Search results for: concentration based internal heat source

Authors: Chiara Barone

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In Naples, the visible architecture is only what emerges from the underground. Caves and tunnels cross it in every direction, intertwining with each other. They are not natural caves but spaces built by removing what is superfluous in order to dig a form out of the material. Architects, as sculptors of space, do not determine the exterior, what surrounds the volume and in which the forms live, but an interior underground space, perceptive and sensitive, able to generate new emotions each time. It is an intracorporeal architecture linked to the body, not in its external relationships, but rather with what happens inside. The proposed aims to reflect on the design of underground spaces in the Neapolitan city. The idea is to intend the underground as a spectacular museum of the city, an opportunity to learn in situ the history of the place along an unpredictable itinerary that crosses the caves and, in certain points, emerges, escaping from the world of shadows. Starting form the analysis and the study of the many overlapping elements, the archaeological one, the geological layer and the contemporary city above, it is possible to develop realistic alternatives for underground itineraries. The objective is to define minor paths to ensure the continuity between the touristic flows and entire underground segments already investigated but now disconnected: open-air paths, which abyss in the earth, retracing historical and preserved fragments. The visitor, in this way, passes from real spaces to sensitive spaces, in which the imaginary replaces the real experience, running towards exciting and secret knowledge. To safeguard the complex framework of the historical-artistic values, it is essential to use a multidisciplinary methodology based on a global approach. Moreover, it is essential to refer to similar design projects for the archaeological underground, capable of guide action strategies, looking at similar conditions in other cities, where the project has led to an enhancement of the heritage in the city. The research limits the field of investigation, by choosing the historic center of Naples, applying bibliographic and theoretical research to a real place. First of all, it’s necessary to deepen the places’ knowledge understanding the potentialities of the project as a link between what is below and what is above. Starting from a scientific approach, in which theory and practice are constantly intertwined through the architectural project, the major contribution is to provide possible alternative configurations for the underground space and its relationship with the city above, understanding how the condition of transition, as passage between the below and the above becomes structuring in the design process. Starting from the consideration of the underground as both a real physical place and a sensitive place, which engages the memory, imagination, and sensitivity of a man, the research aims at identifying possible configurations and actions useful for future urban programs to make the underground a central part of the lived city, again.

Keywords: underground paths, invisible ruins, imaginary, sculpted forms, sensitive spaces, Naples

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Authors: Mohammad Ali Tabibi, Farzad Nazemi, Nasrin Salimian

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Background: Peritoneal dialysis (PD) is a prevalent renal replacement therapy for patients with end-stage renal disease. Despite its benefits, PD patients often experience reduced physical activity and physical function, which can negatively impact dialysis adequacy and overall health outcomes. Despite the known benefits of maintaining physical activity in chronic disease management, the specific interplay between physical inactivity, physical function, and dialysis adequacy in PD patients remains underexplored. Understanding this relationship is essential for developing targeted interventions to enhance patient care and outcomes in this vulnerable population. This study aims to assess the impact of physical inactivity on dialysis adequacy and functional health in PD patients. Methods: This cross-sectional study included 135 peritoneal dialysis patients from multiple dialysis centers. Physical inactivity was measured using the International Physical Activity Questionnaire (IPAQ), while physical function was assessed using the Short Physical Performance Battery (SPPB). Dialysis adequacy was evaluated using the Kt/V ratio. Additional variables such as demographic data, comorbidities, and laboratory parameters were collected to control for potential confounders. Statistical analyses were performed to determine the relationships between physical inactivity, physical function, and dialysis adequacy. Results: The study cohort comprised 70 males and 65 females with a mean age of 55.4 ± 13.2 years. A significant proportion of the patients (65%) were categorized as physically inactive based on IPAQ scores. Inactive patients demonstrated significantly lower SPPB scores (mean 6.2 ± 2.1) compared to their more active counterparts (mean 8.5 ± 1.8, p < 0.001). Dialysis adequacy, as measured by Kt/V, was found to be suboptimal (Kt/V < 1.7) in 48% of the patients. There was a significant positive correlation between physical function scores and Kt/V values (r = 0.45, p < 0.01), indicating that better physical function is associated with higher dialysis adequacy. Also, there was a significant negative correlation between physical inactivity and physical function (r = -0.55, p < 0.01). Additionally, physically inactive patients had lower Kt/V ratios compared to their active counterparts (1.3 ± 0.3 vs. 1.8 ± 0.4, p < 0.05). Multivariate regression analysis revealed that physical inactivity was an independent predictor of reduced dialysis adequacy (β = -0.32, p < 0.01) and poorer physical function (β = -0.41, p < 0.01) after adjusting for age, sex, comorbidities, and dialysis vintage. Conclusion: This study underscores the critical role of physical activity and physical function in maintaining adequate dialysis in peritoneal dialysis patients. These findings highlight the need for targeted interventions to promote physical activity in this population to improve their overall health outcomes. Future research should focus on developing and evaluating exercise programs tailored for PD patients to enhance their physical function and dialysis adequacy. The findings suggest that interventions aimed at increasing physical activity and improving physical function may enhance dialysis adequacy and overall health outcomes in this population. Further research is warranted to explore the mechanisms underlying these associations and to develop targeted strategies for enhancing patient care.

Keywords: inactivity, physical function, peritoneal dialysis, dialysis adequacy

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Authors: Alfonsina Buoniconto

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The aim of this study is to investigate the degree of cross-linguistic and intra-linguistic variation in the encoding of motion events (MEs) in English and Italian, these being typologically different languages both showing signs of disobedience to their respective types. As a matter of fact, the traditional typological classification of MEs encoding distributes languages into two macro-types, based on the preferred locus for the expression of Path, the main ME component (other components being Figure, Ground and Manner) characterized by conceptual and structural prominence. According to this model, Satellite-framed (SF) languages typically express Path information in verb-dependent items called satellites (e.g. preverbs and verb particles) with main verbs encoding Manner of motion; whereas Verb-framed languages (VF) tend to include Path information within the verbal locus, leaving Manner to adjuncts. Although this dichotomy is valid altogether, languages do not always behave according to their typical classification patterns. English, for example, is usually ascribed to the SF type due to the rich inventory of postverbal particles and phrasal verbs used to express spatial relations (i.e. the cat climbed down the tree); nevertheless, it is not uncommon to find constructions such as the fog descended slowly, which is typical of the VF type. Conversely, Italian is usually described as being VF (cf. Paolo uscì di corsa ‘Paolo went out running’), yet SF constructions like corse via in lacrime ‘She ran away in tears’ are also frequent. This paper will try to demonstrate that such a typological overlapping is due to the fact that the semantic units making up MEs are distributed within several loci of the sentence –not only verbs and satellites– thus determining a number of different constructions stemming from convergent factors. Indeed, the linguistic expression of motion events depends not only on the typological nature of languages in a traditional sense, but also on a series morphological, lexical, and syntactic resources, as well as on inferential, discursive, usage-related, and cultural factors that make semantic information more or less accessible, frequent, and easy to process. Hence, rather than describe English and Italian in dichotomic terms, this study focuses on the investigation of cross-linguistic and intra-linguistic variation in the use of all the strategies made available by each linguistic system to express motion. Evidence for these assumptions is provided by parallel corpora analysis. The sample texts are taken from two contemporary Italian novels and their respective English translations. The 400 motion occurrences selected (200 in English and 200 in Italian) were scanned according to the MODEG (an acronym for Motion Decoding Grid) methodology, which grants data comparability through the indexation and retrieval of combined morphosyntactic and semantic information at different levels of detail.

Keywords: construction typology, motion event encoding, parallel corpora, satellite-framed vs. verb-framed type

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

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Authors: Denis A. Sokolov, Andrey V. Mazurkevich

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In the modern world, there is an increasing demand for highly precise measurements in various fields, such as aircraft, shipbuilding, and rocket engineering. This has resulted in the development of appropriate measuring instruments that are capable of measuring the coordinates of objects within a range of up to 100 meters, with an accuracy of up to one micron. The calibration process for such optoelectronic measuring devices (trackers and total stations) involves comparing the measurement results from these devices to a reference measurement based on a linear or spatial basis. The reference used in such measurements could be a reference base or a reference range finder with the capability to measure angle increments (EDM). The base would serve as a set of reference points for this purpose. The concept of the EDM for replicating the unit of measurement has been implemented on a mobile platform, which allows for angular changes in the direction of laser radiation in two planes. To determine the distance to an object, a high-precision interferometer with its own design is employed. The laser radiation travels to the corner reflectors, which form a spatial reference with precisely known positions. When the femtosecond pulses from the reference arm and the measuring arm coincide, an interference signal is created, repeating at the frequency of the laser pulses. The distance between reference points determined by interference signals is calculated in accordance with recommendations from the International Bureau of Weights and Measures for the indirect measurement of time of light passage according to the definition of a meter. This distance is D/2 = c/2nF, approximately 2.5 meters, where c is the speed of light in a vacuum, n is the refractive index of a medium, and F is the frequency of femtosecond pulse repetition. The achieved uncertainty of type A measurement of the distance to reflectors 64 m (N•D/2, where N is an integer) away and spaced apart relative to each other at a distance of 1 m does not exceed 5 microns. The angular uncertainty is calculated theoretically since standard high-precision ring encoders will be used and are not a focus of research in this study. The Type B uncertainty components are not taken into account either, as the components that contribute most do not depend on the selected coordinate measuring method. This technology is being explored in the context of laboratory applications under controlled environmental conditions, where it is possible to achieve an advantage in terms of accuracy. In general, the EDM tests showed high accuracy, and theoretical calculations and experimental studies on an EDM prototype have shown that the uncertainty type A of distance measurements to reflectors can be less than 1 micrometer. The results of this research will be utilized to develop a highly accurate mobile absolute range finder designed for the calibration of high-precision laser trackers and laser rangefinders, as well as other equipment, using a 64 meter laboratory comparator as a reference.

Keywords: femtosecond laser, pulse correlation, interferometer, laser absolute range finder, coordinate measurement

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Authors: Erik Vassøy Olsen, Hirpa G. Lemu

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Inspired by the Formula-1 competition, IMechE (Institute of Mechanical Engineers) and Formula SAE (Society of Mechanical Engineers) organize annual competitions for University and College students worldwide to compete with a single-seat race car they have designed and built. The design of the chassis or the frame is a key component of the competition because the weight and stiffness properties are directly related with the performance of the car and the safety of the driver. In addition, a reduced weight of the chassis has a direct influence on the design of other components in the car. Among others, it improves the power to weight ratio and the aerodynamic performance. As the power output of the engine or the battery installed in the car is limited to 80 kW, increasing the power to weight ratio demands reduction of the weight of the chassis, which represents the major part of the weight of the car. In order to reduce the weight of the car, ION Racing team from the University of Stavanger, Norway, opted for a monocoque design. To ensure fulfilment of the above-mentioned requirements of the chassis, the monocoque design should provide sufficient torsional stiffness and absorb the impact energy in case of a possible collision. The study reported in this article is based on the requirements for Formula Student competition. As part of this study, diverse mechanical tests were conducted to determine the mechanical properties and performances of the monocoque design. Upon a comprehensive theoretical study of the mechanical properties of sandwich composite materials and the requirements of monocoque design in the competition rules, diverse tests were conducted including 3-point bending test, perimeter shear test and test for absorbed energy. The test panels were homemade and prepared with an equivalent size of the side impact zone of the monocoque, i.e. 275 mm x 500 mm so that the obtained results from the tests can be representative. Different layups of the test panels with identical core material and the same number of layers of carbon fibre were tested and compared. Influence of the core material thickness was also studied. Furthermore, analytical calculations and numerical analysis were conducted to check compliance to the stated rules for Structural Equivalency with steel grade SAE/AISI 1010. The test results were also compared with calculated results with respect to bending and torsional stiffness, energy absorption, buckling, etc. The obtained results demonstrate that the material composition and strength of the composite material selected for the monocoque design has equivalent structural properties as a welded frame and thus comply with the competition requirements. The developed analytical calculation algorithms and relations will be useful for future monocoque designs with different lay-ups and compositions.

Keywords: composite material, Formula student, ION racing, monocoque design, structural equivalence

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Authors: Emily Wood, James K. Westphal, Itamar Lerner

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Background: Polysomnography (PSG) recordings are regularly used in research and clinical settings to study sleep and sleep-related disorders. Typical PSG studies are conducted in professional laboratories and performed by qualified researchers. However, the number of sleep labs worldwide is disproportionate to the increasing number of individuals with sleep disorders like sleep apnea and insomnia. Consequently, there is a growing need to supply cheaper yet reliable means to measure sleep, preferably autonomously by subjects in their own home. Over the last decade, a variety of devices for self-monitoring of sleep became available in the market; however, very few have been directly validated against PSG to demonstrate their ability to perform reliable automatic sleep scoring. Two popular mobile EEG-based systems that have published validation results, the DREEM 3 headband and the Z-Machine, have never been directly compared one to the other by independent researchers. The current study aimed to compare the performance of DREEM 3 and the Z-Machine to help investigators and clinicians decide which of these devices may be more suitable for their studies. Methods: 26 participants have completed the study for credit or monetary compensation. Exclusion criteria included any history of sleep, neurological or psychiatric disorders. Eligible participants arrived at the lab in the afternoon and received the two devices. They then spent two consecutive nights monitoring their sleep at home. Participants were also asked to keep a sleep log, indicating the time they fell asleep, woke up, and the number of awakenings occurring during the night. Data from both devices, including detailed sleep hypnograms in 30-second epochs (differentiating Wake, combined N1/N2, N3; and Rapid Eye Movement sleep), were extracted and aligned upon retrieval. For analysis, the number of awakenings each night was defined as four or more consecutive wake epochs between sleep onset and termination. Total sleep time (TST) and the number of awakenings were compared to subjects’ sleep logs to measure consistency with the subjective reports. In addition, the sleep scores from each device were compared epoch-by-epoch to calculate the agreement between the two devices using Cohen’s Kappa. All analysis was performed using Matlab 2021b and SPSS 27. Results/Conclusion: Subjects consistently reported longer times spent asleep than the time reported by each device (M= 448 minutes for sleep logs compared to M= 406 and M= 345 minutes for the DREEM and Z-Machine, respectively; both ps<0.05). Linear correlations between the sleep log and each device were higher for the DREEM than the Z-Machine for both TST and the number of awakenings, and, likewise, the mean absolute bias between the sleep logs and each device was higher for the Z-Machine for both TST (p<0.001) and awakenings (p<0.04). There was some indication that these effects were stronger for the second night compared to the first night. Epoch-by-epoch comparisons showed that the main discrepancies between the devices were for detecting N2 and REM sleep, while N3 had a high agreement. Overall, the DREEM headband seems superior for reliably scoring sleep at home.

Keywords: DREEM, EEG, seep monitoring, Z-machine

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Authors: Christine P. Gibson, Ramona Alex, Michael Farney, Johana Vallejo-Elias, Mitra Esfandiarei

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Aortic aneurysm is the leading cause of death in Marfan syndrome (MFS), a connective tissue disorder caused by mutations in fibrillin-1 gene (FBN1). MFS aneurysm is characterized by weakening of the aortic wall due to elastin fibers fragmentation and disorganization. The above-average height and distinct physical features make young adults with MFS desirable candidates for competitive sports; but little is known about the exercise limit at which they will be at risk for aortic rupture. On the other hand, aerobic cardiovascular exercise has been shown to have protective effects on the heart and aorta. We have previously reported that mild aerobic exercise can delay the formation of aortic aneurysm in a mouse model of MFS. In this study, we aimed to investigate the effects of various levels of exercise intensity on the progression of aortic aneurysm in the mouse model. Starting at 4 weeks of age, we subjected control and MFS mice to different levels of exercise intensity (8m/min, 10m/min, 15m/min, and 20m/min, corresponding to 55%, 65%, 75%, and 85% of VO2 max, respectively) on a treadmill for 30 minutes per day, five days a week for the duration of the study. At 24 weeks of age, aortic tissue were isolated and subjected to structural and functional studies using histology and wire myography in order to evaluate the effects of different exercise routines on elastin fragmentation and organization and aortic wall elasticity/stiffness. Our data shows that exercise training at the intensity levels between 55%-75% significantly reduces elastin fragmentation and disorganization, with less recovery observed in 85% MFS group. The reversibility of elasticity was also significantly restored in MFS mice subjected to 55%-75% intensity; however, the recovery was less pronounced in MFS mice subjected to 85% intensity. Furthermore, our data shows that smooth muscle cells (SMCs) contractilion in response to vasoconstrictor agent phenylephrine (100nM) is significantly reduced in MFS aorta (54.84 ± 1.63 mN/mm2) as compared to control (95.85 ± 3.04 mN/mm2). At 55% of intensity, exercise did not rescue SMCs contraction (63.45 ± 1.70 mN/mm2), while at higher intensity levels, SMCs contraction in response to phenylephrine was restored to levels similar to control aorta [65% (81.88 ± 4.57 mN/mm2), 75% (86.22 ± 3.84 mN/mm2), and 85% (83.91 ± 5.42 mN/mm2)]. This study provides the first time evidence that high intensity exercise (e.g. 85%) may not provide the most beneficial effects on aortic function (vasoconstriction) and structure (elastin fragmentation, aortic wall elasticity) during the progression of aortic aneurysm in MFS mice. On the other hand, based on our observations, medium intensity exercise (e.g. 65%) seems to provide the utmost protective effects on aortic structure and function in MFS mice. These findings provide new insights into the potential capacity, in which MFS patients could participate in various aerobic exercise routines, especially in young adults affected by cardiovascular complications particularly aortic aneurysm. This work was funded by Midwestern University Research Fund.

Keywords: aerobic exercise, aortic aneurysm, aortic wall elasticity, elastin fragmentation, Marfan syndrome

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Authors: Mariam Mtunguja, Henry Laswai, Yasinta Muzanilla, Joseph Ndunguru

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Starchy tuberous roots of cassava provide food for people but also find application in various industries. Recently there has been the focus of concentrated research efforts to fully exploit its potential as a sustainable multipurpose crop. High starch yield is the important trait for commercial cassava production for the starch industries. Furthermore, cyanide present in cassava root poses a health challenge in the use of cassava for food. Farming communities where cassava is a staple food, prefer bitter (high cyanogenic) varieties as protection from predators and thieves. As a result, food insecure farmers prefer growing bitter cassava. This has led to cyanide intoxication to this farming communities. Cassava farmers can benefit from marketing cassava to starch producers thereby improving their income and food security. This will decrease dependency on cassava as staple food as a result of increased income and be able to afford other food sources. To achieve this, adequate information is required on the right cassava cultivars and appropriate harvesting period so as to maximize cassava production and profitability. This study aimed at identifying suitable cassava cultivars and optimum time of harvest to maximize starch production. Six commonly grown cultivars were identified and planted in a complete random block design and further analysis was done to assess variation in physicochemical characteristics, starch yield and cyanogenic potentials across three environments. The analysis showed that there is a difference in physicochemical characteristics between landraces (p ≤ 0.05), and can be targeted to different industrial applications. Among landraces, dry matter (30-39%), amylose (11-19%), starch (74-80%) and reducing sugars content (1-3%) varied when expressed on a dry weight basis (p ≤ 0.05); however, only one of the six genotypes differed in crystallinity and mean starch granule particle size, while glucan chain distribution and granule morphology were the same. In contrast, the starch functionality features measured: swelling power, solubility, syneresis, and digestibility differed (p ≤ 0.05). This was supported by Partial least square discriminant analysis (PLS-DA), which highlighted the divergence among the cassavas based on starch functionality, permitting suggestions for the targeted uses of these starches in diverse industries. The study also illustrated genotypic difference in starch yield and cyanogenic potential. Among landraces, Kiroba showed potential for maximum starch yield (12.8 t ha-1) followed by Msenene (12.3 t ha-1) and third was Kilusungu (10.2 t ha-1). The cyanide content of cassava landraces was between 15 and 800 ppm across all trial sites. GGE biplot analysis further confirmed that Kiroba was a superior cultivar in terms of starch yield. Kilusungu had the highest cyanide content and average starch yield, therefore it can also be suitable for use in starch production.

Keywords: cyanogen, cassava starch, food security, starch yield

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Authors: Madhura Bapat, Uma Krishnan

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Exploring the redefinition of masculinity through the experiences of male Indian classical dancers, this qualitative research focuses on their perceived quality of life, psychosocial challenges, and coping strategies. This study aims to explore the mental health nuances of male Indian classical dancers through an in-depth understanding of their lived experiences with dance. The benefits and personal journeys of dancers, particularly in Indian classical forms, reveal insights into culture, gender, and societal expectations. Men in Indian classical dance frequently encounter stigma due to prevailing gender norms in the arts and society. Acknowledgment of these experiences is key to understanding issues of identity, mental wellness, and communal acceptance of male Indian classical dancers in the Indian dance scenario. This study follows an interpretive phenomenological approach to follow the lived experiences of male Indian classical dancers. Male Indian classical dancers were selected using criterion-based sampling. The participants are male, fluent in English and pursue Indian classical dance styles professionally, like Kathak, Bharatanatyam, Chhau, etc. Six participants were recruited for personal, semi-structured, in-depth interviews. A focus group discussion with four participants was conducted to explore the stigma surrounding their roles. The data were analyzed using interpretive phenomenological analysis (IPA), revealing superordinate themes of (1) identity fragmentation and negotiation in gendered social contexts; (2) gendered constraints and artistic expression; (3) psychosocial distress and mental health challenges; (4) coping mechanisms and resilience; and (5) stigmatization and social integration dynamics. Male Indian classical dancers grapple with identity formation, navigating a paradox of self-perception, artistic identity, and societal expectation. They reported experiencing emasculation, compromising artistic expression, and struggling with gender norms and gendered training constraints. They have faced name-calling, bullying, taunting, slandering, and discrimination. These experiences have led to psychological challenges and distress. However, the paradox continues as male dancers use adaptive coping strategies despite the adversities that intertwine self-perception, societal pressures, and their passion for dance. This research sheds light on the intersection of gender, mental health, and art. These findings provide a strong foundation for making changes in the dance community for acceptance of male dancers, policy making for better job opportunities for male dancers and mental health services to be provided to help them deal with distress. The study offers valuable insights into how male classical dancers navigate stigma and mental health challenges in gendered social contexts, contributing to a deeper understanding of identity formation in the arts.

Keywords: gendered experiences, Indian classical dance, male dancers, mental health, stigma

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Ana Julia Acevedo Urquiaga, Jose A. Acevedo Suarez, Ana Julia Urquiaga Rodriguez, Neyfe Sablon Cossio

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Despite the progress made in logistics and supply chains fields, it is unavoidable the development of business models that use efficiently information to facilitate the integrated logistics flows management between partners. Collaborative management is an important tool for materializing the cooperation between companies, as a way to achieve the supply chain efficiency and effectiveness. The first face of this research was a comprehensive analysis of the collaborative planning on the Cuban companies. It is evident that they have difficulties in supply chains planning where production, supplies and replenishment planning are independent tasks, as well as logistics and distribution operations. Large inventories generate serious financial and organizational problems for entities, demanding increasing levels of working capital that cannot be financed. Problems were found in the efficient application of Information and Communication Technology on business management. The general objective of this work is to develop a methodology that allows the deployment of a planning and control system in a coordinated way on the medicine’s logistics system in Cuba. To achieve these objectives, several mechanisms of supply chain coordination, mathematical programming models, and other management techniques were analyzed to meet the requirements of collaborative logistics management in Cuba. One of the findings is the practical and theoretical inadequacies of the studied models to solve the current situation of the Cuban logistics systems management. To contribute to the tactical-operative management of logistics, the Collaborative Logistics Flow Management Model (CLFMM) is proposed as a tool for the balance of cycles, capacities, and inventories, always to meet the final customers’ demands in correspondence with the service level expected by these. The CLFMM has as center the supply chain planning and control system as a unique information system, which acts on the processes network. The development of the model is based on the empirical methods of analysis-synthesis and the study cases. Other finding is the demonstration of the use of a single information system to support the supply chain logistics management, allows determining the deadlines and quantities required in each process. This ensures that medications are always available to patients and there are no faults that put the population's health at risk. The simulation of planning and control with the CLFMM in medicines such as dipyrone and chlordiazepoxide, during 5 months of 2017, permitted to take measures to adjust the logistic flow, eliminate delayed processes and avoid shortages of the medicines studied. As a result, the logistics cycle efficiency can be increased to 91%, the inventory rotation would increase, and this results in a release of financial resources.

Keywords: collaborative management, medicine logistic system, supply chain planning, tactical-operative planning

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Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

Procedia PDF Downloads 104

Authors: Waseem Akram, Hafiz Azhar Ali Khan

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Unplanned urbanization together with change in life from simple to more technologically advanced style with flow of rural masses to urban areas has played a vital role in pilling loads of solid wastes in our environment. The cities and towns have expanded beyond boundaries. Even the uncontrolled population expansion has caused the overall environmental burden. Thus, today the indifference remains as one of the biggest trash that has come up due to the non-responsive behavior of the people. Everyday huge amount of solid waste is thrown in the streets, on the roads, parks, and in all those places that are frequently and often visited by the human beings. This behavior based response in many countries of the world has led to serious health concerns and environmental issues. Over 80% of our products that are sold in the market are packed in plastic bags. None of the bags are later recycled but simply become a permanent environment concern that flies, choke lines or are burnt and release toxic gases in the environment or form dumps of heaps. Lack of classification of the daily waste generated from houses and other places lead to worst clogging of the sewerage lines and formation of ponding areas which ultimately favor vector borne disease and sometimes become a cause of transmission of polio virus. Solid waste heaps were checked at different places of the cities. All of the wastes on visual assessments were classified into plastic bags, papers, broken plastic pots, clay pots, steel boxes, wrappers etc. All solid waste dumping sites in the cities and wastes that were thrown outside of the trash containers usually contained wrappers, plastic bags, and unconsumed food products. Insect populations seen in these sites included the house flies, bugs, cockroaches and mosquito larvae breeding in water filled wrappers, containers or plastic bags. The population of the mosquitoes, cockroaches and houseflies were relatively very high in dumping sites close to human population. This population has been associated with cases like dengue, malaria, dysentery, gastro and also to skin allergies during the monsoon and summer season. Thus, dumping of the huge amount of solid wastes in and near the residential areas results into serious environmental concerns, bad smell circulation, and health related issues. In some places, the same waste is burnt to get rid of mosquitoes through smoke which ultimately releases toxic material in the atmosphere. Therefore, a proper environmental strategy is needed to minimize environmental burden and promote concepts of recycled products and thus, reduce the disease burden.

Keywords: solid waste accumulation, disease burden, mosquitoes, vector borne diseases

Procedia PDF Downloads 278

Authors: A. Marais

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A challenging aspect of teaching cello to novice adult learners is finding adequate lesson material and applying relevant teaching methodologies. It could play a crucial role in adult learners' decision to commence or stop taking music lessons. This study contributes to the theory and practises of continuing education. This study is important to lifelong learning, especially with the focus on adult teaching and learning and the difficulties concerning these themes. The research problem identified for this study is we are not aware of adults' life stories; thus, cello lesson material is not always relevant for adult's specific needs for motivation and goals for starting cello lessons. In my experience, an adult does not necessarily want to play children songs when they learn a new instrument. They want material and lessons fitted to adult learners. Adults also learn differently from younger beginners. Adults ask questions such as how and why, while children more readily accept what is being taught. This research creates awareness of adults' musical needs and learning methods. If every adult shares their own story for commencing and continuing with cello lessons, material should be created, revised, or adapted for more individually appropriate lessons. A number of studies show that adults taking music lessons experience a decrease in feelings of loneliness and isolation. It gives adults a sense of wellbeing and can help improve immune systems. The purpose of this research study will be to discover the life stories of adult amateur cellists. At this stage in the research, the life stories of amateur cellists can generally be defined as personal reflections of their motivations for and experiences of commencing and continuing with individual lessons. The findings of this study will contribute to the development of cello lesson material for adult beginners based on their stories. This research could also encourage adults to commence with music lessons and could, in that way, contribute to their quality of life. Music learners become aware of deep spiritual, emotional, and social values incorporated or experienced through musical learning. This will be a qualitative study with a narrative approach making use of oral history. The chosen method will encapsulate the stories of amateur individual adults starting and continuing with cello lessons. The narrative method entails experiences as expressed in lived and told stories of individuals. Oral history is used as part of the narrative method and entails gathering of personal reflections of events and their cause and effects from an individual or several individuals. These findings from this study will contribute to adult amateur cellists' motivations to continue with music lessons and inspire others to commence. The inspiring life stories of the amateur cellists would provide insight into finding and creating new cello lesson material and enhance existing teaching methodologies for adult amateur cellists.

Keywords: adult, amateur, cello, education, learning, music, stories

Procedia PDF Downloads 134

Authors: Luisa Windhagen, Atsumi Hirose, Alex Bottle

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Global urbanization has resulted in the expansion of slums, leaving over 10 million Tanzanians in urban poverty and at risk of poor health. Whilst rural residence has historically been associated with an increased risk of adverse pregnancy outcomes, recent studies found higher perinatal mortality rates in urban Tanzania. This study aims to understand to what extent slum neighborhoods may account for the spatial disparities seen in Tanzania. We generated a slum indicator based on UN-HABITAT criteria to identify slum clusters within the 2015-2016 Tanzania Demographic and Health Survey. Descriptive statistics, disaggregated by urban slum, urban non-slum, and rural areas, were produced. Simple and multivariable logistic regression examined the association between cluster residence type and neonatal mortality and stillbirth. For neonatal mortality, we additionally built a multilevel logistic regression model, adjusting for confounding and clustering. The neonatal mortality ratio was highest in slums (38.3 deaths per 1000 live births); the stillbirth rate was three times higher in slums (32.4 deaths per 1000 births) than in urban non-slums. Neonatal death was more likely to occur in slums than in urban non-slums (aOR=2.15, 95% CI=1.02-4.56) and rural areas (aOR=1.78, 95% CI=1.15-2.77). Odds of stillbirth were over five times higher among rural than urban non-slum residents (aOR=5.25, 95% CI=1.31-20.96). The results suggest that slums contribute to the urban disadvantage in Tanzanian neonatal health. Higher neonatal mortality in slums may be attributable to lack of education, lower socioeconomic status, poor healthcare access, and environmental factors, including indoor and outdoor air pollution and unsanitary conditions from inadequate housing. However, further research is required to ascertain specific causalities as well as significant associations between residence type and other pregnancy outcomes. The high neonatal mortality, stillbirth, and slum formation rates in Tanzania signify that considerable change is necessary to achieve international goals for health and human settlements. Disparities in access to adequate housing, safe water and sanitation, high standard antenatal, intrapartum, and neonatal care, and maternal education need to urgently be addressed. This study highlights the spatial neonatal mortality shift from rural settings to urban informal settlements in Tanzania. Importantly, other low- and middle-income countries experiencing overwhelming urbanization and slum expansion may also be at risk of a reversing trend in residential neonatal health differences.

Keywords: urban health, slum residence, neonatal mortality, stillbirth, global urbanisation

Procedia PDF Downloads 64

Authors: Ani Demetrashvili

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As online learning continues to reshape the landscape of education, questions arise regarding its efficacy for diverse learning styles, particularly for visual learners. This abstract delves into the impact of online learning on visual learners, exploring how digital mediums influence their educational experience and how educational platforms can be optimized to cater to their needs. Visual learners comprise a significant portion of the student population, characterized by their preference for visual aids such as diagrams, charts, and videos to comprehend and retain information. Traditional classroom settings often struggle to accommodate these learners adequately, relying heavily on auditory and written forms of instruction. The advent of online learning presents both opportunities and challenges in addressing the needs of visual learners. Online learning platforms offer a plethora of multimedia resources, including interactive simulations, virtual labs, and video lectures, which align closely with the preferences of visual learners. These platforms have the potential to enhance engagement, comprehension, and retention by presenting information in visually stimulating formats. However, the effectiveness of online learning for visual learners hinges on various factors, including the design of learning materials, user interface, and instructional strategies. Research into the impact of online learning on visual learners encompasses a multidisciplinary approach, drawing from fields such as cognitive psychology, education, and human-computer interaction. Studies employ qualitative and quantitative methods to assess visual learners' preferences, cognitive processes, and learning outcomes in online environments. Surveys, interviews, and observational studies provide insights into learners' preferences for specific types of multimedia content and interactive features. Cognitive tasks, such as memory recall and concept mapping, shed light on the cognitive mechanisms underlying learning in digital settings. Eye-tracking studies offer valuable data on attentional patterns and information processing during online learning activities. The findings from research on the impact of online learning on visual learners have significant implications for educational practice and technology design. Educators and instructional designers can use insights from this research to create more engaging and effective learning materials for visual learners. Strategies such as incorporating visual cues, providing interactive activities, and scaffolding complex concepts with multimedia resources can enhance the learning experience for visual learners in online environments. Moreover, online learning platforms can leverage the findings to improve their user interface and features, making them more accessible and inclusive for visual learners. Customization options, adaptive learning algorithms, and personalized recommendations based on learners' preferences and performance can enhance the usability and effectiveness of online platforms for visual learners.

Keywords: online learning, visual learners, digital education, technology in learning

Procedia PDF Downloads 39

Authors: Peter Kus, Anna Ostroverkh, Yurii Yakovlev, Yevheniia Lobko, Roman Fiala, Ivan Khalakhan, Vladimir Matolin

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Hydrogen economy is a concept of low-emission society which harvests most of its energy from renewable sources (e.g., wind and solar) and in case of overproduction, electrochemically turns the excess amount into hydrogen, which serves as an energy carrier. Proton exchange membrane water electrolyzers (PEMWE) are the backbone of this concept. By fast-response electricity to hydrogen conversion, the PEMWEs will not only stabilize the electrical grid but also provide high-purity hydrogen for variety of fuel cell powered devices, ranging from consumer electronics to vehicles. Wider commercialization of PEMWE technology is however hindered by high prices of noble metals which are necessary for catalyzing the redox reactions within the cell. Namely, platinum for hydrogen evolution reaction (HER), running on cathode, and iridium for oxygen evolution reaction (OER) on anode. Possible way of how to lower the loading of Pt and Ir is by using conductive high-surface nanostructures as catalyst supports in conjunction with thin-film catalyst deposition. The presented study discusses unconventional technique of membrane electron assembly (MEA) preparation. Noble metal catalysts (Pt and Ir) were magnetron sputtered in very low loadings onto the surface of porous sublayers (located on gas diffusion layer or directly on membrane), forming so to say localized three-phase boundary. Ultrasonically sprayed corrosion resistant TiC-based sublayer was used as a support material on anode, whereas magnetron sputtered nanostructured etched nitrogenated carbon (CNx) served the same role on cathode. By using this configuration, we were able to significantly decrease the amount of noble metals (to thickness of just tens of nanometers), while keeping the performance comparable to that of average state-of-the-art catalysts. Complex characterization of prepared supported catalysts includes in-cell performance and durability tests, electrochemical impedance spectroscopy (EIS) as well as scanning electron microscopy (SEM) imaging and X-ray photoelectron spectroscopy (XPS) analysis. Our research proves that magnetron sputtering is a suitable method for thin-film deposition of electrocatalysts. Tested set-up of thin-film supported anode and cathode catalysts with combined loading of just 120 ug.cm⁻² yields remarkable values of specific current. Described approach of thin-film low-loading catalyst deposition might be relevant when noble metal reduction is the topmost priority.

Keywords: hydrogen economy, low-loading catalyst, magnetron sputtering, proton exchange membrane water electrolyzer

Procedia PDF Downloads 163

Authors: Debdatta Mukherjee, Abhiman Das, Amit Garg

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In recent years, there is a growing interest about corporate social responsibility of firms in both academic literature and business world. Since business forms a part of society incorporating socio-environment concerns into its value chain, activities are vital for ensuring mutual sustainability and prosperity. But, until now most of the works have been either descriptive or normative rather than positivist in tone. Even the few ones with a positivist approach have mostly studied the link between corporate financial performance and corporate social performance. However, these studies have been severely criticized by many eminent authors on grounds that they lack a theoretical basis for their findings. They have also argued that apart from corporate financial performance, there must be certain other crucial influences that are likely to determine corporate social performance of firms. In fact, several studies have indicated that firms operating in distinct national institutions show significant variations in the corporate social responsibility practices that they undertake. This clearly suggests that the institutional context of a country in which the firms operate is a key determinant of corporate social performance of firms. Therefore, this paper uses an institutional framework to understand why corporate social performance of firms vary across countries. It examines the impact of country level institutions on corporate social performance using a sample of 3240 global publicly-held firms across 33 countries covering the period 2010-2015. The country level institutions include public institutions, private institutions, markets and capacity to innovate. Econometric Analysis has been mainly used to assess this impact. A three way panel data analysis using fixed effects has been used to test and validate appropriate hypotheses. Most of the empirical findings confirm our hypotheses and the economic significance indicates the specific impact of each variable and their importance relative to others. The results suggest that institutional determinants like ethical behavior of private institutions, goods market, labor market and innovation capacity of a country are significantly related to the corporate social performance of firms. Based on our findings, few implications for policy makers from across the world have also been suggested. The institutions in a country should promote competition. The government should use policy levers for upgrading home demands, like setting challenging yet flexible safety, quality and environment standards, and framing policies governing buyer information, providing innovative recourses to low quality goods and services and promoting early adoption of new and technologically advanced products. Moreover, the institution building in a country should be such that they facilitate and improve the capacity of firms to innovate. Therefore, the proposed study argues that country level institutions impact corporate social performance of firms, empirically validates the same, suggest policy implications and attempts to contribute to an extended understanding of corporate social responsibility and corporate social performance in a multinational context.

Keywords: corporate social performance, corporate social responsibility, institutions, markets

Procedia PDF Downloads 166

Authors: Joanna Cydejko, Paulina Mika

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Hypersensitivity reactions are side effects of medications that resemble an allergic reaction. Anaphylaxis is a generalized, severe allergic reaction of the body caused by exposure to a specific agent at a dose tolerated by a healthy body. The most common causes of anaphylaxis are food (about 70%), Hymenoptera venoms (22%), and medications (7%), despite detailed diagnostics in 1% of people, the cause of the anaphylactic reaction was not indicated. Contrast media are anaphylactic agents of unknown mechanism. Hypersensitivity reactions can occur with both immunological and non-immunological mechanisms. Symptoms of anaphylaxis occur within a few seconds to several minutes after exposure to the allergen. Contrast agents are chemical compounds that make it possible to visualize or improve the visibility of anatomical structures. In the diagnosis of computed tomography, the preparations currently used are derivatives of the triiodide benzene ring. Pharmacokinetic and pharmacodynamic properties, i.e., their osmolality, viscosity, low chemotoxicity and high hydrophilicity, have an impact on better tolerance of the substance by the patient's body. In MRI diagnostics, macrocyclic gadolinium contrast agents are administered during examinations. The aim of this study is to present the results of the number and severity of anaphylactic reactions that occurred in patients in all age groups undergoing diagnostic imaging with intravenous administration of contrast agents. In non-ionic iodine CT and in macrocyclic gadolinium MRI. A retrospective assessment of the number of adverse reactions after contrast administration was carried out on the basis of data from the Department of Radiology of the University Clinical Center in Gdańsk, and it was assessed whether their different physicochemical properties had an impact on the incidence of acute complications. Adverse reactions are divided according to the severity of the patient's condition and the diagnostic method used in a given patient. Complications following the administration of a contrast medium in the form of acute anaphylaxis accounted for less than 0.5% of all diagnostic procedures performed with the use of a contrast agent. In the analysis period from January to December 2022, 34,053 CT scans and 15,279 MRI examinations with the use of contrast medium were performed. The total number of acute complications was 21, of which 17 were complications of iodine-based contrast agents and 5 of gadolinium preparations. The introduction of state-of-the-art contrast formulations was an important step toward improving the safety and tolerability of contrast agents used in imaging. Currently, contrast agents administered to patients are considered to be one of the best-tolerated preparations used in medicine. However, like any drug, they can be responsible for the occurrence of adverse reactions resulting from their toxic effects. The increase in the number of imaging tests performed with the use of contrast agents has a direct impact on the number of adverse events associated with their administration. However, despite the low risk of anaphylaxis, this risk should not be marginalized. The growing threat associated with the mass performance of radiological procedures with the use of contrast agents forces the knowledge of the rules of conduct in the event of symptoms of hypersensitivity to these preparations.

Keywords: anaphylactic, contrast medium, diagnostic, medical imagine

Procedia PDF Downloads 62

Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

Procedia PDF Downloads 180

Authors: J. J. Rickard, A. Belli, P. Goldberg Oppenheimer

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Medical diagnostics, environmental monitoring, homeland security and forensics increasingly demand specific and field-deployable analytical technologies for quick point-of-care diagnostics. Although technological advancements have made optical methods well-suited for miniaturization, a highly-sensitive detection technique for minute sample volumes is required. Raman spectroscopy is a well-known analytical tool, but has very weak signals and hence is unsuitable for trace level analysis. Enhancement via localized optical fields (surface plasmons resonances) on nanoscale metallic materials generates huge signals in surface-enhanced Raman scattering (SERS), enabling single molecule detection. This enhancement can be tuned by manipulation of the surface roughness and architecture at the sub-micron level. Nevertheless, the development and application of SERS has been inhibited by the irreproducibility and complexity of fabrication routes. The ability to generate straightforward, cost-effective, multiplex-able and addressable SERS substrates with high enhancements is of profound interest for SERS-based sensing devices. While most SERS substrates are manufactured by conventional lithographic methods, the development of a cost-effective approach to create nanostructured surfaces is a much sought-after goal in the SERS community. Here, a method is established to create controlled, self-organized, hierarchical nanostructures using electrohydrodynamic (HEHD) instabilities. The created structures are readily fine-tuned, which is an important requirement for optimizing SERS to obtain the highest enhancements. HEHD pattern formation enables the fabrication of multiscale 3D structured arrays as SERS-active platforms. Importantly, each of the HEHD-patterned individual structural units yield a considerable SERS enhancement. This enables each single unit to function as an isolated sensor. Each of the formed structures can be effectively tuned and tailored to provide high SERS enhancement, while arising from different HEHD morphologies. The HEHD fabrication of sub-micrometer architectures is straightforward and robust, providing an elegant route for high-throughput biological and chemical sensing. The superior detection properties and the ability to fabricate SERS substrates on the miniaturized scale, will facilitate the development of advanced and novel opto-fluidic devices, such as portable detection systems, and will offer numerous applications in biomedical diagnostics, forensics, ecological warfare and homeland security.

Keywords: hierarchical electrohydrodynamic patterning, medical diagnostics, point-of care devices, SERS

Procedia PDF Downloads 346

Authors: Ali Mohammed Ali Lmbash

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The global refugee crisis points to the vital need for sustainable and resistant solutions to different kinds of problems for displaced persons all over the world. Among the myriads of sustainable concerns, however, there are diverse considerations including energy consumption, waste management, water access, and resiliency of structures. Our research aims to develop distinct ideas for sustainable architecture given the exigent problems in disaster-threatened areas starting with the Hatay Refugee camp in Turkey where the majority of the camp dwellers are Syrian refugees. Commencing community-based participatory research which focuses on the socio-environmental issues of displaced populations, this study will apply two approaches with a specific focus on the Hatay region. The initial experiment uses Richter's predictive model and simulations to forecast earthquake outcomes in refugee campers. The result could be useful in implementing architectural design tactics that enhance structural reliability and ensure the security and safety of shelters through earthquakes. In the second experiment a model is generated which helps us in predicting the quality of the existing water sources and since we understand how greatly water is vital for the well-being of humans, we do it. This research aims to enable camp administrators to employ forward-looking practices while managing water resources and thus minimizing health risks as well as building resilience of the refugees in the Hatay area. On the other side, this research assesses other sustainability problems of Hatay Refugee Camp as well. As energy consumption becomes the major issue, housing developers are required to consider energy-efficient designs as well as feasible integration of renewable energy technologies to minimize the environmental impact and improve the long-term sustainability of housing projects. Waste management is given special attention in this case by imposing recycling initiatives and waste reduction measures to reduce the pace of environmental degradation in the camp's land area. As well, study gives an insight into the social and economic reality of the camp, investigating the contribution of initiatives such as urban agriculture or vocational training to the enhancement of livelihood and community empowerment. In a similar fashion, this study combines the latest research with practical experience in order to contribute to the continuing discussion on sustainable architecture during disaster relief, providing recommendations and info that can be adapted on every scale worldwide. Through collaborative efforts and a dedicated sustainability approach, we can jointly get to the root of the cause and work towards a far more robust and equitable society.

Keywords: smart architecture, Hatay Camp, sustainability, machine learning.

Procedia PDF Downloads 55

Authors: G. C. Santini, C. Potrich, L. Lunelli, L. Vanzetti, S. Marasso, M. Cocuzza, C. Pederzolli

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The relevance of circulating miRNAs as non-invasive biomarkers for several pathologies is nowadays undoubtedly clear, as they have been found to have both diagnostic and prognostic value able to add fundamental information to patients’ clinical picture. The availability of these data, however, relies on a time-consuming process spanning from the sample collection and processing to the data analysis. In light of this, strategies which are able to ease this procedure are in high demand and considerable effort have been made in developing Lab-on-a-chip (LOC) devices able to speed up and standardise the bench work. In this context, a very promising polydimethylsiloxane (PDMS)-based microdevice which integrates the processing of the biological sample, i.e. purification of extracellular miRNAs, and reverse transcription was previously developed in our lab. In this study, we aimed at the improvement of the miRNA extraction performances of this micro device by increasing the ability of its surface to absorb extracellular miRNAs from biological samples. For this purpose, we focused on the modulation of two properties of the material: roughness and charge. PDMS surface roughness was modulated by casting with several templates (terminated with silicon oxide coated by a thin anti-adhesion aluminum layer), followed by a panel of curing conditions. Atomic force microscopy (AFM) was employed to estimate changes at the nanometric scale. To introduce modifications in surface charge we functionalized PDMS with different mixes of positively charged 3-aminopropyltrimethoxysilanes (APTMS) and neutral poly(ethylene glycol) silane (PEG). The surface chemical composition was characterized by X-ray photoelectron spectroscopy (XPS) and the number of exposed primary amines was quantified with the reagent sulfosuccinimidyl-4-o-(4,4-dimethoxytrityl) butyrate (s-SDTB). As our final end point, the adsorption rate of all these different conditions was assessed by fluorescence microscopy by incubating a synthetic fluorescently-labeled miRNA. Our preliminary analysis identified casting on thermally grown silicon oxide, followed by a curing step at 85°C for 1 hour, as the most efficient technique to obtain a PDMS surface roughness in the nanometric scaleable to trap miRNA. In addition, functionalisation with 0.1% APTMS and 0.9% PEG was found to be a necessary step to significantly increase the amount of microRNA adsorbed on the surface, therefore, available for further steps as on-chip reverse transcription. These findings show a substantial improvement in the extraction efficiency of our PDMS microdevice, ultimately leading to an important step forward in the development of an innovative, easy-to-use and integrated system for the direct purification of less abundant circulating microRNAs.

Keywords: circulating miRNAs, diagnostics, Lab-on-a-chip, polydimethylsiloxane (PDMS)

Procedia PDF Downloads 318

Authors: Pooja Ichplani, Archna Kumar, Jessica Mayberry

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Community Video (CV) is a participatory medium that has immense potential to strengthen community communications and amplify the voice of people for their empowerment. By building capacities especially of marginalized community groups and providing a platform to freely voice their ideas, CV endeavours to bring about shifts towards more participatory, bottom up development processes and greater power in the hands of the people, especially the disadvantaged. In various parts of the world, among marginalized community groups, community video initiatives have become instrumental in facilitating micro-level, yet significant changes in communities. Video Volunteers (VV) is an organization that promotes community media and works towards providing disadvantaged communities with journalistic, critical thinking and creative skills they need for catalysing change in their communities. Working since 2002, VV has evolved a unique community media model fostering locally-owned and managed media production, as well as building people’s capacities to articulate and share their perspectives on the issues that matter to them – on a local and a global scale. Further, by integrating a livelihood aspect within its model, VV has actively involved people from poor marginalized communities and provided them a new tool for serving their communities whilst keeping their identities intact. This paper, based on a qualitative research, seeks to map the range of VV impacts in communities and provide an in-depth analysis of factors contributing to VV impacting change in communities. Study tools included content analysis of a longitudinal sample of impact videos produced, narratives of community correspondents using the Most Significant Change Technique (MSCT) and interviews with key informants. Using a multi-fold analysis, the paper seeks to gain holistic insights. At the first level, the paper profiles the Community Correspondents (CCs), spearheading change, and maps their personal and social context and their perceptions about VV in their personal lives. Secondly, at an organizational level, the paper maps the significance of impacts brought about in the CCs communities and their association, challenges and achievements while working with VV. Lastly, at the community level, it consists of analysis of the nature of impacts achieved and aspects influencing the same. Finally, the study critiques the functioning of Video Volunteers as a community media initiative using the tipping point theory emphasizing on the power of context that is constituted by their socio-cultural environment. It concludes how empowerment of its Community Correspondents, multifarious activities during pre and post video production, and other innovative mechanisms have enabled in center staging issues of marginalized communities and snowballing processes of change in communities.

Keywords: community media, empowerment, participatory communication, social change

Procedia PDF Downloads 137

Authors: Fei Chen, Wei Lu, Jun Cai

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During the Twelve Five period, China promulgated industrial policies promoting the relocation of energy-intensive industries to coastal areas in order to utilize marine shipping resources. Consequently, some major state-owned steel and gas enterprises have relocated and resulted in a large-scale coastal area development. However, some land may have been over-exploited with seamless coastline projects. To balance between employment and housing, new industrial coastal towns were constructed to support the industrial-led development. In this paper, we adopt a case-study approach to closely examine the development of several new industrial coastal towns of Liaoning Province situated in the Bohai Bay area, which is currently under rapid economic growth. Our investigations reflect the common phenomenon of long distance commuting and a massive amount of vacant residences. More specifically, large plant relocation caused hundreds of kilometers of daily commute and enterprises had to provide housing subsidies and education incentives to motivate employees to relocate to coastal areas. Nonetheless, many employees still refuse to relocate due to job stability, diverse needs of family members and access to convenient services. These employees averaged 4 hours of commute daily and some who lived further had to reside in temporary industrial housing units and subject to long-term family separation. As a result, only a small portion of employees purchase new coastal residences but mostly for investment and retirement purposes, leading to massive vacancy and ghost-town phenomenon. In contrast to the low demand, coastal areas tend to develop large amount of residences prior to industrial relocation, which may be directly related to local government finances. Some local governments have sold residential land to developers to general revenue to support the subsequent industrial development. Subject to the strong preference of ocean-view, residential housing developers tend to select coast-line land to construct new residential towns, which further reduces the access of marine resources for major industrial enterprises. This violates the original intent of developing industrial coastal towns and drastically limits the availability of marine resources. Lastly, we analyze the co-existence of over-exploiting residential areas and massive vacancies in reference to the demand and supply of land, as well as the demand of residential housing units with the choice criteria of enterprise employees.

Keywords: coastal industry town, commuter traffic, employment-housing space, outer suburb industrial area

Procedia PDF Downloads 221

Authors: Mylena McCoggle, Shyra Wilson, Andrea Rivera, Rocio Alba-Flores

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This work introduces the use of EMGs (electromyography) from muscle sensors to develop an Artificial Neural Network (ANN) for pattern recognition to control a small unmanned aerial vehicle. The objective of this endeavor exhibits interfacing drone applications beyond manual control directly. MyoWare Muscle sensor contains three EMG electrodes (dual and single type) used to collect signals from the posterior (extensor) and anterior (flexor) forearm and the bicep. Collection of raw voltages from each sensor were connected to an Arduino Uno and a data processing algorithm was developed with the purpose of interpreting the voltage signals given when performing flexing, resting, and motion of the arm. Each sensor collected eight values over a two-second period for the duration of one minute, per assessment. During each two-second interval, the movements were alternating between a resting reference class and an active motion class, resulting in controlling the motion of the drone with left and right movements. This paper further investigated adding up to three sensors to differentiate between hand gestures to control the principal motions of the drone (left, right, up, and land). The hand gestures chosen to execute these movements were: a resting position, a thumbs up, a hand swipe right motion, and a flexing position. The MATLAB software was utilized to collect, process, and analyze the signals from the sensors. The protocol (machine learning tool) was used to classify the hand gestures. To generate the input vector to the ANN, the mean, root means squared, and standard deviation was processed for every two-second interval of the hand gestures. The neuromuscular information was then trained using an artificial neural network with one hidden layer of 10 neurons to categorize the four targets, one for each hand gesture. Once the machine learning training was completed, the resulting network interpreted the processed inputs and returned the probabilities of each class. Based on the resultant probability of the application process, once an output was greater or equal to 80% of matching a specific target class, the drone would perform the motion expected. Afterward, each movement was sent from the computer to the drone through a Wi-Fi network connection. These procedures have been successfully tested and integrated into trial flights, where the drone has responded successfully in real-time to predefined command inputs with the machine learning algorithm through the MyoWare sensor interface. The full paper will describe in detail the database of the hand gestures, the details of the ANN architecture, and confusion matrices results.

Keywords: artificial neural network, biosensors, electromyography, machine learning, MyoWare muscle sensors, Arduino

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Authors: Oliver Fuo

Abstract:

One of the central features of post-apartheid constitutional reform was the establishment of local government as a distinct sphere of government in the Constitution of the Republic of South Africa, 1996. Local government, constituted by about 279 wall-to-wall municipalities, have legislative and executive powers vested in democratically elected municipal councils to govern areas within their jurisdiction subject only to limits imposed by the Constitution. In addition, unlike the past where municipalities merely played a service delivery role, they are now mandated to realise an expanded developmental mandate – pursue social justice and sustainable development; contribute, together with national and provincial government, to the realisation of socio-economic rights entrenched in the Bill of Rights; and facilitate public participation in local governance. In order to finance their developmental programmes, municipalities receive equitable allocations from national government and have legal powers to generate additional finances by charging rates on property and imposing surcharges on services provided. In addition to its general obligation to foster public participation in local governance, the law requires municipalities to facilitate public participation in their budgeting processes. This requirement is generally consistent with recent trends in local government democratic reforms which call for inclusive budget planning and implementation whereby citizens, civil society and NGOs participate in the allocation of resources. This trend is best captured in the concept of participatory budgeting. This paper specifically analyses the legal and policy framework for participatory budgeting at the local government level in South Africa. Using Borbet South Africa (Pty) Ltd and Others v Nelson Mandela Bay Municipality 2014 (5) SA 256 (ECP) as an example, this paper argues that the legal framework for participatory budgeting creates an illusory right for citizens to participate in municipal budgeting processes. This challenge is further compounded by the barrenness of the jurisprudence of courts that interpret the obligation of municipalities in this regard. It is submitted that the wording of s 27(4) of the Municipal Finance Management Act (MFMA) 53 of 2003 - which expressly stipulates that non-compliance by a municipality with a provision relating to the budget process or a provision in any legislation relating to the approval of a budget-related policy, does not affect the validity of an annual or adjustments budget – is problematic as it seems to trivialise the obligation to facilitate public participation in budgeting processes. It is submitted that where this provision is abused by municipal officials, this could lead to the sidelining of the real interests of communities in local budgets. This research is based on a critical and integrated review of primary and secondary sources of law.

Keywords: courts and jurisprudence, local government law, participatory budgeting, South Africa

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Authors: Liliana Gomez Cardona, Echo Parent-Racine, Joy Outerbridge, Arlene Laliberté, Outi Linnaranta

Abstract:

Suicide rates among Inuit in Nunavik are six to eleven times larger than the Canadian average. The colonization, religious missions, residential schools as well as economic and political marginalization are factors that have challenged the well-being and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous peoples because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Inuit in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Inuit population. Qualitative, collaborative, and participatory action research project which respects First Nations and Inuit protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Inuit. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Inuit in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in resilience and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Inuit population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Inuit, mental health, Nunavik, resiliency

Procedia PDF Downloads 118

Authors: Mathilde Kirkegaard

Abstract:

The paper will focus on management of heritage that integrates the local community, and argue towards an obligation to integrate this social aspect in heritage management. By broadening the understanding of heritage, a sustainable heritage management takes its departure in more than a continual conservation of the physicality of heritage. The social aspect, or the local community, is in many govern heritage management situations being overlooked and it is not managed through community based urban planning methods, e.g.: citizen-inclusion, a transparent process, informative and inviting initiatives, etc. Historical sites are often being described by embracing terms such as “ours” and “us”: “our history” and “a history that is part of us”. Heritage is not something static, it is a link between the life that has been lived in the historical frames, and the life that is defining it today. This view on heritage is rooted in the strive to ensure that heritage sites, besides securing the national historical interest, have a value for those people who are affected by it: living in it or visiting it. Antigua Guatemala is a UNESCO-defined heritage site and this site is being ‘threatened’ by tourism, habitation and recreation. In other words: ‘the use’ of the site is considered a threat of the preservation of the heritage. Contradictory the same types of use (tourism and habitation) can also be considered development ability, and perhaps even a sustainable management solution. ‘The use’ of heritage is interlinked with the perspective that heritage sites ought to have a value for people today. In other words, the heritage sites should be comprised of a contemporary substance. Heritage is entwined in its context of physical structures and the social layer. A synergy between the use of heritage and the knowledge about the heritage can generate a sustainable preservation solution. The paper will exemplify this symbiosis with different examples of a heritage management that is centred around a local community inclusion. The inclusive method is not new in architectural planning and it refers to a top-down and bottom-up balance in decision making. It can be endeavoured through designs of an inclusive nature. Catalyst architecture is a planning method that strives to move the process of design solutions into the public space. Through process-orientated designs, or catalyst designs, the community can gain an insight into the process or be invited to participate in the process. A balance between bottom-up and top-down in the development process of a heritage site can, in relation to management measures, be understood to generate a socially sustainable solution. The ownership and engagement that can be created among the local community, along with the use that ultimately can gain an economic benefit, can delegate the maintenance and preservation. Informative, inclusive and transparent planning methods can generate a heritage management that is long-term due to the collective understanding and effort. This method handles sustainable management on two levels: the current preservation necessities and the long-term management, while ensuring a value for people today.

Keywords: community, intangible, inclusion, planning

Procedia PDF Downloads 118