Search results for: clinical rotation

Authors: Diane Ghanem, Arjun Gupta, Rohan Vijayan, Ali Uneri, Babar Shafiq

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Introduction: Ankle sprains and fractures often result in syndesmosis injuries. Unstable syndesmotic injuries result from relative motion between the distal ends of the tibia and fibula, anatomic juncture which should otherwise be rigid, and warrant operative management. Clinical and radiological evaluations of intraoperative syndesmosis stability remain a challenging task as traditional 2D fluoroscopy is limited to a uniplanar translational displacement. The purpose of this pilot cadaveric study is to compare the 2D fluoroscopy and 3D cone beam computed tomography (CBCT) stress-induced syndesmosis displacements. Methods: Three fresh-frozen lower legs underwent 2D fluoroscopy and 3D CIOS CBCT to measure syndesmosis position before dissection. Syndesmotic injury was simulated by resecting the (1) anterior inferior tibiofibular ligament (AITFL), the (2) posterior inferior tibiofibular ligament (PITFL) and the inferior transverse ligament (ITL) simultaneously, followed by the (3) interosseous membrane (IOM). Manual external rotation and Cotton stress test were performed after each of the three resections and 2D and 3D images were acquired. Relevant 2D and 3D parameters included the tibiofibular overlap (TFO), tibiofibular clear space (TCS), relative rotation of the fibula, and anterior-posterior (AP) and medial-lateral (ML) translations of the fibula relative to the tibia. Parameters were measured by two independent observers. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) to determine measurement precision. Results: Significant mismatches were found in the trends between the 2D and 3D measurements when assessing for TFO, TCS and AP translation across the different resection states. Using 3D CBCT, TFO was inversely proportional to the number of resected ligaments while TCS was directly proportional to the latter across all cadavers and ‘resection + stress’ states. Using 2D fluoroscopy, this trend was not respected under the Cotton stress test. 3D AP translation did not show a reliable trend whereas 2D AP translation of the fibula was positive under the Cotton stress test and negative under the external rotation. 3D relative rotation of the fibula, assessed using the Tang et al. ratio method and Beisemann et al. angular method, suggested slight overall internal rotation with complete resection of the ligaments, with a change < 2mm - threshold which corresponds to the commonly used buffer to account for physiologic laxity as per clinical judgment of the surgeon. Excellent agreement (>0.90) was found between the two independent observers for each of the parameters in both 2D and 3D (overall ICC 0.9968, 95% CI 0.995 - 0.999). Conclusions: The 3D CIOS CBCT appears to reliably depict the trend in TFO and TCS. This might be due to the additional detection of relevant rotational malpositions of the fibula in comparison to the standard 2D fluoroscopy which is limited to a single plane translation. A better understanding of 3D imaging may help surgeons identify the precise measurements planes needed to achieve better syndesmosis repair.

Keywords: 2D fluoroscopy, 3D computed tomography, image processing, syndesmosis injury

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Authors: İbrahim Hakkı Erkan, Özcan Tan

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The performance of jet grout columns was affected by many controlled and uncontrolled parameters. The leading parameters for the controlled ones can be listed as injection pressure, rod pulling speed, rod rotation speed, number of nozzles, nozzle diameter and Water/Cement ratio. And the uncontrolled parameters are soil type, soil structure, soil layering condition, underground water level, the changes in strength parameters and the rheologic properties of cement in time. In this study, the performance of jet grout columns and the effects of pulling speed and rotation speed were investigated experimentally. For this purpose, a laboratory type jet grouting system was designed for the experiments. Through this system, jet grout columns were produced in three different conditions. The results of the study showed that the grout pressure and the lifting speed significantly affect the performance of the jet grouting columns.

Keywords: jet grout, sandy soils, soil improvement, soilcreate

Procedia PDF Downloads 229

Authors: K. Zehouani, I. Oldal

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Purpose: In the human knee joint, degenerative joint disease may happen with time. The standard treatment of this disease is the total knee replacement through prosthesis implanting. The reason lies in the fact that this phenomenon causes different material abrasion as compare to pure sliding or rolling alone. This study focuses on developing a knee prosthesis geometry, which fulfills the mechanical and kinematical requirements. Method: The MSC ADAMS program is used to describe the rotation of the human knee joint as a function of flexion, and to investigate how the flexion and rotation movement changes between the condyles of a multi-body model of the knee prosthesis as a function of flexion angle (in the functional arc of the knee (20-120º)). Moreover, the multi-body model with identical boundary conditions is constituted, and the numerical simulations are carried out using the MSC ADAMS program system. Results: It is concluded that the use of the multi-body model reduces time and cost since it does not need to manufacture the tibia and the femur as it requires for the knee prosthesis of the test machine. Moreover, without measuring or by dispensing with a test machine for the knee prosthesis geometry, approximation of the results of our model to a human knee is carried out directly. Conclusion: The pattern obtained by the multi-body model provides an insight for future experimental tests related to the rotation and flexion of the knee joint concerning the actual average and friction load.

Keywords: biomechanics, knee joint, rotation, flexion, kinematics, MSC ADAMS

Procedia PDF Downloads 113

Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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Authors: M. Samadzadeh Mahabadi, J. Shanbehzadeh

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This paper presents a hybrid digital image-watermarking scheme, which is robust against varieties of attacks and geometric distortions. The image content is represented by important feature points obtained by an image-texture-based adaptive Harris corner detector. These feature points are extracted from LL2 of 2-D discrete wavelet transform which are obtained by using the Harris-Laplacian detector. We calculate the Fourier transform of circular regions around these points. The amplitude of this transform is rotation invariant. The experimental results demonstrate the robustness of the proposed method against the geometric distortions and various common image processing operations such as JPEG compression, colour reduction, Gaussian filtering, median filtering, and rotation.

Keywords: digital watermarking, geometric distortions, geometrical attack, Harris Laplace, important feature points, rotation, scale invariant feature

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Authors: Seema Saini, Nidhi Chandra, Tushar Palekar

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Objective: To determine the effect of Passive pectoralis minor muscle stretching on scapular kinematics in individuals with scapular dyskinesia. Design: A randomized controlled study was conducted in Pune. The sample size was 30 subjects, which were randomly allocated to either Group A, the experimental group in which passive pectoralis minor stretch was given, or Group B, the control group, in which conventional exercises were given for 3 days a week over 4 weeks. Pre and Post treatment readings of the outcome measures, pectoralis minor length, scapular upward rotation, and lateral scapular slide test were recorded. Results: The results obtained prove a significant difference between pre and post mean values of pectoralis minor length in group A (pre 21.91, post 22.87) and in group B (pre 23.55 post 23.99); scapular upward rotation in group A (pre 49.95, post 50.61) and group B (pre 52.64, post 53.51); lateral scapular slide test at 0° abduction in group A (pre 6.613, post 6.14) and group B (pre 6.84, post 6.22); lateral scapular slide test at 45° abduction in group A (pre 7.14 and post 7.12) and group B (pre 8.18, post 7.53). With an inter-group analysis, it was found that mean of pectoralis minor length, scapular upward rotation, and LSST at 0° abduction in group A was significant than group B (p<0.05). Conclusion: Passive pectoralis minor stretching along with conventional strengthening exercises was shown to be more effective in improving scapular kinematics among patients with scapular dyskinesia.

Keywords: scapulohumeral rhythm, scapular upward rotation, rounded shoulders, scapular strengthening

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Authors: Ben Abdallah Aicha

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In this work we show a H∞ synthesis method which enables us to calculate a feedback controller according to considerations of stability robustness and disturbance rejection translated on to the open loop response. However, it may happen that we have an additional specification on the closed loop response relating to tracking of the reference trajectory. The H∞ synthesis has the advantage of offering increased specifications in robustness stability. Implemented for a DC motor, it offers invaluable performance in speed control in both directions of rotation.

Keywords: H∞ synthesis, DC motor, robustness stability, performance conditions

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Authors: Merve Sagiroglu

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The earthquake-resistant steel structure design is required taking into account the behavior of beam-column connections besides the basic properties of the structure such as material and geometry. Beam-column connections play an important role in the behavior of frame systems. Taking into account the behaviour of connection in analysis and design of steel frames is important due to presenting the actual behavior of frames. So, the behavior of the connections should be well known. The most important force which transmitted by connections in the structural system is the moment. The rotational deformation is customarily expressed as a function of the moment in the connection. So, the moment-rotation curves are the best expression of behaviour of the beam-to-column connections. The designed connections form various moment-rotation curves according to the elements of connection and the shape of placement. The only way to achieve this curve is with real-scale experiments. The experiments of some connections have been carried out partially and are formed in the databank. It has been formed the models using this databank to express the behavior of connection. In this study, theoretical studies have been carried out to model a real behavior of the top and seat angles connections with angles. Two stiffeners in the top and seat angle to increase the stiffness of the connection, and two stiffeners in the beam web to prevent local buckling are used in this beam-to-column connection. Mathematical models have been performed using the database of the beam-to-column connection experiments previously by authors. Using the data of the tests, it has been aimed that analytical expressions have been developed to obtain the moment-rotation curve for the connection details whose test data are not available. The connection has been dimensioned in various shapes and the effect of the dimensions of the connection elements on the behavior has been examined.

Keywords: top and seat angle connection, stiffener, moment-rotation curves, analytical study

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Kahil Amar, Meziani Faroudja, Khelil Nacim

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The principal objective of this study is the evaluation of the seismic performance of reinforced concrete frame structures, taking into account of the behavior laws, reflecting the real behavior of materials, using CASTEM2000 software. A finite element model used is based in modified Takeda model with Timoshenko elements for columns and beams. This model is validated on a Vecchio experimental reinforced concrete (RC) frame model. Then, a study focused on the behavior of a RC frame with three-level and three-story in order to visualize the positioning the plastic hinge (plastic rotation), determined from the curvature distribution along the elements. The results obtained show that the beams of the 1^st and 2^nd level developed a very large plastic rotations, or these rotations exceed the values corresponding to CP (Collapse prevention with cp q_CP = 0.02 rad), against those developed at the 3^rd level, are between IO and LS (Immediate occupancy and life Safety with q_IO = 0.005 rad and rad q_LS = 0.01 respectively), so the beams of first and second levels submit a very significant damage.

Keywords: seismic performance, performance level, pushover analysis, plastic rotation, plastic hinge

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Authors: Soumitr Sanjay Dubey, Shubhajit Roy Chowdhury, Rahul Shrestha

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In this paper, we have presented a novel approach of calculating eigenvalues of any matrix for the first time on Field Programmable Gate Array (FPGA) using Triangular Systolic Arra (TSA) architecture. Conventionally, additional computation unit is required in the architecture which is compliant to the algorithm for determining the eigenvalues and this in return enhances the delay and power consumption. However, recently reported works are only dedicated for symmetric matrices or some specific case of matrix. This works presents an architecture to calculate eigenvalues of any matrix based on QR algorithm which is fully implementable on FPGA. For the implementation of QR algorithm we have used TSA architecture, which is further utilising CORDIC (CO-ordinate Rotation DIgital Computer) algorithm, to calculate various trigonometric and arithmetic functions involved in the procedure. The proposed architecture gives an error in the range of 10−4. Power consumption by the design is 0.598W. It can work at the frequency of 900 MHz.

Keywords: coordinate rotation digital computer, three angle complex rotation, triangular systolic array, QR algorithm

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Authors: Mohsin Javed

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School Education department is usually criticized for utilizing quite low or fewer academic days due to many reasons like extreme weather conditions, sudden holidays, summer vocations, pandemics and, terrorism etc. The purpose of the experimental study was to determine the efficacy of online cooperative learning (OCL) integrated in the rotation model of blended learning. The effects on academic achievement of students and students' attitude about OCL embedded learning were assessed. By using a posttest only control group design, sixty-two first-year students were randomly allocated to either the experimental (30) or control (32) group. The control group received face to face classes for six sessions per week, while the experimental group had three OCL and three formal sessions per week under rotation model. Students' perceptions of OCL were evaluated using a survey questionnaire. Data was analyzed by independent sample t test and one sample t test. According to findings, the intervention greatly improved the state of the dependent variables. The results demonstrate that OCL can be successfully implemented in formal education using a blended learning rotation approach. Higher secondary institutions are advised to use this model in situations like Covid 19, smog, unexpected holidays, instructor absence from class due to increased responsibilities, and summer vacations.

Keywords: blended learning, online cooperative learning, rotation model of blended learning, supplementing

Procedia PDF Downloads 36

Authors: Li Hui, Riyadh Hindi

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In the United States, bridge construction often employs overhang brackets to support the deck overhang, the weight of fresh concrete, and loads from construction equipment. This approach, however, can lead to significant torsional moments on the exterior girders, potentially causing excessive girder rotation. Such rotations can result in various safety and maintenance issues, including thinning of the deck, reduced concrete cover, and cracking during service. Traditionally, these issues are addressed by installing temporary lateral bracing systems and conducting comprehensive torsional analysis through detailed finite element analysis for the construction of bridge deck overhang. However, this process is often intricate and time-intensive, with the spacing between temporary lateral bracing systems usually relying on the field engineers’ expertise. In this study, a deep neural network model is introduced to limit exterior girder rotation during bridge deck construction. The model predicts the optimal spacing between temporary bracing systems. To train this model, over 10,000 finite element models were generated in SAP2000, incorporating varying parameters such as girder dimensions, span length, and types and spacing of lateral bracing systems. The findings demonstrate that the deep neural network provides an effective and efficient alternative for limiting the exterior girder rotation for bridge deck construction. By reducing dependence on extensive finite element analyses, this approach stands out as a significant advancement in improving safety and maintenance effectiveness in the construction of bridge decks.

Keywords: bridge deck construction, exterior girder rotation, deep learning, finite element analysis

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: Xuewen Chen, Aizhen Liang, Xiaoping Zhang

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To better understand the spatial variability of soil penetration resistance (SPR) and soil water content (SWC) induced by different tillage and crop rotation in a Mollisol of Northeast China, the soil was sampled from the tillage experiment which was established in Dehui County, Jilin Province, Northeast China, in 2001. Effect of no-tillage (NT), moldboard plow (MP) and ridge tillage (RT) under corn-soybean rotation (C-S) and continuous corn (C-C) system on SPR and SWC were compared with horizontal and vertical variations. The results showed that SPR and SWC spatially varied across the ridge. SPR in the rows was higher than inter-rows, especially in topsoil (2.5-15 cm) of NT and RT plots. SPR of MP changed in the trend with the curve-shaped ridge. In contrast to MP, NT, and RT resulted in average increment of 166.3% and 152.3% at a depth of 2.5-17.5 cm in the row positions, respectively. The mean SPR in topsoil in the rows means soil compaction is not the main factor limiting plant growth and crop yield. SPR in the row of RT soil was lower than NT at a depth of 2.5-12.5 cm. The SWC in NT and RT soil was highest in the inter-rows and least in the rows or shoulders, respectively. However, the lateral variation trend of MP was opposite to NT. From the profile view of SWC, MP was greater than NT and RT in 0-20 cm of the rows. SWC in RT soil was higher than NT in the row of 0-20 cm. Crop rotation did not have a marked impact on SPR and SWC. In addition to the tillage practices, the factor which affects SPR greatly was depth but not position. These two factors have significant effects on SWC. These results indicated that the adoption of RT was a more suitable conservation tillage practices than NT in the black soil of Northeast China.

Keywords: row, soil penetration resistance, spatial variability, tillage practice

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Authors: Yasuyuki Takahashi, Maya Yamashita, Kyoko Saito

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In general, dynamic SPECT data acquisition needs a few minutes for one rotation. Thus, the time-activity curve (TAC) derived from the dynamic SPECT is relatively coarse. In order to effectively shorten the interval, between data points, we adopted a 180-degree interpolation method. This method is already used for reconstruction of the X-ray CT data. In this study, we applied this 180-degree interpolation method to SPECT and investigated its effectiveness.To briefly describe the 180-degree interpolation method: the 180-degree data in the second half of one rotation are combined with the 180-degree data in the first half of the next rotation to generate a 360-degree data set appropriate for the time halfway between the first and second rotations. In both a phantom and a patient study, the data points from the interpolated images fell in good agreement with the data points tracking the accumulation of 99mTc activity over time for appropriate region of interest. We conclude that data derived from interpolated images improves the apparent time resolution of dynamic SPECT.

Keywords: dynamic SPECT, time resolution, 180-degree interpolation method, 99mTc-GSA.

Procedia PDF Downloads 473

Authors: Nupur Karmaker, Hasin Aupama Azhari, Abdul Al Mortuza, Abhijit Chanda, Golam Abu Zakaria

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Purpose: The purpose of gait analysis is to determine the biomechanics of the joint, phases of gait cycle, graphical and analytical analysis of degree of rotation, analysis of the electrical activity of muscles and force exerted on the hip joint at different locomotion during walking, running and cart pulling. Methods and Materials: Visual gait analysis and electromyography method has been used to detect the degree of rotation of joints and electrical activity of muscles. In cinematography method an object is observed from different sides and takes its video. Cart pulling length has been divided into frames with respect to time by using video splitter software. Phases of gait cycle, degree of rotation of joints, EMG profile and force analysis during walking and running has been taken from different papers. Gait cycle and degree of rotation of joints during cart pulling has been prepared by using video camera, stop watch, video splitter software and Microsoft Excel. Results and Discussion: During the cart pulling the force exerted on hip is the resultant of various forces. The force on hip is the vector sum of the force Fg= mg, due the body of weight of the person and Fa= ma, due to the velocity. Maximum stance phase shows during cart pulling and minimum shows during running. During cart pulling shows maximum degree of rotation of hip joint, knee: running, and ankle: cart pulling. During walking, it has been observed minimum degree of rotation of hip, ankle: during running. During cart pulling, dynamic force depends on the walking velocity, body weight and load weight. Conclusions: 80% people suffer gait related disease with increasing their age. Proper care should take during cart pulling. It will be better to establish the gait laboratory to determine the gait related diseases. If the way of cart pulling is changed i.e the design of cart pulling machine, load bearing system is changed then it would possible to reduce the risk of limb loss, flat foot syndrome and varicose vein in lower limb.

Keywords: kinematic, gait, gait lab, phase, force analysis

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Authors: Mohammadali Abedini Sanigy, Jiangang Fei

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In this paper, a mathematical optimization model was developed to maximize the profit in a vegetable production planning problem. It serves as a decision support system that assists farmers in land allocation to crops and harvest scheduling decisions. The developed model can handle different rotation rules in two consecutive cycles of production, which is a common practice in organic production system. Moreover, different production methods of the same crop were considered in the model formulation. The main strength of the model is that it is not restricted to predetermined production periods, which makes the planning more flexible. The model is classified as a mixed integer programming (MIP) model and formulated in PYOMO -a Python package to formulate optimization models- and solved via Gurobi and CPLEX optimizer packages. The model was tested with secondary data from 'Australian vegetable growing farms', and the results were obtained and discussed with the computational test runs. The results show that the model can successfully provide reliable solutions for real size problems.

Keywords: crop rotation, harvesting, mathematical model formulation, vegetable production

Procedia PDF Downloads 156

Authors: S. Altmeyer, B. Hof, F. Marques, J. M. Lopez

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We present numerical simulations concerning the reversal of spiraling vortices in short highly counter-rotating cylinders. Increasing the differential cylinder rotation results in global flow-inversion is which develops various different and complex flow dynamics of several quasi-periodic solutions that differ in their number of vortex cells in the bulk. The dynamics change from being dominated of the inner cylinder boundary layer with ’passive’ only responding outer one to be dominated by the outer cylinder boundary layer with only responding inner one. Solutions exist on either two or three tori invariant manifolds whereby they appear as symmetric or asymmetric states. We find for either moderate and high inner cylinder rotation speed the quasiperiodic flow to consist of only two vortex cells but differ as the vortices has opposite spiraling direction. These both flows live on 2-tori but differ in number of symmetries. While for the quasi-periodic flow (q^a_2) at lower rotation speed a pair of symmetrically related 2-tori T2 exists the quasi-periodic flow (q^s_2) at higher rotation speeds is symmetric living on a single 2-torus T2. In addition these both flows differ due to their dominant azimuthal m modes. The first is dominated by m=1 whereas for the latter m=3 contribution is largest. The 2-tori states are separated by a further quasi-periodic flow (q^a_3) living on pair of symmetrically related 3-tori T3. This flow offers a ’periodical’ competition between a two and three vortex cell states in the bulk. This flow is also an m=1 solution as for the quasiperiodic flows living on the pair of symmetrically-related 2-tori states. Moreover we find hysteresis resulting in coexisting regions of different quasiperiodic flows q^s_2 and q^a_3 with increasing and decreasing the differential rotation.

Keywords: transition, bifurcation, torus, symmetries

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Authors: Yan Wang, Guowei Chen, Gang Wang

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Soil microbial diversity is one of the important parameters to assess the soil fertility and soil health, even stability of the ecosystem. In this paper, we aim to reveal the soil microbial difference in rhizosphere and root zone, even to pick the special biomarkers influenced by the long term tillage practices, which included four treatments of no-tillage, ridge tillage, continuous cropping with corn and crop rotation with corn and soybean. Here, high-throughput sequencing was performed to investigate the difference of bacteria in rhizosphere and root zone. The results showed a very significant difference of species richness between rhizosphere and root zone soil at the same crop rotation system (p < 0.01), and also significant difference of species richness was found between continuous cropping with corn and corn-soybean rotation treatment in the rhizosphere statement, no-tillage and ridge tillage in root zone soils. Implied by further beta diversity analysis, both tillage methods and crop rotation systems influence the soil microbial diversity and community structure in varying degree. The composition and community structure of microbes in rhizosphere and root zone soils were clustered distinctly by the beta diversity (p < 0.05). Linear discriminant analysis coupled with effect size (LEfSe) analysis of total taxa in rhizosphere picked more than 100 bacterial taxa, which were significantly more abundant than that in root zone soils, whereas the number of biomarkers was lower between the continuous cropping with corn and crop rotation treatment, the same pattern was found at no-tillage and ridge tillage treatment. Bacterial communities were greatly influenced by main environmental factors in large scale, which is the result of biological adaptation and acclimation, hence it is beneficial for optimizing agricultural practices.

Keywords: tillage methods, biomarker, biodiversity, rhizosphere

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Authors: R. Z. R. R. Rosdin, N. M. Ali, S. W. Harun, H. Arof

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We have experimentally demonstrated bright-dark pulses in a nonlinear polarization rotation (NPR) based mode-locked Erbium-doped fiber laser (EDFL) with a long cavity configuration. Bright–dark pulses could be achieved when the laser works in the passively mode-locking regime and the net group velocity dispersion is quite anomalous. The EDFL starts to generate a bright pulse train with degenerated dark pulse at the mode-locking threshold pump power of 35.09 mW by manipulating the polarization states of the laser oscillation modes using a polarization controller (PC). A split bright–dark pulse is generated when further increasing the pump power up to 37.95 mW. Stable bright pulses with no obvious evidence of a dark pulse can also be generated when further adjusting PC and increasing the pump power up to 52.19 mW. At higher pump power of 54.96 mW, a new form of bright-dark pulse emission was successfully identified with the repetition rate of 29 kHz. The bright and dark pulses have a duration of 795.5 ns and 640 ns, respectively.

Keywords: Erbium-doped fiber laser, nonlinear polarization rotation, bright-dark pulse, photonic

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Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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Authors: P. G. Siddheshwar, T. N. Sakshath

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In the paper we make linear and non-linear stability analyses of Rayleigh-Bénard convection of a Newtonian nanoliquid in a rotating medium (called as Rayleigh-Bénard-Taylor convection). Rigid-rigid isothermal boundaries are considered for investigation. Khanafer-Vafai-Lightstone single phase model is used for studying instabilities in nanoliquids. Various thermophysical properties of nanoliquid are obtained using phenomenological laws and mixture theory. The eigen boundary value problem is solved for the Rayleigh number using an analytical method by considering trigonometric eigen functions. We observe that the critical nanoliquid Rayleigh number is less than that of the base liquid. Thus the onset of convection is advanced due to the addition of nanoparticles. So, increase in volume fraction leads to advanced onset and thereby increase in heat transport. The amplitudes of convective modes required for estimating the heat transport are determined analytically. The tri-modal standard Lorenz model is derived for the steady state assuming small scale convective motions. The effect of rotation on the onset of convection and on heat transport is investigated and depicted graphically. It is observed that the onset of convection is delayed due to rotation and hence leads to decrease in heat transport. Hence, rotation has a stabilizing effect on the system. This is due to the fact that the energy of the system is used to create the component V. We observe that the amount of heat transport is less in the case of rigid-rigid isothermal boundaries compared to free-free isothermal boundaries.

Keywords: nanoliquid, rigid-rigid, rotation, single phase

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Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

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Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

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Authors: Rana Alkattan

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Aim: This study aims to identify and analyze the factors predicting the professional clinical competency among newly recruited registered nurses. In addition, it aims to explore factors significantly correlated with high and low professional clinical competency score. Method: A descriptive analytical is applied in this study, cross-sectional which conducted between June 2012 and June 2013 at King Abdulaziz University Hospital, as one of the largest governmental university tertiary Hospital in Saudi Arabia. A survey questionnaire was designed to collect data. And then, data were analyzed using the SPSS. Results: A total of the 86 nurses provided valid responses. 69 were female and 17 were male. The majority of the participants in this study were married, from the Philippines, between 20-29 years old. The majority had certified university bachelor’s degree in nursing, as well as had prior experience in nursing between 1 to 5 years. There are two categories emerged from the data, which significantly correlated with nurses' professional competence and development. The first was the newly employed registered nurses demographic characteristic (correlation coefficients 0.154 to 0.470, P < 0.05), while the second was the list of studied environmental factors except 'job rotation factor' (correlation coefficients 0.122 to 0.540, P < 0.01). However, nurses' attitude including motivation and confidence were not associated with nurse's professional competency. Conclusion: that nurses' professional competence development is a process affected by certain personal demographic and environmental factors which will enable newly graduates nurses to provide safe effective patients' care and maintain their career responsibilities.

Keywords: clinical, competence, development nurses professional, registered

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Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

Procedia PDF Downloads 46