Search results for: endome¬trial receptivity
626 User Satisfaction in Rama-Chest Mouthpiece for Flexible Bronchoscopy in Ramathibodi Hospital
Authors: Chariya Laohavich
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Background: Some limitations and complications have been found associated with commercial mouthpiece in bronchoscopic procedure. Therefore, we invented the Rama-chest mouthpiece from plastic normal saline bottle. Objective: The aim of this study was to compare user satisfaction in Rama-chest mouthpiece with the commercial mouthpiece. Methods: A prospective randomized controlled trial between commercial mouthpiece and Rama-chest mouthpiece was conducted on patients who were underwent bronchoscopy and required mouthpiece insertion from May to June 2014. The questionnaire about satisfaction was completed by the bronchoscopists, assistant nurses, and patients. Results: Thirty procedures in both groups were investigated. Mean satisfaction scores filled by the bronchoscopists and assistant nurses were not different between both groups. However, higher satisfaction score filled by the patients was found in Rama-chest mouthpiece than the comparator (p=0.011). Complications such as abrasion, pain, and itching were observed in commercial mouthpiece but not found in Rama-chest mouthpiece. Conclusion: We have introduced Rama-chest mouthpiece and proved its usefulness comparable to the commercial mouthpiece.Keywords: mouthpiece, bronchoscopist, bronchology, pulmonology and respiratory diseases
Procedia PDF Downloads 360625 Comparison of an Upflow Anaerobic Sludge Blanket and an Anaerobic Filter for Treating Wheat Straw Washwater
Authors: Syazwani Idrus, S. Charles J. Banks, Sonia Heaven
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The study compared the performance of upflow anaerobic sludge blanket (UASB) reactors and anaerobic filters (AF) for the treatment of wheat straw washwater (WSW) which has a high concentration of Potassium ions. The trial was conducted at mesophilic temperatures (37 °C). The digesters were started up over a 48-day period using a synthetic wastewater feed and reached an organic loading rate (OLR) of 6 g COD L^-1 day^-1 with a specific methane production (SMP) of 0.333 L CH4 g^-1 COD. When the feed was switched to WSW it was not possible to maintain the same loading rate as the SMP in all reactors fell sharply to less than 0.1 L CH4 g^-1 COD, with the AF affected more than the UASB. On reducing the OLR to 3 g COD L^-1 day^-1 the reactors recovered to produce 0.21 L CH4 g^-1 CODadded and gave 82% COD removal. A discrepancy between the COD consumed and the methane produced could be accounted for through increased maintenance energy requirement of the microbial community for osmo-regulation as K+ was found to accumulate in the sludge and in the UASB reached a concentration of 4.5 mg K g^-1 wet weight of granules.Keywords: anaerobic digestion, osmotic stress, chemical oxygen demand, specific methane production
Procedia PDF Downloads 652624 In situ Biodegradation of Endosulfan, Imidacloprid, and Carbendazim Using Indigenous Bacterial Cultures of Agriculture Fields of Uttarakhand, India
Authors: Geeta Negi, Pankaj, Anjana Srivastava, Anita Sharma
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In the present study, the presence of endosulfan, imidacloprid, carbendazim, in the soil /vegetables/cereals and water samples was observed in agriculture fields of Uttarakhand. In view of biodegradation of these pesticides, nine bacterial isolates were recovered from the soil samples of the fields which tolerated endosulfan, imidacloprid, carbendazim from 100 to 200 µg/ml. Three bacterial consortia used for in vitro bioremediation experiments were three bacterial isolates for carbendazim, imidacloprid and endosulfan, respectively. Maximum degradation (87 and 83%) of α and β endosulfan respectively was observed in soil slurry by consortium. Degradation of Imidacloprid and carbendazim under similar conditions was 88.4 and 77.5% respectively. FT-IR analysis of biodegraded samples of pesticides in liquid media showed stretching of various bonds. GC-MS of biodegraded endosulfan sample in soil slurry showed the presence of non-toxic intermediates. A pot trial with Bacterial treatments lowered down the uptake of pesticides in onion plants.Keywords: biodegradation, carbendazim, consortium, endosulfan
Procedia PDF Downloads 365623 A Randomised Controlled Trial and Process Evaluation of the Lifestart Parenting Programme
Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson
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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness
Procedia PDF Downloads 438622 Efficacy and Safety by Baseline A1c with Once-Weekly Dulaglutide in the AWARD Program
Authors: Alaa Mostafa, Samuel Dagogo-Jack, Vivian Thieu, Maria Yu, Nan Zhang, Dara Schuster, Luis-Emilio Garcia-Perez
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Dulaglutide (DU), a once-weekly glucagon-like peptide-1 receptor agonist, was studied in the AWARD clinical trial program in adult patients with type 2 diabetes (T2D) and demonstrated significant hemoglobin A1c (A1c) reduction and potential for weight loss. To evaluate the efficacy and safety of DU 1.5 mg and DU 0.75 mg in patients with T2D by baseline A1c <8.5% or ≥8.5%, a post-hoc analysis was conducted on AWARD-1 to -6 and -8 at 6 months. Across 7 studies, 55% to 82% of the DU-treated patients had a baseline A1c <8.5%, and 18% to 45% had a baseline A1c ≥8.5%. The ranges of A1c reductions with baseline A1c <8.5% and ≥8.5%, respectively, were: DU 1.5 mg: -0.67% to -1.25% and -1.22% to -2.37%; DU 0.75 mg: -0.53% to -1.07% and -1.37% to -2.19%. The A1c reduction from the pooled analysis was greater in patients with baseline A1c ≥8.5% than patients with baseline A1c <8.5%, respectively: DU 1.5 mg: -1.86% and -1.02%; DU 0.75 mg: -1.75% and -0.83%. DU treatments were well tolerated among baseline A1c subgroups. Across the AWARD program, DU 1.5 mg and DU 0.75 mg demonstrated significant A1c reduction in both subgroups with an acceptable safety profile. Compared to patients with baseline A1c <8.5%, patients with baseline A1c ≥8.5% had greater A1c reduction. Disclosures: This study was supported and conducted by Eli Lilly and Company, Indianapolis, IN, USA.Keywords: A1c reduction, dulaglutide, type 2 diabetes, weight loss
Procedia PDF Downloads 389621 Potential of Grass Silage as a Source of Nutrients in Poultry Production
Authors: Hamim Abbas, Jean Luc-Hornick, Isabelle Dufrasne
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Feed costs constitute over 60% of total expenses in organic layer poultry production, with feed protein supply being a significant concern. Alfalfa-based dehydrated silage pellets are mainly diets composed of leaves (ABSP), which are non-conventional protein sources that could enhance profits by reducing feed costs and ensuring consistent availability. This experiment studied the effects on the performances of Novogen Brown light layers of a commercial control diet replaced with 10% ABSP. After a 21-day trial, this diet (ABSP) has improved the laying rate, yolk color of eggs, feed conversion rate, ω−3 (PUFAs) and ω−6/ω−3 ratio (P<0.05) while the body weight and egg weight were degraded with the substitution of the ABSP in the diet(P>0.05). The laying rate showed a tendency to increase (P=0.06). These findings suggest that ABSP can replace at least 10% of the feed in organic layer diets without compromising production parameters negatively.Keywords: alfalfa, silage, pellet, organic layers
Procedia PDF Downloads 39620 Characterization and Design of a Crumb Rubber Modified Asphalt Mix Formulation
Authors: H. Al-Baghli
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Laboratory trial results of mixing crumb rubber produced from discarded tires with 60/70 pen grade Kuwaiti bitumen are presented on this paper. PG grading and multiple stress creep recovery tests were conducted on Kuwaiti bitumen blended with 15% and 18% crumb rubber at temperatures ranging from 40 to 70 °C. The results from elastic recovery and non-recoverable creep presented optimum performance at 18% rubber content. The optimum rubberized-bitumen mix was next transformed into a pelletized form (PelletPave®), and was used as a partial replacement to the conventional bitumen in the manufacture of continuously graded hot mix asphalts at a number of binder contents. The trialed PelletPave® contents were at 2.5%, 3.0%, and 3.5% by mass of asphalt mix. In this investigation, it was not possible to utilize the results of standard Marshall method of mix design (i.e. volumetric, stability and flow tests) and subsequently additional assessment of mix compactability was carried out using gyratory compactor in order to determine the optimum PelletPave® and total binder contents.Keywords: crumb rubber, Marshall mix design, PG grading, rubberized-bitumen
Procedia PDF Downloads 214619 A Methodology of Testing Beam to Column Connection under Lateral Impact Load
Authors: A. Al-Rifaie, Z. W. Guan, S. W. Jones
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Beam to column connection can be considered as the most important structural part that affects the response of buildings to progressive collapse. However, many studies were conducted to investigate the beam to column connection under accidental loads such as fire, blast and impact load to investigate the connection response. The study is a part of a PhD plan to investigate different types of connections under lateral impact load. The conventional test setups, such as cruciform setup, were designed to apply shear forces and bending moment on the connection, whilst, in the lateral impact case, the connection is subjected to combined tension and moment. Hence, a review is presented to introduce the previous test setup that is used to investigate the connection behaviour. Then, the design and fabrication of the novel test setup is presented. Finally, some trial test results to investigate the efficiency of the proposed setup are discussed. The final results indicate that the setup was efficient in terms of the simplicity and strength.Keywords: connections, impact load, drop hammer, testing methods
Procedia PDF Downloads 289618 The Effectiveness of Multi-Media Experiential Training Programme on Advance Care Planning in Enhancing Acute Care Nurses’ Knowledge and Confidence in Advance Care Planning Discussion: An Interim Report
Authors: Carmen W. H. Chan, Helen Y. L. Chan, Kai Chow Choi, Ka Ming Chow, Cecilia W. M. Kwan, Nancy H. Y. Ng, Jackie Robinson
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Introduction: In Hong Kong, a significant number of deaths occur in acute care wards, which requires nurses in these settings to provide end-of-life care and lead ACP implementation. However, nurses in these settings, in fact, have very low-level involvement in ACP discussions because of limited training in ACP conversations. Objective: This study aims to assess the impact of a multi-media experiential ACP (MEACP) training program, which is guided by the experiential learning model and theory of planned behaviour, on nurses' knowledge and confidence in assisting patients with ACP. Methodology: The study utilizes a cluster randomized controlled trial with a 12-week follow-up. Eligible nurses working in acute care hospital wards are randomly assigned at the ward level, in a 1:1 ratio, to either the control group (no ACP education) or the intervention group (4-week MEACP training program). The training programme includes training through a webpage and mobile application, as well as a face-to-face training workshop with enhanced lectures and role play, which is based on the Theory of Planned Behavior and Kolb's Experiential Learning Model. Questionnaires were distributed to assess nurses' knowledge (a 10-item true/false questionnaire) and level of confidence (five-point Likert scale) in ACP at baseline (T0), four weeks after the baseline assessment (T1), and 12 weeks after T1 (T2). In this interim report, data analysis was mainly descriptive in nature. Result: The interim report focuses on the preliminary results of 165 nurses at T0 (Control: 74, Intervention: 91) over a 5-month period, 69 nurses from the control group who completed the 4-week follow-up and 65 nurses from the intervention group who completed the 4-week MEACP training program at T1. The preliminary attrition rate is 6.8% and 28.6% for the control and intervention groups, respectively, as some nurses did not complete the whole set of online modules. At baseline, the two groups were generally homogeneous in terms of their years of nursing practice, weekly working hours, working title, and level of education, as well as ACP knowledge and confidence levels. The proportion of nurses who answered all ten knowledge questions correctly increased from 13.8% (T0) to 66.2% (T1) for the intervention group and from 13% (T0) to 20.3% (T1) for the control group. The nurses in the intervention group answered an average of 7.57 and 9.43 questions correctly at T0 and T1, respectively. They showed a greater improvement in the knowledge assessment at T1 with respect to T0 when compared with their counterparts in the control group (mean difference of change score, Δ=1.22). They also exhibited a greater gain in level of confidence at T1 compared to their colleagues in the control group (Δ=0.91). T2 data is yet available. Conclusion: The prevalence of nurses engaging in ACP and their level of knowledge about ACP in Hong Kong is low. The MEACP training program can enrich nurses by providing them with more knowledge about ACP and increasing their confidence in conducting ACP.Keywords: advance directive, advance care planning, confidence, knowledge, multi-media experiential, randomised control trial
Procedia PDF Downloads 73617 Risk Prioritization in Tunneling Construction Projects
Authors: David Nantes, George Gilbert
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There are a lot of risks that might crop up as a tunneling project develops, and it's crucial to be aware of them. Due to the unexpected nature of tunneling projects and the interconnectedness of risk occurrences, the risk assessment approach presents a significant challenge. The purpose of this study is to provide a hybrid FDEMATEL-ANP model to help prioritize risks during tunnel construction projects. The ambiguity in expert judgments and the relative severity of interdependencies across risk occurrences are both taken into consideration by this model, thanks to the Fuzzy Decision-Making Trial and Evaluation Laboratory (FDEMATEL). The Analytic Network Process (ANP) method is used to rank priorities and assess project risks. The authors provide a case study of a subway tunneling construction project to back up the validity of their methodology. The results showed that the proposed method successfully isolated key risk factors and elucidated their interplay in the case study. The proposed method has the potential to become a helpful resource for evaluating dangers associated with tunnel construction projects.Keywords: risk, prioritization, FDEMATEL, ANP, tunneling construction projects
Procedia PDF Downloads 82616 Suitable Die Shaping for a Rectangular Shape Bottle by Application of FEM and AI Technique
Authors: N. Ploysook, R. Rugsaj, C. Suvanjumrat
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The characteristic requirement for producing rectangular shape bottles was a uniform thickness of the plastic bottle wall. Die shaping was a good technique which controlled the wall thickness of bottles. An advance technology which was the finite element method (FEM) for blowing parison to be a rectangular shape bottle was conducted to reduce waste plastic from a trial and error method of a die shaping and parison control method. The artificial intelligent (AI) comprised of artificial neural network and genetic algorithm was selected to optimize the die gap shape from the FEM results. The application of AI technique could optimize the suitable die gap shape for the parison blow molding which did not depend on the parison control method to produce rectangular bottles with the uniform wall. Particularly, this application can be used with cheap blow molding machines without a parison controller therefore it will reduce cost of production in the bottle blow molding process.Keywords: AI, bottle, die shaping, FEM
Procedia PDF Downloads 233615 Polishing Machine Based on High-Pressure Water Jet
Authors: Mohammad A. Khasawneh
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The design of high pressure water jet based polishing equipment and its fabrication conducted in this study is reported herein, together with some preliminary test results for assessing its applicability for HMA surface polishing. This study also provides preliminary findings concerning the test variables, such as the rotational speed, the water jet pressure, the abrasive agent used, and the impact angel that were experimentally investigated in this study. The preliminary findings based on four trial tests (two on large slab specimens and two on small size gyratory compacted specimens), however, indicate that both friction and texture values tend to increase with the polishing durations for two combinations of pressure and rotation speed of the rotary deck. It seems that the more polishing action the specimen is subjected to; the aggregate edges are created such that the surface texture values are increased with the accompanied increase in friction values. It may be of interest (but which is outside the scope of this study) to investigate if the similar trend exist for HMA prepared with aggregate source that is sand and gravel.Keywords: high-pressure, water jet, friction, texture, polishing, statistical analysis
Procedia PDF Downloads 480614 A Patient-Centered Approach to Clinical Trial Development: Real-World Evidence from a Canadian Medical Cannabis Clinic
Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk
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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.Keywords: medical cannabis, safety, real-world data, Canada
Procedia PDF Downloads 126613 Ascorbic Acid Application Mitigates the Salt Stress Effects on Helianthus annuus L. Plants Grown on a Reclaimed Saline Soil
Authors: Mostafa M. Rady, Majed M. Howladar, Saad M. Howladar
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A field trial was conducted during two successive seasons (2013 and 2014) in Southeast Fayoum, Egypt (29º 17'N; 30º 53'E) to investigate the improving effect of ascorbic acid (Vit C) foliar spray at the rates of 0, 1, 2 or 3 mM on the growth, seed and oil yields, and some chemical constituents of sunflower plants grown on a reclaimed saline soil (EC = 7.98–7.83). Vit C application at all rates (1, 2 and 3 mM) was significantly increased growth traits, seed and oil yields, and the concentrations of endogenous Vit C, leaf photosynthetic pigments, total soluble sugars, free proline and nutrient elements as well as K/Na ratio. In contrast, Na concentration was significantly reduced with the application of all Vit C levels. Vit C foliar spray at the rate of 2 mM was found to be the best treatment, alleviating the inhibitory effects of salinity on sunflower plants grown on a reclaimed saline soil.Keywords: Helianthus annuus L., Vit C, salinity, growth, seed and oil yields, osmoprotectants
Procedia PDF Downloads 412612 A Randomized, Controlled Trial to Test Habit Formation Theory for Low Intensity Physical Exercise Promotion in Older Adults
Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson
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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.Keywords: aging, exercise, habit, walking
Procedia PDF Downloads 134611 Effect of Concrete Waste Quality on the Compressive Strength of Recycled Concrete
Authors: Kebaili Bachir
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The reuse of concrete waste as a secondary aggregate could be an efficient solution for sustainable development and long-term environmental protection. The variable nature of waste concrete, with various compressive strengths, can have a negative effect on the final compressive strength of recycled concrete. Accordingly, an experimental test programme was developed to evaluate the effect of parent concrete qualities on the performance of recycled concrete. Three grades with different compressive strengths 10MPa, 20MPa, and 30MPa were considered in the study; moreover, an unknown compressive strength was introduced as well. The trial mixes used 40% secondary aggregates (both course and fine) and 60% of natural aggregates. The compressive strength of the test concrete decrease between 15 and 25% compared to normal concrete with no secondary aggregates. This work proves that the strength properties of the parent concrete have a limited effect on the compressive strength of recycled concrete. Low compressive strength parent concrete when crushed generate a high percentage of recycled coarse aggregates with the less attached mortar and give the same compressive strength as an excellent parent concrete. However, the decrease in compressive strength can be mitigated by increasing the cement content 4% by weight of recycled aggregates used.Keywords: compressive, concrete, quality, recycled, strength
Procedia PDF Downloads 318610 Optimizing PelletPAVE Rubberized Asphalt MIX Design Using Gyratory Compaction and Volumetrics
Authors: Hussain Al-Baghli
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In comparison to hot mix asphalt (HMAs) composed of non-modified bitumens, the superior performance of rubberized HMAs is very well documented, and numerous trials in the USA and elsewhere have demonstrated excellent performance in terms of creep, fatigue, and durability. In this investigation, rubberized HMA technology was examined to address the most critical forms of pavement distresses in the State of Kuwait, namely, high-temperature rutting and moisture-induced raveling. Pelletpave additive was selected as the preferred technology since it offered a convenient method of directly modifying the exiting local HMA recipe without having to polymer modify the bitumen. Experimental work using various Pelletpave contents was carried out at Kuwait Institute for Scientific Research (KISR) to design an optimum rubberized HMA formulation prior to conducting a pilot-scale road trial. With the aid of a gyratory compactor, the compaction and volumetric properties of HMAs containing 2.5% and 3.0% Pelletpave additive were investigated at a range of bitumen contents, all by mass of total mix.Keywords: modified bitumen, rubberized hot mix asphalt, gyratory compaction, volumetric properties
Procedia PDF Downloads 176609 The Breast Surgery Movement: A 50 Year Development of the Surgical Specialty
Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman
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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.Keywords: breast cancer, breast fellowship, breast surgery, surgical history
Procedia PDF Downloads 127608 Metareasoning Image Optimization Q-Learning
Authors: Mahasa Zahirnia
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The purpose of this paper is to explore new and effective ways of optimizing satellite images using artificial intelligence, and the process of implementing reinforcement learning to enhance the quality of data captured within the image. In our implementation of Bellman's Reinforcement Learning equations, associated state diagrams, and multi-stage image processing, we were able to enhance image quality, detect and define objects. Reinforcement learning is the differentiator in the area of artificial intelligence, and Q-Learning relies on trial and error to achieve its goals. The reward system that is embedded in Q-Learning allows the agent to self-evaluate its performance and decide on the best possible course of action based on the current and future environment. Results show that within a simulated environment, built on the images that are commercially available, the rate of detection was 40-90%. Reinforcement learning through Q-Learning algorithm is not just desired but required design criteria for image optimization and enhancements. The proposed methods presented are a cost effective method of resolving uncertainty of the data because reinforcement learning finds ideal policies to manage the process using a smaller sample of images.Keywords: Q-learning, image optimization, reinforcement learning, Markov decision process
Procedia PDF Downloads 209607 Traditional Medicines Used for the Enhancement of Male Sexual Performance among the Indigenous Populations of Madhya Pradesh, India
Authors: A. N. Sharma
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A traditional medicine comprises a knowledge system, practices related to the cure of various ailments that developed over generations by indigenous people or populations. The indigenous populations developed a unique understanding with wild plants, herbs, etc., and earned specialized knowledge of disease pattern and curative therapy-though hard experiences, common sense, trial, and error methods. Here, an attempt has been made to study the possible aspects of traditional medicines for the enhancement of male sexual performance among the indigenous populations of Madhya Pradesh, India. Madhya Pradesh state is situated more or less in the central part of India. The data have been collected from the 305 Bharias of Patalkot, traditional health service providers of Sagar district, and other indigenous populations of Madhya Pradesh. It may be concluded that sizable traditional medicines exist in Madhya Pradesh, India, for the enhancement of male sexual performance, which still awaits for scientific exploration and intensive pharmaceutical investigations.Keywords: Bharias, indigenous, Madhya Pradesh, sexual performance, traditional medicine
Procedia PDF Downloads 141606 Intensive Biological Control in Spanish Greenhouses: Problems of the Success
Authors: Carolina Sanchez, Juan R. Gallego, Manuel Gamez, Tomas Cabello
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Currently, biological control programs in greenhouse crops involve the use, at the same time, several natural enemies during the crop cycle. Also, large number of plant species grown in greenhouses, among them, the used cultivars are also wide. However, the cultivar effects on entomophagous species efficacy (predators and parasitoids) have been scarcely studied. A new method had been developed, using the factitious prey or host Ephestia kuehniella. It allows us to evaluate, under greenhouse or controlled conditions (semi-field), the cultivar effects on the entomophagous species effectiveness. The work was carried out in greenhouse tomato crop. It has been found the biological and ecological activities of predatory species (Nesidiocoris tenuis) and egg-parasitoid (Trichogramma achaeae) can be well represented with the use of the factitious prey or host; being better in the former than the latter. The data found in the trial are shown and discussed. The developed method could be applied to evaluate new plant materials before making available to farmers as commercial varieties, at low costs and easy use.Keywords: cultivar effects, efficiency, predators, parasitoids
Procedia PDF Downloads 266605 A Nutrient Formulation Affects Brain Myelination in Infants: An Investigative Randomized Controlled Trial
Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni
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Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).Keywords: brain development, infant nutrition, MRI, myelination
Procedia PDF Downloads 186604 The Effect of Spent Mushroom Substrate on Blood Metabolites in Kurdish Male Lambs
Authors: Alireza Vakili, Shahab Ehtesham, Mohsen Danesh Mesgaran
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The objective of this study was use different levels of spent mushroom substrate as a suitable substitute for wheat straw in the ration of male lambs. In this study 20 male lambs with the age of 90 days and initial average weight of 33± 1.7 kg were used. The animals were divided separately into single boxes with four treatments (control treatment, spent mushroom substrate 15%, spent mushroom substrate 25% and spent mushroom substrate 35%) and five replications. The experiment period was 114 days being 14 days adaptation and 90 days for breeding. On the days 36 and 94, blood samples were taken from the jugular vein. In order to carry out the trial, 20 male lambs received the four experimental diets in completely randomized design. The statistical analyses were carried out by using the GLM procedure of SAS 9.1. Means among treatments were compared by Tukey test. The results of the study showed that there was no significant differences between the serum biochemical and hematological contents of the lambs in the four treatments (p>0.05). It was concluded that spent mushroom substrate consumption has no harmful effect on the blood parameters of Kurdish male lambs.Keywords: alternative food, nutrition, sheep performance, spent mushroom substrate
Procedia PDF Downloads 337603 Effects on Inflammatory Biomarkers and Respiratory Mechanics in Laparoscopic Bariatric Surgery: Desflurane vs. Total Intravenous Anaesthesia with Propofol
Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal
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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.Keywords: bariatric, biomarkers, inflammation, laparoscopy
Procedia PDF Downloads 118602 Alternate Dispute Resolution: Expeditious Justice
Authors: Uzma Fakhar, Osama Fakhar, Aamir Shafiq Ch
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Methods of alternate dispute resolution (ADR) like conciliation, arbitration, mediation are the supplement to ensure inexpensive and expeditious justice in a country. Justice delayed has not only created chaos, but an element of rebellious behavior towards judiciary is being floated among people. Complexity of traditional judicial system and its diversity has created an overall coherence. Admittedly, In Pakistan the traditional judicial system has failed to achieve its goals which resulted in the backlog of cases pending in courts, resultantly even the critics of alternate dispute resolution agree to restore the spirit of expeditious justice by reforming the old Panchayat system. The Government is keen to enact certain laws and make amendments to facilitate the resolution of a dispute through a simple and faster ADR framework instead of a lengthy and exhausting complex trial in order to create proliferation and faith in alternate dispute resolution. This research highlights the value of ADR in a country like Pakistan for revival of the confidence of the people upon the judicial process and a useful judicial tool to reduce the pressure on the judiciary.Keywords: alternate dispute resolution, development of law, expeditious justice, Pakistan
Procedia PDF Downloads 216601 Automated End of Sprint Detection for Force-Velocity-Power Analysis with GPS/GNSS Systems
Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra
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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.Keywords: automated, biomechanics, team-sports, sprint
Procedia PDF Downloads 114600 An Investigation the Effectiveness of Emotion Regulation Training on the Reduction of Cognitive-Emotion Regulation Problem in Patients with Multiple Sclerosis
Authors: Mahboobeh Sadeghi, Zahra Izadi Khah, Mansour Hakim Javadi, Masoud Gholamali Lavasani
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Background: Since there is a relation between psychological and physiological factors, the aim of this study was to examine the effect of Emotion Regulation training on cognitive emotion regulation problem in patients with Multiple Sclerosis(MS) Method: In a randomized clinical trial thirty patients diagnosed with Multiple Sclerosis referred to state welfare organization were selected. The sample group was randomized into either an experimental group or a nonintervention control group. The subjects participated in 75-minute treatment sessions held three times a week for 4weeks (12 sessions). All 30 individuals were administered with Cognitive Emotion Regulation questionnaire (CERQ). Participants completed the questionnaire in pretest and post-test. Data obtained from the questionnaire was analyzed using Mancova. Results: Emotion Regulation significantly decreased the Cognitive Emotion Regulation problems patients with Multiple sclerosis (p < 0.001). Conclusions: Emotion Regulation can be used for the treatment of cognitive-emotion regulation problem in Multiple sclerosis.Keywords: Multiple Sclerosis, cognitive-emotion regulation, emotion regulation, MS
Procedia PDF Downloads 452599 The Impact of Improved Grain Storage Technology on Marketing Behaviour and Livelihoods of Maize Farmers: A Randomized Controlled Trial in Ethiopia
Authors: Betelhem M. Negede, Maarten Voors, Hugo De Groote, Bart Minten
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Farmers in Ethiopia produce most of their own food during one agricultural season per year. Therefore, they need to use on-farm storage technologies to bridge the lean season and benefit from price arbitrage. Maize stored using traditional storage bags offer no protection from insects and molds, leading to high storage losses. In Ethiopia access to and use of modern storage technologies are still limited, restraining farmers to benefit from local maize price fluctuations. We used a randomized controlled trial among 871 maize farmers to evaluate the impacts of Purdue Improved Crop Storage (PICS) bags, also known as hermetic bags, on storage losses, and especially on behavioral changes with respect to consumption, marketing, and income among maize farmers in Ethiopia. This study builds upon the limited previous experimental research that has tried to understand farmers’ grain storage and post-harvest losses and identify mechanisms behind the persistence of these challenges. Our main hypothesis is that access to PICS bags allows farmers to increase production, storage and maize income. Also delay the length of maize storage, reduce maize post-harvest losses and improve their food security. Our results show that even though farmers received only three PICS bags that represent 10percent of their total maize stored, they delay their length of maize storage for sales by two weeks. However, we find no treatment effect on maize income, suggesting that the arbitrage of two weeks is too small. Also, we do not find any reduction in storage losses due to farmers’ reaction by selling early and by using cheap and readily available but potentially harmful storage chemicals. Looking at the heterogeneity treatment effects between the treatment variable and highland and lowland villages, we find a decrease in the percentage of maize stored by 4 percent in the highland villages. This confirms that location specific factors, such as agro-ecology and proximity to markets are important factors that influence whether and how much of the harvest a farmer stores. These findings highlight the benefits of hermetic storage bags, by allowing farmers to make inter-temporal arbitrage and by reducing potential health risks from storage chemicals. The main policy recommendation that emanates from our study is that postharvest losses reduction throughout the whole value chain is an important pathway to food and income security in Sub-Saharan Africa (SSA). However, future storage loss interventions with hermetic storage technologies should take into account the agro-ecology of the study area and quantify storage losses beyond farmers self-reported losses, such as the count and weigh method. Finally, studies on hermetic storage technologies indicate positive impacts on post-harvest losses and in improving food security, but the adoption and use of these technologies is currently still low in SSA. Therefore, future works on the scaling up of hermetic bags, should consider reasons why farmers only use PICS bags to store grains for consumption, which is usually related to a safety-first approach or due to lack of incentives (higher price from maize not treated with chemicals), and no grain quality check.Keywords: arbitrage, PICS hermetic bags, post-harvest storage loss, RCT
Procedia PDF Downloads 127598 Challenging Convections: Rethinking Literature Review Beyond Citations
Authors: Hassan Younis
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Purpose: The objective of this study is to review influential papers in the sustainability and supply chain studies domain, leveraging insights from this review to develop a structured framework for academics and researchers. This framework aims to assist scholars in identifying the most impactful publications for their scholarly pursuits. Subsequently, the study will apply and trial the developed framework on selected scholarly articles within the sustainability and supply chain studies domain to evaluate its efficacy, practicality, and reliability. Design/Methodology/Approach: Utilizing the "Publish or Perish" tool, a search was conducted to locate papers incorporating "sustainability" and "supply chain" in their titles. After rigorous filtering steps, a panel of university professors identified five crucial criteria for evaluating research robustness: average yearly citation counts (25%), scholarly contribution (25%), alignment of findings with objectives (15%), methodological rigor (20%), and journal impact factor (15%). These five evaluation criteria are abbreviated as “ACMAJ" framework. Each paper then received a tiered score (1-3) for each criterion, normalized within its category, and summed using weighted averages to calculate a Final Normalized Score (FNS). This systematic approach allows for objective comparison and ranking of the research based on its impact, novelty, rigor, and publication venue. Findings: The study's findings highlight the lack of structured frameworks for assessing influential sustainability research in supply chain management, which often results in a dependence on citation counts. A complete model that incorporates five essential criteria has been suggested as a response. By conducting a methodical trial on specific academic articles in the field of sustainability and supply chain studies, the model demonstrated its effectiveness as a tool for identifying and selecting influential research papers that warrant additional attention. This work aims to fill a significant deficiency in existing techniques by providing a more comprehensive approach to identifying and ranking influential papers in the field. Practical Implications: The developed framework helps scholars identify the most influential sustainability and supply chain publications. Its validation serves the academic community by offering a credible tool and helping researchers, students, and practitioners find and choose influential papers. This approach aids field literature reviews and study suggestions. Analysis of major trends and topics deepens our grasp of this critical study area's changing terrain. Originality/Value: The framework stands as a unique contribution to academia, offering scholars an important and new tool to identify and validate influential publications. Its distinctive capacity to efficiently guide scholars, learners, and professionals in selecting noteworthy publications, coupled with the examination of key patterns and themes, adds depth to our understanding of the evolving landscape in this critical field of study.Keywords: supply chain management, sustainability, framework, model
Procedia PDF Downloads 36597 Web-Based Intervention for Addressing Cigarette Smoking Prevention among College Students
Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh, Mohammad Ahmadpanah, Behzad Karami Matin, Abbas Aghaei, Ahmad Ali Eslami
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Background: Smoking is introduced as one of the main risky factors to develop different types of diseases around the world, especially related to non-contagious diseases. The goal of the present study was assessment of the effectiveness of web based education program to prevent cigarette smoking among college students. Methods: In a randomized controlled trial, during 2014, 150 male college students in Isfahan and Kermanshah University of medical sciences were assigned to intervention group (receiving web based education program) and control groups. The study information was analyzed by SPSS software version 21 using cross-tabulation, t-test, repeated measures and GEE. Results: It was found significantly that average response for attitude towards cigarette smoking and sensation seeking after education reduced (P < 0.05). After intervention there was no significant difference between intervention and control group of cigarette smoking (P > 0.05). Conclusion: web based education have usefulness to reduce belief towards cigarette smoking.Keywords: web-based intervention, smoking, students, Iran
Procedia PDF Downloads 478