho Yang

Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

Procedia PDF Downloads 268

Authors: Jiashu Shen, Guoting Zhang, Zhicheng Wang, Yu Wang, Yun Liang, Siyu Zou, Fan Yang, Kun Tang

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Objectives: This study aims to enhance the understanding of paid blood donors’ characteristics in Chinese population and devise strategies to protect these paid donors. Background: Paid blood donation was the predominant mode of blood donation in China from the 1970s to 1998 and caused several health and social problems including largely increased the risk of infectious diseases with nonstandard operation in unhygienic conditions. Methods: This study utilized the cross-sectional data from the China Kadoorie Biobank with about 0.5 million people from 10 regions of China from 2004 to 2008. Multivariable logistic regression was performed to examine the associations between socio-demographic factors and paid blood donation. Furthermore, a stratified analysis was applied in education level and annual household income by rural and urban areas. Results: The prevalence of paid blood donation was 0.50% in China and males were more likely to donate blood than females (Adjusted odds ratio (AOR) =0.81, 95%Confident Intervals (CI): 0.75-0.88). Urban people had much lower odds than rural people (AOR =0.24, 95%CI: 0.21-0.27). People with a high annual household income had lower odds of paid blood donation compared with that of people with low income (AOR=0.37, 95%CI: 0.31-0.44). Compared with people who didn’t receive school education, people in a higher level of education had increased odds of paid blood donation (AOR=2.31, 95%CI: 1.94-2.74). Conclusion: Paid blood donors in China were associated with those who were males, living in rural areas, with low annual household income and educational background.

Keywords: China Kadoorie Biobank, Chinese population, paid blood donation, socio-demographic factors

Procedia PDF Downloads 146

Authors: Jung-En Kuan, Whei-Fen Wu

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In this study, a symbiotic bacteria from yellow mealworm's (Tenebrio molitor) mid-gut was isolated with characteristics of growth on minimal-tributyrin medium. After a PCR-amplification of its 16s rDNA, the resultant nucleotide sequences were then analyzed by schemes of the phylogeny trees. Accordingly, it was designated as Pseudomonas nitroreducens D-01. Next, by searching the lipolytic enzymes in its protein data bank, one of those potential lipolytic α/β hydrolases was identified, again using PCR-amplification and nucleotide-sequencing methods. To construct an expression of this lipolytic gene in plasmids, the target-gene primers were then designed, carrying the C-terminal his-tag sequences. Using the vector pET21a, a recombinant lipolytic hydrolase D gene with his-tag nucleotides was successfully cloned into it, of which the lipolytic D gene is under a control of the T7 promoter. After transformation of the resultant plasmids into Eescherichia coli BL21 (DE3), an IPTG inducer was used for the induction of the recombinant proteins. The protein products were then purified by metal-ion affinity column, and the purified proteins were found capable of forming a clear zone on tributyrin agar plate. Shortly, its enzyme activities were determined by degradation of p-nitrophenyl ester(s), and the substantial yellow end-product, p-nitrophenol, was measured at O.D.405 nm. Specifically, this lipolytic enzyme efficiently targets p-nitrophenyl butyrate. As well, it shows the most reactive activities at 40°C, pH 8 in potassium phosphate buffer. In thermal stability assays, the activities of this enzyme dramatically drop when the temperature is above 50°C. In metal ion assays, MgCl₂ and NH₄Cl induce the enzyme activities while MnSO₄, NiSO₄, CaCl₂, ZnSO₄, CoCl₂, CuSO₄, FeSO₄, and FeCl₃ reduce its activities. Besides, NaCl has no effects on its enzyme activities. Most organic solvents decrease the activities of this enzyme, such as hexane, methanol, ethanol, acetone, isopropanol, chloroform, and ethyl acetate. However, its enzyme activities increase when DMSO exists. All the surfactants like Triton X-100, Tween 80, Tween 20, and Brij35 decrease its lipolytic activities. Using Lineweaver-Burk double reciprocal methods, the function of the enzyme kinetics were determined such as Km = 0.488 (mM), Vmax = 0.0644 (mM/min), and kcat = 3.01x10³ (s⁻¹), as well the total efficiency of kcat/Km is 6.17 x10³ (mM⁻¹/s⁻¹). Afterwards, based on the phylogenetic analyses, this lipolytic protein is classified to type IV lipase by its homologous conserved region in this lipase family.

Keywords: enzyme, esterase, lipotic hydrolase, type IV

Procedia PDF Downloads 129

Authors: David A. Harness

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Natural evolution of ATP cognitive systems is to meet AI peer review standards. ATP process of axiom selection from Mizar to prove a conjecture would be further refined, as in all human and machine learning, by solving the real world problem of the proposed AI peer review challenge: Determine which conjecture forms the higher confidence level constructive proof between Standard Model of Physics SU(n) lattice gauge group operation vs. present non-standard 4D GEM EOS SU(n) lattice gauge group spatially extended operation in which the photon and electron are the first two trace angular momentum invariants of a gravitoelectromagnetic (GEM) energy momentum density tensor wavetrain integration spin-stress pressure-volume equation of state (EOS), initiated via 32 lines of Mathematica code. Resulting gravitoelectromagnetic spectrum ranges from compressive through rarefactive of the central cosmological constant vacuum energy density in units of pascals. Said self-adjoint group operation exclusively operates on the stress energy momentum tensor of the Einstein field equations, introducing quantization directly on the 4D spacetime level, essentially reformulating the Yang-Mills virtual superpositioned particle compounded lattice gauge groups quantization of the vacuum—into a single hyper-complex multi-valued GEM U(1) × SU(1,3) lattice gauge group Planck spacetime mesh quantization of the vacuum. Thus the Mizar corpus already contains all of the axioms required for relevant DeepMath premise selection and unambiguous formal natural language parsing in context deep learning.

Keywords: automated theorem proving, constructive quantum field theory, information theory, neural networks

Procedia PDF Downloads 174

Authors: Hao Yang, Lei Chen, Ting Mei, Jianbang Zheng

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Currently, the uncooled PbSe photodetectors in the mid-infrared range (2-5μm) with sensitization technology extract more photoelectric response than traditional ones, and enable the room temperature (300K) photo-detection with high detectivity, which have attracted wide attentions in many fields. This technology generally contains the film fabrication with vapor phase deposition (VPD) and a sensitizing process with doping of oxygen and iodine. Many works presented in the recent years almost provide and high temperature activation method with oxygen/iodine vapor diffusion, which reveals that oxygen or iodine plays an important role in the sensitization of PbSe material. In this paper, we provide our latest experimental results and discussions in the stoichiometry of oxygen and iodine and its influence on the polycrystalline structure and photo-response. The experimental results revealed that crystal orientation was transformed from (200) to (420) by sensitization, and the responsivity of 5.42 A/W was gained by the optimal stoichiometry of oxygen and iodine with molecular density of I2 of ~1.51×1012 mm-3 and oxygen pressure of ~1Mpa. We verified that I2 plays a role in transporting oxygen into the lattice of crystal, which is actually not its major role. It is revealed that samples sensitized with iodine transform atomic proportion of Pb from 34.5% to 25.0% compared with samples without iodine from XPS data, which result in the proportion of about 1:1 between Pb and Se atoms by sublimation of PbI2 during sensitization process, and Pb/Se atomic proportion is controlled by I/O atomic proportion in the polycrystalline grains, which is very an important factor for improving responsivity of uncooled PbSe photodetector. Moreover, a novel sensitization and dopant activation method is proposed using oxygen ion implantation with low ion energy of < 500eV and beam current of ~120μA/cm2. These results may be helpful to understanding the sensitization mechanism of polycrystalline lead salt materials.

Keywords: polycrystalline PbSe, sensitization, transport, stoichiometry

Procedia PDF Downloads 345

Authors: Eun-Young Kwon, Myung-Sook Choi, Su-Jung Cho, Ji-Young Choi, So Young Kim, Youngji Han

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Overweight and obesity have been linked to a low-grade chronic inflammatory response and an increased risk of developing metabolic syndrome including insulin resistance, type 2 diabetes mellitus and certain types of cancers. Luteolin is a dietary flavonoid with anti-inflammatory, anti-oxidant, anti-cancer and anti-diabetic properties. However, little is known about the detailed mechanism associated with the effect of luteolin on inflammation-related obesity and its complications. The aim of the present study was to reveal the anti-diabetic effect of luteolin in diet-induced obesity mice using “transcriptomics” tool. Thirty-nine male C57BL/6J mice (4-week-old) were randomly divided into 3 groups and were fed normal diet, high-fat diet (HFD, 20% fat) and HFD+0.005% (w/w) luteolin for 16 weeks. Luteolin improved insulin resistance, as measured by HOMA-IR and glucose tolerance, along with preservation action of pancreatic β-cells, compared to the HFD group. Luteoiln was significantly decreased the levels of leptin and ghrelin that play a pivotal role in energy balance, and the macrophage low-grade inflammation marker sCD163 (soluble Cd antigen 163) in plasma. Activities of hepatic anti-oxidant enzymes (catalase and glutathione peroxidase) were increased, while the levels of plasma transaminase (GOT and GPT) and oxidative damage markers (hepatic mitochondria H2O2 and TBARS) were markedly decreased by luteolin supplementation. In addition, luteolin increased oxidative capacity and fatty acid utilization by presenting decrease in enzyme activities of citrate synthase, cytochrome C oxidase and β-hydroxyacyl CoA dehydrogenase and UCP3 gene expression compared to high-fat diet. Moreover, our microarray results of muscle also revealed down-regulated gene expressions associated with TCA cycle by HFD were reversed to normal level by luteolin treatment. Taken together, our results indicate that luteolin is one of bioactive components for improving insulin resistance by increasing oxidative capacity, modulating anti-oxidant metabolism and suppressing inflammatory signaling cascades in diet-induced obese mice. These results provide possible therapeutic targets for prevention and treatment of diet-induced obesity and its complications.

Keywords: anti-oxidant metabolism, diabetes, luteolin, oxidative capacity

Procedia PDF Downloads 335

Authors: Sunghun Jung, Wonkook Kim

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Due to the difficulty of the utilization of satellite and an aircraft, conventional ocean color remote sensing has a disadvantage in that it is difficult to obtain images of desired places at desired times. These disadvantages make it difficult to capture the anomalies such as the occurrence of the red tide which requires immediate observation. It is also difficult to understand the phenomena such as the resuspension-precipitation process of suspended solids and the spread of low-salinity water originating in the coastal areas. For the remote sensing reflectance of seawater, above-water radiometers (AWR) have been used either by carrying portable AWRs on a ship or installing those at fixed observation points on the Ieodo ocean research station, Socheongcho base, and etc. In particular, however, it requires the high cost to measure the remote reflectance in various seawater environments at various times and it is even not possible to measure it at the desired frequency in the desired sea area at the desired time. Also, in case of the stationary observation, it is advantageous that observation data is continuously obtained, but there is the disadvantage that data of various sea areas cannot be obtained. It is possible to instantly capture various marine phenomena occurring on the coast using the unmanned aerial system (UAS) including vertical takeoff and landing (VTOL) type unmanned aerial vehicles (UAV) since it could move and hover at the one location and acquire data of the desired form at a high resolution. To remotely estimate seawater constituents, it is necessary to install an ultra-spectral sensor. Also, to calculate reflected light from the surface of the sea in consideration of the sun’s incident light, a total of three sensors need to be installed on the UAV. The remote sensing reflectance of seawater is the most basic optical property for remotely estimating color components in seawater and we could remotely estimate the chlorophyll concentration, the suspended solids concentration, and the dissolved organic amount. Estimating seawater physics from the remote sensing reflectance requires the algorithm development using the accumulation data of seawater reflectivity under various seawater and atmospheric conditions. The UAS with three AWRs is developed for the remote reflection sensing on the surface of the sea. Throughout the paper, we explain the details of each UAS component, system operation scenarios, and simulation and experiment results. The UAS consists of a UAV, a solar tracker, a transmitter, a ground control station (GCS), three AWRs, and two gimbals.

Keywords: above-water radiometers (AWR), ground control station (GCS), unmanned aerial system (UAS), unmanned aerial vehicle (UAV)

Procedia PDF Downloads 158

Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

Procedia PDF Downloads 191

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

Procedia PDF Downloads 80

Authors: Ning Li, Jiacheng Zhang, Zheng Yang, Sylvia Kang

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Introduction: Polycystic ovary syndrome (PCOS) is a common physiological symptom in women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods and excess male hormone (androgen) levels. Mira analyzes the cycle profiles and the luteinizing hormone (LH) changes in urine, closely related to the fertility level of healthy women and PCOS women. From the difference between the two groups, Mira helps to understand the physiological state of PCOS women and their hormonal changes in the menstrual cycle. Methods: In this study, data from 1496 cycles and information from 342 women belonging to two groups (181 PCOS and 161 Healthy) were collected and analyzed. Women test their luteinizing hormone (LH) in urine daily with Mira fertility test wand and Mira analyzer, from the day after the menstruation to the starting day of the next menstruation. All the collected data meets Mira’s user agreement and users’ identification was removed. The cycle length, LH peak, and other cycle information of the PCOS group were compared with the Healthy group. Results: The average cycle length of PCOS women is 41 days and of the Healthy women is 33 days. 91.4% of cycle length is within 40 days for the Healthy group, while it decreases to 71.9% for the PCOS group. This means PCOS women have a longer menstrual cycle and more variation during the cycle. With more variation, the ovulation prediction becomes more difficult for the PCOS group. The deviation between the LH surge day and the predicted ovulation day, calculated by the starting day of the next menstruation minus 14 days, is greater in the PCOS group compared with the Healthy group. Also, 46.96% of PCOS women have an irregular cycle, and only 19.25% of healthy women show an irregular cycle. Conclusion: PCOS women have longer menstrual cycles and more variation during the menstrual cycles. The traditional ovulation prediction is not suitable for PCOS women.

Keywords: menstrual cycle, PCOS, urinary luteinizing hormone, Mira

Procedia PDF Downloads 172

Authors: Yang Shen, Yongpan Cheng, Jinliang Xu

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The effective blade cooling is of great significance for improving the performance of turbine. The mist cooling emerges as the promising way compared with the transitional single-phase cooling. In the mist cooling, the injected droplet will evaporate rapidly, and cool down the blade surface due to the absorbed latent heat, hence the lifetime for evaporating droplet becomes critical for design of cooling passages for the blade. So far there have been extensive studies on the droplet evaporation, but usually the isothermal model is applied for most of the studies. Actually the surface cooling effect can affect the droplet evaporation greatly, it can prolong the droplet evaporation lifetime significantly. In our study, a new theoretical model for sessile droplet evaporation with surface cooling effect is built up in toroidal coordinate. Three evaporation modes are analyzed during the evaporation lifetime, include “Constant Contact Radius”(CCR) mode、“Constant Contact Angle”(CCA) mode and “stick-slip”(SS) mode. The dimensionless number E0 is introduced to indicate the strength of the evaporative cooling, it is defined based on the thermal properties of the liquid and the atmosphere. Our model can predict accurately the lifetime of evaporation by validating with available experimental data. Then the temporal variation of droplet volume, contact angle and contact radius are presented under CCR, CCA and SS mode, the following conclusions are obtained. 1) The larger the dimensionless number E0, the longer the lifetime of three evaporation cases is; 2) The droplet volume over time still follows “2/3 power law” in the CCA mode, as in the isothermal model without the cooling effect; 3) In the “SS” mode, the large transition contact angle can reduce the evaporation time in CCR mode, and increase the time in CCA mode, the overall lifetime will be increased; 4) The correction factor for predicting instantaneous volume of the droplet is derived to predict the droplet life time accurately. These findings may be of great significance to explore the dynamics and heat transfer of sessile droplet evaporation.

Keywords: blade cooling, droplet evaporation, lifetime, theoretical analysis

Procedia PDF Downloads 140

Authors: Saem Lee, Thanh Nguyen, Hio-Jung Shin, Thomas Koellner

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Land-use management has an influence on the provision of ecosystem service in dynamic, agricultural landscapes. Agricultural land use is important for maintaining the productivity and sustainability of agricultural ecosystems. However, in Korea, intensive farming activities in this highland agricultural zone, the upper stream of Soyang has led to contaminated soil caused by over-use pesticides and fertilizers. This has led to decrease in water and soil quality, which has consequences for ecosystem services and human wellbeing. Conventional farming has still high percentage in this area and there is no special measure to prevent low water quality caused by farming activities. Therefore, the adoption of environmentally friendly farming has been considered one of the alternatives that lead to improved water quality and increase in biomass production. Concurrently, farm households with environmentally friendly farming have occupied still low rates. Therefore, our research involved a farm household survey spanning conventional farming, the farm in transition and organic farming in Soyang watershed. Another purpose of our research was to compare economic advantage of the farmers adopting environmentally friendly farming and non-adaptors and to investigate the different factors by logistic regression analysis with socio-economic and benefit-cost ratio variables. The results found that farmers with environmentally friendly farming tended to be younger than conventional farming and farmer in transition. They are similar in terms of gender which was predominately male. Farmers with environmentally friendly farming were more educated and had less farming experience than conventional farming and farmer in transition. Based on the benefit-cost analysis, total costs that farm in transition farmers spent for one year are about two times as much as the sum of costs in environmentally friendly farming. The benefit of organic farmers was assessed with 2,800 KRW per household per year. In logistic regression, the factors having statistical significance are subsidy and district, residence period and benefit-cost ratio. And district and residence period have the negative impact on the practice of environmentally friendly farming techniques. The results of our research make a valuable contribution to provide important information to describe Korean policy-making for agricultural and water management and to consider potential approaches to policy that would substantiate ways beneficial for sustainable resource management.

Keywords: organic farming, logistic regression, profitability, agricultural land-use

Procedia PDF Downloads 398

Authors: Xiang Zhang, Daohong Yang, Ziyuan Wu, Lei Li, Wanting Zhou

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Visual Simultaneous Localization and Mapping (VSLAM) uses cameras to collect information in unknown environments to realize simultaneous localization and environment map construction, which has a wide range of applications in autonomous driving, virtual reality and other related fields. At present, the related research achievements about VSLAM can maintain high accuracy in static environment. But in dynamic environment, due to the presence of moving objects in the scene, the movement of these objects will reduce the stability of VSLAM system, resulting in inaccurate localization and mapping, or even failure. In this paper, a robust VSLAM method was proposed to effectively deal with the problem in dynamic environment. We proposed a dynamic region removal scheme based on semantic segmentation neural networks and geometric constraints. Firstly, semantic extraction neural network is used to extract prior active motion region, prior static region and prior passive motion region in the environment. Then, the light weight frame tracking module initializes the transform pose between the previous frame and the current frame on the prior static region. A motion consistency detection module based on multi-view geometry and scene flow is used to divide the environment into static region and dynamic region. Thus, the dynamic object region was successfully eliminated. Finally, only the static region is used for tracking thread. Our research is based on the ORBSLAM3 system, which is one of the most effective VSLAM systems available. We evaluated our method on the TUM RGB-D benchmark and the results demonstrate that the proposed VSLAM method improves the accuracy of the original ORBSLAM3 by 70%˜98.5% under high dynamic environment.

Keywords: dynamic scene, dynamic visual SLAM, semantic segmentation, scene flow, VSLAM

Procedia PDF Downloads 108

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

Procedia PDF Downloads 239

Authors: Robel Wondimu Alemayehu, Sihwa Jung, Manwoo Park, Young K. Ju

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Following the aftermath of the 1994 Northridge earthquake, intensive research on beam to column connections is conducted, leading to the current design basis. The current design codes require the use of either a prequalified connection or a connection that passes the requirements of large-scale cyclic qualification test prior to use in intermediate or special moment frames. The second alternative is expensive both in terms of money and time. On the other hand, the maximum beam depth in most of the prequalified connections is limited to 900mm due to the reduced rotation capacity of deeper beams. However, for long span beams the need to use deeper beams may arise. In this study, a beam to column connection detail suitable for deep beams is presented. The connection detail comprises of thicker-tapered beam flange adjacent to the beam to column connection. Within the thicker-tapered flange region, two reduced beam sections are provided with the objective of forming two plastic hinges within the tapered-thicker flange region. In addition, the length, width, and thickness of the tapered-thicker flange region are proportioned in such a way that a third plastic hinge forms at the end of the tapered-thicker flange region. As a result, the total rotation demand is distributed over three plastic zones. Making it suitable for deeper beams that have lower rotation capacity at one plastic hinge. The effectiveness of this connection detail is studied through finite element analysis. For the study, a beam that has a depth of 1200mm is used. Additionally, comparison with welded unreinforced flange-welded web (WUF-W) moment connection and reduced beam section moment connection is made. The results show that the rotation capacity of a WUF-W moment connection is increased from 2.0% to 2.2% by applying the proposed moment connection detail. Furthermore, the maximum moment capacity, energy dissipation capacity and stiffness of the WUF-W moment connection is increased up to 58%, 49%, and 32% respectively. In contrast, applying the reduced beam section detail to the same WUF-W moment connection reduced the rotation capacity from 2.0% to 1.50% plus the maximum moment capacity and stiffness of the connection is reduced by 22% and 6% respectively. The proposed connection develops three plastic hinge regions as intended and it shows improved performance compared to both WUF-W moment connection and reduced beam section moment connection. Moreover, the achieved rotation capacity satisfies the minimum required for use in intermediate moment frames.

Keywords: connections, finite element analysis, seismic design, steel intermediate moment frame

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Authors: Wuqi Yang, Sufeng Li, Linda Zhai, Zhizhong Yuan, Shengli Wang

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How to assess and evaluate a not-for-profit (NFP) organisation’s performance should be of concern to all stakeholders because, amongst other things, without correctly evaluating its performance might affect an NFP being not able to continue to meet its service objectives. Given the growing importance of this sector in China, more and more existing and potential donors, governments and others are starting to take an increased interest in the financial conditions and performance of NFPs. However, when these various groups look for ways (methods) to assess the performance of NFPs, they find there has been relatively little research conducted into methods for assessing the performance of NFPs in China. Furthermore, there does not appear to have been any research to date into the performance evaluation of Chinese NFPs. The focus of this paper is to investigate how the Chinese government manages and evaluates not-for-profit (NFP) organisations' performances in China. Through examining and evaluating the NFPs in China from different aspects such as business development, mission fulfillment, financial position and other status, this paper finds some institutional constraints currently facing by the NFPs in China. At the end of this paper, a new regulatory framework is proposed for regulators’ considerations. The research methods are based on a combination of a literature review; using Balanced Scorecard to assess NFPs in China; Case Study method is employed to analyse a charity foundation’s performance in Hebei Province and proposing solutions to resolve the current issues and challenges facing by the NFPs. These solutions include: formulating laws and regulations on NFPs; simplifying management procedures, introducing tax incentives, providing financial support and other incentives to support the development of non-profit organizations in China. This study provides the first step towards a greater understanding of the NFP performance evaluation in China. It is expected that the findings and solutions from this study will be useful to anyone involved with the China NFP sector; particularly CEOs, managers, bankers, independent auditors and government agencies.

Keywords: Chinese non-profit organizations, evaluation, management, supervision

Procedia PDF Downloads 171

Authors: Hsiu Tan Liu, Chun Jung Liu

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It has multiple purposes to develop a sign language receptive skills test. For example, this test can be used to be an important tool for education and to understand the sign language ability of deaf children. There is no available test for these purposes in Taiwan. Through the discussion of experts and the references of standardized Taiwanese Sign Language Receptive Test for adults and adolescents, the frame of Taiwanese Sign Language Receptive Skills Test (TSL-RST) for deaf children was developed, and the items were further designed. After multiple times of pre-trials, discussions and corrections, TSL-RST is finally developed which can be conducted and scored online. There were 33 deaf children who agreed to be tested from all three deaf schools in Taiwan. Through item analysis, the items were picked out that have good discrimination index and fair difficulty index. Moreover, psychometric indexes of reliability and validity were established. Then, derived the regression formula was derived which can predict the sign language receptive skills of deaf children. The main results of this study are as follows. (1). TSL-RST includes three sub-test of vocabulary comprehension, syntax comprehension and paragraph comprehension. There are 21, 20, and 9 items in vocabulary comprehension, syntax comprehension, and paragraph comprehension, respectively. (2). TSL-RST can be conducted individually online. The sign language ability of deaf students can be calculated fast and objectively, so that they can get the feedback and results immediately. This can also contribute to both teaching and research. The most subjects can complete the test within 25 minutes. While the test procedure, they can answer the test questions without relying on their reading ability or memory capacity. (3). The sub-test of the vocabulary comprehension is the easiest one, syntax comprehension is harder than vocabulary comprehension and the paragraph comprehension is the hardest. Each of the three sub-test and the whole test are good in item discrimination index. (4). The psychometric indices are good, including the internal consistency reliability (Cronbach’s α coefficient), test-retest reliability, split-half reliability, and content validity. The sign language ability are significantly related to non-verbal IQ, the teachers’ rating to the students’ sign language ability and students’ self-rating to their own sign language ability. The results showed that the higher grade students have better performance than the lower grade students, and students with deaf parent perform better than those with hearing parent. These results made TLS-RST have great discriminant validity. (5). The predictors of sign language ability of primary deaf students are age and years of starting to learn sign language. The results of this study suggested that TSL-RST can effectively assess deaf student’s sign language ability. This study also proposed a model to develop a sign language tests.

Keywords: comprehension test, elementary school, sign language, Taiwan sign language

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Authors: Xiao-Yan Li, Takashi Hashimoto, Guanhong Li, Shuo Yang

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In Japanese, onomatopoeia is an important element in the lively expression of feelings and experiences. It is very difficult for students of Japanese to acquire onomatopoeia, especially, its nuances. In this paper, based on traditional L2 learning theories, we propose a new method to improve the efficiency of teaching the nuances – both explicit and tacit - to non-native speakers of Japanese. The method for teaching the tacit nuances of onomatopoeia consists of three elements. First is to teach the formal rules representing the explicit nuances of onomatopoeic words. Second is to have the students create new onomatopoeic words by utilizing those formal rules. The last element is to provide feedback by evaluating the onomatopoeias created. Our previous study used five-grade relative estimation. However students were confused about the five-grade system, because they could not understand the evaluation criteria only based on a figure. In this new system, then, we built an evaluation database through native speakers’ narrative interpretation. We asked Japanese native speakers to describe their awareness of the nuances of onomatopoeia in writing. Then they voted on site and defined priorities for showing to learners on the system. To verify the effectiveness of the proposed method and the learning system, we conducted a preliminary experiment involving two groups of subjects. While Group A got feedback about the appropriateness of their onomatopoeic constructions from the native speakers’ narrative interpretation, Group B got feedback just in the form of the five-grade relative estimation. A questionnaire survey administered to all of the learners clarified our learning system availability and also identified areas that should be improved. Repetitive learning of word-formation rules, creating new onomatopoeias and gaining new awareness from narrative interpretation is the total process used to teach the explicit and tacit nuances of onomatopoeia.

Keywords: onomatopoeia, tacit nuance, narrative interpretation, e-learning system, second language teaching

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Authors: Luc de Brabandere

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Searchers in various disciplines have long tried to understand how a human being thinks. Most of them seem to agree that the brain works in two very different modes. For us, the first phase of thought imagines, diverges, and unlocks the field of possibilities. The second phase, judges converge and choose. But if we were to stop there, that would give the impression that thought is essentially an individual effort that seldom depends on context. This is, however, not the case. Whether we be a champion in creativity, so primarily in induction, or a master in logic where we are confronted with reality, the ideas we layout are indeed destined to be presented to third parties. They should therefore be exposed, defended, communicated, negotiated, or even sold. Regardless of the quality of the concepts we craft (creative thinking) and the interferences we build (logical thinking) we will take one day, or another, be confronted by people whose beliefs, opinions and ideas differ from ours (critical thinking). Logic and critique: The shared characteristics of logical and critical thoughts include a three-level structure of reasoning invented by the Greeks. For the first time in history, Aristotle tried to model thought deployable in three stages: the concept, the statement, and the reasoning. The three levels can be assessed according to different criteria. A concept is more or less useful, a statement is true or false, and reasoning is right or wrong. This three-level structure allows us to differentiate logic and critique, where the intention and words used are not the same. Logic only deals with the structure of reasoning and exhausts the problem. It regards premises as acquired and excludes the debate. Logic is in all certainty and pursues the truth. Critique is most probably searching for the plausible. Logic and creativity: Many known models present the brain as a two-stroke engine (divergence vs convergence, fast vs. slow, left-brain vs right-brain, Yin vs Yang, etc.). But that’s not the only thing. “Why didn’t we think of that before?” How often have we heard that sentence? A creative idea is the outcome of logic, but you can only understand it afterward! Through the use of exercises, we will witness how logic and creativity work together. A third theme is hidden behind the two main themes of the conference: logical thought, which the author can shed some light on.

Keywords: creativity, logic, critique, digital

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Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Daniyal Haider, Xiaodong Yang

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Chest X-rays are instrumental in the detection and monitoring of a wide array of diseases, including viral infections such as COVID-19, tuberculosis, pneumonia, lung cancer, and various cardiac and pulmonary conditions. To enhance the accuracy of diagnosis, artificial intelligence (AI) algorithms, particularly deep learning models like Convolutional Neural Networks (CNNs), are employed. However, these deep learning models demand a substantial and varied dataset to attain optimal precision. Generative Adversarial Networks (GANs) can be employed to create new data, thereby supplementing the existing dataset and enhancing the accuracy of deep learning models. Nevertheless, GANs have their limitations, such as issues related to stability, convergence, and the ability to distinguish between authentic and fabricated data. In order to overcome these challenges and advance the detection and classification of CXR normal and abnormal images, this study introduces a distinctive technique known as DCWGAN (Diverse Conditional Wasserstein GAN) for generating synthetic chest X-ray (CXR) images. The study evaluates the effectiveness of this Idiosyncratic DCWGAN technique using the ResNet50 model and compares its results with those obtained using the traditional GAN approach. The findings reveal that the ResNet50 model trained on the DCWGAN-generated dataset outperformed the model trained on the classic GAN-generated dataset. Specifically, the ResNet50 model utilizing DCWGAN synthetic images achieved impressive performance metrics with an accuracy of 0.961, precision of 0.955, recall of 0.970, and F1-Measure of 0.963. These results indicate the promising potential for the early detection of diseases in CXR images using this Inimitable approach.

Keywords: CNN, classification, deep learning, GAN, Resnet50

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Authors: Rong-Yang Lai, Jia-Yu Wu, Chih-Han Chang, Yung-Chung Chen

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The dental bridge is one of the clinical methods of the treatment for missing teeth. The dental bridge is generally designed for two layers, containing the inner layer of the framework(zirconia) and the outer layer of the porcelain-fused to framework restorations. The design of a conventional bridge is generally based on the antagonist tooth profile so that the framework evenly indented by an equal thickness from outer contour. All-ceramic dental bridge made of zirconia have well demonstrated remarkable potential to withstand a higher physiological occlusal load in posterior region, but it was found that there is still the risk of all-ceramic bridge failure in five years. Thus, how to reduce the incidence of failure is still a problem to be solved. Therefore, the objective of this study is to develop mechanical designs for all-ceramic dental bridges framework by reducing the stress and enhancing fracture resistance under given loading conditions by finite element method. In this study, dental design software is used to design dental bridge based on tooth CT images. After building model, Bi-directional Evolutionary Structural Optimization (BESO) Method algorithm implemented in finite element software was employed to analyze results of finite element software and determine the distribution of the materials in dental bridge; BESO searches the optimum distribution of two different materials, namely porcelain and zirconia. According to the previous calculation of the stress value of each element, when the element stress value is higher than the threshold value, the element would be replaced by the framework material; besides, the difference of maximum stress peak value is less than 0.1%, calculation is complete. After completing the design of dental bridge, the stress distribution of the whole structure is changed. BESO reduces the peak values of principle stress of 10% in outer-layer porcelain and avoids producing tensile stress failure.

Keywords: dental bridge, finite element analysis, framework, automatic program

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Authors: Ying Deng, Fan Yang

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Aim: To study the growth pattern of preterm infants during the first year of life and explore the association between head circumference (HC) and neurodevelopment sequences and to get a general knowledge of the incidence of anemia in preterm babies in Chengdu, Southwest China. Method: We conducted a prospective longitudinal study, neonates with gestational age < 37 weeks were enrolled this study from 2012.1.1 to 2014.7.9. Anthropometry (weight, height, HC) was obtained at birth, every month before 6 months-old and every 2 months in the next half year. All the infants’ age were corrected to 40 weeks. Growth data presented as Z-scores which was calculated by WHO Anthro software. Z-score defined as (the actual value minus the average value)/standard deviation. Neurodevelopment was assessed at 12 months-old [9-11 months corrected age (CA)] by using “Denver Development Screen Test (DDST)". The hemoglobin (Hb) was examined at 6 months for CA. Result: 445 preterm infants were followed-up 1 year, including 64 very low birth weight infants (VLBW), 246 low birth weight infants (LBW) and 135 normal birth weight infants(NBW). From full-term to 12 months after birth, catch-up growth was observed in most preterm infants. From VLBW to NBW, HCZ was -1.17 (95 % CI: -1.53,-0.80; P value < 0.0001) lower during the first12 months. WAZ was-1.12(95 % CI: -1.47,-0.76; p < 0.0001) lower. WHZ and HAZ were -1.04 (95%CI:-1.38, -0.69; P<0.0001) and -0.69 (95%CI:-1.06,-0.33; P < 0.0001) lower respectively. The peak of WAZ appeared during 0-3 months CA among preterm infants. For VLBW infants, the peak of HAZ and HCZ emerged at 8-11 months CA. However, the trend of HAZ and HCZ is the same as WAZ in LBW and NBW infants. Growth in the small for gestational age (SGA) infants was poorer than appropriate for gestational age (AGA) infants. The rate of DQ < 70 in VLBW and LBW were 29.6%, 7.7%, respectively (P < 0.0001). HCZ < -1SD at 3 months emerged as an independent predictor of DQ scores below 85 at 12 months after birth. The incidence of anemia in preterm infants was 11% at 6 months for CA. Moreover, 7 children (1.7%) diagnosed with Cerebral palsy (CP). Conclusions: The catch-up growth was observed in most preterm infants. VLBW and SGA showed poor growth. There was imbalance between WAZ and HAZ in VLBW infants. The VLBW babies had higher severe abnormal scores than LBW and NBW, especially in boys. Z score for HC at 3 months < -1SDwas a significant risk factor for abnormal DQ scores at the first year. The iron supplement reduced the morbidity of anemia in preterm infants.

Keywords: preterm infant, growth and development, DDST, Z-scores

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Authors: Pei-Chun Chen, Chi-Ting Tseng, Lih-Chi Chen, Kai-Hsiang Yang

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Introduction: The pharmacist is responsible for encouraging adverse drug reaction (ADR) reporting. In a local center in Northern Taiwan, promotion and rewarding of ADR reporting have continued for over six years but failed to bring significant changes. This study aims to find a solution to increase ADR reporting. Research question or hypothesis: We hypothesized that under-reporting is due to the inconvenience of the reporting system. Reports were made conventionally through printed sheets. We proposed that reports made per month will increase if they were computerized. Study design: An ADR reporting platform was established in April 2015, before which was defined as the first stage of this study (January-March, 2015) and after which the second stage. The third stage commenced in November, 2015, after adding a reporting module to physicians prescription system. ADRs could be reported simultaneously when documenting drug allergies. Methods: ADR report rates during the three stages of the study were compared. Effects of the information platform on reporting were also analyzed. Results: During the first stage, the number of ADR reports averaged 6 per month. In the second stage, the number of reports per month averaged 1.86. Introducing the information platform had little effect on the monthly number of ADR reports. The average number of reports each month during the third stage of the study was 11±3.06, with 70.43% made electronically. Reports per month increased significantly after installing the reporting module in November, 2015 (P<0.001, t-test). In the first two stages, 29.03% of ADR reports were made by physicians, as compared to 70.42% of cases in the third stage of the study. Increased physician reporting possibly account for these differences. Conclusion: Adding a reporting module to the prescription system significantly increased ADR reporting. Improved accessibility is likely the cause. The addition of similar modules to computer systems of other healthcare professions may be considered to encourage spontaneous ADR reporting.

Keywords: adverse drug reactions, adverse drug reaction reporting systems, regional hospital, prescription system

Procedia PDF Downloads 342

Authors: Chun-Ming Huang, Yi-Jun Liu, Yi-Jie Hsieh, Jin-Ju Chue, Wei-Lin Lai, Chun-Yu Chen, Chih-Chyau Yang, Chien-Ming Wu

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The market of wearable devices has been growing rapidly in two years. The integration of sensors and wearable devices has become the trend of the next technology products. Thus, the academics and industries are eager to cultivate talented persons in sensing technology. Currently, academic and industries have more and more demands on the integrations of versatile sensors and applications, especially for the teams who focus on the development of sensor circuit architectures. These teams tape-out many MEMs sensors chips through the chip fabrication service from National Chip Implementation Center (CIC). However, most of these teams are only able to focus on the circuit design of MEMs sensors; they lack the key support of further system demonstration. This paper follows the CIC’s main mission of promoting the chip/system advanced design technology and aims to establish the environments of the modularized sensing system platform and the system design flow with the measurement and calibration technology. These developed environments are used to support these research teams and help academically advanced sensor designs to perform the system demonstration. Thus, the research groups can promote and transfer their advanced sensor designs to industrial and further derive the industrial economic values. In this paper, the modularized sensing platform is proposed to enable the system demonstration for advanced sensor chip design. The environment of sensor measurement and calibration is established for academic to achieve an accurate sensor result. Two reference sensor designs cooperated with the modularized sensing platform are given to show the sensing system integration and demonstration. These developed environments and platforms are currently provided to academics in Taiwan, and so that the academics can obtain a better environment to perform the system demonstration and improve the research and teaching quality.

Keywords: modularized sensing platform, sensor design and calibration, sensor system, sensor system design flow

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Authors: Miao Zhang, Limin Liu, Feng Zhi, Panpan Niu, Mengya Yang, Xuemei Zhu, Ying Diao, Jun Wang, Ying Zhao

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Background and Aims: Clinical studies have demonstrated that serum semicarbazide-sensitive amine oxidase (SSAO) activities positively correlate with the progression of atherosclerosis. The aim of the present study is to investigate the effect of SSAO inactivation on the development of atherosclerosis. Methods: Female LDLr knockout (KO) mice were given the Western-type diet for 6 and 9 weeks to induce the formation of early and advanced lesions, and semicarbazide (SCZ, 0.125%) was added into the drinking water to inactivate SSAO in vivo. Results: Despite no impact on plasma total cholesterol levels, abrogation of SSAO by SCZ not only resulted in the enlargement of both early (1.5-fold, p=0.0043) and advanced (1.8-fold, p=0.0013) atherosclerotic lesions, but also led to reduced/increased lesion contents of macrophages/smooth muscle cells (SMCs) (macrophage: ~0.74-fold, p=0.0002(early)/0.0016(advanced); SMC: ~1.55-fold, p=0.0003(early) /0.0001(advanced)), respectively. Moreover, SSAO inactivation inhibited the migration of circulating monocytes into peripheral tissues and reduced the amount of circulating Ly6Chigh monocytes (0.7-fold, p=0.0001), which may account for the reduced macrophage content in lesions. In contrast, the increased number of SMCs in lesions of SCZ-treated mice is attributed to an augmented synthetic vascular SMC phenotype switch as evidenced by the increased proliferation of SMCs and accumulation of collagens in vivo. Conclusion: SSAO inactivation by SCZ promotes the phenotypic switch of SMCs and the development of atherosclerosis. The enzymatic activity of SSAO may thus represent a potential target in the prevention and/or treatment of atherosclerosis.

Keywords: atherosclerosis, phenotype switch of smooth muscle cells, SSAO/VAP-1, semicarbazide

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Authors: A. K. R. Gobinath, He Jianzhong, Kun-Lin Yang

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Fruit waste was used as a feedstock to produce biohydrogen in this study. Fruit waste used in this study was collected from several fruit juice stalls in Singapore. Based on our observation, the fruit waste contained 35-40% orange, 10-20% watermelon, 10-15% apple, 10-15% pineapple, 1-5% mango. They were mixed with water (1:1 ratio based on wet biomass) and blended to attain homogenous mixtures. Later, fruit waste was subjected to one of the following pretreatments: autoclave (121 °C for 20min), microwave (20min) or both. After pretreatment, the total sugar concentration in the hydrolysate was high (>12g/l) when both autoclave and microwave were applied. In contrast, samples without pretreatment measured only less than 2g/l of sugar. While using these hydrolysates as carbon sources, Clostridium strain BOH3 produces 2526-3126 ml/l of hydrogen after 72h of anaerobic fermentation. The hydrogen yield was 295-300 ml/g of sugar which is close to the hydrogen yields from glucose (338 ml/gm) and xylose (330 ml/gm). Our HPLC analysis showed that fruit waste hydrolysate contained oligosugars (25-27%), sucrose (18-23%), fructose (25-30%), glucose (10-15%) and mannose (2-5%). Additionally, pretreatment led to the release of free amino acids (160-512 mg/l), calcium (7.8-12.9 ppm), magnesium (4.32-6.55 ppm), potassium (5.4-65.1 ppm) and sodium (0.4-0.5 ppm) into the hydrolysate. These nutrients were able to support strain-BOH3 to grow and produce high level of hydrogen. Notably, unlike other pretreatment methods (with strong acids and bases), these pretreatment techniques did not generate any inhibitors (e.g. furfural and phenolic acids) to suppress the hydrogen production. Interestingly, strain BOH3 can also ferment pretreated fruit waste slurry and produce hydrogen with a high yield (156-343 ml/gm fruit waste). While fermenting pretreated fruit waste slurry, strain-BOH3 excreted several saccharolytic enzymes majorly xylanase (1.84U/ml), amylase (1.10U/ml), pectinase (0.36U/ml) and cellulase (0.43U/ml). Due to expressions of these enzymes, strain BOH3 was able to directly utilize pretreated fruit waste hydrolysate and produces high-level of hydrogen.

Keywords: autoclave pretreatment, biohydrogen production, clostridial fermentation, fruit waste, and microwave pretreatment

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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Authors: Yang Ye, Hongfei Qiu, Yaqi Li

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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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Authors: Chen-Jung Chen, Yi-Chang Chen

Abstract:

While traditional virtual reality and augmented reality only allow for small movement learning and cannot provide a truly immersive teaching experience to give it the illusion of movement, the new technology of both content creation and immersive interactive simulation of the metaverse can just reach infinite close to the natural teaching situation. However, the mixed reality virtual classroom of metaverse has not yet explored its theory, and it is rarely implemented in the situational simulation teaching of nursing education. Therefore, in the first year, the study will intend to use grounded theory and case study methods and in-depth interviews with nursing education and information experts. Analyze the interview data to investigate the uniqueness of metaverse development. The proposed analysis will lead to alternative theories and methods for the development of nursing education. In the second year, it will plan to integrate the metaverse virtual situation simulation technology into the alternate teaching strategy in the pediatric nursing technology course and explore the nursing students' use of this teaching method as the construction of personal technology and experience. By leveraging the unique features of distinct teaching platforms and developing processes to deliver alternative teaching strategies in a nursing technology teaching environment. The aim is to increase learning achievements without compromising teaching quality and teacher-student relationships in the post-pandemic era. A descriptive and convergent mixed methods design will be employed. Sixty third-grade nursing students will be recruited to participate in the research and complete the pre-test. The students in the experimental group (N=30) agreed to participate in 4 real-time mixed virtual situation simulation courses in self-practice after class and conducted qualitative interviews after each 2 virtual situation courses; the control group (N=30) adopted traditional practice methods of self-learning after class. Both groups of students took a post-test after the course. Data analysis will adopt descriptive statistics, paired t-tests, one-way analysis of variance, and qualitative content analysis. This study addresses key issues in the virtual reality environment for teaching and learning within the metaverse, providing valuable lessons and insights for enhancing the quality of education. The findings of this study are expected to contribute useful information for the future development of digital teaching and learning in nursing and other practice-based disciplines.

Keywords: metaverse, post-pandemic era, online virtual classroom, immersive teaching

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Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

Abstract:

Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

Procedia PDF Downloads 112