Search results for: long term outcome

Authors: T. Nishido, S. Fukumoto

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The functions of movable bearings decline due to corrosion and sediments. As the result, they cannot move or rotate according to the behaviors of girders. Because of the constraints, the bending moments are generated by the horizontal reaction forces and the heights of girders. Under these conditions, the authors obtained the following results by analysis and experiment. Tensile stresses due to the moments occurred at temperature fluctuations. The large tensile stresses on concrete slabs around the bearings caused cracks. Even if concrete slabs are newly replaced, cracks will come out again with function declined bearings. The functional declines of bearings are generally found by using displacement gauges. However the method is not suitable for long-term measurements. We focused on the change in the strains at the bearings and the lower flanges near them at temperature fluctuations. It was found that their strains were particularly large when the movements of the bearings were constrained. Therefore, we developed a long-term health monitoring wireless system with FBG (Fiber Bragg Grating) sensors which were attached to bearings and lower flanges. The FBG sensors have the characteristics such as non-electrical influence, resistance to weather, and high strain sensitivity. Such characteristics are suitable for long-term measurements. The monitoring system was inexpensive because it was limited to the purpose of measuring strains and temperature. Engineers can monitor the behaviors of bearings in real time with the wireless system. If an office is away from bridge sites, the system will save traveling time and cost.

Keywords: bridge bearing, concrete slab, 　FBG sensor, health monitoring

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Authors: Andreas Aceranti, Stefano Costa

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The aim of this study was to demonstrate that manipulative treatment combined with therapeutic exercisetherapywas more effective than isolated therapeutic exercise in the short-term treatment of eye convergence disorders in boxers. A randomized controlled trial (RCT) pilot trial was performed at our physiotherapy practices. 30 adult subjects who practice the discipline of boxing were selected after an initial skimming defined by the Convergence Insufficiency Symptom Survey (CISS) test (results greater than or equal to 10) starting from the initial sample of 50 subjects; The 30 recruits were evaluated by an orthoptist using prisms to know the diopters of each eye and were divided into 2 groups (experimental group and control group). The members of the experimental group were subjected to manipulation of the lateral strain of sphenoid from the side contralateral to the eye that had fewer diopters and were subjected to a sequence of 3 ocular motor exercises immediately after manipulation. The control group, on the other hand, received only ocular motor treatment. A secondary outcome was also drawn up that demonstrated how changes in ocular motricity also affected cervical rotation. Analysis of the data showed that the experimental treatment was in the short term superior to the control group to astatistically significant extent both in terms of the prismatic delta of the right eye (0 OT median without manipulation and 10 OT median with manipulation) and that of the left eye (0 OT median without manipulation and 5 OT median with manipulation). Cervical rotation values also showed better values in the experimental group with a median of 4° in the right rotation without manipulation and 6° with thrust; the left rotation presented a median of 2° without manipulation and 7° with thrust. From the results that emerged, the treatment was effective. It would be desirable to increase the sample number and set up a timeline to see if the net improvements obtained in the short term will also be maintained in the medium to long term.

Keywords: boxing, basilar spheno synchondrosis, ocular convergence deficit, osteopathic treatment

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Authors: Xing Wang, Lin Feng, Xuan Zou, Hongchen liu

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Immediate Implantation after tooth extraction is considered to be the ideal way to retain the alveolar bone, but some scholars believe the aesthetic effect in the Early Implantation case are more reliable. In this study, 89 patients were added to this retrospective study up to 5 years. Assessment indicators was including the survival of the implant (peri-implant infection, implant loosening, shedding, crowns and occlusal), aesthetics (color and fullness gums, papilla height, probing depth, X-ray alveolar crest height, the patient's own aesthetic satisfaction, doctors aesthetics score), repair defects around the implant (peri-implant bone changes in height and thickness, whether the use of autologous bone graft, whether to use absorption/repair manual nonabsorbable material), treatment time, cost and the use of antibiotics.The results demonstrated that there is no significant difference in long-term success rate of immediate implantation, early implantation and delayed implantation (p> 0.05). But the results indicated immediate implantation group could get get better aesthetic results after two years (p< 0.05), but may increase the risk of complications and failures (p< 0.05). High-risk indicators include gingival recession, labial bone wall damage, thin gingival biotypes, planting position and occlusal restoration bad and so on. No matter which type of implanting methods was selected, the extraction methods and bone defect amplification techniques are observed as a significant factors on aesthetic effect (p< 0.05).

Keywords: immediate implantation, long-term effects, aesthetics area, dental implants

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Authors: R. Marhenke, M. Martini

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The distraction of attentional resources after learning hinders long-term memory consolidation compared to several minutes of post-encoding inactivity in form of wakeful resting. We tested whether an 8-minute period of wakeful resting, compared to performing an adapted version of the d2 test of attention after learning, supports memory retention. Participants encoded and immediately recalled a word list followed by either an 8 minute period of wakeful resting (eyes closed, relaxed) or by performing an adapted version of the d2 test of attention (scanning and selecting specific characters while ignoring others). At the end of the experimental session (after 12-24 min) and again after 7 days, participants were required to complete a surprise free recall test of both word lists. Our results showed no significant difference in memory retention between the experimental conditions. However, we found that participants who completed the first lines of the d2 test in less than the given time limit of 20 seconds and thus had short unfilled intervals before switching to the next test line, remembered more words over the 12-24 minute and over the 7 days retention interval than participants who did not complete the first lines. This interaction occurred only for the first test lines, with the highest temporal proximity to the encoding task and not for later test lines. Differences in retention scores between groups (completed first line vs. did not complete) seem to be widely independent of the general performance in the d2 test. Implications and limitations of these exploratory findings are discussed.

Keywords: long-term memory, retroactive interference, attention, forgetting

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Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar

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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.

Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life

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Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

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Authors: Davide Fuscà, Kanan Rahimli, Roberto Leuzzi

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Preventing abuse and illegal activities in a given area of the sea is a very difficult and expensive task. Artificial intelligence offers the possibility to implement new methods to identify the vessel class type from the kinematic features of the vessel itself. The task strictly depends on the quality of the data. This paper explores the application of a deep, long short-term memory model by using AIS flow only with a relatively low quality. The proposed model reaches high accuracy on detecting nine vessel classes representing the most common vessel types in the Ionian-Adriatic Sea. The model has been applied during the Adriatic-Ionian trial period of the international EU ANDROMEDA H2020 project to identify vessels performing behaviors far from the expected one depending on the declared type.

Keywords: maritime surveillance, artificial intelligence, behavior analysis, LSTM

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Authors: Helia Moayedi, Mahdi Moaidi

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Nowadays, the managing and planning of hospitals is facing many problems. Failure to recognize the main criteria for strategic management to ensure long-term hospital performance can lead to many health problems. To achieve this goal, a qualitative-quantitate method titled Delphi-Fuzzy has been applied. This strategy makes it possible for experts to screen among the most important criteria in strategic management. To conduct this operation, a statistical society consisting of 20 experts in Ahwaz hospitals has been questioned. The final model confirms the key criterions after three stages of Delphi. This model provides the possibility to focus on the basic criteria and can determine the organization’s main orientation.

Keywords: Delphi-fuzzy method, hospital management, long-term planning, qualitative-quantitate method, screening of strategic criteria, strategic planning

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Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

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Authors: Telma Fontao de Castro, Kylee Miller, Maria Xavier Araújo, Isabel Brandao, Sandra Torres

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Objective: There is a dearth of research investigating the long-term emotional functioning of individuals recovered from anorexia nervosa (AN). This 15-year longitudinal study aimed to examine whether difficulties in cognitive processing of emotions persisted after long-term AN recovery and its link to anxiety and depression. Method: Twenty-four females, who were tested longitudinally during their acute and recovered AN phases, and 24 healthy control (HC) women, were screened for anxiety, depression, alexithymia, and emotion regulation difficulties (ER; only assessed in recovery phase). Results: Anxiety, depression, and alexithymia levels decreased significantly with AN recovery. However, scores on anxiety and difficulty in identifying feelings (alexithymia factor) remained high when compared to the HC group. Scores on emotion regulation difficulties were also lower in HC group. The abovementioned differences between AN recovered group and HC group in difficulties in identifying and accepting feelings and lack of emotional clarity were no longer present when the effect of anxiety and depression was controlled. Conclusions: Findings suggest that emotional dysfunction tends to decrease in AN recovered phase. However, using an HC group as a reference, we conclude that several emotional difficulties are still increased after long-term AN recovery, in particular, limited access to emotion regulation strategies, and difficulty controlling impulses and engaging in goal-directed behavior, thus suggesting to be a trait vulnerability. In turn, competencies related to emotional clarity and acceptance of emotional responses seem to be state-dependent phenomena linked to anxiety and depression. In sum, managing emotions remains a challenge for individuals recovered from AN. Under this circumstance, maladaptive eating behavior can serve as an affect regulatory function, increasing the risk of relapse. Emotional education and stabilization of depressive and anxious symptomatology after recovery emerge as an important avenue to protect from long-term AN relapse.

Keywords: alexithymia, anorexia nervosa, emotion recognition, emotion regulation

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Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain

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Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)

Keywords: health belief, medication understanding, medication use, self-efficacy

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Authors: Douglas J. Kube

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At the beginning of the COVID-19 pandemic, the Canadian Red Cross deployed workers into long-term care homes across Canada to support our most vulnerable citizens. It began by recruiting and training small teams of workers to provide non-clinical services for facilities in outbreak. Deployed workers were trained on an approach based on successful Red Cross deployments used with Ebola in which zones were established, levels of protection used, and strict protocols followed to prevent exposure. This paper addresses aspects of human performance through a safety culture lens. The Red Cross deployments highlight valuable insights and are an excellent case study in the principles of human performance and organizational culture. This paper looks at human performance principles, including human fallibility, predictability of error-likely situations, avoiding events by understanding reasons mistakes occur, and the influence on behaviour by organizational factors. This study demonstrates how the Red Cross’s organizational culture and work design positively influenced performance to protect workers and residents/clients. Lastly, this paper shares lessons that can be applied in many workplaces to improve worker health and safety and safety culture. This critical examination is based on the author’s experience as a Senior Occupational Health and Safety Advisor with the Red Cross during the pandemic as part of the team responsible for developing and implementing biological safety practices in long-term care deployments.

Keywords: COVID, human performance, organizational culture, work design

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Authors: Anna Kizinska

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The research aims at discussing Polish and British incongruent terms that refer to company law. The Polish terms under analysis appear in the Polish Code of Commercial Partnerships and Companies and constitute legal terms or factual terms. The English equivalents of each Polish term under research appear in two Polish Code of Commercial Partnerships and Companies translations into English. The theoretical part of the paper includes the presentation of the definitions of a system-bound term and incongruity of terms. The aim of the analysis is to check if the classification of translation methods used in civil law terms translation comprehends the translation methods applied while translating company law terms into English. The translation procedures are defined according to Newmark. The stages of the research include 1) presentation of a definition of a Polish term, 2) enumerating the so-far published English equivalents of a given Polish term and comparing their definitions (as long as they appear in English law dictionaries ) with the definition of a given Polish term under analysis, 3) checking whether an English equivalent appears or not in, among others, the sources of the British law (legislation.gov.uk database) , 4) identifying the translation method that was applied while forming a given English equivalent.

Keywords: translation, legal terms, equivalence, company law, incongruency

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Authors: Mohammad Abu-Taleb

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The final report of the Royal Commission into Australian financial services misconduct, released in February 2019, has had a significant impact on the financial advice industry. The recommendations released in the Commissioner’s final report include changes to ongoing fee arrangements, a new disciplinary system for financial advisers, and mandatory reporting of compliance concerns. This thesis aims to explore the impact of the Royal Commission’s recommendations on the operating model of financial advice firms in terms of advice products, processes, delivery models, and customer segments. Also, this research seeks to investigate whether the Royal Commission’s outcome has accelerated the use of enhanced technology solutions within the operating model of financial advice firms. And to identify the key challenges confronting financial advice firms whilst implementing the Commissioner’s recommendations across their operating models. In order to achieve the objectives of this thesis, a qualitative research design has been adopted through semi-structured in-depth interviews with 24 financial advisers and managers who are engaged in the operation of financial advice services. The study used the thematic analysis approach to interpret the qualitative data collected from the interviews. The findings of this thesis reveal that customer-centric operating models will become more prominent across the financial advice industry in response to the Commissioner’s final report. And the Royal Commission’s outcome has accelerated the use of advice technology solutions within the operating model of financial advice firms. In addition, financial advice firms have started more than before using simpler and more automated web-based advice services, which enable financial advisers to provide simple advice in a greater scale, and also to accelerate the use of robo-advice models and digital delivery to mass customers in the long term. Furthermore, the study identifies process and technology changes as, long with technical and interpersonal skills development, as the key challenges encountered financial advice firms whilst implementing the Commissioner’s recommendations across their operating models.

Keywords: hayne royal commission, financial planning advice, operating model, advice products, advice processes, delivery models, customer segments, digital advice solutions

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Authors: Jose Gonzalez, Fai Cheng, Ivy Fan

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Shipping has a mature and ever expanding worldwide market. The future of the marine industry itself is not only irrevocably linked with the global economic, social, and political landscape; it is also subject to the technological developments in different fields. Some of them may have never been linked to the marine industry before. Companies in the marine sector are getting more dependent on technologies to achieve competitive advantage in an increasing open market. Technologies can be fused across different business functions and geopolitical influences. A successful marine business should be prepared to embrace such potential changes that lie ahead. The present paper intends to articulate long-term marine technology strategies from an industrial perspective. Methodology and current development are introduced. The paper will also provide insight into future technological trends demand for major commercial ship types. It may also assist different stakeholders in tailoring their long-term strategies to achieve a Sea Change and to uncap opportunity.

Keywords: commercial sector, marine, trends, technology

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Authors: Mahdi Almaky

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The thermostabilization of High Density Polyethylene (HDPE) is realized through the action of primary antioxidant such as phenolic antioxidants and secondary antioxidants as aryl phosphates. The efficiency of two secondary antioxidants, commercially named Irgafos 168 and Weston 399, was investigated using different physical, mechanical, spectroscopic, and calorimetric methods. The effect of both antioxidants on the processing stability and long term stability of HDPE produced in Ras Lanuf oil and gas processing Company were measured and compared. The combination of Irgafos 168 with Irganox 1010, as used in smaller concentration, results in a synergetic effect against thermo-oxidation and protect better than the combination of Weston 399 with Irganox 1010 against the colour change at processing temperature and during long term oxidation process.

Keywords: thermostabilization, high density polyethylene, primary antioxidant, phenolic antioxidant, Irgafos 168, Irganox 1010, Weston 399

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Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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Authors: Gabriela Sardinha Pacheco

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In a context of elderly population growth, the need to provide high quality infrastructure and services to these people becomes even more evident. The act of designing a space dedicated to elderly people goes beyond the concept of well-being and reaches to a point of evaluating and changing the way which society sees this part of the population as well as how it can build a relationship with energy efficiency. In this context, the care facilities for elderly have an extremely important role to provide this infrastructure to the population. A common issue is that, for many times, these facilities face financial issues, and the full operation of the establishment can be impacted. The intention of this work is to develop a project in which the energy efficiency measures can be lived daily and that the residents of the institution can participate actively, directly, or indirectly in the construction of this relationship. The use of energy efficiency strategies should become a natural process when thinking about buildings as it is an essential step to provide increased well-being, climate change mitigation, and cost reduction.

Keywords: energy efficiency, environmental comfort, long-term care facility, well-being

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Authors: Oindrila Nath, S. Sridharan

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Long-term (2002-2012) temperature and ozone measurements by Sounding of Atmosphere by Broadband Emission Radiometry (SABER) instrument onboard Thermosphere, Ionosphere, Mesosphere Energetics and Dynamics (TIMED) satellite zonally averaged over 10°N-15°N are used to study their long-term changes and their responses to solar cycle, quasi-biennial oscillation and El Nino Southern Oscillation. The region is selected to provide more accurate long-term trends and variabilities, which were not possible earlier with lidar measurements over Gadanki (13.5°N, 79.2°E), which are limited to cloud-free nights, whereas continuous data sets of SABER temperature and ozone are available. Regression analysis of temperature shows a cooling trend of 0.5K/decade in the stratosphere and that of 3K/decade in the mesosphere. Ozone shows a statistically significant decreasing trend of 1.3 ppmv per decade in the mesosphere although there is a small positive trend in stratosphere at 25 km. Other than this no significant ozone trend is observed in stratosphere. Negative ozone-QBO response (0.02ppmv/QBO), positive ozone-solar cycle (0.91ppmv/100SFU) and negative response to ENSO (0.51ppmv/SOI) have been found more in mesosphere whereas positive ozone response to ENSO (0.23ppmv/SOI) is pronounced in stratosphere (20-30 km). The temperature response to solar cycle is more positive (3.74K/100SFU) in the upper mesosphere and its response to ENSO is negative around 80 km and positive around 90-100 km and its response to QBO is insignificant at most of the heights. Composite monthly mean of ozone volume mixing ratio shows maximum values during pre-monsoon and post-monsoon season in middle stratosphere (25-30 km) and in upper mesosphere (85-95 km) around 10 ppmv. Composite monthly mean of temperature shows semi-annual variation with large values (~250-260 K) in equinox months and less values in solstice months in upper stratosphere and lower mesosphere (40-55 km) whereas the SAO becomes weaker above 55 km. The semi-annual variation again appears at 80-90 km, with large values in spring equinox and winter months. In the upper mesosphere (90-100 km), less temperature (~170-190 K) prevails in all the months except during September, when the temperature is slightly more. The height profiles of amplitudes of semi-annual and annual oscillations in ozone show maximum values of 6 ppmv and 2.5 ppmv respectively in upper mesosphere (80-100 km), whereas SAO and AO in temperature show maximum values of 5.8 K and 4.6 K in lower and middle mesosphere around 60-85 km. The phase profiles of both SAO and AO show downward progressions. These results are being compared with long-term lidar temperature measurements over Gadanki (13.5°N, 79.2°E) and the results obtained will be presented during the meeting.

Keywords: trends, QBO, solar cycle, ENSO, ozone, temperature

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: Alemayehu Muluneh, Saskia Keesstra, Leo Stroosnijder, Woldeamlak Bewket, Ashenafi Burka

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There are some scientific evidences and a belief by many that forests attract rain and deforestation contributes to a decline of rainfall. However, there is still a lack of concrete scientific evidence on the role of forests in rainfall amount. In this paper, we investigate the forest-rainfall relationships in the environmentally hot spot area of the Central Rift Valley (CRV) of Ethiopia. Specifically, we evaluate long term (1970-2009) rainfall variability and its relationship with historical forest cover and the relationship between existing forest cover and topographical variables and rainfall distribution. The study used 16 long term and 15 short term rainfall stations. The Mann-Kendall test, bi variate and multiple regression models were used. The results show forest and wood land cover continuously declined over the 40 years period (1970-2009), but annual rainfall in the rift valley floor increased by 6.42 mm/year. But, on the escarpment and highlands, annual rainfall decreased by 2.48 mm/year. The increase in annual rainfall in the rift valley floor is partly attributable to the increase in evaporation as a result of increasing temperatures from the 4 existing lakes in the rift valley floor. Though, annual rainfall is decreasing on the escarpment and highlands, there was no significant correlation between this rainfall decrease and forest and wood land decline and also rainfall variability in the region was not explained by forest cover. Hence, the decrease in annual rainfall on the escarpment and highlands is likely related to the global warming of the atmosphere and the surface waters of the Indian Ocean. Spatial variability of number of rainy days from systematically observed two-year’s rainfall data (2012-2013) was significantly (R2=-0.63) explained by forest cover (distance from forest). But, forest cover was not a significant variable (R2=-0.40) in explaining annual rainfall amount. Generally, past deforestation and existing forest cover showed very little effect on long term and short term rainfall distribution, but a significant effect on number of rainy days in the CRV of Ethiopia.

Keywords: elevation, forest cover, rainfall, slope

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Authors: Syed Mahbubuz Zaman, A. B. M. Abrar Haque, Mehedi Hassan Nayeem, Misbah Uddin Sagor

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Everyday e-mails are being used by millions of people as an effective form of communication over the Internet. Although e-mails allow high-speed communication, there is a constant threat known as spam. Spam e-mail is often called junk e-mails which are unsolicited and sent in bulk. These unsolicited emails cause security concerns among internet users because they are being exposed to inappropriate content. There is no guaranteed way to stop spammers who use static filters as they are bypassed very easily. In this paper, a smart system is proposed that will be using neural networks to approach spam in a different way, and meanwhile, this will also detect the most relevant features that will help to design the spam filter. Also, a comparison of different parameters for different neural network models has been shown to determine which model works best within suitable parameters.

Keywords: long short-term memory, bidirectional long short-term memory, gated recurrent unit, natural language processing, natural language processing

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Authors: Namwinwelbere Dabire, Eugene C. Ezin, Adandedji M. Firmin

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The prediction of hydrological flows (rainfall-depth or rainfall-discharge) is becoming increasingly important in the management of hydrological risks such as floods. In this study, the Long Short-Term Memory (LSTM) network, a state-of-the-art algorithm dedicated to time series, is applied to predict the daily water level of Nokoue Lake in Benin. This paper aims to provide an effective and reliable method enable of reproducing the future daily water level of Nokoue Lake, which is influenced by a combination of two phenomena: rainfall and river flow (runoff from the Ouémé River, the Sô River, the Porto-Novo lagoon, and the Atlantic Ocean). Performance analysis based on the forecasting horizon indicates that LSTM can predict the water level of Nokoué Lake up to a forecast horizon of t+10 days. Performance metrics such as Root Mean Square Error (RMSE), coefficient of correlation (R²), Nash-Sutcliffe Efficiency (NSE), and Mean Absolute Error (MAE) agree on a forecast horizon of up to t+3 days. The values of these metrics remain stable for forecast horizons of t+1 days, t+2 days, and t+3 days. The values of R² and NSE are greater than 0.97 during the training and testing phases in the Nokoué Lake basin. Based on the evaluation indices used to assess the model's performance for the appropriate forecast horizon of water level in the Nokoué Lake basin, the forecast horizon of t+3 days is chosen for predicting future daily water levels.

Keywords: forecasting, long short-term memory cell, recurrent artificial neural network, Nokoué lake

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Authors: Vani Tanggamani, Azlan Amran

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The issues of Corporate Social Responsibility (CSR) have been extended from developmental economics to corporate and business in recent years. Research in issues related to CSR is deemed to make higher impacts as CSR encourages long-term economy and business success without neglecting social, environmental risks, obligations and opportunities. Therefore, CSR is a key matter for any organisation aiming for long term sustainability since business incorporates principles of social responsibility into each of its business decisions. Thus, this paper presents a theoretical proposition based on stakeholder theory from the organisational perspective as a foundation for better CSR practices. The primary subject of this paper is to explore how looping concept can be effectively embedded into corporate CSR strategy to foster sustainable long term growth. In general, the concept of a loop is a structure or process, the end of which is connected to the beginning, whereas the narrow view of a loop in business field means plan, do, check, and improve. In this sense, looping concept is a blend of balance and agility with the awareness to know when to which. Organisations can introduce similar pull mechanisms by formulating CSR strategies in order to perform the best plan of actions in real time, then a chance to change those actions, pushing them toward well-organized planning and successful performance. Through the analysis of an exploratory study, this paper demonstrates that approaching looping concept in the context of corporate CSR strategy is an important source of new idea to propel CSR practices by deepening basic understanding through the looping concept which is increasingly necessary to attract and retain business stakeholders include people such as employees, customers, suppliers and other communities for long-term business survival. This paper contributes to the literature by providing a fundamental explanation of how the organisations will experience less financial and reputation risk if looping concept logic is integrated into core business CSR strategy.The value of the paper rests in the treatment of looping concept as a corporate CSR strategy which demonstrates "looping concept implementation framework for CSR" that could further foster business sustainability, and help organisations move along the path from laggards to leaders.

Keywords: corporate social responsibility, looping concept, stakeholder theory, sustainable growth

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Authors: A. Binnui, O. Kalinowska-Beszczynska, G. Shaw

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It is postulated that innovative deployment of entrepreneurial activities leads to firm's growth. This paper draws upon the key predictions of the core theories on entrepreneurship and innovation to formulate a conceptual framework which can be used to depict the casual chain of events from which entrepreneurs can manage more innovatively and ultimately deliver higher growth which benefits of the regional and national economies. It examines the key firm-based factors extracted from the theories, namely the characteristics of entrepreneurial hi-tech firms, characteristics of innovating firms, and firm growth dynamics that lead to enhanced economic growth. The framework postulates that the key determinants extracted such as entrepreneurial demographics, firm characteristic, skills and competencies, research and development, product/service characteristics, market development, financial of the firm and internationalization might lead to the survival and long term development of high-technology startups.

Keywords: innovative entrepreneurial activities, entrepreneuship, determinants, growth, hi-technology start-upws

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Authors: Archana Gandhi

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Indian apparel manufacturers see several benefits of Corporate Social Responsibility (CSR). At the same time, they clearly face steep challenges in its implementation. From the perspective of the participants, the challenges tend to outweigh the benefits. The short-term expenses, misperceptions about the financial benefits of CSR and the additional burden of implementing CSR-related policies and activities tend to overshadow perceptions of the long-term benefits. CSR activities currently seen in the Indian apparel industry are primarily people focused, society-focused or environment-focused. However, most CSR activities focus on employee welfare, including teaching employees about health and safety awareness, creating opportunities for community building, and providing general education to employees. Employee retention is very high in socially responsible Indian firms as compared to non-CSR firms, largely because CSR plays a crucial role in overall employee satisfaction, which translates to worker loyalty and low turnover. Employee retention and commitment are not the​ only potential benefits of CSR in the Indian apparel industry. CSR can also enhance a company’s image. Although it is a long-term benefit, being socially responsible can build a company’s social reputation and help it to gain others’ trust. Buyers do not hesitate to do business with these companies, since it is difficult to find socially responsible firms in India.

Keywords: corporate social responsibility, apparel industry, workers, improve work life

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Authors: E. Tarantino, G. Disciglio, G. Gatta, L. Frabboni, A. Libutti, A. Tarantino

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Worldwide, about two-thirds of industrial and domestic wastewater effluent is discharged without treatment, which can cause contamination and eutrophication of the water. In particular, for Mediterranean countries, irrigation with treated wastewater would mitigate the water stress and support the agricultural sector. Changing global weather patterns will make the situation worse, due to increased susceptibility to drought, which can cause major environmental, social, and economic problems. The study was carried out in open field in an intensive agricultural area of the Apulian region in Southern Italy where freshwater resources are often scarce. As well as providing a water resource, irrigation with treated wastewater represents a significant source of nutrients for soil–plant systems. However, the use of wastewater might have further effects on soil. This study thus investigated the long-term impact of irrigation with reclaimed agro-industrial wastewater on the chemical characteristics of the soil. Two crops (processing tomato and broccoli) were cultivated in succession in Stornarella (Foggia) over four years from 2012 to 2016 using two types of irrigation water: groundwater and tertiary treated agro-industrial wastewater that had undergone an activated sludge process, sedimentation filtration, and UV radiation. Chemical analyses were performed on the irrigation waters and soil samples. The treated wastewater was characterised by high levels of several chemical parameters including TSS, EC, COD, BOD₅, Na⁺, Ca²⁺, Mg²⁺, NH₄-N, PO₄-P, K⁺, SAR and CaCO₃, as compared with the groundwater. However, despite these higher levels, the mean content of several chemical parameters in the soil did not show relevant differences between the irrigation treatments, in terms of the chemical features of the soil.

Keywords: agro-industrial wastewater, broccoli, long-term re-use, tomato

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Authors: Mohamed Eladham Fadl M. E. Fadl

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In Egypt, wastewater has been used for irrigation in areas with fresh water scarcity. However, continuous applications may cause potential risks. Thus, the current study aims at screening the impacts of long-term wastewater irrigation on soil pollution and human health due to the exposure of heavy metals. Soils of nine sites in Al-Qalyubiyah Governorate, Egypt were sampled and analyzed for different properties. Wastewater resulted in a build-up of metals in soils. The pollution index (PI) showed the order of Cd > Pb > Ni > Zn. The integrated pollution index of Nemerow’s (IPIN) exceeded the safe limit of 0.7. The enrichment factor (EF) surpassed 1.0 value proving anthropogenic effects. The geo-accumulation index (Igeo) indicated that Pb, Ni, and Zn-induced none to moderate pollution, while high threats were associated with Cd. The calculated hazard index proved a potential health risk for humans, particularly children. It is recommended to perform a treatment to the wastewater used in irrigation to avoid such threats.

Keywords: pollution, health risks, heavy metals, effluent, irrigation, GIS techniques

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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