Search results for: polygenic risk score

Authors: Siti Noor Syahirah Mohd Sabri

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The oil and gas industry is committed to net zero carbon emissions because the consequences of climate change could be catastrophic unless responded to very soon. One way of reducing CO₂ emissions is to inject it into a depleted reservoir buried underground. This greenhouse gas reduction technique significantly reduces CO₂ released into the atmosphere. In general, depleted oil and gas reservoirs provide readily available sites for the storage of CO₂ in offshore areas. This is mainly due to the hydrocarbons have been optimally produced and the existence of voids for effective CO₂ storage. Hence, make it a good candidate for a CO₂ well injector location. Geological storage sites are often evaluated in terms of capacity, injectivity and containment. Leakage through the cap rock or existing well is the main concern in the depleted fields. In order to develop these fields as CO₂ storage sites, the long-term integrity of wells drilled in these oil & gas fields must be ascertained to ensure good CO₂ containment. Well, integrity is often defined as the ability to contain fluids without significant leakage through the project lifecycle. Most plugged and abandoned (P & A) wells in Peninsular Malaysia have drilled 20 – 30 years ago and were not designed to withstand downhole conditions having >50%vol CO₂ and CO₂/H₂O mixture. In addition, Corrosive-Resistant Alloy (CRA) tubular and CO₂-resistant cement was not used during good construction. The reservoir pressure and temperature conditions may have further degraded the material strength and elevated the corrosion rate. Understanding all the uncertainties that may have affected cement-casing bonds, such as the quality of cement behind the casing, subsidence effect, corrosion rate, etc., is the first step toward well integrity evaluation. Secondly, proper quantification of all the uncertainties involved needs to be done to ensure long-term underground storage objectives of CO₂ are achieved. This paper will discuss challenges associated with estimating the performance of well barrier elements in existing P&A wells. Risk ranking of the existing P&A wells is to be carried out in order to ensure the integrity of the storage site is maintained for long-term CO₂ storage. High-risk existing P&A wells are to be re-entered to restore good integrity and to reduce future leakage that may happen. In addition, the requirement to design a fit-for-purpose monitoring and mitigation technology package for potential CO₂ leakage/seepage in the marine environment will be discussed accordingly. The holistic approach will ensure that the integrity is maintained, and CO₂ is contained underground for years to come.

Keywords: CCUS, well integrity, co₂ storage, offshore

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Authors: Kimberly J. Cribbs, Ryan M. Lefers, TorOve Leiknes, Noreddine Ghaffour

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In Gulf Cooperation Council (GCC) countries, domestic agriculture is hindered by a lack of freshwater, poor soil quality, and ambient temperatures unsuitable for cultivation resulting in a heavy reliance on imported food. Attempts to minimize the risk of food insecurity by growing crops domestically creates a significant demand on limited freshwater resources in this region. Cultivating food in a greenhouse allows some of these challenges, such as poor soil quality and temperatures unsuitable for cultivation, to be overcome. One of the most common methods for greenhouse cooling is evaporative cooling. This method cools the air by the evaporation of water and requires a large amount of water relative to that needed for plant growth and air with a low relative humidity. Considering that much of the population in GCC countries live within 100 km of a coast and that sea water can be utilized for evaporative cooling, coastal agriculture could reduce the risk of food insecurity and water demand. Unfortunately, coastal regions tend to experience both high temperatures and high relative humidity causing evaporative cooling by itself to be inadequate. Therefore, dehumidification is needed prior to utilizing evaporative cooling. Utilizing a liquid desiccant for air dehumidification is promising, but the desiccant regeneration to retain its dehumidification potential remains a significant obstacle for the adoption of this technology. This project studied the regeneration of a magnesium chloride (MgCl₂) desiccant solution from 20wt% to 30wt% by direct contact membrane distillation (DCMD) and explored the possibility of using the recovered water for irrigation. Two 0.2 µm hydrophobic PTFE membranes were tested at feed temperatures of 80, 70, and 60°C and with a permeate temperature of 20°C. It was observed that the permeate flux increases as the difference between the feed and coolant temperature increases and also as the feed concentration decreases. At 21wt% the permeate flux was 34,17, and 14 L m⁻² h⁻¹ for feed temperatures of 80, 70, and 60°C, respectively. Salt rejection decreased overtime; however, it remained greater than 99.9% over an experimental time span of 10 hours. The results show that DCMD can successfully regenerate the magnesium chloride desiccant solution.

Keywords: agriculture, direct contact membrane distillation, GCC countries, liquid desiccant, water recovery

Procedia PDF Downloads 143

Authors: Soheila Sadeghi

Abstract:

Construction projects are complex and often subject to significant cost overruns due to the multifaceted nature of the activities involved. Accurate cost estimation is crucial for effective budget planning and resource allocation. Traditional methods for predicting overruns often rely on expert judgment or analysis of historical data, which can be time-consuming, subjective, and may fail to consider important factors. However, with the increasing availability of data from construction projects, machine learning techniques can be leveraged to improve the accuracy of overrun predictions. This study applied machine learning algorithms to enhance the prediction of cost overruns in a case study of a construction project. The methodology involved the development and evaluation of two machine learning models: Random Forest and Neural Networks. Random Forest can handle high-dimensional data, capture complex relationships, and provide feature importance estimates. Neural Networks, particularly Deep Neural Networks (DNNs), are capable of automatically learning and modeling complex, non-linear relationships between input features and the target variable. These models can adapt to new data, reduce human bias, and uncover hidden patterns in the dataset. The findings of this study demonstrate that both Random Forest and Neural Networks can significantly improve the accuracy of cost overrun predictions compared to traditional methods. The Random Forest model also identified key cost drivers and risk factors, such as changes in the scope of work and delays in material delivery, which can inform better project risk management. However, the study acknowledges several limitations. First, the findings are based on a single construction project, which may limit the generalizability of the results to other projects or contexts. Second, the dataset, although comprehensive, may not capture all relevant factors influencing cost overruns, such as external economic conditions or political factors. Third, the study focuses primarily on cost overruns, while schedule overruns are not explicitly addressed. Future research should explore the application of machine learning techniques to a broader range of projects, incorporate additional data sources, and investigate the prediction of both cost and schedule overruns simultaneously.

Keywords: cost prediction, machine learning, project management, random forest, neural networks

Procedia PDF Downloads 35

Authors: Rachell Denise S. Concepcion, Chantelle Vianca D. L. Cobarrubias, Kimberly B. Coloma, Celina Renee R. Colorado, Charlene S. Constantino, Huette Iris C. Consulta

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AIMS: This study determined the effect of motivational video in increasing the level of self-motivation among first year nursing students to pursue their nursing career. METHODS: A quantitative quasi experimental one-group pretest-posttest research design was used and purposive sampling technique was utilized. Motivation for Choosing Nursing as a Career Questionnaire was used in determining the level of motivation before and after using the motivational video. The of motivational video entitled, “Testimonials from Nurses” was used as the intervention wherein testimonials from successful Thomasian nursing graduates was considered and viewed by the students in order to inspire them to take nursing as their career. The subjects are nursing students who obtained a score ranging from 21-40 in the questionnaire. Before the viewing, the researchers provided a brief introduction and background to enable the participants to fully understand the contents. After which, debriefing was done. The data gathered was analyzed using the Paired T-Test using SPSS version 21.0. The Pre-test and Post-test scores were compared, which further statistically, differentiated by mean, standard deviation and t-test scores. Results: The t-test value is -17.221 and p value of 0.00 < 0.05 which indicates that there is a statistically significant change in the level of self-motivation of first year nursing students before and after viewing the motivational video. Conclusion: It was therefore concluded that motivational video entitled, “Testimonials From Nurses is an effective intervention in increasing the level of self-motivation of first year nursing students to pursue their nursing career.

Keywords: motivational video, freshmen, self-motivation, nursing career

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Authors: Xiaoyuan Chen

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Background: This study aimed to characterize the epidemiological and clinical features of five rare subtypes of hepatocellular carcinoma (HCC) and to create a competing risk nomogram for predicting cancer-specific survival. Methods: This study used the Surveillance, Epidemiology, and End Results database to analyze the clinicopathological data of 50,218 patients with classic HCC and five rare subtypes (ICD-O-3 Histology Code=8170/3-8175/3) between 2004 and 2018. The annual percent change (APC) was calculated using Joinpoint regression, and a nomogram was developed based on multivariable competing risk survival analyses. The prognostic performance of the nomogram was evaluated using the Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve. Decision curve analysis was used to assess the clinical value of the models. Results: The incidence of scirrhous carcinoma showed a decreasing trend (APC=-6.8%, P=0.025), while the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality plateau in all subtypes during the period. Clear cell carcinoma was the most common subtype (n=551, 1.1%), followed by fibrolamellar (n=241, 0.5%), scirrhous (n=82, 0.2%), spindle cell (n=61, 0.1%), and pleomorphic (n=17, ~0%) carcinomas. Patients with fibrolamellar carcinoma were younger and more likely to have non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro clinical characteristics and outcomes as classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were identified as independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice. Conclusion: The rare subtypes of HCC had distinct clinicopathological features and biological behaviors compared with classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could accurately predict prognoses, which is beneficial for individualized management.

Keywords: hepatocellular carcinoma, pathological subtype, fibrolamellar carcinoma, scirrhous carcinoma, clear cell carcinoma, spindle cell carcinoma, pleomorphic carcinoma

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Authors: Larry Powell, Seth Polsley, Drew Casey, Tracy Hammond

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Human activity recognition (HAR) systems have shown positive performance when recognizing repetitive activities like walking, running, and sleeping. Water-based activities are a reasonably new area for activity recognition. However, water-based activity recognition has largely focused on supporting the elite and competitive swimming population, which already has amazing coordination and proper form. Beginner swimmers are not perfect, and activity recognition needs to support the individual motions to help beginners. Activity recognition algorithms are traditionally built around short segments of timed sensor data. Using a time window input can cause performance issues in the machine learning model. The window’s size can be too small or large, requiring careful tuning and precise data segmentation. In this work, we present a method that uses a time window as the initial segmentation, then separates the data based on the change in the sensor value. Our system uses a multi-phase segmentation method that pulls all peaks and valleys for each axis of an accelerometer placed on the swimmer’s lower back. This results in high recognition performance using leave-one-subject-out validation on our study with 20 beginner swimmers, with our model optimized from our final dataset resulting in an F-Score of 0.95.

Keywords: time window, peak/valley segmentation, feature extraction, beginner swimming, activity recognition

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Authors: Corina E. Niculaescu, Ivan Sangiorgi, Adrian R. Bell

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The COVID-19 pandemic has been life-changing in many aspects of people’s daily and social lives, but has it also changed attitudes towards investments? This paper explores the effect of the COVID-19 pandemic on retail investors’ levels of investments in the U.S. during the first COVID-19 wave in summer 2020. This is an unprecedented health crisis, which could lead to changes in investment behavior, including irrational behavior in retail investors. As such, this study aims to inform policymakers of what happened to investment decisions during the COVID-19 pandemic so that they can protect retail investors during extreme events like a global health crisis. The study aims to answer two research questions. First, was the level of investments affected by the COVID-19 pandemic, and if so, why? Second, how were investments affected by retail investors’ personal experience with COVID-19? The research analysis is based on primary survey data collected on the Amazon Mechanical Turk platform from a representative sample of U.S. respondents. Responses were collected between the 15th of July and 28th of August 2020 from 1,148 U.S. retail investors who hold mutual fund investments and a savings account. The research explores whether being affected by COVID-19, change in the level of savings, and risk capacity can explain the change in the level of investments by using regression analysis. The dependent variable is changed in investments measured as decrease, no change, and increase. For this reason, the methodology used is ordered probit regression models. The results show that retail investors in the U.S. increased their investments during the first wave of COVID-19, which is unexpected as investors are usually more cautious in crisis times. Moreover, the study finds that those who were affected personally by COVID-19 (e.g., tested positive) were more likely to increase their investments, which is irrational behavior and contradicts expectations. An increase in the level of savings and risk capacity was also associated with increased investments. Overall, the findings show that having personal experience with a health crisis can have an impact on one’s investment decisions as well. Those findings are important for both retail investors and policymakers, especially now that online trading platforms have made trading easily accessible to everyone. There are risks and potential irrational behaviors associated with investment decisions during times of crisis, and it is important that retail investors are aware of them before making financial decisions.

Keywords: COVID-19, financial decision-making, health crisis retail investors, survey

Procedia PDF Downloads 186

Authors: E. Abustam, M. I. Said, M. Yusuf, H. M. Ali

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This study aims to examine the sensory quality of meatballs made from Balinese beef and buffalo meat after the addition of smoke powder prior to storage at the temperatures of 2-5°C for 7 days. This study used meat from Longissimus dorsi muscle of male Balinese cattle aged 3 years and of male buffalo aged 5 years as the main raw materials, and smoke powder as a binder and preservative in making meatballs. The study was based on completely randomized design (CRD) of factorial pattern of 2 x 3 x 2 where factors 1, 2 and 3 included the types of meat (cattle and buffalo), types of smoke powder (oven dried, freeze dried and spray dried) with a level of 2% of the weight of the meat (b/b), and storage duration (0 and 7 days) with three replications respectively. The parameters measured were the meatball sensory quality (scores of tenderness, firmness, chewing residue, and intensity of flavor). The results of this study show that each type of meat has produced different sensory characteristics. The meatballs made from buffalo meat have higher tenderness and elasticity scores than the Balinese beef. Meanwhile, the buffalo meatballs have a lower residue mastication score than the Balinese beef. Each type of smoke powders has produced a relatively similar sensory quality of meatballs. It can be concluded that the smoke powder of 2% of the weight of the meat (w/w) could maintain the sensory quality of the meatballs for 7 days of storage.

Keywords: Balinese beef meatballs, buffalo meatballs, sensory quality, smoke powder

Procedia PDF Downloads 332

Authors: Simone Leonardi, Luca Ardito

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Micro-influencers are effective elements in the marketing strategies of companies and institutions because of their capability to create an hyper-engaged audience around a specific topic of interest. In recent years, many scientific approaches and commercial tools have handled the task of detecting this type of social media users. These strategies adopt solutions ranging from rule based machine learning models to deep neural networks and graph analysis on text, images, and account information. This work compares the existing solutions and proposes an ensemble method to generalize them with different input data and social media platforms. The deployed solution combines deep learning models on unstructured data with statistical machine learning models on structured data. We retrieve both social media accounts information and multimedia posts on Twitter and Instagram. These data are mapped into feature vectors for an eXtreme Gradient Boosting (XGBoost) classifier. Sixty different topics have been analyzed to build a rule based gold standard dataset and to compare the performances of our approach against baseline classifiers. We prove the effectiveness of our work by comparing the accuracy, precision, recall, and f1 score of our model with different configurations and architectures. We obtained an accuracy of 0.91 with our best performing model.

Keywords: deep learning, gradient boosting, image processing, micro-influencers, NLP, social media

Procedia PDF Downloads 173

Authors: Soheila Sadeghi

Abstract:

Construction projects are complex and often subject to significant cost overruns due to the multifaceted nature of the activities involved. Accurate cost estimation is crucial for effective budget planning and resource allocation. Traditional methods for predicting overruns often rely on expert judgment or analysis of historical data, which can be time-consuming, subjective, and may fail to consider important factors. However, with the increasing availability of data from construction projects, machine learning techniques can be leveraged to improve the accuracy of overrun predictions. This study applied machine learning algorithms to enhance the prediction of cost overruns in a case study of a construction project. The methodology involved the development and evaluation of two machine learning models: Random Forest and Neural Networks. Random Forest can handle high-dimensional data, capture complex relationships, and provide feature importance estimates. Neural Networks, particularly Deep Neural Networks (DNNs), are capable of automatically learning and modeling complex, non-linear relationships between input features and the target variable. These models can adapt to new data, reduce human bias, and uncover hidden patterns in the dataset. The findings of this study demonstrate that both Random Forest and Neural Networks can significantly improve the accuracy of cost overrun predictions compared to traditional methods. The Random Forest model also identified key cost drivers and risk factors, such as changes in the scope of work and delays in material delivery, which can inform better project risk management. However, the study acknowledges several limitations. First, the findings are based on a single construction project, which may limit the generalizability of the results to other projects or contexts. Second, the dataset, although comprehensive, may not capture all relevant factors influencing cost overruns, such as external economic conditions or political factors. Third, the study focuses primarily on cost overruns, while schedule overruns are not explicitly addressed. Future research should explore the application of machine learning techniques to a broader range of projects, incorporate additional data sources, and investigate the prediction of both cost and schedule overruns simultaneously.

Keywords: resource allocation, machine learning, optimization, data-driven decision-making, project management

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Authors: Sharifirad M., Poursaeed A., Lashgarara F., Mirdamadi S. M.

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Introduction: Paddy farming has been reported as one of the most important causes of non-fatal injuries and occupational accidents among farmers. The ignorance of the health of farmers can cause harm to farmers and lead to disability. As a result, these health consequences can result in less exploitation and economic growth in households. Therefore, this study aimed to determine the general health status of paddy field workers in Mazandaran province, Iran. Materials & Methods: This cross-sectional descriptive study evaluated 384 paddy farmers in Mazandaran province, Iran, who were selected using stratified random sampling. The required data were collected using the standard questionnaire of GHQ-28 with four domains of somaticsymptoms, anxiety and insomnia, social dysfunction, and symptoms of depression. The obtained data were then analyzed using SPSS software (version 25) through Spearman, Kendall, Mann-Whitney, and Kruskal-Wallis tests. Findings: The highest number of participants in this study was in the age group of 50-59 years, with a mean age of 46.9 years. According to the results, the total general health score was obtained at 64.3% for the subjects. Moreover, the scores of four areas of general health were determined at 91.1% (depression symptoms), 73.4% (social dysfunction), 48.7% (anxiety symptoms and insomnia), and 47.1% (somatic symptoms) in descending order. Discussions& Conclusions: The general health of the studied population was not in a good range. In addition, the most observed disorder in the general health of paddy farmers was related to the symptoms of depression, followed by somatic symptoms.

Keywords: general-health, mazandaran, paddyfield

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Authors: Viacheslav Sushko, Viktor Sushko

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Pre-cancerous breast diseases are pathological changes that precede the appearance of adenocarcinoma. The most common benign breast disease is mastopathy. We examined the life and disease history of 114 women aged 58-69 who were diagnosed with adenocarcinoma of the breast at different stages of development. They filled out the Reeder Scale to determine the level of stress. The results of the study revealed that 62 of them had mastopathy at the age of 30-45 years old. These women refused surgical treatment for mastopathy. Five to six years before their diagnosis of adenocarcinoma of the mammary gland, 84 women had experienced severe stress (death of a beloved close relative, torture accompanied by rape, prolonged stay in extreme conditions (under bombardment and bombardment). In the assessment of data from completed Reeder scales, 114 women had a high level of mental stress, with a score from 1-1.72. The 84 women who suffered from severe stress showed overeating or a significant decrease in food intake, insomnia, apathy, increased irritability and restlessness, loss of interest in sexual relationships, forgetfulness, difficulty in performing routine work, prolonged uncontrollable headaches, unexplained fatigue, heart pain, reduced capacity for work. In conclusion, it is important to provide psychotherapy for breast cancer patients as the diagnosis, and the different stages of treatment are very stressful. It is also advisable to see a psychiatrist at an early stage and prevent distress and treat precancerous breast disease.

Keywords: breast cancer, distress, mastopathy, severe stress

Procedia PDF Downloads 130

Authors: D. Zahraddeen, N. M. Lemu, P. P. Barje, I. S. R. Butswat

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This study was conducted to investigate some of the factors affecting the optimum reproductive capacity of the indigenous breeds of sheep in Nigeria. A total of 767 sheep of different breeds were investigated. The reproductive indices considered were birth/weaning weights, litter size, parity, mortality, reproductive problems/disorders, body condition score (BCS), as well as growth traits. The results showed that litter size, parity, and BCS had significant (p < 0.05) effects on birth/weaning weights, mortality rates and growth traits of the sheep breeds studied. Similarly, the rearing method/system significantly (p < 0.05) influenced other reproductive traits such as birth/weaning weights, mortality, growth performance of lambs. However, the major reproductive problems/disorders in the ewes were dystocia (30.94%), retained placenta (16.91%), mastitis (15.83), pregnancy toxaemia (11.51%), uterine prolapse (6.48%) and vaginal prolapse (3.24%). In the rams, the incidence of reproductive problems included cryptorchidism (1.08%), orchitis (2.87%) and scrotal dermatophilosis (1.79%), among others. This study concludes that the four breeds of sheep (Balami, Yankasa, Uda, and West African Dwarf sheep) and their crosses exhibited varied genetic make-up and potentials. However, the large number of sheep farmers practicing the extensive production system might be responsible for the low reproductive performance of this species in the country. It is, therefore, recommended that significant improvement could be achieved through enhanced management practices of these animals.

Keywords: sheep, breeds, reproduction, disorders

Procedia PDF Downloads 149

Authors: Ziyun Li, Jiudi Zhong, June Zhang

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Background: The diagnosis and treatment of lung cancer lead to varying degrees of psychological and social maladjustment among patients with lung cancer. Understanding psychosocial adjustment (PA) and its influencing factors in young and middle-aged lung cancer patients is essential to help them return to society and lead a normal life. Objectives: This study aims to examine the mediating role of resilience in the association between stigma and psychosocial adjustment among young and middle-aged patients with lung cancer. Methods: A total of 235 patients with lung cancer were recruited from a tertiary grade A cancer center in southern China and investigated using a self-designed general information questionnaire, Psychosocial Adjustment to Illness Scale Self-Report, Social Impact Scale, and Conner-Davidson Resilience Scale. Results: The mean score of PA was (32.61±14.75), and its influencing factors included treatment modalities, stigma, and resilience. The total effect of stigma on PA was significant (total effect=0.418, SE=0.045, 95%CI [0.310-0.497]), and a positive indirect effect was identified for stigma on PA via resilience (indirect effect=0.143, SE=0.041, 95% CI [0.075-0.236]). Conclusion: Stigma and resilience are significantly associated with PA, and resilience is also a mediating variable between stigma and PA. This study suggests that individualized interventions can be made to improve the PA by alleviating their stigma, or by enhancing their resilience in young and middle-aged lung cancer patients.

Keywords: psychosocial adjustment, lung cancer, cancer caring, nursing, young and middle-aged

Procedia PDF Downloads 80

Authors: Oladele V. Adeniyi, B. Longo-Mbenza, Daniel T. Goon

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Background: Lipids are often low or in the normal ranges and controversial in the atherogenesis among Black Africans. The effect of the severity of obesity on some traditional and novel cardiovascular disease risk factors is unclear before and after a diet and exercise maintenance programme among obese black South Africans with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to identify the risk factors to discriminate obesity classes among patients with T2DM before and after a diet and exercise programme. Methods: This interventional cohort of Black South Africans with T2DM was followed by a very – low calorie diet and exercise programme in Mthatha, between August and November 2013. Gender, age, and the levels of body mass index (BMI), blood pressure, monthly income, daily frequency of meals, blood random plasma glucose (RPG), serum creatinine, total cholesterol (TC), triglycerides (TG), LDL –C, HDL – C, Non-HDL, ratios of TC/HDL, TG/HDL, and LDL/HDL were recorded. Univariate analysis (ANOVA) and multivariate discriminant analysis were performed to separate obesity classes: normal weight (BMI = 18.5 – 24.9 kg/m2), overweight (BMI = 25 – 29.9 kg/m2), obesity Class 1 (BMI = 30 – 34.9 kg/m2), obesity Class 2 (BMI = 35 – 39.9 kg/m2), and obesity Class 3 (BMI ≥ 40 kg/m2). Results: At the baseline (1st Month September), all 327 patients were overweight/obese: 19.6% overweight, 42.8% obese class 1, 22.3% obese class 2, and 15.3% obese class 3. In discriminant analysis, only systolic blood pressure (SBP with positive association) and LDL/HDL ratio (negative association) significantly separated increasing obesity classes. At the post – evaluation (3rd Month November), out of all 327 patients, 19.9%, 19.3%, 37.6%, 15%, and 8.3% had normal weight, overweight, obesity class 1, obesity class 2, and obesity class 3, respectively. There was a significant negative association between serum creatinine and increase in BMI. In discriminant analysis, only age (positive association), SBP (U – shaped relationship), monthly income (inverted U – shaped association), daily frequency of meals (positive association), and LDL/HDL ratio (positive association) classified significantly increasing obesity classes. Conclusion: There is an epidemic of diabesity (Obesity + T2DM) in this Black South Africans with some weight loss. Further studies are needed to understand positive or negative linear correlations and paradoxical curvilinear correlations between these markers and increase in BMI among black South African T2DM patients.

Keywords: atherogenic dyslipidaemia, dietary interventions, obesity, south africans

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Authors: Fatemeh Nemati, Lucinda Leonard, Gwyn Lintern, Richard Thomson

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In this study, we will use modern numerical modeling approaches to estimate tsunami risks to the southern coast of British Columbia from landslides. Wave generation is to be simulated using the NHWAVE model, which solves the Navier-Stokes equations due to the more complex behavior of flow near the landslide source; far-field wave propagation will be simulated using the simpler model FUNWAVE_TVD with high-order Boussinesq-type wave equations, with a focus on the accurate simulation of wave propagation and regional- or coastal-scale inundation predictions.

Keywords: FUNWAVE-TVD, landslide-generated tsunami, NHWAVE, tsunami risk

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Authors: Abdikarim Yusuf

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This study uses data from Somalia to analyse child labour using a descriptive and qualitative method. The study set out to identify root causes of child labour in Hargeisa and its implications for children. The study shows that poverty, droughts, family separation, and loss of properties are primary drivers of child labour in Hargeisa. The study found that children work in very difficult jobs such as car wash, casual work, and shoe shining for boys while girls work as housemaids, selling tea, Khat and sometimes are at risk of exploitation such as sexual abuse, rape and harassment. The majority of the parents responded that they don’t know any policy, act or law that protects children. Men showed greater awareness than the women respondents in recognizing child labour as a child rights violation.

Keywords: abuse, child, violence, protection

Procedia PDF Downloads 139

Authors: Lida Moghaddam-Banaem, Mahmood Tavoosi, Soheila Khalili

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Objective: The main objective of this study was designing a breast cancer health literacy questionnaire and assess its psychometric properties. Methods: A comprehensive literature review was performed to develop a primary questionnaire consisting of five domains. Qualitative and quantitative content validity were assessed by relevant experts, and after some modifications, the content validity index (CVI) and content validity ratio (CVR) were calculated. Qualitative and quantitative face validity were evaluated by a number of patients, and the impact score for each item was calculated. 225 women with breast cancer were asked to fill out the questionnaire and construct validity was determined by using exploratory factor analysis. The reliability was tested by Cronbach's alpha coefficient. Results: A 36-item questionnaire with five domains of reading, having access, understanding, assessing/judgment, and decision making/behavior was designed. 2 items were omitted in the qualitative content validity process. All items achieved optimum values in CVI, CVR and impact scores. Content and face validity of the questionnaire were confirmed too. According to the exploratory factor analysis, the five-factor solution accounted for 64.98 percent of the observed variance. Conclusion: Due to the obtained satisfactory validity and reliability, this tool can be used to assess health literacy in women with breast cancer. Health policy makers can use these findings for improving health-related behaviors in breast cancer patients.

Keywords: health literacy, breast cancer, questionnaire, psychometric properties

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Authors: Khaled M. Khleifat

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Pseudomonas aeruginosa was isolated from infected burn patients and characterized by standard biochemical tests. The in vitro copper uptake was compared between this isolated pathogenic strain and two non-pathogenic control strains of Gram-positive bacteria Bacillusthuringiensis strain Israelisas well as Gram-negative bacteria Enterobacter aerogenes. Maximum copper uptake of 470 ppm/g biomass was obtained by P. aeruginosa strain, while the control strains B. thuringiensis and Enterobacter aerogenes had copper uptake of 350 and 383 ppm/g biomass, respectively. However, the lowest copper uptake (60 ppm/g biomass) was observed with another control the saprophytic strain Pseudomonas (Shewanella) putrefaciens. A further investigation regarding the effect of copper toxicity on bacterial growth, gave an MIC score of 600 ppm for P. aeruginosa strain compared to 460 and 300 ppm for the two Gram positive and Gram negative control strains, respectively. In tandem with these in vitro findings, blood analysis on burn patients infected with P. aeruginosa has indicated a selective decrease of copper (hypocupremia) and ceruloplasmin plasma levels. The iron metabolism was also affected by this copper deprivation leading to a similar decrease in plasma levels of PCV, iron, total iron-binding capacity, and transferrin. All these hematological changes were significantly different (P < 0.05) from the matched group of non-infected burn patients. The observed hypocupremia in infected burn patients was attributed to demanding scavenger ability by P. aeruginosa strain for the copper of plasma.

Keywords: Pseudomonas aeruginosa, hypocupremia, correlation, PCV

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Authors: Patricia O. Carvalho, Marcia C. F. Messias, Salvador Sanchez Vinces, Caroline F. A. Gatinoni, Vitor P. Iordanu, Carlos A. R. Martinez

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Lipidomics methods are widely used in the identification and validation of disease-specific biomarkers and therapy response evaluation. The present study aimed to identify a panel of potential lipid biomarkers to evaluate response to neoadjuvant chemoradiotherapy in rectal adenocarcinoma (RAC). Liquid chromatography–mass spectrometry (LC-MS)-based untargeted lipidomic was used to profile human serum samples from patients with clinical stage T2 or T3 resectable RAC, after and before chemoradiotherapy treatment. A total of 28 blood plasma samples were collected from 14 patients with RAC who recruited at the São Francisco University Hospital (HUSF/USF). The study was approved by the ethics committee (CAAE 14958819.8.0000.5514). Univariate and multivariate statistical analyses were applied to explore dysregulated metabolic pathways using untargeted lipidic profiling and data mining approaches. A total of 36 statistically significant altered lipids were identified and the subsequent partial least-squares discriminant analysis model was both cross validated (R2, Q2) and permutated. Lisophosphatidyl-choline (LPC) plasmalogens containing palmitoleic and oleic acids, with high variable importance in projection score, showed a tendency to be lower after completion of chemoradiotherapy. Chemoradiotherapy seems to change plasmanyl-phospholipids levels, indicating that these lipids play an important role in the RAC pathogenesis.

Keywords: lipidomics, neoadjuvant chemoradiotherapy, plasmalogens, rectal adenocarcinoma

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Authors: Selena Ferrian, Erin Mccaffrey, Toshie Saito, Aiqin Cao, Noah Greenwald, Mark Robert Nicolls, Trevor Bruce, Roham T. Zamanian, Patricia Del Rosario, Marlene Rabinovitch, Michael Angelo

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Recent experimental and clinical observations are advancing immunotherapies to clinical trials in pulmonary arterial hypertension (PAH). However, comprehensive mapping of the immune landscape in pulmonary arteries (PAs) is necessary to understand how immune cell subsets interact to induce pulmonary vascular pathology. We used multiplexed ion beam imaging by time-of-flight (MIBI-TOF) to interrogate the immune landscape in PAs from idiopathic (IPAH) and hereditary (HPAH) PAH patients. Massive immune infiltration in I/HPAH was observed with intramural infiltration linked to PA occlusive changes. The spatial context of CD11c+DCs expressing SAMHD1, TIM-3 and IDO-1 within immune-enriched microenvironments and neutrophils were associated with greater immune activation in HPAH. Furthermore, CD11c-DC3s (mo-DC-like cells) within a smooth muscle cell (SMC) enriched microenvironment were linked to vessel score, proliferating SMCs, and inflamed endothelial cells. Experimental data in cultured cells reinforced a causal relationship between neutrophils and mo-DCs in mediating pulmonary arterial SMC proliferation. These findings merit consideration in developing effective immunotherapies for PAH.

Keywords: pulmonary arterial hypertension, vascular remodeling, indoleamine 2-3-dioxygenase 1 (IDO-1), neutrophils, monocyte-derived dendritic cells, BMPR2 mutation, interferon gamma (IFN-γ)

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Authors: Annette Joseph

Abstract:

Background: The construction industry is dynamic in nature owing to the increasing uncertainties in technology, budgets, and development processes making projects more complex. Thus, predicting project performance and chances of its likely success has become difficult. The goal of all parties involved in construction projects is to successfully complete it on schedule, within planned budget and with the highest quality and in the safest manner. However, the concept of project success has remained ambiguously defined in the mind of the construction professionals. Purpose: This paper aims to study the analysis of a project in terms of its performance and measure the success. Methodology: The parameters for evaluating project success and the indices to measure success/performance of a project are identified through literature study. Through questionnaire surveys aimed at the stakeholders in the projects, data is collected from two live case studies (an ongoing and completed project) on the overall performance in terms of its success/failure. Finally, with the help of SPSS tool, the data collected from the surveys are analyzed and applied on the selected performance indices. Findings: The score calculated by using the indices and models helps in assessing the overall performance of the project and interpreting it to find out whether the project will be a success or failure. This study acts as a reference for firms to carry out performance evaluation and success measurement on a regular basis helping projects to identify the areas which are performing well and those that require improvement. Originality & Value: The study signifies that by measuring project performance; a project’s deviation towards success/failure can be assessed thus helping in suggesting early remedial measures to bring it on track ensuring that a project will be completed successfully.

Keywords: project, performance, indices, success

Procedia PDF Downloads 182

Authors: Katalin Gombos, Bence Gálik, Krisztina Ildikó Kalács, Krisztina Gödöny, Ákos Várnagy, József Bódis, Attila Gyenesei, Gábor L. Kovács

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Although non-invasive pre-implantation genetic testing for aneuploidy (NIPGT-A) is potentially appropriate to assess chromosomal ploidy of the embryo, practical application of it in a routine IVF center has not been started in the absence of a recommendation. We developed a comprehensive workflow for a clinically applicable strategy for NIPGT-A based on next-generation sequencing (NGS) technology. We performed MALBAC whole genome amplification and NGS on spent blastocyst culture media of Day 3 embryos fertilized with intra-cytoplasmic sperm injection (ICSI). Spent embryonic culture media of morphologically good quality score embryos were enrolled in further analysis with the blank culture media as background control. Chromosomal abnormalities were identified by an optimized bioinformatics pipeline applying a copy number variation (CNV) detecting algorithm. We demonstrate a comprehensive workflow covering both wet- and dry-lab procedures supporting a clinically applicable strategy for NIPGT-A. It can be carried out within 48 h which is critical for the same-cycle blastocyst transfer, but also suitable for “freeze all” and “elective frozen embryo” strategies. The described integrated approach of non-invasive evaluation of embryonic DNA content of the culture media can potentially supplement existing pre-implantation genetic screening methods.

Keywords: next generation sequencing, in vitro fertilization, embryo assessment, non-invasive pre-implantation genetic testing

Procedia PDF Downloads 151

Authors: Hamad Albadr

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Joint Commission International (JCI) accreditation process intent to improve the safety and quality of care in the international community through the provision of education, publications, consultation, and evaluation services. These standards apply to the entire organization as well as to each department, unit, or service within the organization. Medical Technology that contains both medical equipment and devices, is an essential part of health care. Appropriate management of equipment maintenance for ensuring medical technology safe, the equipment life is maximized, and the total costs are minimized. JCI medical technology evaluation and accreditation use standards, intents, and measurable elements. The paper focuses on evaluation of JCI standards for medical technology in Saudi Arabian hospitals: a Study Case of PSMMC that define the performance expectation, structures, or functions that must be in place for a hospital to be accredited by JCI through measurable elements that indicate a score during the survey process that identify the requirements for full compliance with the standard specially through Facility Management and Safety (FMS) section that require the hospital establishes and implements a program for inspecting, testing, and maintaining medical technology and documenting the results, to ensure that medical technology is available for use and functioning properly, the hospital performs and documents; an inventory of medical technology; regular inspections of medical technology; testing of medical technology according to its use and manufacturers’ requirements; and performance of preventive maintenance.

Keywords: joint commission international (JCI) accreditation, medical technology, Saudi Arabia, Saudi Arabian hospitals

Procedia PDF Downloads 546

Authors: Tamer E. Yared

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The use of driving simulators has made laboratory testing easier. It has been proven to be valid for testing driving ability by many researchers. One benefit of using driving simulators is keeping the human subjects away from traffic hazards, which drivers usually face in a real driving environment while performing a driving experiment. In this study, a driving simulator was developed with a navigation system using a game development software (Unity 3D) and C-sharp codes to measure and evaluate driving performance, safety, and workload for different driving tasks. The driving simulator hardware included a gaming steering wheel and pedals as well as a monitor to view the driving tasks. Moreover, driver distraction was evaluated by utilizing an eye-tracking system working in conjunction with the driving simulator. Twenty subjects were recruited to evaluate driver distraction, workload, driving safety, and performance, as well as provide their feedback about the driving simulator. The subjects’ feedback was obtained by filling a survey after conducting several driving tasks. The main question of that survey was asking the subjects to compare driving on the driving simulator with real driving. Furthermore, other aspects of the driving simulator were evaluated by the subjects in the survey. The survey revealed that the recruited subjects gave an average score of 7.5 out of 10 to the driving simulator when compared to real driving, where the scores ranged between 6 and 8.5. This study is a preliminary effort that opens the door for more improvements to the driving simulator in terms of hardware and software development, which will contribute significantly to driving ability testing.

Keywords: driver distraction, driving performance, driving safety, driving simulator, driving workload, navigation system

Procedia PDF Downloads 162

Authors: Alexi Colleen F. Lim, Inna Felicia I. Agoncillo, Quenniejoy T. Dizon, Jennifer Joyce T. Eti, Carlota Aileen H. Monares, Neil Roy B. Rosales, Joshua F. Santillan, Alyssa Francesca D. S. Tanchuling, Josefina A. Tuazon, Mary Joan Therese C. Valera-Kourdache

Abstract:

Majority of leading causes of mortality in the Philippines are NCDs, which are preventable through control of known risk factors such as smoking, obesity, physical inactivity, and alcohol. Sugar-sweetened beverages such as soda and energy drinks also contribute to NCD risk and are of concern particularly for youth. This study provides baseline data on beverage consumption of university students in Manila with the focus on alcohol and soda. It further aims to identify factors affecting consumption. Specific objectives include: (1) to describe beverage consumption practices of university students in Manila; and (2) to determine factors promoting excessive consumption of alcohol and soda including demographic characteristics, attitude, interpersonal and environmental variables. Methods: The study employed correlational design with randomly selected students from two universities in Manila. Students 18 years or older who agreed to participate were included after obtaining ethical clearance. The study had two instruments: (1) World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) was used with permission, to determine excessive alcohol consumption; and (2) a questionnaire to obtain information regarding soda and energy drink consumption. Results: Out of 400 students surveyed, 70% were female and 78.75% were 18-20 years old (mean=19.79; SD=3.76). Among them, 51.50% consumed alcohol, with 30.10% excessive drinkers. Soda consumption is 91.50% with 37.70% excessive consumers. For energy drinks, 36.75% consume this and only 4.76% drink excessively. Using logistic regression, students who were more likely to be excessive alcohol drinkers belonged to non-health courses (OR=2.21) and purchased alcohol from bars (OR=7.84). Less likely to drink excessively are students who do not drink due to stress (OR=0.05) and drink when it is accessible (OR=0.02). Excessive soda consumption was less likely for female students (OR=0.28), those who drink when it is accessible (OR=0.14), do not drink soda during stressful situations (OR=0.19), and do not use soda as hangover treatment (OR=0.15). Conclusion: Excessive alcohol consumption was greater among students in Manila (30.10%) than in US (20%). Drinking alcohol with friends was not related to excessive consumption but availability in bars was. It is expected that health sciences students are less likely to engage in excessive alcohol as they are more aware of its ill effects. Prevalence of soda consumption in Manila (91.50%) is markedly higher compared to 24.5% in the US. These findings can inform schools in developing appropriate health education interventions and policies. For greater understanding of these behaviors and factors, further studies are recommended to explore knowledge and other factors that may promote excessive consumption.

Keywords: alcohol consumption, beverage consumption, energy drinks consumption, soda consumption, university students

Procedia PDF Downloads 274

Authors: Kotomi Yamashita, Hiromi Kawasaki, Satoko Yamasaki, Susumu Fukita, Risako Sakai

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Lifestyle-related diseases develop from the long-term accumulation of health consequences from a poor lifestyle. Thus, schoolchildren, who have not accumulated long-term lifestyle habits, are believed to be at a lower risk for lifestyle-related diseases. However, schoolchildren rarely receive blood tests unless they are under treatment for a serious disease; without such data on their blood, the impacts of their young lifestyle could not be known. Blood data from physical measurements can help in the implementation of more effective health education. Therefore, we examined the correlation between body mass index (BMI) and blood sugar/serum lipid (BS/SL) levels. From 2014 to 2016, we measured the blood data of fourth-grade students living in a city in Japan. The present study reported on the results of 281 fourth-grade boys only (80.3% of total). We analyzed their BS/SL levels by comparing the blood data against the criteria of the National Center for Child Health and Development in Japan. Next, we examined the correlation between BMI and BS/SL levels. IBM SPSS Statistics for Windows, Version 25 was used for analysis. A total of 69 boys (24.6%) were within the normal range for BMI (18.5–24), whereas 193 (71.5%) and 8 boys (2.8%) had lower and higher BMI, respectively. Regarding BS levels, 280 boys were within the normal range (70–90 mg/dl); 1 boy reported a higher value. All the boys were within the normal range for glycated Hemoglobin (HbA1c) (4.6–6.2%). Regarding SL levels, 271 boys were within the normal range (125–230 mg/dl) for total cholesterol (TC), whereas 5 boys (1.8%) had lower and 5 boys (1.8%) had higher levels. A total of 243 boys (92.7%) were within the normal range (36-138mg/dL) for triglycerides (TG), whereas 19 boys (7.3%) had lower and 19 boys (7.3%) had higher levels. Regarding high-density lipoprotein cholesterol (HDL-C), 276 boys (98.2%) were within the normal range (40-mg/dl), whereas 5 boys (1.8%) reported lower values. All but one boy (280, 99.6%) were within the normal range (-170 mg/dl) for low-density lipoprotein cholesterol (LDL-C); the exception (0.4%) had a higher level. BMI and BS didn’t show a correlation. BMI and HbA1c were moderately positively correlated (r = 0.139, ｐ＝0.019). We also observed moderate positive correlations between BMI and TG (r = 0.328, p < 0.01), TC (r=0.239, p< 0.01), LDL-C (r = 0.324, p < 0.01), respectively. BMI and HDL-C were low correlated (r = -0.185, p = 0.002). Most of the boys were within the normal range for BS/SL levels. However, some boys exceeded the normal TG range. Fourth graders with a high TG may develop a lifestyle-related disease in the future. Given its relation to TG, food habits should be improved in this group. Our findings suggested a positive correlation between BMI and BS/SL levels. Fourth-grade schoolboys with a high BMI may be at high risk for developing lifestyle-related diseases. Lifestyle improvement may be recommended to lower the BS/SL levels in this group.

Keywords: blood sugar level, lifestyle-related diseases, school students, serum lipid level

Procedia PDF Downloads 135

Authors: Saranchuluun Otgon, Sugarmaa Myagmarjav, Khorolsuren Lkhagvasuren, Fabio Casati

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Background: Flourishing is a eudaimonic dimension of psychological well-being that has been associated with positive social and health-related outcomes. Determining the factors associated with health and well-being is important to the development of evidence-based intervention programs, policies, and action plans targeting the older adult population, especially in low- and middle-income countries, such as Mongolia, where evidence-based research on aging, health, and well-being is still scarce. This study makes important contributions to the study of well-being in later age and also to policy activities for the older population in Mongolia. Methods: We employed multiple regression models to predict the factors of flourishing using data from 304 older adults living in urban and rural Mongolia. Data is collected by the standardized and validated questionnaire adopted by Ed Diener. Results: The median score of the flourishing of urban and rural older adults in Mongolia was significantly different, 53 and 50, respectively. The sex (β = 2.52,p = 0.034), level of education(β = 0.94, p = 0.026), receive help for the activity of daily living (β = 2.16, p = 0.022) determine the flourishing of older adults living in a rural area, while self-reported health (β = 0.94, p = 0.026), the number of social activities, friends network determine to flourish of older adults living urban area. Conclusion: Older adults who live in urban areas have more psychological resources and strengths than those in rural areas. Determinants of flourishing are different in different settings. For instance, individual and family factors determine flourishing in rural areas, and social ties determine flourishing in urban areas.

Keywords: flourishing, predictors, older adults, Mongolia, psychological well-being

Procedia PDF Downloads 123

Authors: Annis Lai Chu Fung

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While aggression had high stability throughout developmental stages and across generations, it should be the top priority of researchers and frontline helping professionals to develop prevention and intervention programme for aggressive children and children at risk of developing aggressive behaviours. Although there is a substantial amount of anti-bullying programmes, they gave disappointingly small effect sizes. The neglectful practical significance could be attributed to the overly simplistic categorisation of individuals involved as bullies or victims. In the past three decades, the distinction between reactive and proactive aggression has been well-proved. As children displaying reactively aggressive behaviours have distinct social-information processing pattern with those showing proactively aggressive behaviours, it is critical to identify the unique needs of the two subtypes accordingly when designing an intervention. The onset of reactive aggression and proactive aggression was observed at earliest in 4.4 and 6.8 years old respectively. Such findings called for a differential early intervention targeting these high-risk children. However, to the best of the author’s knowledge, the author was the first to establish an evidence-based intervention programme against reactive and proactive aggression. With the largest samples in the world, the author, in the past 10 years, explored three different approaches and their effectiveness against aggression quantitatively and qualitatively with longitudinal design. The three approaches presented are (a) cognitive-behavioral approach, (b) moral education, with Chinese marital arts and ethics as the medium, and (c) bioneurological measures (omega-3 supplementation). The studies adopted a multi-informant approach with repeated measures before and after the intervention, and follow-up assessment. Participants were recruited from primary and secondary schools in Hong Kong. In the cognitive-behavioral approach, 66 reactive aggressors and 63 proactive aggressors, aged from 11 to 17, were identified from 10,096 secondary-school children with questionnaire and subsequent structured interview. Participants underwent 10 group sessions specifically designed for each subtype of aggressor. Results revealed significant declines in aggression levels from the baseline to the follow-up assessment after 1 year. In moral education through the Chinese martial arts, 315 high-risk aggressive children, aged 6 to 12 years, were selected from 3,511 primary-school children and randomly assigned into four types of 10-session intervention group, namely martial-skills-only, martial-ethics-only, both martial-skills-and-ethics, and physical fitness (placebo). Results showed only the martial-skills-and-ethics group had a significant reduction in aggression after treatment and 6 months after treatment comparing with the placebo group. In the bioneurological approach, 218 children, aged from 8 to 17, were randomly assigned to the omega-3 supplement group and the placebo group. Results revealed that compared with the placebo group, the omega-3 supplement group had significant declines in aggression levels at the 6-month follow-up assessment. All three approaches were effective in reducing proactive and reactive aggression. Traditionally, intervention programmes against aggressive behaviour often adapted the cognitive and/or behavioural approach. However, cognitive-behavioural approach for children was recently challenged by its demanding requirement of cognitive ability. Traditional cognitive interventions may not be as beneficial to an older population as in young children. The present study offered an insightful perspective in aggression reduction measures.

Keywords: intervention, outcome effectiveness, proactive aggression, reactive aggression

Procedia PDF Downloads 217

Authors: Santosh Sharma Parajuli, Diwas Manandhar

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Background: Perioperative pain management plays an integral part in patients undergoing cardiac surgery. We studied the effect of Erector Spinae Plane block on acute postoperative pain reduction and 24 hours opioid consumption in adult cardiac surgical patients. Methods: Twenty-five adult cardiac surgical patients who underwent cardiac surgery with sternotomy in whom ESP catheters were placed preoperatively were kept in group E, and the other 25 patients who had undergone cardiac surgery without ESP catheter and pain management done with conventional opioid injection were placed in group C. Fentanyl was used for pain management. The primary study endpoint was to compare the consumption of fentanyl and to assess the numeric rating scale in the postoperative period in the first 24 hours in both groups. Results: The 24 hours fentanyl consumption was 43.00±51.29 micrograms in the Erector Spinae Plane catheter group and 147.00±60.94 micrograms in the control group postoperatively which was statistically significant (p <0.001). The numeric rating scale was also significantly reduced in the Erector Spinae Plane group compared to the control group in the first 24 hours postoperatively. Conclusion: Erector Spinae Plane block is superior to the conventional opioid injection method for postoperative pain management in CABG patients. Erector Spinae Plane block not only decreases the overall opioid consumption but also the NRS score in these patients.

Keywords: erector, spinae, plane, numerical rating scale

Procedia PDF Downloads 60