Search results for: surgical safety checklist

Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

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Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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Authors: Craig A. Kaplan

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If AGI proves to be a “winner-take-all” scenario where the first company or country to develop AGI dominates, then the first AGI must also be the safest. The safest, and fastest, path to Artificial General Intelligence (AGI) may be to harness the collective intelligence of multiple AI and human agents in an AGI network. This approach has roots in seminal ideas from four of the scientists who founded the field of Artificial Intelligence: Allen Newell, Marvin Minsky, Claude Shannon, and Herbert Simon. Extrapolating key insights from these founders of AI, and combining them with the work of modern researchers, results in a fast and safe path to AGI. The seminal ideas discussed are: 1) Society of Mind (Minsky), 2) Information Theory (Shannon), 3) Problem Solving Theory (Newell & Simon), and 4) Bounded Rationality (Simon). Society of Mind describes a collective intelligence approach that can be used with AI and human agents to create an AGI network. Information theory helps address the critical issue of how an AGI system will increase its intelligence over time. Problem Solving Theory provides a universal framework that AI and human agents can use to communicate efficiently, effectively, and safely. Bounded Rationality helps us better understand not only the capabilities of SuperIntelligent AGI but also how humans can remain relevant in a world where the intelligence of AGI vastly exceeds that of its human creators. Each key idea can be combined with recent work in the fields of Artificial Intelligence, Machine Learning, and Large Language Models to accelerate the development of a working, safe, AGI system.

Keywords: AI Agents, Collective Intelligence, Minsky, Newell, Shannon, Simon, AGI, AGI Safety

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Authors: Adebisi M. Tiamiyu, Adewale F. Adeyemi, Olu-Ayobamikale V. Irewunmi

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Fish consumption has increased in recent years in both developing and advanced countries, owing to increased awareness of its nutritional and therapeutic benefits and its availability and affordability relative to other animal protein sources. Fish and fish products, however, are extremely prone to contamination by a wide range of hazardous organic and inorganic substances. This study assessed the levels of three heavy metals, copper (Cu), iron (Fe), and zinc (Zn), in frozen fish imported into Nigeria and sold in Ondo City for their safety for human consumption as recommended by WHO and FEPA. Three species of frozen fish (Scombrus scombrus, Merluccius merluccius, and Clupea harengus) were purchased, and the wet tissues (gills, muscles, and liver) were digested using a 3:1 mixture of nitric acid (HNO3) and hydrochloric acid (HCL). An atomic absorption spectrophotometer (AAS) was used to detect the amount of metal in the tissues. The levels of heavy metals in different fish species' organs varied. The fish had Zn > Fe > Cu heavy metal concentrations in that order. While the concentration of Cu and Fe in the tissues of all three fish species studied were within the WHO and FEPA prescribed limits for food fish, the concentration of Zn in the muscles of M. merluccius (0.262±0.052), C. harengus harengus (0.327±0.099), and S. scombrus (0.362±0.119) was above the prescribed limit (0.075 ppm) set by FEPA. An excessive amount of zinc in the body can cause nausea, headaches, decreased immunity, and appetite loss.

Keywords: heavy metal, atomic absorption spectrophotometer, fish, agencies

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Authors: Maedeh Pourmajidian, Joseph R. McDermid

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Advanced High Strength Steels are revolutionizing both the steel and automotive industries due to their high specific strength and ability to absorb energy during crash events. This allows manufacturers to design vehicles with significantly increased fuel efficiency without compromising passenger safety. To maintain the structural integrity of the fabricated parts, they must be protected from corrosion damage through continuous hot-dip galvanizing process, which is challenging due to selective oxidation of Mn and Si on the surface of this AHSSs. The effects of process atmosphere oxygen partial pressure and small additions of Sn on the selective oxidation of a medium-Mn C-6Mn-2Si advanced high strength steel was investigated. Intercritical annealing heat treatments were carried out at 690˚C in an N2-5%H2 process atmosphere under dew points ranging from –50˚C to +5˚C. Surface oxide chemistries, morphologies, and thicknesses were determined at a variety of length scales by several techniques, including SEM, TEM+EELS, and XPS. TEM observations of the sample cross-sections revealed the transition to internal oxidation at the +5˚C dew point. EELS results suggested that the internal oxides network was composed of a multi-layer oxide structure with varying chemistry from oxide core towards the outer part. The combined effect of employing a known surface active element as a function of process atmosphere on the surface structure development and the possible impact on reactive wetting of the steel substrates by the continuous galvanizing zinc bath will be discussed.

Keywords: 3G AHSS, hot-dip galvanizing, oxygen partial pressure, selective oxidation

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Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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Authors: Belén Vinaixa Kinnear, Arturo Hidalgo López, Bernardo Elembo Wilasi, Pablo Fernández Pérez, Cecilia Hernández Fuentealba

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The expanded use of risk assessment in legislative and corporate decision-making has increased the role of expert judgement in giving data for security-related decision-making. Expert judgements are required in most steps of risk assessment: danger recognizable proof, hazard estimation, risk evaluation, and examination of choices. This paper presents a fault tree analysis (FTA), which implies a probabilistic failure analysis applied to leakage of oil in a subsea production system. In standard FTA, the failure probabilities of items of a framework are treated as exact values while evaluating the failure probability of the top event. There is continuously insufficiency of data for calculating the failure estimation of components within the drilling industry. Therefore, fuzzy hypothesis can be used as a solution to solve the issue. The aim of this paper is to examine the leaks from the Zafiro West subsea oil facility by using fuzzy fault tree analysis (FFTA). As a result, the research has given theoretical and practical contributions to maritime safety and environmental protection. It has been also an effective strategy used traditionally in identifying hazards in nuclear installations and power industries.

Keywords: expert judgment, probability assessment, fault tree analysis, risk analysis, oil pipelines, subsea production system, drilling, quantitative risk analysis, leakage failure, top event, off-shore industry

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Authors: Muhammad Saleem

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Tourism stands as one of the swiftly expanding sectors globally, contributing to 10% of the overall worldwide GDP. It holds a vital role in generating income, fostering employment opportunities, alleviating poverty, facilitating foreign exchange earnings, and advancing intercultural understanding. This industry encompasses a spectrum of activities, encompassing transportation, communication, hospitality, catering, entertainment, and advertising. The objective of this study is to assess the evolution and obstacles encountered by sports tourism in Pakistan. In pursuit of this objective, relevant literature has been scrutinized, while data has been acquired from 60 respondents, employing a simple random sampling approach for analysis. The survey comprised close-ended inquiries directed towards all participants. Analytical tools such as mean, mode, median, graphs, and percentages have been employed for data analysis. The findings revealed through robust analysis, indicate that the mean, mode, and median tools consistently yield results surpassing the 70% mark, underscoring that heightened development within sports tourism significantly augments its progress. Effective governance demonstrates a favorable influence on sports tourism, with increased government-provided safety and security potentially amplifying its expansion, thus attracting a higher number of tourists and consequently propelling the growth of the sports tourism sector. This study holds substantial significance for both academic scholars and industry practitioners within Pakistan's tourism landscape, as previous explorations in this realm have been relatively limited.

Keywords: obstacles-spots, evolution-tourism, sports-pakistan, sports-obstacles-pakistan

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Authors: Ali Kuzu

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There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Maria Luisa Nozawa Ribeiro, Maria Teresa Miceli Kerbauy

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This paper aims to present the theories of public participation in order to understand the context of the public GMO (Genetic Modified Organisms) policies in Brazil, highlighting the characteristics of its configuration and the dialog with the experts. As a controversy subject, the commercialization of GMO provoked manifestation of some popular and environmental representative groups questioning the decisions of policy makers and experts on the matter. Many aspects and consequences of the plantation and consumption of this crops emerged and the safety of this technology was questioned. Environmentalists, Civil Right's movement, representatives of rural workers, farmers and organics producers, etc. demonstrated their point of view, also sustained by some experts of medical, genetical, environmental, agronomical sciences, etc. fields. Despite this movement, the precautionary principle (risk management), implemented in 1987, suggested precaution facing new technologies and innovations in the sustainable development society. This principle influenced many legislation and regulation on GMO around the world, including Brazil, which became a reference among the world regulatory GMO systems. The Brazilian legislation ensures the citizens participation on GMO discussion, characteristic that was important to establish the connection between the subject and the participation theory. These deliberation spaces materialized in Brazil through the "Public Audiences", which are managed by the National Biosafety Technical Commission (CTNBio), the department responsible for controlling the research, production and commercialization of GMOs in Brazil.

Keywords: public engagement, public participation, science and technology studies, transgenic politics

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Authors: Seon Yeong Byeon, Hwa Sung Shin

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Nanofibrous sheets are of interest in the beauty industries due to the properties of moisturizing, adhesion to skin and delivery of nutrient materials. The benefit and function of the cosmetic products should not be considered without safety thus a non-toxic manufacturing process is ideal when fabricating the products. In this study, we have developed cosmetic patches consisting of alginate and Spirulina extract, a marine resource which has antibacterial and antioxidant effects, without addition of harmful cross-linkers. The patches obtained their structural stabilities by layer-upon-layer electrospinning of an alginate layer on a formerly spread polycaprolactone (PCL) layer instead of crosslinking method. The morphological characteristics, release of Spirulina extract, water absorption, skin adhesiveness and cytotoxicity of the double-layered patches were assessed. The image of scanning electron microscopy (SEM) showed that the addition of Spirulina extract has made the fiber diameter of alginate layers thinner. Impregnation of Spirulina extract increased their hydrophilicity, moisture absorption ability and skin adhesive ability. In addition, wetting the pre-dried patches resulted in releasing the Spirulina extract within 30 min. The patches were detected to have no cytotoxicity in the human keratinocyte cell-based MTT assay, but rather showed increased cell viability. All the results indicate the bioactive and hydro-adhesive double-layered patches have an excellent applicability to bioproducts for personal skin care in the trend of ‘A mask pack a day’.

Keywords: alginate, cosmetic patch, electrospun nanofiber, polycaprolactone, Spirulina extract

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Authors: Herawanti Kumalasari, Raldi Hendro Koestoer, Hayati Sari Hasibuan

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Geographically, Indonesia is located in the arc of volcanoes that cause disaster prone one of them is landslide disaster. One of the causes of the landslide is the conversion of land from forest to agricultural land in upland areas and river border that has a steep slope. The study area is located in the highlands with fertile soil conditions, so most of the land is used as agricultural land and plantations. Land use transfer also occurs around the geothermal field in Pangalengan District, West Java Province which will threaten the sustainability of geothermal energy utilization and the safety of the community. The purpose of this research is to arrange the concept of spatial pattern arrangement in the geothermal area based on disaster mitigation. This research method using superimpose analysis. Superimpose analysis to know the basic physical condition of the planned area through the overlay of disaster risk map with the map of the plan of spatial plan pattern of Bandung Regency Spatial Plan. The results of the analysis will then be analyzed spatially. The results have shown that most of the study areas were at moderate risk level. Planning of spatial pattern of existing study area has not fully considering the spread of disaster risk that there are settlement area and the agricultural area which is in high landslide risk area. The concept of the arrangement of the spatial pattern of the study area will use zoning system which is divided into three zones namely core zone, buffer zone and development zone.

Keywords: spatial planning, geothermal, disaster risk, zoning

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Authors: Ali Reza Ghanbarnezhad Ghazvini, Seyyed Hamid Reza Mosayyebi

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In recent years, an earthquake has occurred approximately every five years in certain regions of Iran. To mitigate the impact of these seismic events, it is crucial to identify and thoroughly assess the vulnerability of buildings and infrastructure, ensuring their safety through principled reinforcement. By adopting new methods of risk assessment, we can effectively reduce the potential risks associated with future earthquakes. In our research, we have observed that the coefficient of behavior in the fourth chapter is 1.65 for the initial structure and 1.72 for the Superframe structure. This indicates that the Superframe structure can enhance the strength of the main structural members by approximately 10% through the utilization of super beams. Furthermore, based on the comparative analysis between the two structures conducted in this study, we have successfully designed a stronger structure with minimal changes in the coefficient of behavior. Additionally, this design has allowed for greater energy dissipation during seismic events, further enhancing the structure's resilience to earthquakes. By comprehensively examining and reinforcing the vulnerability of buildings and infrastructure, along with implementing advanced risk assessment techniques, we can significantly reduce casualties and damages caused by earthquakes in Iran. The findings of this study offer valuable insights for civil engineering professionals in the field of structural engineering, aiding them in designing safer and more resilient structures.

Keywords: modal pushover analysis, response modification factor, high-strength concrete, concrete shear walls, high-rise building

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Authors: Rabitah Zakaria, Chan M. Luan, Nor Hakimah Ramly

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The extraction of vegetable oil using aqueous extraction process assisted by ionic extended surfactant has been investigated as an alternative to hexane extraction. However, the ionic extended surfactant has not been commercialised and its safety with respect to food processing is uncertain. Hence, food-grade non-ionic surfactants (Tween 20, Span 20, and Span 80) were proposed for the extraction of residual oil from palm-pressed mesocarp fibre. Palm-pressed mesocarp fibre contains a significant amount of residual oil ( 5-10 wt %) and its recovery is beneficial as the oil contains much higher content of vitamin E, carotenoids, and sterols compared to crude palm oil. In this study, the formulation of food-grade surfactants using a combination of high hydrophilic-lipophilic balance (HLB) surfactants and low HLB surfactants to produce micro-emulsion with very low interfacial tension (IFT) was investigated. The suitable surfactant formulation was used in the oil extraction process and the efficiency of the extraction was correlated with the IFT, droplet size and viscosity. It was found that a ternary surfactant mixture with a HLB value of 15 (82% Tween 20, 12% Span 20 and 6% Span 80) was able to produce micro-emulsion with very low IFT compared to other HLB combinations. Results suggested that the IFT and droplet size highly affect the oil recovery efficiency. Finally, optimization of the operating parameters shows that the highest extraction efficiency of 78% was achieved at 1:31 solid to liquid ratio, 2 wt % surfactant solution, temperature of 50˚C, and 50 minutes contact time.

Keywords: food-grade surfactants, aqueous extraction of residual oil, palm-pressed mesocarp fibre, interfacial tension

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Authors: Oluwatofunmi Musa-Ajakaiye, Paul Olorunfemi M.D MPH, John Obafaiye

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Introduction: The U.S Food and Drug Administration (FDA) reports the public notices for recalled FDA-regulated products over periods of time. It study reviewed the primary reasons for recalls of products of various types over a period of 7 years. Methods: The study analyzed data provided in the FDA’s archived recalls for the years 2010-2017. It identified the various reasons for product recalls in the categories of foods, beverages, drugs, medical devices, animal and veterinary products, and dietary supplements. Using SPSS version 29, descriptive statistics and chi-square analysis of the data were performed. Results (numbers, percentages, p-values, chi-square): Over the period of analysis, a total of 931 recalls were reported. The most frequent reason for recalls was undeclared products (36.7%). The analysis showed that the most recalled product type in the data set was foods and beverages, representing 591 of all recalled products (63.5%).In addition, it was observed that foods and beverages represent 77.2% of products recalled due to the presence of microorganisms. Also, a sub-group analysis of recall reasons of food and beverages found that the most prevalent reason for such recalls was undeclared products (50.1%) followed by Listeria (17.3%) then Salmonella (13.2%). Conclusion: This analysis shows that foods and beverages have the greatest percentages of total recalls due to the presence of undeclared products listeria contamination and Salmonella contamination. The prevalence of Salmonella and Listeria contamination suggests that there is a high risk of microbial contamination in FDA-approved products and further studies on the effects of such contamination must be conducted to ensure consumer safety.

Keywords: food, beverages, listeria, salmonella, FDA, contamination, microbial

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Huanhuan Qiang, Sijia Jin

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Population aging has become a global trend, and China has entered an aging society, implementing an active aging system focused on home and community-based care. However, most urban communities where elderly people live face issues such as monotonous planning, unappealing landscapes, and inadequate aging infrastructure, which do not meet the requirements for active aging. Intergenerational friendliness and mutual assistance are key components in China's active aging policy framework. Therefore, residential development should prioritize enhancing intergenerational friendliness. Residential and public spaces are central to community life and well-being, offering new and challenging venues to improve relationships among residents of different ages. They are crucial for developing intergenerational communities with diverse generations and non-blood relationships. This paper takes the Maigaoqiao community in Nanjing, China, as a case study, examining intergenerational interactions in public spaces. Based on Maslow's hierarchy of needs and using time geography analysis, it identifies the spatiotemporal behavior characteristics of intergenerational groups in outdoor activities. Then construct an intergenerational-friendly evaluation system and an IPA quadrant model for public spaces in residential areas. Lastly, it explores optimization strategies for public spaces to promote intergenerational friendly interactions, focusing on five aspects: accessibility, safety, functionality, a sense of belonging, and interactivity.

Keywords: intergenerational friendliness, demand theory, spatiotemporal behavior, IPA analysis, existing residential public space

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Authors: Ahmed Noor Al-qayyim, Barlas Özden Çağlayan

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Structural failure is caused mainly by damage that often occurs on structures. Many researchers focus on obtaining very efficient tools to detect the damage in structures in the early state. In the past decades, a subject that has received considerable attention in literature is the damage detection as determined by variations in the dynamic characteristics or response of structures. This study presents a new damage identification technique. The technique detects the damage location for the incomplete structure system using output data only. The method indicates the damage based on the free vibration test data by using “Two Points - Condensation (TPC) technique”. This method creates a set of matrices by reducing the structural system to two degrees of freedom systems. The current stiffness matrices are obtained from optimization of the equation of motion using the measured test data. The current stiffness matrices are compared with original (undamaged) stiffness matrices. High percentage changes in matrices’ coefficients lead to the location of the damage. TPC technique is applied to the experimental data of a simply supported steel beam model structure after inducing thickness change in one element. Where two cases are considered, the method detects the damage and determines its location accurately in both cases. In addition, the results illustrate that these changes in stiffness matrix can be a useful tool for continuous monitoring of structural safety using ambient vibration data. Furthermore, its efficiency proves that this technique can also be used for big structures.

Keywords: damage detection, optimization, signals processing, structural health monitoring, two points–condensation

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Authors: Camila Amin-Puello, Lina Vasco-Diaz, Juan Ramirez-Arias, Claudia Munoz, Carlos Gonzalez-Calderon

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Operational flexibility is a fundamental aspect in the field of airlines because although demand is constantly changing, it is the duty of companies to provide a service to users that satisfies their needs in an efficient manner without sacrificing factors such as comfort, safety and other perception variables. The objective of this research is to understand the factors that describe and explain operational flexibility by implementing advanced analytical methods such as exploratory factor analysis and structural equation modeling, examining multiple levels of operational flexibility and understanding how these variable influences users' decision-making when choosing an airline and in turn how it affects the airlines themselves. The use of a hybrid model and latent variables improves the efficiency and accuracy of airline performance prediction in the unpredictable Colombian market. This pioneering study delves into traveler motivations and their impact on domestic flight demand, offering valuable insights to optimize resources and improve the overall traveler experience. Applying the methods, it was identified that low-cost airlines are not useful for flexibility, while users, especially women, found airlines with greater flexibility in terms of ticket costs and flight schedules to be more useful. All of this allows airlines to anticipate and adapt to their customers' needs efficiently: to plan flight capacity appropriately, adjust pricing strategies and improve the overall passenger experience.

Keywords: hybrid choice model, airline, business travelers, domestic flights

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Authors: Khaled M. Ali, M. A. Abdel-Hamid, Ayman A. Mostafa

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Objective: Safety and efficacy of Ahmed glaucoma valve implantation for the management of uveitis induced glaucoma evaluated on the five dogs with uncontrollable glaucoma. Materials and Methods: Ahmed Glaucoma Valve (AGV®; New World Medical, Rancho Cucamonga, CA, USA) is a flow restrictive, non-obstructive self-regulating valve system. Preoperative ocular evaluation included direct ophthalmoscopy and measurement of the intraocular pressure (IOP). The implant was examined and primed prior to implantation. The selected site of the valve implantation was the superior quadrant between the superior and lateral rectus muscles. A fornix-based incision was made through the conjunectiva and Tenon’s capsule. A pocket is formed by blunt dissection of Tenon’s capsule from the episclera. The body of the implant was inserted into the pocket with the leading edge of the device around 8-10 mm from the limbus. Results: No post operative complications were detected in the operated eyes except a persistent corneal edema occupied the upper half of the cornea in one case. Hyphaema was very mild and seen only in two cases which resolved quickly two days after surgery. Endoscopical evaluation for the operated eyes revealed a normal ocular fundus with clearly visible optic papilla, tapetum and retinal blood vessels. No evidence of hemorrhage, infection, adhesions or retinal abnormalities was detected. Conclusion: Ahmed glaucoma valve is safe and effective implant for treatment of uveitic glaucoma in dogs.

Keywords: Ahmed valve, endoscopy, glaucoma, ocular fundus

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Authors: Dainius Genys, Vylius Leonavicius, Ricardas Krikstolaitis

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Energy security problems in Lithuania are analyzed on a regular basis; however, there is no comprehensive research on the very issue of the concept of public energy security. There is a lack of attention not only to social determinants of perception of energy security, but also a lack of a deeper analysis of the public opinion. This article aims to research the Lithuanian public perception of energy security. Complex tasks were set during the sociological study. Survey questionnaire consisted of different sets of questions: view of energy security (risk perception, political orientation, and energy security; comprehensiveness and energy security); view of energy risks and threats (perception of energy safety factors; individual dependence and burden; disobedience and risk); view of the activity of responsible institutions (energy policy assessment; confidence in institutions and energy security), demographic issues. In this article, we will focus on two aspects: a) We will analyze public opinion on the most important aspects of energy security and social factors influencing them; The hypothesis is made that public perception of energy security is related to value orientations: b) We will analyze how public opinion on energy policy executed by the government and confidence in the government are intertwined with the concept of energy security. Data of the survey, conducted on May 10-19 and June 7-17, 2013, when Seimas and the government consisted of the coalition dominated by Social Democrats with Labor, Order and Justice Parties and the Electoral Action of Poles, were used in this article. It is important to note that the survey was conducted prior to Russia’s occupation of the Crimea.

Keywords: energy security, public opinion, risk, energy threat, energy security policy

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Authors: Waqed H. Almohammed, Mohammed Y. Fattah, Sajjad E. Rasheed

Abstract:

Dynamic traffic loads cause deformation of underground pipes, resulting in vehicle discomfort. This makes it necessary to reinforce the layers of soil above underground pipes. In this study, the subbase layer was reinforced. Finite element software (PLAXIS 3D) was used to in the simulation, which includes geocell reinforcement, vehicle loading, soil layers and Glass Fiber Reinforced Plastic (GRP) pipe. Geocell reinforcement was modeled using a geogrid element, which was defined as a slender structure element that has the ability to withstand axial stresses but not to resist bending. Geogrids cannot withstand compression but they can withstand tensile forces. Comparisons have been made between the numerical models and experimental works, and a good agreement was obtained. Using the mathematical model, the performance of three different pipes of diameter 600 mm, 800 mm, and 1000 mm, and three different vehicular speeds of 20 km/h, 40 km/h, and 60 km/h, was examined to determine their impact on surface settlement and vertical pressure at the pipe crown for two cases: with and without geocell reinforcement. The results showed that, for a pipe diameter of 600 mm under geocell reinforcement, surface settlement decreases by 94 % when the speed of the vehicle is 20 km/h and by 98% when the speed of the vehicle is 60 km/h. Vertical pressure decreases by 81 % when the diameter of the pipe is 600 mm, while the value decreases to 58 % for a pipe with diameter 1000 mm. The results show that geocell reinforcement causes a significant and positive reduction in surface settlement and vertical stress above the pipe crown, leading to an increase in pipe safety.

Keywords: dynamic loading, finite element, geocell-reinforcement, GRP pipe, PLAXIS 3D, surface settlement

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Authors: Ateeth Shetty, K. S. Jayappa, Ratheesh Ramakrishnan, A. S. Rajawat

Abstract:

Suspended Sediment Concentration (SSC) was estimated for the period of four months (November, 2013 to February 2014) using Oceansat-2 (Ocean Colour Monitor) satellite images to understand the coastal dynamics and regional sediment transport, especially distribution and budgeting in coastal waters. The coastal zone undergoes continuous changes due to natural processes and anthropogenic activities. The importance of the coastal zone, with respect to safety, ecology, economy and recreation, demands a management strategy in which each of these aspects is taken into account. Monitoring and understanding the sediment dynamics and suspended sediment transport is an important issue for coastal engineering related activities. A study of the transport mechanism of suspended sediments in the near shore environment is essential not only to safeguard marine installations or navigational channels, but also for the coastal structure design, environmental protection and disaster reduction. Such studies also help in assessment of pollutants and other biological activities in the region. An accurate description of the sediment transport, caused by waves and tidal or wave-induced currents, is of great importance in predicting coastal morphological changes. Satellite-derived SSC data have been found to be useful for Indian coasts because of their high spatial (360 m), spectral and temporal resolutions. The present paper outlines the applications of state‐of‐the‐art operational Indian Remote Sensing satellite, Oceansat-2 to study the dynamics of sediment transport.

Keywords: suspended sediment concentration, ocean colour monitor, sediment transport, case – II waters

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Authors: Hesham Abd Elkhalek, Sherif M. Hafez, Yasser M. El Fahham

Abstract:

Allocating limited budget to maintain bridge networks and selecting effective maintenance strategies for each bridge represent challenging tasks for maintenance managers and decision makers. In Egypt, bridges are continuously deteriorating. In many cases, maintenance works are performed due to user complaints. The objective of this paper is to develop a practical and reliable framework to manage the maintenance, repair, and rehabilitation (MR&R) activities of Bridges network considering performance and budget limits. The model solves an optimization problem that maximizes the average condition of the entire network given the limited available budget using Genetic Algorithm (GA). The framework contains bridge inventory, condition assessment, repair cost calculation, deterioration prediction, and maintenance optimization. The developed model takes into account multiple parameters including serviceability requirements, budget allocation, element importance on structural safety and serviceability, bridge impact on network, and traffic. A questionnaire is conducted to complete the research scope. The proposed model is implemented in software, which provides a friendly user interface. The framework provides a multi-year maintenance plan for the entire network for up to five years. A case study of ten bridges is presented to validate and test the proposed model with data collected from Transportation Authorities in Egypt. Different scenarios are presented. The results are reasonable, feasible and within acceptable domain.

Keywords: bridge management systems (BMS), cost optimization condition assessment, fund allocation, Markov chain

Procedia PDF Downloads 291

Authors: Jiraporn Prommaha

Abstract:

The purpose of this research is to study the development of Thailand Brand Identity and the perception of its image in order to find any guidelines for the identity development and the image perception of Thailand Brand in Health and Wellness Tourism. The paper is conducted through mixed methods research, both the qualitative and quantitative researches. The qualitative focuses on the in-depth interview of executive administrations from public and private sectors involved scholars and experts in identity and image issue, main 11 people. The quantitative research was done by the questionnaires to collect data from foreign tourists 800; Chinese tourists 400 and UK tourists 400. The technique used for this was the Exploratory Factor Analysis (EFA), this was to determine the relation between the structures of the variables by categorizing the variables into group by applying the Varimax rotation technique. This technique showed recognition the Thailand brand image related to the 2 countries, China and UK. The results found that guidelines for brand identity development and image perception of health and wellness tourism in Thailand; as following (1) Develop communication in order to understanding of the meaning of the word 'Health and beauty tourism' throughout the country, (2) Develop human resources as a national agenda, (3) Develop awareness rising in the conservation and preservation of natural resources of the country, (4) Develop the cooperation of all stakeholders in Health and Wellness Businesses, (5) Develop digital communication throughout the country and (6) Develop safety in Tourism.

Keywords: brand identity, image perception, nation branding, health and wellness tourism, mixed methods research

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Authors: Thodoris Tsagkaris, Marios Stavropoulos, Panagiotis Theodosis-Nobelos, Charalampos Triantis

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Isotretinoin is a widely used therapeutic for the treatment of acne vulgaris and various other skin disorders. However, since its approval, many side effects and contraindications have been described, particularly important, such as teratogenicity as well as liver disease and dermal deterioration. In a very important allegation, isotretinoin has been linked with psychiatric symptoms like depression, suicidal ideation, schizophrenia, and hypervitaminosis A syndrome characteristics. These adverse effects have raised significant concerns regarding the safety of isotretinoin. Numerous studies and research have associated isotretinoin with side effects on the mental health of patients and have proposed plausible mechanisms regarding this suspected causative relationship. However, the evidence is still contradicting, and the data disperse, making their validity less valuable. Thus, in the present study, we aim to analyze further the available literature and present a complete analysis of the side effects of isotretinoin, with particular emphasis on the effects it may have on the mental health of patients. The review is based on international articles from broad scientific electronic databases like PubMed and Scopus. This review concludes that although many studies have associated isotretinoin with mental effects like depression, bipolar disorder, schizophrenia, and suicidal ideation, the data are still insufficient and often contradictory. In fact, additional studies with accurate data and larger double-blinded samples, and more analytic systematic reviews are required. It is especially important to monitor the dose and the intervals that isotretinoin has to be administered in order to potentially cause mental health problems, as well as the duration of treatment and the role that the patient's medical and pharmaceutical history may play.

Keywords: acne, depression, isotretinoin, mental health

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Authors: Carol Yue-En Ong, Angelina Hui-Min Tan, Quan Liu, Paul Chi-Lui Ho

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A public general hospital in Singapore has recently implemented an automated unit-dose machine in their inpatient dispensary, Swisslog, with the objective of reducing human error and improving patient safety. However, a concern in stability arises as tablets are removed from their original packaging (bottled loose tablets/capsules) and are repackaged into individual, clear plastic wrappers as unit doses in the system. Drugs that are light-sensitive and hygroscopic would be more susceptible to degradation as the wrapper does not offer full protection. Hence, this study was carried out to study the stability of haloperidol tablets and phenytoin capsules that are light-sensitive and hygroscopic respectively. Validated HPLC-UV assays were first established for quantification of these two compounds. The medications involved were put in the Swisslog and sampled every week for one month. The collected data was analysed and showed no degradation over time. This study also explored an alternative approach for drug stability determination-Raman spectroscopy. The advantage of Raman spectroscopy is its high time efficiency and non-destructive nature. The results suggest that drug degradation can indeed be detected using Raman microscopy, but further research is needed to establish this approach for quantification or qualification of compounds. NanoRam®, a portable Raman spectrocope was also used alongside Raman microscopy but was unsuccessful in detecting degradation in this study.

Keywords: drug stability, haloperidol, HPLC, phenytoin, raman spectroscopy, Swisslog

Procedia PDF Downloads 347

Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, L. Di Thommazo, D. Braatz

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Prototypes can be understood as representations of a product concept. Furthermore, prototyping consists in an important stage in product development and results in better team communication, decision making, testing and problem solving through feedback. Although there are several methods of prototyping suggested by recent studies for designers to choose from, some methods present different advantages, such as cost and time reduction, performance and fidelity, which should be taken in account during a product development project. In this multidisciplinary study, involving areas of physiotherapy, engineering and computer science (hardware and software), we compared four developed prototypes of an ergometric step: a virtual prototype, a 3D printed prototype, a bricolage prototype and a prototype manufactured by a third-party company. These prototypes were evaluated in a comparative-qualitative approach for their contribution to the concept’s maturation of the product, the different prototyping methods used and the advantages and disadvantages of each one based on the product’s design specifications (performance, safety, materials, cost, maintenance, usability, ergonomics and portability). Our results indicated that despite prototypes show overall advantages, all of them have limitations, thus being crucial to have different methods of testing and interacting with the product. Additionally, virtual and 3D printed prototypes were essential at early stages of the project due to their low-cost and high-fidelity representation of the product, while the prototype manufactured by a third-party company and bricolage prototype introduced functional tests in real scenarios, allowing more detailed evaluations. This study also resulted in a patent for an ergometric step.

Keywords: Product Design, Product Development, Prototypes, Step

Procedia PDF Downloads 117

Authors: Rujnan Tuna, Ayse Cil Akinci

Abstract:

Work life takes up an important place in human life, and an employed person faces many stimuli from internal and external environments and is affected by them in a positive or negative way. Also, the handover process, which is the process of sharing information about the patient with other health professionals, is an important criterion to maintain patient care and enhance the quality of care provided. Handover is a key component for sustaining daily basic clinical practices and is also essential to maintain the safe patient care. This investigation followed a descriptive and correlation design in order to establish job stress and the handover efficiency of nurses and the relationship in between. The study was conducted with 192 nurses working in a public hospital in Istanbul between January and March 2017. Descriptive information form, Job Stressors Scale, and Handover Evaluation Scale were used to collect the data of the study. The data were analyzed by using IBM SPSS Statistics 22.0 statistical software. Approvals from participants, managers of institution, and ethics committee were taken for the study. As a result of the research, it was found that job stress was above the median value, and the highest score in the ‘work role conflict’ subdimension. Also, it was found that the effectiveness of the nurses' handover effectiviness was above the median value and the highest score in the ‘quality of information’ subdimension. In the study, there was a negatively weak correlation between ‘work role overload’ subdimension of Job Stressors Scale and ‘interaction and support’ subdimension of Handover Evaluation Scale. There is a need for further study in order to maintain patient safety.

Keywords: handover, job stress, nurse, patient

Procedia PDF Downloads 168

Authors: Bo Zhang, Ellen S. Wilschut, Dehlia M. C. Willemsen, Marieke H. Martens

Abstract:

With the rapid development of intelligent transportation systems, automated platooning of trucks is drawing increasing interest for its beneficial effects on safety, energy consumption and traffic flow efficiency. Nevertheless, one major challenge lies in the safe transition of control from the automated system back to the human drivers, especially when they have been inattentive after a long period of highly automated driving. In this study, we investigated driver take-over time after a system initiated request to leave the platooning system Virtual Tow Bar in a non-critical scenario. 22 professional truck drivers participated in the truck driving simulator experiment, and each was instructed to drive under three experimental conditions before the presentation of the take-over request (TOR): driver ready (drivers were instructed to monitor the road constantly), driver not-ready (drivers were provided with a tablet) and eye-shut. The results showed significantly longer take-over time in both driver not-ready and eye-shut conditions compared with the driver ready condition. Further analysis revealed hand movement time as the main factor causing long response time in the driver not-ready condition, while in the eye-shut condition, gaze reaction time also influenced the total take-over time largely. In addition to comparing the means, large individual differences can be found especially in two driver, not attentive conditions. The importance of a personalized driver readiness predictor for a safe transition is concluded.

Keywords: driving simulation, highly automated driving, take-over time, transition of control, truck platooning

Procedia PDF Downloads 253