Search results for: life prediction

Authors: N. Abbas, S. Lagomarsino, S. Cattari

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Examining existing experimental results for shallow rigid foundations subjected to vertical centric load (N), accompanied or not with a bending moment (M), two main non-linear mechanisms governing the cyclic ‎response of the soil-foundation system can be distinguished: foundation uplift and soil yielding. A soil-foundation failure limit, is defined as a domain of resistance in the two dimensional (2D) load space (N, M) inside of which lie all the admissible combinations of loads; these latter correspond to a pure elastic, non-linear elastic or plastic behavior of the soil-foundation system, while the points lying on the failure limit correspond to a combination of loads leading to a failure of the soil-foundation system. In this study, the proposed resistance domain is constructed analytically based on mechanics. Original elastic limit, uplift initiation ‎limit and iso-uplift limits are constructed inside this domain. These limits give a prediction ‎of the mechanisms activated for each combination of loads applied to the ‎foundation. A comparison of the proposed failure limit with experimental tests existing in the literature shows interesting results. Also, the developed uplift initiation limit and iso-uplift curves are confronted with others already proposed in the literature and widely used due to the absence of other alternatives, and remarkable differences are noted, showing evident errors in the past proposals and relevant accuracy for those given in the present work.

Keywords: foundation uplift, iso-uplift curves, resistance domain, soil yield

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Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

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Authors: Akeem Akinboro, Bala Alhaj Kegun

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Haemoglobinopathy is a genetic disorder that has the potentiality to cause death of individuals in whom both the alpha (α) and beta (β) globin chains of the haemoglobin molecule are defective due to mutations in their genes. The haemoglobin genotype variants among some residents of Niger state, Nigeria, were determined using the secondary data available at Bida, Minna and Kotangora general hospitals of the state. A total of 1,639 data, representing 434, 655 and 550, collected from the outside patients who visited the medical laboratory units of the three general hospitals, respectively, over five years period (2015-2020) were analyzed into gene frequency, sex and age to determine their haemoglobin genotypes status. More males (51.6 – 58.7%) than females (41.3 – 48.4%) visited the three hospitals during the period covered and most of the patients were between 11 - 20 years old. The frequency of HbA allele in the human population was 0.72, 0.65, 0.68 for Bida, Minna and Kotangora, respectively, while it was 0.25, 0.29 and 0.28 for HbS allele. The HbC allele was prevalent at 0.03, 0.06 and 0.05 among the human population in Bida, Minna and Kotangora cities of Niger state. In overall, the prevalence of HbA, HbS and HbC alleles in Niger state of Nigeria was 0.68, 0.28 and 0.05. Minna being the capital city of Niger state and the most populous among the three cities in the state seems to have influx of more people who are carriers of abnormal haemoglobin genotypes which has resulted to higher frequency of HbS and HbC than those of the other two cities in this study. These results show that the pattern of haemoglobin genotypes frequency of Kontagora could be a prediction for the whole of Niger state. It is therefore necessary and important to take screening of blood for haemoglobin genotype serious among intending couples to prevent and reduce the possibility of having increase in the number of people with abnormal haemoglobin genotypes in the state.

Keywords: haemoglobin, genotype, niger state, gene frequency, general hospitals

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Authors: Md. Shams Razi Shopnil, Tanvir Imtiaz, Sabrina Mahjabin, Md. Sahadat Hossain

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Saturated hydraulic conductivity is one of the most significant attributes of pavement base course. Determination of hydraulic conductivity is a routine procedure for regular aggregate base courses. However, in many cases, a cement-stabilized base course is used with compromised drainage ability. Traditional hydraulic conductivity testing procedure is a readily available option which leads to two consequential drawbacks, i.e., the time required for the specimen to be saturated and extruding the sample after completion of the laboratory test. To overcome these complications, this study aims at formulating an empirical approach to predicting hydraulic conductivity based on Unconfined Compressive Strength test results. To do so, this study comprises two separate experiments (Constant Head Permeability test and Unconfined Compressive Strength test) conducted concurrently on a specimen having the same physical credentials. Data obtained from the two experiments were then used to devise a correlation between hydraulic conductivity and unconfined compressive strength. This correlation in the form of a polynomial equation helps to predict the hydraulic conductivity of cement-treated pavement base course, bypassing the cumbrous process of traditional permeability and less commonly used horizontal permeability tests. The correlation was further corroborated by a different set of data, and it has been found that the derived polynomial equation is deemed to be a viable tool to predict hydraulic conductivity.

Keywords: hydraulic conductivity, unconfined compressive strength, recycled plastics, recycled concrete aggregates

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Authors: Eve-Andree Laramee

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The aesthetics and ethics of the Nuclear Anthropocene are explored through artists responses to the impact of radioactive materials on ecological systems, global issues, energy policies and ourselves. This presentation tracks and reveals the invisible traces of the nuclear weapons complex and the nuclear energy industry, in relation to environmental justice. Radioactive pollution transgresses international borders, boundaries between land and water, contaminating ecological systems. Radioactive waste is never disposed of; it is dispositioned, placed out of sight and out of mind. These materials leave behind an invisible toxic legacy lasting millions of years. As we are learning post-Fukushima, when climate change occurs and vulnerability spectrums shift, nuclear sites and the life forms surrounding them are at increased risk. By visualizing this contamination through art installations, videos, and social-sculpture interventions, information is shared with the public, raising awareness, and activating community participation in remediation and nonproliferation efforts. The emerging Ecological Art genre proposes paradigms sustainable with the life forms and resources of our planet. It is comprised of artists, scientists, philosophers and activists devoted to these. EcoArt is distinguished by a focus on systems and interrelationships within our environment: the ecological, geographic, political, biological and cultural. This presentation will cover artworks addressing the recent Fukushima meltdowns, weapons proliferation, climate change, radioactive waste disposal and environmental justice. Possibilities for art-and-science collaborations will be discussed as projects that sharpen our ethics and politics in our behaviors and social interactions. The presentation will consist of a PowerPoint talk (paper presentation) accompanied by images and video clips.

Keywords: art, ecology, environment, anthropocene, nuclear

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Authors: Etienne Provencal, David L. St-Pierre

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A facility exploiting only electronic gambling machines (EGMs) opened in 2007 in Quebec City, Canada under the name of Salons de Jeux du Québec (SdjQ). This facility is one of the first worldwide to rely on that business model. This paper models the performance of such EGMs. The interest from a managerial point of view is to identify the variables that can be controlled or influenced so that a comprehensive model can help improve the overall performance of the business. The EGM individual performance model contains eight different variables under study (Game Title, Progressive jackpot, Bonus Round, Minimum Coin-in, Maximum Coin-in, Denomination, Slant Top and Position). Using data from Quebec City’s SdjQ, a linear regression analysis explains 90.80% of the EGM performance. Moreover, results show a behavior slightly different than that of a casino. The addition of GameTitle as a factor to predict the EGM performance is one of the main contributions of this paper. The choice of the game (GameTitle) is very important. Games having better position do not have significantly better performance than games located elsewhere on the gaming floor. Progressive jackpots have a positive and significant effect on the individual performance of EGMs. The impact of BonusRound on the dependent variable is significant but negative. The effect of Denomination is significant but weakly negative. As expected, the Language of an EGMS does not impact its individual performance. This paper highlights some possible improvements by indicating which features are performing well. Recommendations are given to increase the performance of the EGMs performance.

Keywords: EGM, linear regression, model prediction, slot operations

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Authors: Ayoub Bouazza, Ali Faddouli, Said Amal, Rachid Benhida, Khaoula Khaless

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Brine waste generated from reverse osmosis (RO) desalination plants contains various valuable compounds, mainly salts, trace elements, and organic matter. These wastes are up to two times saltier than standard seawater. Therefore, there is a strong economic interest in recovering these salts. The current practice in desalination plants is to reject the brine back to the sea, which affects the marine ecosystem and the environment. Our study aims to bring forth a reliable management solution for the valorisation of waste brines. Natural evaporation, isothermal evaporation at 25°C and 50°C, and evaporation using continuous heating were used to crystallize valuable salts from a reverse osmosis desalination plant brine located on the Moroccan Atlantic coast. The crystallization sequence of the brine was studied in comparison with standard seawater. The X-Ray Diffraction (XRD) of the precipitated solid phases showed similar results, where halite was the main solid phase precipitated from both the brine and seawater. However, Jänecke diagram prediction, along with FREZCHEM simulations, showed that Kainite should crystallize before Epsomite and Carnallite. As the absence of kainite formation in many experiments in the literature has been related to the metastability of kainite and the critical relative humidity conditions, and the precipitation of K–Mg salts is very sensitive to climatic conditions. An evaporation process is proposed as a solution to achieve the predicted crystallization path and to affirm the recovery of Kainite.

Keywords: salts crystallization, reverse osmosis, solar evaporation, frezchem, ZLD

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Authors: Odeyemi Ifeoluwayemi, Maha Joushua, Fulani Omoyeni

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In the search for sustainability, over time, architectural approaches to design have moved from just nature inspired design to the study of nature’s principles to produce effective designs that solve the issue of sustainability. Nature has established materials, shapes and processes that are effective right from a minor scale to an enormous scale. A branch of human knowledge that studies nature is called biology. Biology helps us to grasp and understand nature. Biomimicry is a new way of viewing and valuing nature, based not on what we can extract from the natural world but on what we can learn from it. Life has sustained on the earth for the last 3.85 billion years, and it is necessary for us to find out how life has been able to stay sustained for that long. The building must teach the society new ecological morals, thus, a better understanding of how nature works can usefully inspire architectural designs to resolve issues that have already been resolved by nature. This will not only help in creating a healthy environment but will also produce positive environmental impacts. Biomimetic Architecture connects and reproduces the ideologies found in nature in order to create built environment which benefit people and other living creatures as well as preserving it for the future. Understanding the bioprocess would lead to the establishment of ecological approaches that serve as a platform for creating a built environment that goes beyond sustaining current settings but also mimic nature’s regenerative ecosystem. This paper aims to explain these design methods under the name of biomimicry and biomimetic architecture by reviewing literature and research works done by examining these approaches classified as forms, processes and ecosystems. It is expected that this research will provide information that would, therefore, lead to the creation of buildings that are eco-friendly and provide greater comfort to the populaces.

Keywords: biomimetic architecture, biomimicry, ecological design, nature

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Authors: Melina Kopke, Jelle Van Dijk

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Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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Authors: Oyesoji Aremu, Taiwo Williams

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This study examined some factors (academic self-efficacy, locus of control, motivation and gender) that could predict academic dishonesty among serially frustrated students in Ogun State, South West, Nigeria. Serial academically frustrated students are students who are unable to attain and meet academic expectations set by themselves or significant others. A sample of 250 undergraduate students selected from two faculties from a University in Ogun State,South West Nigeria took part in the study. Multiple regression analysis was employed to determine the joint and relative contributions of the independent variables to the prediction of the dependent variable. T-test was used to test the hypothesis determining the gender difference between the independent variables (academic self-efficacy, locus of control and motivation) and academic dishonesty of serial academically frustrated male and female students. The results of the study showed all the independent variables jointly contributed to predicting academic dishonesty, while only academic self-efficacy and motivation had relative contributions to the dependent measure. There was no significant difference in the academic self-efficacy and motivation among males and females on academic dishonesty of the serial academically frustrated students but locus of control showed a significant difference between male and female students on academic dishonesty. Implications for counseling of the findings are discussed in the study.

Keywords: academic dishonesty, serially frustrated students, academic self-efficacy, locus of control

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Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

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Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

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Authors: Pradeep M. C. Chand

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Virtual infrastructure initiatives often spring from data center server consolidation projects, which focus on reducing existing infrastructure “box count”, retiring older hardware or life-extending legacy applications. Server consolidation benefits result from a reduction in the overall number of systems and related recurring costs (power, cooling, rack space, etc.) and also helps in the reduction of heat to the environment.

Keywords: server virtualization, data center, consolidation, project

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Authors: Daniel M. Muntean, Viorel Ungureanu

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More than half of the urban population in Romania lives today in residential buildings made out of large prefabricated reinforced concrete panels. Since their initial design was made in the 1960’s, these housing units are now being technically and morally outdated, consuming large amounts of energy for heating, cooling, ventilation and lighting, while failing to meet the needs of the contemporary life-style. Due to their widespread use, the design of a system that improves their energy efficiency would have a real impact, not only on the energy consumption of the residential sector, but also on the quality of life that it offers. Furthermore, with the transition of today’s existing power grid to a “smart grid”, buildings could become an active element for future electricity networks by contributing in micro-generation and energy storage. One of the most addressed issues today is to find locally adapted strategies that can be applied considering the 20-20-20 EU policy criteria and to offer sustainable and innovative solutions for the cost-optimal energy performance of buildings adapted on the existing local market. This paper presents a possible adaptive design scenario towards sustainable retrofitting of these housing units. The apartments are transformed in order to meet the current living requirements and additional extensions are placed on top of the building, replacing the unused roof space, acting not only as housing units, but as active solar energy collection systems. An adaptive building envelope is ensured in order to achieve overall air-tightness and an elevator system is introduced to facilitate access to the upper levels.

Keywords: adaptive building, energy efficiency, retrofitting, residential buildings, smart grid

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Authors: Adeniyi G. Adeogun, Bolaji F. Sule, Adebayo W. Salami, Michael O. Daramola

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Estimation of water yield and water balance in a river catchment is critical to the sustainable management of water resources at watershed level in any country. Therefore, in the present study, Soil and Water Assessment Tool (SWAT) interfaced with Geographical Information System (GIS) was applied as a tool to predict water balance and water yield of a catchment area in Nigeria. The catchment area, which was 12,992km2, is located upstream Jebba hydropower dam in North central part of Nigeria. In this study, data on the observed flow were collected and compared with simulated flow using SWAT. The correlation between the two data sets was evaluated using statistical measures, such as, Nasch-Sucliffe Efficiency (NSE) and coefficient of determination (R2). The model output shows a good agreement between the observed flow and simulated flow as indicated by NSE and R2, which were greater than 0.7 for both calibration and validation period. A total of 42,733 mm of water was predicted by the calibrated model as the water yield potential of the basin for a simulation period 1985 to 2010. This interesting performance obtained with SWAT model suggests that SWAT model could be a promising tool to predict water balance and water yield in sustainable management of water resources. In addition, SWAT could be applied to other water resources in other basins in Nigeria as a decision support tool for sustainable water management in Nigeria.

Keywords: GIS, modeling, sensitivity analysis, SWAT, water yield, watershed level

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Authors: Upasana Bhumbla

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Background: Hepatitis C virus is a major cause of chronic hepatitis, which can further lead to cirrhosis of the liver and hepatocellular carcinoma. Worldwide the burden of Hepatitis C infection has become a serious threat to the human race. Hepatitis C virus (HCV) has population-specific genotypes and provides valuable epidemiological and therapeutic information. Genotyping and assessment of viral load in HCV patients are important for planning the therapeutic strategies. The aim of the study is to study the changing trends of prevalence and genotypic distribution of hepatitis C virus in a tertiary care hospital in Western India. Methods: It is a retrospective study; blood samples were collected and tested for anti HCV antibodies by ELISA in Dept. of Microbiology. In seropositive Hepatitis C patients, quantification of HCV-RNA was done by real-time PCR and in HCV-RNA positive samples, genotyping was conducted. Results: A total of 114 patients who were seropositive for Anti HCV were recruited in the study, out of which 79 (69.29%) were HCV-RNA positive. Out of these positive samples, 54 were further subjected to genotype determination using real-time PCR. Genotype was not detected in 24 samples due to low viral load; 30 samples were positive for genotype. Conclusion: Knowledge of genotype is crucial for the management of HCV infection and prediction of prognosis. Patients infected with HCV genotype 1 and 4 will have to receive Interferon and Ribavirin for 48 weeks. Patients with these genotypes show a poor sustained viral response when tested 24 weeks after completion of therapy. On the contrary, patients infected with HCV genotype 2 and 3 are reported to have a better response to therapy.

Keywords: hepatocellular, genotype, ribavarin, seropositive

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Authors: Assel Thami Lahlou, Soufiane Stouti, Ismail Lagrat, Hamid Mounir, Oussama Bouazaoui

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The purpose of this research work is to predict the helicopter from stalling by finding the minimum and maximum values that the pitch angle can take in order to fly in a hover state condition. The stall of a helicopter in hover occurs when the pitch angle is too small to generate the thrust required to support its weight or when the critical angle of attack that gives maximum lift is reached or exceeded. In order to find the minimum pitch angle, a 3D CFD simulation was done in this work using ANSYS FLUENT as the CFD solver. We started with a small value of the pitch angle θ, and we kept increasing its value until we found the thrust coefficient required to fly in a hover state and support the weight of the helicopter. For the CFD analysis, the Multiple Reference Frame (MRF) method with k-ε turbulent model was used to study the 3D flow around the rotor for θmin. On the other hand, a 2D simulation of the airfoil NACA 0012 was executed with a velocity inlet Vin=ΩR/2 to visualize the flow at the location span R/2 of the disk rotor using the Spallart-Allmaras turbulent model. Finding the critical angle of attack at this position will give us the ability to predict the stall in hover flight. The results obtained will be exposed later in the article. This study was so useful in analyzing the limitations of the helicopter’s main rotor and thus, in predicting accidents that can lead to a lot of damage.

Keywords: aerodynamic, CFD, helicopter, stall, blades, main rotor, minimum pitch angle, maximum pitch angle

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Authors: Filipa Cortez, Vanessa Pereira

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Introduction: The main challenge of obesity treatment is long-term weight loss maintenance. The 3 phases method is a weight loss program that combines a low carb and moderately high-protein diet, food supplements and a weekly one-to-one consultation with a certified nutritionist. Sustained weight control is the ultimate goal of phase 3. Success criterion was the minimum loss of 10% of initial weight and its maintenance after 12 months. Objective: The aim of this study was to identify factors associated with successful weight loss maintenance after 12 months at the end of 3 phases method. Methods: The study included 199 subjects that achieved their weight loss goal (phase 3). Weight and body mass index (BMI) were obtained at the baseline and every week until the end of the program. Therapeutic adherence was measured weekly on a Likert scale from 1 to 5. Subjects were considered in compliance with nutritional recommendation and supplementation when their classification was ≥ 4. After 12 months of the method, the current weight and number of previous weight-loss attempts were collected by telephone interview. The statistical significance was assumed at p-values < 0.05. Statistical analyses were performed using SPSS TM software v.21. Results: 65.3% of subjects met the success criterion. The factors which displayed a significant weight loss maintenance prediction were: greater initial percentage weight loss (OR=1.44) during the weight loss intervention and a higher number of consultations in phase 3 (OR=1.10). Conclusion: These findings suggest that the percentage weight loss during the weight loss intervention and the number of consultations in phase 3 may facilitate maintenance of weight loss after the 3 phases method.

Keywords: obesity, weight maintenance, low-carbohydrate diet, dietary supplements

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Authors: Sohil I. Alqazlan

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Introduction and Objectives: There is limited research focusing on young adults with intellectual disabilities (ID) and their experiences after finishing compulsory education, especially in the Middle Eastern/Arab countries. This paper aims to further understand the lives of young adults with ID in Riyadh [the capital city of Saudi Arabia], particularly as they go on to access Post-Secondary Education [PSE]. As part of this study, it is important to understand the roles of high schools in Riyadh in terms of preparing their students for post-school life. To achieve this, the researcher has asked Saudi Arabia’s Ministry of Education to provide student transition plans (TPs) for post-school opportunities. However, and unfortunately, high schools in Riyadh do not use transition plans for their students. Therefore, the researcher has requested individual education plans (IEPs) for students with ID in their final year at high school to find the type of support the students had regarding both their long- and short-term goals that might help them access PSE or the labour market. Methods: The researcher analysed 10 IEPs of students in their final year at high school. To achieve the aim of the study, the researcher compared these IEPs with expectations set out in the official IEP framework of the MoE in Saudi Arabia, such as collaboration on the IEP sample and the focus on adult life. By analysing the students’ IEPs in terms of various goals, this study attempts to highlight skills that might offer students more independence after finishing compulsory education and going on to PSE. Results: Unfortunately, communication between IEP team members proved persistently absent in the sample. This was clear from the fact that none of the team members, apart from the SEN teachers, had signed any of the IEPs. Thus, none of the daily or weekly goals outlined were sent to parents to review at home. As a result of this, there were no goals in the IEPs that clearly referred to PSE. However, some long-term goals were set which might help those with ID become more independent in their adult life. For example, in the IEPs, which dealt with computer skills, the student had goals related to using Microsoft Word. Finally, just one goal of these IEPs set an important independent skill for the young adults with ID: “the student will learn how to use public transportation”. Conclusions: From analysing the ten IEPs, it was clear that SEN teachers in Riyadh schools were working without any help from other professionals. The students with ID, as well as their families, were not consulted on their views on important goals. Therefore, more work needs to be done with the students regarding their transition to PSE, perhaps by building partnerships between high schools and potential PSE institutions. Finally, more PSE programmes and a higher level of employer awareness could help create a bridge for students transferring from high school to PSE. Schools could also focus their IEP goals towards specific PSE programmes the student might attend, which could increase their chances of success.

Keywords: high school, post-secondary education, PSE, students with intellectual disabilities

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Authors: G. S. Ayyappan, Srinivas Kota, Jaffer R. C. Sheriff, C. Prakash Chandra Joshua

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In the present scenario of energy crises, energy conservation in the electrical machines is very important in the industries. In order to conserve energy, one needs to monitor the performance of an induction motor on-site and in-situ. The instruments available for this purpose are very meager and very expensive. This paper deals with the design and development of induction motor performance analyser on-line, on-site, and in-situ. The system measures only few electrical input parameters like input voltage, line current, power factor, frequency, powers, and motor shaft speed. These measured data are coupled to name plate details and compute the operating efficiency of induction motor. This system employs the method of computing motor losses with the help of equivalent circuit parameters. The equivalent circuit parameters of the concerned motor are estimated using the developed algorithm at any load conditions and stored in the system memory. The developed instrument is a reliable, accurate, compact, rugged, and cost-effective one. This portable instrument could be used as a handy tool to study the performance of both slip ring and cage induction motors. During the analysis, the data can be stored in SD Memory card and one can perform various analyses like load vs. efficiency, torque vs. speed characteristics, etc. With the help of the developed instrument, one can operate the motor around its Best Operating Point (BOP). Continuous monitoring of the motor efficiency could lead to Life Cycle Assessment (LCA) of motors. LCA helps in taking decisions on motor replacement or retaining or refurbishment.

Keywords: energy conservation, equivalent circuit parameters, induction motor efficiency, life cycle assessment, motor performance analysis

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Authors: E. Heintz, H. J. van Lent, K. Glass, J. Lim

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The trend for sodium reduction in food products is clear. Following the World Health Organization (WHO) publication on sodium usage and intake, several countries have introduced initiatives to reduce food-related sodium intake. As salt is a common food preservative, this trend motivates the formulation of a suitable additive with comparable benefits of shelf life extension and microbial safety. Organic acid derivatives like acetates are known as generic microbial growth inhibitors and are commonly applied as additives to meet food safety demands. However, modern consumers have negative perceptions towards -synthetic-derived additives and increasingly prefer natural alternatives. Vinegar, for example, is a well-known natural fermentation product used in food preservation. However, the high acidity of vinegar often makes it impractical for direct use in meat products and a neutralized form would be desirable. This research demonstrates the efficacy of powdered vinegar (Provian DV) in inhibiting Listeria and spoilage organisms (LAB) to increase safety and shelf life of meat products. For this, the efficacy of Provian DV was compared to the efficacy of Provian K, a commonly used sodium free acetate-based preservative, which is known for its inhibition against Listeria. Materials & methods— Cured pork hams: Ingredients: Pork ham muscle, water, salt, dextrose, sodium tripolyphosphate, carrageenan, sodium nitrite, sodium erythorbate, and starch. Targets: 73-74% moisture, 1.75+0.1% salt, and pH 6.4+0.1. Treatments: Control (no antimicrobials), Provian®K 0.5% and 0.75%, Provian®DV 0.5%, 0.65%, 0.8% and 1.0%. Meat formulations in casings were cooked reaching an internal temperature of 73.9oC, cooled overnight and stored for 4 days at 4oC until inoculation. Inoculation: Sliced products were inoculated with approximately 3-log per gram of a cocktail of L. monocytogenes (including serotypes 4b, 1/2a and 1/2b) or LAB-cocktail (C. divergens and L. mesenteroides). Inoculated slices were vacuum packaged and stored at 4oC and 7°C. Samples were incubated 28 days (LAB) or 12 weeks (L. monocytogenes) Microbial analysis: Microbial populations were enumerated in rinsate obtained after adding 100ml of sterile Butterfield’s phosphate buffer to each package and massaging the contents externally by hand. L. monocytogenes populations were determined on triplicate samples by surface plating on Modified Oxford agar whereas LAB plate counts were determined on triplicate samples by surface plating on All Purpose Tween agar with 0.4% bromocresol purple. Proximate analysis: Triplicate non-inoculated ground samples were analyzed for the moisture content, pH, aw, salt, and residual nitrite. Results—The results confirmed the no growth of Listeria on cured ham with 0.5% Provian K stored at 4°C and 7°C for 12 weeks, whereas the no-antimicrobial control showed a 1-log increase within two weeks. 0.5% Provian DV demonstrated similar efficacy towards Listeria inhibition at 4°C while 0.65% Provian DV was required to match the Listeria control at 7°C. 0.75% Provian K and 1% Provian DV were needed to show inhibition of the LAB for 4 weeks at both temperatures. Conclusions—This research demonstrated that it is possible to increase safety and shelf life of cured ready-to-eat ham using preservatives that meet current food trends, like sodium reduction and natural origin.

Keywords: food safety, natural preservation, listeria control, shelf life extension

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Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: B. Elshafei, X. Mao

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The demand for renewable energy is significantly increasing, major investments are being supplied to the wind power generation industry as a leading source of clean energy. The wind energy sector is entirely dependable and driven by the prediction of wind speed, which by the nature of wind is very stochastic and widely random. This s0tudy employs deep multi-fidelity Gaussian process regression, used to predict wind speeds for medium term time horizons. Data of the RUNE experiment in the west coast of Denmark were provided by the Technical University of Denmark, which represent the wind speed across the study area from the period between December 2015 and March 2016. The study aims to investigate the effect of pre-processing the data by denoising the signal using empirical wavelet transform (EWT) and engaging the vector components of wind speed to increase the number of input data layers for data fusion using deep multi-fidelity Gaussian process regression (GPR). The outcomes were compared using root mean square error (RMSE) and the results demonstrated a significant increase in the accuracy of predictions which demonstrated that using vector components of the wind speed as additional predictors exhibits more accurate predictions than strategies that ignore them, reflecting the importance of the inclusion of all sub data and pre-processing signals for wind speed forecasting models.

Keywords: data fusion, Gaussian process regression, signal denoise, temporal extrapolation

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Authors: M. S. Matlala, I. Ignatious

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Environmental sustainability has taken the center stage in human life all over the world. Energy is the most essential component of our life. The conventional sources of energy are non-renewable and have a detrimental environmental impact. Therefore, there is a need to move from conventional to non-conventional renewable energy sources to satisfy the world’s energy demands. The study aimed at screening for microbial cellulolytic enzymes using a proteomic approach. The objectives were to screen for microbial cellulases with high specific activity and separate the cellulolytic enzymes using a combination of zymography and two-dimensional (2-D) gel electrophoresis followed by tryptic digestion, Matrix-assisted Laser Desorption Ionisation-Time of Flight (MALDI-TOF) and bioinformatics analysis. Fungal and bacterial isolates were cultured in M9 minimal and Mandel media for a period of 168 hours at 60°C and 30°C with cellobiose and Avicel as carbon sources. Microbial cells were separated from supernatants through centrifugation, and the crude enzyme from the cultures was used for the determination of cellulase activity, zymography, SDS-PAGE, and two-dimensional gel electrophoresis. Five isolates, with lytic action on carbon sources studied, were a bacterial strain (BARK) and fungal strains (VCFF1, VCFF14, VCFF17, and VCFF18). Peak cellulase production by the selected isolates was found to be 3.8U/ml, 2.09U/ml, 3.38U/ml, 3.18U/ml, and 1.95U/ml, respectively. Two-dimensional gel protein maps resulted in the separation and quantitative expression of different proteins by the microbial isolates. MALDI-TOF analysis and database search showed that the expressed proteins in this study closely relate to different glycoside hydrolases produced by other microbial species with an acceptable confidence level of 100%.

Keywords: cellulases, energy, two-dimensional gel electrophoresis, matrix-assisted laser desorption ionisation-time of flight, MALDI-TOF MS

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Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas

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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.

Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital

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Authors: Shohreh Ghasemi

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Introduction: Melanoma is a complex disease with various clinical and histopathological features that impact prognosis and treatment decisions. Traditional methods of melanoma prognosis involve manual examination and interpretation of clinical and histopathological data by dermatologists and pathologists. However, the subjective nature of these assessments can lead to inter-observer variability and suboptimal prognostic accuracy. AI, with its ability to analyze vast amounts of data and identify patterns, has emerged as a promising tool for improving melanoma prognosis. Methods: A comprehensive literature search was conducted to identify studies that employed AI techniques for melanoma prognosis. The search included databases such as PubMed and Google Scholar, using keywords such as "artificial intelligence," "melanoma," and "prognosis." Studies published between 2010 and 2022 were considered. The selected articles were critically reviewed, and relevant information was extracted. Results: The review identified various AI methodologies utilized in melanoma prognosis, including machine learning algorithms, deep learning techniques, and computer vision. These techniques have been applied to diverse data sources, such as clinical images, dermoscopy images, histopathological slides, and genetic data. Studies have demonstrated the potential of AI in accurately predicting melanoma prognosis, including survival outcomes, recurrence risk, and response to therapy. AI-based prognostic models have shown comparable or even superior performance compared to traditional methods.

Keywords: artificial intelligence, melanoma, accuracy, prognosis prediction, image analysis, personalized medicine

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Authors: Maryam Ghavam Sadri, Maryam Shahrooz

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Background: Nowadays the prevalence of metabolic syndrome (Mets) has taken on a growing trend. Studies have shown the relationship between vitamin D deficiency (VDD) status and Mets in children. Also studies have recorded that exerting strategies for vitamin D status improvement can help prevent Mets in children. This study investigated multiple strategies of prevention of Mets resulting from VDD in children. Methods: This review study has been done by using keywords related to the topic and 54 articles were found (2000-2015) that 25 were selected according to the indicators of Mets, supplementation and fortification of foods with vitamin D and attention to children environment and life style. Results: Studies have suggested the correlation between serum levels of vitamin D with waist circumference (p < 0.0001), systolic blood pressure (p=0.01), HOMA-IR (p=0.001) and HDL cholesterol (p < 0.0001). An inverse correlation between serum 25 (OH) D and HOMA-IR (p = 0.006) and insulin (P = 0.002) has been proved in overweight group. Higher HOMASDS and triglycerides found in vitamin D deficient obese children compared to control group without VDD (p=0.04). After supplementation with vitamin D, serum TG concentration decreases significantly (p=0.04), and improves insulin resistance (p=0.02). The prevalence of VDD is associated with time of watching TV (P < 0.01), hours of physical activity per week (P = 0.01), skipping breakfast (P < 0.001) soda intake (P < 0.001), and milk intake per day (P < 0.01). Conclusion: According to the beneficial role of vitamin D in prevention of Mets and proven relationship between serum levels of vitamin D and Mets indicators, we can prevent childhood Mets through the application of appropriate strategies such as supplementation and food fortification with vitamin D and positive changes in children life style with especial attention to physical activity in exposure of sunlight and their environment condition.

Keywords: children, metabolic syndrome, prevention strategies, vitamin D

Procedia PDF Downloads 551

Authors: Haruna Maama

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Environmental, social and governance (ESG) reporting is gaining considerable attention despite being voluntary. Meanwhile, it consumes resources to provide ESG reporting, raising a question of its value relevance. The study examined the impact of ESG reporting on the market value of listed firms in SSA. The annual and integrated reports of 276 listed sub-Sahara Africa (SSA) firms. The integrated reporting scores of the firm were analysed using a content analysis method. A multiple regression estimation technique using a GMM approach was employed for the analysis. The results revealed that ESG has a positive relationship with firms’ market value, suggesting that investors are interested in the ESG information disclosure of firms in SSA. This suggests that extensive ESG disclosures are attempts by firms to obtain the approval of powerful social, political and environmental stakeholders, especially institutional investors. Furthermore, the market value analysis evidence is consistent with signalling theory, which postulates that firms provide integrated reports as a signal to influence the behaviour of stakeholders. This finding reflects the value placed on investors' social, environmental and governance disclosures, which affirms the views that conventional investors would care about the social, environmental and governance issues of their potential or existing investee firms. Overall, the evidence is consistent with the prediction of signalling theory. In the context of this theory, integrated reporting is seen as part of firms' overall competitive strategy to influence investors' behaviour. The findings of this study make unique contributions to knowledge and practice in corporate reporting.

Keywords: environmental accounting, ESG accounting, signalling theory, sustainability reporting, sub-saharan Africa

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Authors: Andrew Fox, Qingping Yang, Yuanhong Zhao, Tao Zhang

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Furniture is a very significant subdivision of architecture and its inherent interior design activities. The furniture industry has developed from an artisan-driven craft industry, whose forerunners saw themselves manifested in their crafts and treasured a sense of pride in the creativity of their designs, these days largely reduced to an anonymous collective mass-produced output. Although a very conservative industry, there is great potential for the implementation of collaborative digital technologies allowing a reconfigured artisan experience to be reawakened in a new and exciting form. The furniture manufacturing industry, in general, has been slow to adopt new methodologies for a design using artificial and rule-based generative design. This tardiness has meant the loss of potential to enhance its capabilities in producing sustainable, flexible, and mass customizable ‘right first-time’ designs. This paper aims to demonstrate the concept methodology for the creation of alternative and inspiring aesthetic structures for robot-based additive manufacturing (RBAM). These technologies can enable the economic creation of previously unachievable structures, which traditionally would not have been commercially economic to manufacture. The integration of these technologies with the computing power of generative design provides the tools for practitioners to create concepts which are well beyond the insight of even the most accomplished traditional design teams. This paper aims to address the problem by introducing generative design methodologies employing the Autodesk Fusion 360 platform. Examination of the alternative methods for its use has the potential to significantly reduce the estimated 80% contribution to environmental impact at the initial design phase. Though predominantly a design methodology, generative design combined with RBAM has the potential to leverage many lean manufacturing and quality assurance benefits, enhancing the efficiency and agility of modern furniture manufacturing. Through a case study examination of a furniture artifact, the results will be compared to a traditionally designed and manufactured product employing the Ecochain Mobius product life cycle analysis (LCA) platform. This will highlight the benefits of both generative design and robot-based additive manufacturing from an environmental impact and manufacturing efficiency standpoint. These step changes in design methodology and environmental assessment have the potential to revolutionise the design to manufacturing workflow, giving momentum to the concept of conceiving a pre-industrial model of manufacturing, with the global demand for a circular economy and bespoke sustainable design at its heart.

Keywords: robot, manufacturing, generative design, sustainability, circular econonmy, product life cycle assessment, furniture

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Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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