Search results for: safety compliance

Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Xiao Wang, Qinge Zhang

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Background: This randomized, open-label study examined the therapeutic effects of computerized cognitive training (CCT) combined with selective serotonin reuptake inhibitors (SSRIs) on cognitive impairment among patients with late-life depression (LLD). Method: Study data were collected from May 5, 2021, to April 21, 2023. Outpatients who met diagnostic criteria for major depressive disorder according to the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (i.e., a total score on the 17-item Hamilton Depression Rating Scale (HAMD-17) ≥ 18 and a total score on the Montreal Cognitive Assessment scale (MOCA) <26) were randomly assigned to receive up to 12 weeks of CCT and SSRIs treatment (n=57) or SSRIs and Control treatment (n=61). The primary outcome was the change in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores from baseline to week 12 between the two groups. The secondary outcomes included changes in the HAMD-17 score, Hamilton Anxiety Scale (HAMA) score and Neuropsychiatric Inventory (NPI) score. Mixed model repeated measures (MMRM) analysis was performed on modified intention-to-treat (mITT) and completer populations. Results: The full analysis set (FAS) included 118 patients (CCT and SSRIs group, n=57; SSRIs and Control group, n =61). Over the 12-week study period, the reduction in the ADAS-cog total score was significant (P < 0.001) in both groups, while MMRM analysis revealed a significantly greater reduction in cognitive function (ADAS-cog total scores) from baseline to posttreatment in the CCT and SSRIs group than in the SSRI and Control group [(F (1,115) =13.65, least-squares mean difference [95% CI]: −2.77 [−3.73, −1.81], p<0.001)]. There were significantly greater improvements in depression symptoms (measured by the HAMD-17) in the CCT and SSRIs group than in the control group [MMRM, estimated mean difference (SE) between groups −3.59 [−5.02, −2.15], p < 0.001]. The least-squares mean changes in the HAMA scores and NPI scores between baseline and week 8 were greater in the CCT and SSRIs group than in the control group (all P < 0.05). There was no significant difference between groups on response rates and remission rates by using the last-observation-carried-forward (LOCF) method (all P > 0.05). The most frequent adverse events (AEs) in both groups were dry mouth, somnolence, and constipation. There was no significant difference in the incidence of adverse events between the two groups. Conclusions: CCT combined with SSRIs was efficacious and well tolerated in LLD patients with cognitive impairment.

Keywords: late-life depression, cognitive function, computerized cognitive training, SSRIs

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Authors: Nursultan Turdakyn, Alisher Medeubayev, Didar Meiramov, Zhibek Bekezhankyzy, Desmond Adair, Gulnur Kalimuldina

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In recent years the development of sustainable energy sources is getting extensive research interest due to the ever-growing demand for energy. As an alternative energy source to power small electronic devices, ambient energy harvesting from vibration or human body motion is considered a potential candidate. Despite the enormous progress in the field of battery research in terms of safety, lifecycle and energy density in about three decades, it has not reached the level to conveniently power wearable electronic devices such as smartwatches, bands, hearing aids, etc. For this reason, the development of self-charging power units with excellent flexibility and integrated energy harvesting and storage is crucial. Self-powering is a key idea that makes it possible for the system to operate sustainably, which is now getting more acceptance in many fields in the area of sensor networks, the internet of things (IoT) and implantable in-vivo medical devices. For solving this energy harvesting issue, the self-powering nanogenerators (NGS) were proposed and proved their high effectiveness. Usually, sustainable power is delivered through energy harvesting and storage devices by connecting them to the power management circuit; as for energy storage, the Li-ion battery (LIB) is one of the most effective technologies. Through the movement of Li ions under the driving of an externally applied voltage source, the electrochemical reactions generate the anode and cathode, storing the electrical energy as the chemical energy. In this paper, we present a simultaneous process of converting the mechanical energy into chemical energy in a way that NG and LIB are combined as an all-in-one power system. The electrospinning method was used as an initial step for the development of such a system with a β-PVDF separator. The obtained film showed promising voltage output at different stress frequencies. X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FT-IR) analysis showed a high percentage of β phase of PVDF polymer material. Moreover, it was found that the addition of 1 wt.% of BTO (Barium Titanate) results in higher quality fibers. When comparing pure PVDF solution with 20 wt.% content and the one with BTO added the latter was more viscous. Hence, the sample was electrospun uniformly without any beads. Lastly, to test the sensor application of such film, a particular testing device has been developed. With this device, the force of a finger tap can be applied at different frequencies so that electrical signal generation is validated.

Keywords: electrospinning, nanogenerators, piezoelectric PVDF, self-charging li-ion batteries

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Authors: Heli Makkonen, Eini Hyppönen

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The ageing of employees, the availability of workforce, and employees’ engagement in work are today’s challenges in the field of health care and social services, and particularly in the care of older people. Therefore, it is important to enhance both the attractiveness of the work in the field of older people’s care and the retention of employees in the field, and also to pay attention to the length of careers. The length of careers can be affected, for example, by developing an age-friendly organisational culture. Changing the organisational culture in a workplace is, however, a slow process which requires engagement from employees and enhanced dialogue between employees. This article presents an example of age-friendly organisational culture in an older people’s care unit and presents the results of the development of this organisational culture to meet the identified development challenges. In this research-based development process, cycles used in action research were applied. Three workshops were arranged for employees in a service home for older people. The workshops worked as interventions, and the employees and their manager were given several consecutive assignments to be completed between them. In addition to workshops, the employees benchmarked two other service homes. In the workshops, data was collected by observing and documenting the conversations. After that, thematic analysis was used to identify the factors connected to an age-friendly organisational culture. By analysing the data and comparing it to previous studies, some dilemmas we recognised that were hindering or enhancing the attractiveness of work and the retention of employees in this nursing home. After each intervention, the process was reflected and evaluated, and the next steps were planned. The areas of development identified in the study were related to, for example, the flexibility of work, holistic ergonomics, the physical environment at the workplace, and the workplace culture. Some of the areas of development were taken over by the work community and carried out in cooperation with e.g. occupational health care. We encouraged the work community, and the employees provided us with information about their progress. In this research project, the focus was on the development of the workplace culture and, in particular, on the development of the culture of interaction. The workshops showed employees’ attitudes and strong opinions, which can be a challenge from the point of view of the attractiveness of work and the retention of employees in the field. On the other hand, the data revealed that the work community has an interest in developing the dialogue in the work community. Enhancing the dialogue gave the employees the opportunity and resources to face even challenging dilemmas related to the attractiveness of work and the retention of employees in the field. The psychological safety was also enhanced at the same time. The results of this study are part of a broader study that aims at building a model for extending older employees’ careers.

Keywords: age-friendliness, attractiveness of work, dialogue, older people, organisational culture, workplace culture

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Authors: Rangrong Yoksan, Amporn Sane, Nattaporn Khanoonkon, Chanakorn Yokesahachart, Narumol Noivoil, Khanh Minh Dang

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Polylactic acid (PLA) is the most commercially available bio-based and biodegradable plastic at present. PLA has been used in plastic related industries including single-used containers, disposable and environmentally friendly packaging owing to its renewability, compostability, biodegradability, and safety. Although PLA demonstrates reasonably good optical, physical, mechanical, and barrier properties comparable to the existing petroleum-based plastics, its brittleness and mold shrinkage as well as its price are the points to be concerned for the production of rigid and semi-rigid packaging. Blending PLA with other bio-based polymers including thermoplastic starch (TPS) is an alternative not only to achieve a complete bio-based plastic, but also to reduce the brittleness, shrinkage during molding and production cost of the PLA-based products. TPS is a material produced mainly from starch which is cheap, renewable, biodegradable, compostable, and non-toxic. It is commonly prepared by a plasticization of starch under applying heat and shear force. Although glycerol has been reported as one of the most plasticizers used for preparing TPS, its migration caused the surface stickiness of the TPS products. In some cases, mixed plasticizers or natural fibers have been applied to impede the retrogradation of starch or reduce the migration of glycerol. The introduction of fibers into TPS-based materials could reinforce the polymer matrix as well. Therefore, the objective of the present research is to study the effect of starch type (i.e. native starch and phosphate starch), plasticizer type (i.e. glycerol and xylitol with a weight ratio of glycerol to xylitol of 100:0, 75:25, 50:50, 25:75, and 0:100), and fiber content (i.e. in the range of 1-25 % wt) on properties of PLA/TPS blend and composite. PLA/TPS blends and composites were prepared using a twin-screw extruder and then converted into dumbbell-shaped specimens using an injection molding machine. The PLA/TPS blends prepared by using phosphate starch showed higher tensile strength and stiffness than the blends prepared by using the native one. In contrast, the blends from native starch exhibited higher extensibility and heat distortion temperature (HDT) than those from the modified starch. Increasing xylitol content resulted in enhanced tensile strength, stiffness, and water resistance, but decreased extensibility and HDT of the PLA/TPS blend. Tensile properties and hydrophobicity of the blend could be improved by incorporating silane treated-jute fibers.

Keywords: polylactic acid, thermoplastic starch, Jute fiber, composite, blend

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Authors: P. Kavuma, J. Mukasa, M. Lusunku

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Background and Problem: The widespread poverty in Africa- together with the negative impacts of climate change-are two great global challenges that call for everyone’s involvement including Architects. This in particular places serious challenges on architects to have additional skills in both Entrepreneurship and Environmental Design (SEED). Regrettably, while Architectural Training in most African Universities including those from Uganda lack comprehensive implementation of SEED in their curricula, regulatory bodies have not contributed towards the effective integration of SEED in their professional practice. In response to these challenges, Nkumba University (NU) under Architect Kavuma Paul supported by the Uganda Chambers of Architects– initiated the SEED integration in the undergraduate Architectural curricula to cultivate SEED know-how and examples of best practices. Main activities: Initiated in 2007, going beyond the traditional Architectural degree curriculum, the NU Architect department offers SEED courses including provoking passions for creating desirable positive changes in communities. Learning outcomes are assessed theoretically and practically through field projects. The first set of SEED graduates came out in 2012. As part of the NU post-graduation and alumni survey, in October 2014, the pioneer SEED graduates were contacted through automated reminder emails followed by individual, repeated personal follow-ups via email and phone. Out of the 36 graduates who responded to the survey, 24 have formed four (4) private consortium agencies of 5-7 graduates all of whom have pioneered Ugandan-own-cultivated Architectural social projects that include: fishing farming in shipping containers; solar powered mobile homes in shipping containers, solar powered retail kiosks in rural and fishing communities, and floating homes in the flood-prone areas. Primary outcomes: include being business self –reliant in creating the social change the architects desired in the communities. Examples of the SEED project returns to communities reported by the graduates include; employment creation via fabrication, retail business, marketing, improved diets, safety of life and property, decent shelter in the remote mining and oil exploration areas. Negative outcomes-though not yet evaluated include the disposal of used-up materials. Conclusion: The integration of SEED in Architectural Training has established a baseline benchmark and a replicable model based on best practice projects.

Keywords: architectural training, entrepreneurship, environment, integration

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Authors: Lubna M. Al-Otaibi

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Mucocele is a common benign neoplasm of the oral cavity and the most common after fibroma. The lesion develops as a result of retention or extravasation of mucous material from minor salivary glands. Extravasation type of mucocele results from trauma and mostly occurs in the lower lip of young patients. The various treatment options available for the treatment of mucocele are associated with a relatively high incidence of recurrence making surgical intervention necessary for a permanent cure. The conventional surgical procedure, however, arouses apprehension in the patient and is associated with bleeding and postoperative pain. Recently, treatment of mucocele with lasers has become a viable treatment option. Various types of lasers are being used and are preferable over the conventional surgical procedure as they provide good hemostasis, reduced postoperative swelling and pain, reduced bacterial population, lesser need for suturing, faster healing and low recurrence rates. Er,Cr:YSGG is a solid-state laser with great affinity to water molecule. Its hydrokinetic cutting action allows it to work effectively on hydrated tissues without any thermal damage. However, up to date, only a few studies have reported its use in the removal of lip mucocele, especially in children. In this case, a 6 year old female patient with history of trauma to the lower lip presented with a soft, sessile, whitish-bluish 4 mm papule. The lesion was present for approximately four months and was fluctuant in size. The child developed a habit of biting the lesion causing injury, bleeding and discomfort. Surgical excision under local anaesthesia was performed using 2780 nm Er,Cr:YSGG Laser (WaterLase iPlus, Irvine, CA) with a Gold handpiece and MZ6 tip (3.5w, 50 Hz, 20% H2O, 20% Air, S mode). The tip was first applied in contact mode with focused beam using the Circumferential Incision Technique (CIT) to excise the tissue followed by the removal of the underlying causative minor salivary gland. Bleeding was stopped using Laser Dry Bandage setting (0.5w, 50 Hz, 1% H2O, 20% Air, S mode) and no suturing was needed. Safety goggles were worn and high-speed suction was used for smoke evacuation. Mucocele excision using 2780 nm Er,Cr:YSGG laser was rapid, easy to perform with excellent precision and allowed for histopathological examination of the excised tissue. The patient was comfortable and there were minimum bleeding and no sutures, postoperative pain, scarring or recurrence. Laser assisted mucocele excision appears to have efficient and reliable benefits in young patients and should be considered as an alternative to conventional surgical and non-surgical techniques.

Keywords: Erbium, excision, laser, lip, mucocele

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Authors: Vilas Warudkar, Dinkar Janghel, Siraj Ahmed

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Rapid development experienced by India requires huge amount of energy. Actual supply capacity additions have been consistently lower than the targets set by the government. According to World Bank 40% of residences are without electricity. In 12th five year plan 30 GW grid interactive renewable capacity is planned in which 17 GW is Wind, 10 GW is from solar and 2.1 GW from small hydro project, and rest is compensated by bio gas. Renewable energy (RE) and energy efficiency (EE) meet not only the environmental and energy security objectives, but also can play a crucial role in reducing chronic power shortages. In remote areas or areas with a weak grid, wind energy can be used for charging batteries or can be combined with a diesel engine to save fuel whenever wind is available. India according to IEC 61400-1 belongs to class IV Wind Condition; it is not possible to set up wind turbine in large scale at every place. So, the best choice is to go for small scale wind turbine at lower height which will have good annual energy production (AEP). Based on the wind characteristic available at MANIT Bhopal, rotor for small scale wind turbine is designed. Various Aero foil data is reviewed for selection of airfoil in the Blade Profile. Airfoil suited of Low wind conditions i.e. at low Reynold’s number is selected based on Coefficient of Lift, Drag and angle of attack. For designing of the rotor blade, standard Blade Element Momentum (BEM) Theory is implanted. Performance of the Blade is estimated using BEM theory in which axial induction factor and angular induction factor is optimized using iterative technique. Rotor performance is estimated for particular designed blade specifically for low wind Conditions. Power production of rotor is determined at different wind speeds for particular pitch angle of the blade. At pitch 15o and velocity 5 m/sec gives good cut in speed of 2 m/sec and power produced is around 350 Watts. Tip speed of the Blade is considered as 6.5 for which Coefficient of Performance of the rotor is calculated 0.35, which is good acceptable value for Small scale Wind turbine. Simple Load Model (SLM, IEC 61400-2) is also discussed to improve the structural strength of the rotor. In SLM, Edge wise Moment and Flap Wise moment is considered which cause bending stress at the root of the blade. Various Load case mentioned in the IEC 61400-2 is calculated and checked for the partial safety factor of the wind turbine blade.

Keywords: annual energy production, Blade Element Momentum Theory, low wind Conditions, selection of airfoil

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Authors: Bonnie Clough, Tamara Ownsworth, Vladimir Estivill-Castro, Matt Stainer, Rene Hexel, Andrew Bulmer, Wendy Moyle, Allison Waters, David Neumann, Jayke Bennett

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The success of global vaccination programs is reliant on the uptake of vaccines to achieve herd immunity. Yet, many individuals do not obtain vaccines or venipuncture procedures when needed. Whilst health education may be effective for those individuals who are hesitant due to safety or efficacy concerns, for many of these individuals, the primary concern relates to blood or injection fear or phobia (BII). BII is highly prevalent and associated with a range of negative health impacts, both at individual and population levels. Exposure therapy is an efficacious treatment for specific phobias, including BII, but has high patient dropout and low implementation by therapists. Whilst virtual reality approaches exposure therapy may be more acceptable, they have similarly low rates of implementation by therapists and are often difficult to tailor to an individual client’s needs. It was proposed that a piloted robot may be able to adequately facilitate fear induction and be an acceptable approach to exposure therapy. The current study examined fear induction responses, acceptability, and feasibility of a piloted robot for BII exposure. A Nao humanoid robot was programmed to connect with a virtual reality head-mounted display, enabling live streaming and exploration of real environments from a distance. Thirty adult participants with BII fear were randomly assigned to robot-pilot or virtual reality exposure conditions in a laboratory-based fear exposure task. All participants also completed a computer-based two-dimensional exposure task, with an order of conditions counterbalanced across participants. Measures included fear (heart rate variability, galvanic skin response, stress indices, and subjective units of distress), engagement with a feared stimulus (eye gaze: time to first fixation and a total number of fixations), acceptability, and perceived treatment credibility. Preliminary results indicate that fear responses can be adequately induced via a robot-piloted platform. Further results will be discussed, as will implications for the treatment of BII phobia and other fears. It is anticipated that piloted robots may provide a useful platform for facilitating exposure therapy, being more acceptable than in-vivo exposure and more flexible than virtual reality exposure.

Keywords: anxiety, digital mental health, exposure therapy, phobia, robot, virtual reality

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Authors: Kristina Pflug, Markus Busch

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Being able to predict polymer properties and processing behavior based on the applied operating reaction conditions in one of the key challenges in modern polymer reaction engineering. Especially, for cost-intensive processes such as the high-pressure polymerization of low-density polyethylene (LDPE) with high safety-requirements, the need for simulation-based process optimization and product design is high. A multi-scale modelling approach was set-up and validated via a series of high-pressure mini-plant autoclave reactor experiments. The approach starts with the numerical modelling of the complex reaction network of the LDPE polymerization taking into consideration the actual reaction conditions. While this gives average product properties, the complex polymeric microstructure including random short- and long-chain branching is calculated via a hybrid Monte Carlo-approach. Finally, the processing behavior of LDPE -its melt flow behavior- is determined in dependence of the previously determined polymeric microstructure using the branch on branch algorithm for randomly branched polymer systems. All three steps of the multi-scale modelling approach can be independently validated against analytical data. A triple-detector GPC containing an IR, viscosimetry and multi-angle light scattering detector is applied. It serves to determine molecular weight distributions as well as chain-length dependent short- and long-chain branching frequencies. 13C-NMR measurements give average branching frequencies, and rheological measurements in shear and extension serve to characterize the polymeric flow behavior. The accordance of experimental and modelled results was found to be extraordinary, especially taking into consideration that the applied multi-scale modelling approach does not contain parameter fitting of the data. This validates the suggested approach and proves its universality at the same time. In the next step, the modelling approach can be applied to other reactor types, such as tubular reactors or industrial scale. Moreover, sensitivity analysis for systematically varying process conditions is easily feasible. The developed multi-scale modelling approach finally gives the opportunity to predict and design LDPE processing behavior simply based on process conditions such as feed streams and inlet temperatures and pressures.

Keywords: low-density polyethylene, multi-scale modelling, polymer properties, reaction engineering, rheology

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Authors: Sharon Garyn-Tal, Shoshana Shahrabani

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Military service in general, and in combat units in particular, can be physically and psychologically stressful. Therefore, type of service may have significant implications for soldiers during and after their military service including emotions, judgments and risk perceptions. Previous studies have focused on risk propensity and risky behavior among soldiers, however there is still lack of knowledge on the impact of type of army service on risk perceptions. The current study examines the effect of type of army service (combat versus non-combat service) and negative incidental emotions on risk perceptions. In 2014 a survey was conducted among 153 combat and non-combat Israeli soldiers. The survey was distributed in train stations and central bus stations in various places in Israel among soldiers waiting for the train/bus. Participants answered questions related to the levels of incidental negative emotions they felt, to their risk perceptions (chances to be hurt by terror attack, by violent crime and by car accident), and personal details including type of army service. The data in this research is unique because military service in Israel is compulsory, so that the Israeli population serving in the army is wide and diversified. The results indicate that currently serving combat participants were more pessimistic in their risk perceptions (for all type of risks) compared to the currently serving non-combat participants. Since combat participants probably experienced severe and distressing situations during their service, they became more pessimistic regarding their probabilities of being hurt in different situations in life. This result supports the availability heuristic theory and the findings of previous studies indicating that those who directly experience distressing events tend to overestimate danger. The findings also indicate that soldiers who feel higher levels of incidental fear and anger have pessimistic risk perceptions. In addition, respondents who experienced combat army service also have pessimistic risk perceptions if they feel higher levels of fear. In addition, the findings suggest that higher levels of the incidental emotions of fear and anger are related to more pessimistic risk perceptions. These results can be explained by the compulsory army service in Israel that constitutes a focused threat to soldiers' safety during their period of service. Thus, in this stressful environment, negative incidental emotions even during routine times correlate with higher risk perceptions. In conclusion, the current study results suggest that combat army service shapes risk perceptions and the way young people control their negative incidental emotions in everyday life. Recognizing the factors affecting risk perceptions among soldiers is important for better understanding the impact of army service on young people.

Keywords: army service, combat soldiers, incidental emotions, risk perceptions

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Authors: Liam Martin, Martha Watson

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Patients with learning disabilities (LD) are at increased risk of physical and mental illness due to health inequality. To address this, NICE recommends that people from the age of 14 with a learning disability should have an annual LD health check. This consultation should include a holistic review of the patient’s physical, mental and social health needs with a view of creating an action plan to support the patient’s care. The expected standard set by the Quality and Outcomes Framework (QOF) is that each general practice should review at least 75% of their LD patients annually. During COVID-19, there have been barriers to primary care, including health anxiety, the shift to online general practice and the increase in GP workloads. A surgery in North London wanted to assess whether they were falling short of the expected standard for LD patient annual reviews in order to optimize care post Covid-19. A baseline audit was completed to assess how many LD patients were receiving their annual reviews over the period of 29th September 2020 to 29th September 2021. This information was accessed using EMIS Web Health Care System (EMIS). Patients included were aged 14 and over as per QOF standards. Doctors were not notified of this audit taking place. Following the results of this audit, the creation of learning disability clinics was recommended. These clinics were recommended to be on the ground floor and should be a dedicated time for LD reviews. A re-audit was performed via the same process 6 months later in March 2022. At the time of the baseline audit, there were 71 patients aged 14 and over that were on the LD register. 54% of these LD patients were found to have documentation of an annual LD review within the last 12 months. None of the LD patients between the ages of 14-18 years old had received their annual review. The results were discussed with the practice, and dedicated clinics were set up to review their LD patients. A second pass of the audit was completed 6 months later. This showed an improvement, with 84% of the LD patients registered at the surgery now having a documented annual review within the last 12 months. 78% of the patients between the ages of 14-18 years old had now been reviewed. The baseline audit revealed that the practice was not meeting the expected standard for LD patient’s annual health checks as outlined by QOF, with the most neglected patients being between the ages of 14-18. Identification and awareness of this vulnerable cohort is important to ensure measures can be put into place to support their physical, mental and social wellbeing. Other practices could consider an audit of their annual LD health checks to make sure they are practicing within QOF standards, and if there is a shortfall, they could consider implementing similar actions as used here; dedicated clinics for LD patient reviews.

Keywords: COVID-19, learning disability, learning disability health review, quality and outcomes framework

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Authors: Weeradej Cheewapattananuwong, Keeree Srivichian, Godchamon Somchai, Wasin Phusanong, Nontawat Yoddamnern

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Natural rubber used for traffic devices in Thailand has been developed and researched for several years. When compared with Dry Rubber Content (DRC), the quality of Rib Smoked Sheet (RSS) is better. However, the cost of admixtures, especially CaCO₃ and sulphur, is higher than the cost of RSS itself. In this research, Flexible Guideposts and Rubber Fender Barriers (RFB) are taken into consideration. In case of flexible guideposts, the materials used are both RSS and DRC60%, but for RFB, only RSS is used due to the controlled performance tests. The objective of flexible guideposts and RFB is to decrease a number of accidents, fatal rates, and serious injuries. Functions of both devices are to save road users and vehicles as well as to absorb impact forces from vehicles so as to decrease of serious road accidents. This leads to the mitigation methods to remedy the injury of motorists, form severity to moderate one. The solution is to find the best practice of traffic devices using natural rubber under the engineering concepts. In addition, the performances of materials, such as tensile strength and durability, are calculated for the modulus of elasticity and properties. In the laboratory, the simulation of crashes, finite element of materials, LRFD, and concrete technology methods are taken into account. After calculation, the trials' compositions of materials are mixed and tested in the laboratory. The tensile test, compressive test, and weathering or durability test are followed and based on ASTM. Furthermore, the Cycle-Repetition Test of Flexible Guideposts will be taken into consideration. The final decision is to fabricate all materials and have a real test section in the field. In RFB test, there will be 13 crash tests, 7 Pickup Truck tests, and 6 Motorcycle Tests. The test of vehicular crashes happens for the first time in Thailand, applying the trial and error methods; for example, the road crash test under the standard of NCHRP-TL3 (100 kph) is changed to the MASH 2016. This is owing to the fact that MASH 2016 is better than NCHRP in terms of speed, types, and weight of vehicles and the angle of crash. In the processes of MASH, Test Level 6 (TL-6), which is composed of 2,270 kg Pickup Truck, 100 kph, and 25 degree of crash-angle is selected. The final test for real crash will be done, and the whole system will be evaluated again in Korea. The researchers hope that the number of road accidents will decrease, and Thailand will be no more in the top tenth ranking of road accidents in the world.

Keywords: LRFD, load and resistance factor design, ASTM, american society for testing and materials, NCHRP, national cooperation highway research program, MASH, manual for assessing safety hardware

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Authors: Josiah Damisa, Michelle Louise Richardson, Morenike Adewuyi

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Lower back pain is a significant cause of disability worldwide and associated with great implications in terms of the well-being of affected individuals and society as a whole due to its undeniable socio-economic impact. With its prevalence on the increase as a result of an aging global population, the need for novel forms of pain management is ever paramount. This review aims to provide further insight into current research regarding a role for the endocannabinoid signaling pathway as a target in the treatment of chronic pain, with particular emphasis on its potential use as part of the treatment of lower back pain. Potential advantages and limitations of cannabis-based medicines over other forms of analgesia currently licensed for medical use are discussed in addition to areas that require ongoing consideration and research. To evaluate the efficacy of cannabis-based medicines in chronic pain, studies pertaining to the role of medical cannabis in chronic disease were reviewed. Standard searches of PubMed, Google Scholar and Web of Science databases were undertaken with peer-reviewed journal articles reviewed based on the indication for pain management, cannabis treatment modality used and study outcomes. Multiple studies suggest an emerging role for cannabis-based medicines as therapeutic agents in the treatment of chronic back pain. A potential synergistic effect has also been purported if these medicines are co-administered with opiate analgesia due to the similarity of the opiate and endocannabinoid signaling pathways. However, whilst recent changes to legislation in the United Kingdom mean that cannabis is now licensed for medicinal use on NHS prescription for a number of chronic health conditions, concerns remain as to the efficacy and safety of cannabis-based medicines. Research is lacking into both their side effect profiles and the long-term effects of cannabis use. Legal and ethical considerations to the use of these products in standardized medical practice also persist due to the notoriety of cannabis as a drug of abuse. Despite this, cannabis is beginning to gain traction as an alternative or even complementary drug to opiates, with some preclinical studies showing opiate-sparing effects. Whilst there is a paucity of clinical trials in this field, there is scope for cannabinoids to be successful anti-nociceptive agents in managing chronic back pain. The ultimate aim would be to utilize cannabis-based medicines as alternative or complementary therapies, thereby reducing opiate over-reliance and providing hope to individuals who have exhausted all other forms of standard treatment.

Keywords: endocannabinoids, cannabis-based medicines, chronic pain, lower back pain

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Authors: May B. Eclar, Romeo M. Alip, Ailyn C. Eay, Jennifer M. Alip, Michelle A. Mejica, Eloy C.eclar

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The COVID-19 pandemic has significantly changed the educational landscape of the Philippines. The groups affected by these changes are the poor and those living in the Geographically Isolated and Depressed Areas (GIDA), such as the Indigenous Peoples (IP). This was heavily experienced by the ten IP schools in Zambales, a province in the country. With this in mind, plus other factors relative to safety, the Schools Division of Zambales selected these ten schools to conduct the pilot implementation of in-person classes two (2) years after the country-wide school closures. This study aimed to explore the lived experiences of the school heads of the first ten Indigenous People’s (IP) schools that shifted from distance learning to limited in-person learning. These include the challenges met and the coping mechanism they set to overcome the challenges. The study is linked to experiential learning theory as it focuses on the idea that the best way to learn things is by having experiences). It made use of qualitative research, specifically phenomenology. All the ten school heads from the IP schools were chosen as participants in the study. Afterward, participants underwent semi-structured interviews, both individual and focus group discussions, for triangulation. Data were analyzed through thematic analysis. As a result, the study found that most IP schools did not struggle to convince parents to send their children back to school as they downplay the pandemic threat due to their geographical location. The parents struggled the most during modular learning since many of them are either illiterate, too old to teach their children, busy with their lands, or have too many children to teach. Moreover, there is a meager vaccination rate in the ten barangays where the schools are located because of local beliefs. In terms of financial needs, school heads did not find it difficult even though funding is needed to adjust the schools to the new normal because of the financial support coming from the central office. Technical assistance was also provided to the schools by division personnel. Teachers also welcomed the idea of shifting back to in-person classes, and minor challenges were met but were solved immediately through various mechanisms. Learning losses were evident since most learners struggled with essential reading, writing, and counting skills. Although the community has positively received the conduct of in-person classes, the challenges these IP schools have been experiencing pre-pandemic were also exacerbated due to the school closures. It is therefore recommended that constant monitoring and provision of support must continue to solve other challenges the ten IP schools are still experiencing due to in-person classes

Keywords: In-person learning, indigenous peoples, phenomenology, philippines

Procedia PDF Downloads 110

Authors: Abdul Haq

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The goal of this research is to better understand how wind loads affect bridges and develop strategies for designing bridges that are more stable and resistant to wind. The effect of wind on bridges is essential to their safety and functionality, especially in areas that are prone to high wind speeds or violent wind conditions. The study looks at the aerodynamic forces and vibrations caused by wind and how they affect bridge construction. Part of the research method involves first understanding the underlying ideas influencing wind flow near bridges. Computational fluid dynamics (CFD) simulations are used to model and forecast the aerodynamic behaviour of bridges under different wind conditions. These models incorporate several factors, such as wind directionality, wind speed, turbulence intensity, and the influence of nearby structures or topography. The results provide significant new insights into the loads and pressures that wind places on different bridge elements, such as decks, pylons, and connections. Following the determination of the wind loads, the structural response of bridges is assessed. By simulating their dynamic behavior under wind-induced forces, Finite Element Analysis (FEA) is used to model the bridge's component parts. This work contributes to the understanding of which areas are at risk of experiencing excessive stresses, vibrations, or oscillations due to wind excitations. Because the bridge has inherent modes and frequencies, the study considers both static and dynamic responses. Various strategies are examined to maximize the design of bridges to withstand wind. It is possible to alter the bridge's geometry, add aerodynamic components, add dampers or tuned mass dampers to lessen vibrations, and boost structural rigidity. Through an analysis of several design modifications and their effectiveness, the study aims to offer guidelines and recommendations for wind-resistant bridge design. In addition to the numerical simulations and analyses, there are experimental studies. In order to assess the computational models and validate the practicality of proposed design strategies, scaled bridge models are tested in a wind tunnel. These investigations help to improve numerical models and prediction precision by providing valuable information on wind-induced forces, pressures, and flow patterns. Using a combination of numerical models, actual testing, and long-term performance evaluation, the project aims to offer practical insights and recommendations for building wind-resistant bridges that are secure, long-lasting, and comfortable for users.

Keywords: wind effects, aerodynamic forces, computational fluid dynamics, finite element analysis

Procedia PDF Downloads 64

Authors: Robin Anderson, Elizabeth Latham, David Nisbet

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Propagation and dissemination of antimicrobial resistant and pathogenic microbes from spoiled silages and composts represents a serious public health threat to humans and animals. In the present study, the antimicrobial activity of the short chain nitro-compound, 2-nitro-1-propanol (9 mM) as well as the medium chain fatty acid, lauric acid, and its glycerol monoester, monolaurin, (each at 25 and 17 µmol/mL, respectfully) were investigated against select pathogenic and multi-drug resistant antimicrobial resistant Gram-positive bacteria common to spoiled silages and composts. In an initial study, we found that growth rates of a multi-resistant Enterococcus faecalis (expressing resistance against erythromycin, quinupristin/dalfopristin and tetracycline) and Staphylococcus aureus strain 12600 (expressing resistance against erythromycin, linezolid, penicillin, quinupristin/dalfopristin and vancomycin) were more than 78% slower (P < 0.05) by 2-nitro-1-propanol treatment during culture (n = 3/treatment) in anaerobically prepared ½ strength Brain Heart Infusion broth at 37oC when compared to untreated controls (0.332 ± 0.04 and 0.108 ± 0.03 h-1, respectively). The growth rate of 2-nitro-1-propanol-treated Listeria monocytogenes was also decreased by 96% (P < 0.05) when compared to untreated controls cultured similarly (0.171 ± 0.01 h-1). Maximum optical densities measured at 600 nm were lower (P < 0.05) in 2-nitro-1-propanol-treated cultures (0.053 ± 0.01, 0.205 ± 0.02 and 0.041 ± 0.01, respectively) than in untreated controls (0.483 ± 0.02, 0.523 ± 0.01 and 0.427 ± 0.01, respectively) for E. faecalis, S. aureus and L. monocytogenes, respectively. When tested against mixed microbial populations during anaerobic 24 h incubation of spoiled silage, significant effects of treatment with 1 mg 2-nitro-1-propanol (approximately 9.5 µmol/g) or 5 mg lauric acid/g (approximately 25 µmol/g) on populations of wildtype Enterococcus and Listeria were not observed. Mixed populations treated with 5 mg monolaurin/g (approximately 17 µmol/g) had lower (P < 0.05) viable cell counts of wildtype enterococci than untreated controls after 6 h incubation (2.87 ± 1.03 versus 5.20 ± 0.25 log10 colony forming units/g, respectively) but otherwise significant effects of monolaurin were not observed. These results reveal differential susceptibility of multi-drug resistant enterococci and staphylococci as well as L. monocytogenes to the inhibitory activity of 2-nitro-1-propanol and the medium chain fatty acid, lauric acid and its glycerol monoester, monolaurin. Ultimately, these results may lead to improved treatment technologies to preserve the microbiological safety of silages and composts.

Keywords: 2-nitro-1-propanol, lauric acid, monolaurin, gram positive bacteria

Procedia PDF Downloads 108

Authors: Sophie Oakes-Rogers, Di Bailey, Karen Slade

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Female offenders are a uniquely vulnerable group, who are at high risk of suicide. Whilst the prevention of self-harm and suicide remains a key global priority, we need to better understand the relationship between these challenging behaviours that constitute a pressing problem, particularly in environments designed to prioritise safety and security. Method choice is unlikely to be random, and is instead influenced by a range of cultural, social, psychological and environmental factors, which change over time and between countries. A key aspect of self-harm and suicide in women receiving forensic care is the lack of free access to methods. At a time where self-harm and suicide rates continue to rise internationally, understanding the role of these influencing factors and the impact of current suicide prevention strategies on the use of near-lethal methods is crucial. This poster presentation will present findings from 25 interviews and 3 focus groups, which enlisted a Participatory Action Research approach to explore the differences between self-harming and suicidal behavior. A key element of this research was using the lived experiences of women receiving forensic care from one forensic pathway in the UK, and the staffs who care for them, to discuss the role of near-lethal self-harm (NLSH). The findings and suggestions from the lived accounts of the women and staff will inform a draft assessment tool, which better assesses the risk of suicide based on the lethality of methods. This tool will be the first of its kind, which specifically captures the needs of women receiving forensic services. Preliminary findings indicate women engage in NLSH for two key reasons and is determined by their history of self-harm. Women who have a history of superficial non-life threatening self-harm appear to engage in NLSH in response to a significant life event such as family bereavement or sentencing. For these women, suicide appears to be a realistic option to overcome their distress. This, however, differs from women who appear to have a lifetime history of NLSH, who engage in such behavior in a bid to overcome the grief and shame associated with historical abuse. NLSH in these women reflects a lifetime of suicidality and indicates they pose the greatest risk of completed suicide. Findings also indicate differences in method selection between forensic provisions. Restriction of means appears to play a role in method selection, and findings suggest it causes method substitution. Implications will be discussed relating to the screening of female forensic patients and improvements to the current suicide prevention strategies.

Keywords: forensic mental health, method substitution, restriction of means, suicide

Procedia PDF Downloads 177

Authors: Kaila A. Vento

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Within the field of sports science, financial situations have been reported as a key barrier in purchasing high-quality foods. A lack of proper nutrition leads to insecurities of health, impairs training, and diminishes optimal performances. Consequently, insufficient nutrient intake, disordered eating patterns, and eating disorders may arise, leading to poor health and well-being. Athletic scholarships, nutrition resources, and meal programs are available, yet are disproportionally allocated, favoring male sports, Caucasian athletes, and higher sport levels. Direct athlete finances towards nutrition at various sport levels and the role race influences aid received has yet to be examined. Additionally, a diverse female athlete population is missing in the sports science literature, specifically in nutrition. To address this gap, the current project assesses how financial and nutrition support and nutrition knowledge impacts physical health, dietary intake, and overall quality of life of a diverse sample of female athletes at the National Collegiate Athletic Association (NCAA), National Junior Collegiate Athletic Association (NJCAA), and cub sport levels. The project will identify differences in financial support in relation to race, as well. Approximately (N = 120) female athletes will participate in a single 30-minute lab visit. At this visit, body composition (i.e., height, weight, body mass index, and fat percent), blood health indicators (fasted blood glucose and lipids), and resting blood pressure are measured. In addition, three validated questionnaires pertaining to nutrition knowledge (Sports Nutrition Knowledge Questionnaire; SNKQ), dietary intake (Rapid Eating Assessment for Participants; REAP), and quality of life (World Health Organization Quality of Life Brief; WHOQL-B) are gathered. Body composition and blood health indicators will be compared with the results of self-reported sports nutrition knowledge, dietary intake, and quality of life questionnaires. It is hypothesized that 1) financial and nutrition support and nutrition knowledge will differ between the sport levels and 2) financial and nutrition support and nutrition knowledge will have a positive association with quality of dietary intake and blood health indicators, 3) financial and nutrition support will differ significantly among racial background across the various competition levels, and 4) dietary intake will influence blood health indicators and quality of life. The findings from this study could have positive implications on athletic associations' policies on equity of financial and nutrition support to improve the health and safety of all female athletes across several sport levels.

Keywords: athlete, equity, finances, health, resources

Procedia PDF Downloads 104

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

Procedia PDF Downloads 105

Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

Procedia PDF Downloads 27

Authors: Bahar Salavati Vie Le Sage, Ismaïl Ben Hariz, Flavien Viguier, Sirine Noura Kahil, Audrey Jacquin, Maxime Convert

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The ballast layer plays a key role in railroad maintenance and the geometry of the track structure. Ballast also holds the track in place as the trains roll over it. Track ballast is packed between the sleepers and on the sides of railway tracks. An imbalance in ballast volume on the tracks can lead to safety issues as well as a quick degradation of the overall quality of the railway segment. If there is a lack of ballast in the track bed during the summer, there is a risk that the rails will expand and buckle slightly due to the high temperatures. Furthermore, the knowledge of the ballast quantities that will be excavated during renewal works is important for efficient ballast management. The volume of excavated ballast per meter of track can be calculated based on excavation depth, excavation width, volume of track skeleton (sleeper and rail) and sleeper spacing. Since 2012, SNCF has been collecting 3D points cloud data covering its entire railway network by using 3D laser scanning technology (LiDAR). This vast amount of data represents a modelization of the entire railway infrastructure, allowing to conduct various simulations for maintenance purposes. This paper aims to present an automated method for ballast volume estimation based on the processing of LiDAR data. The estimation of abnormal volumes in ballast on the tracks is performed by analyzing the cross-section of the track. Further, since the amount of ballast required varies depending on the track configuration, the knowledge of the ballast profile is required. Prior to track rehabilitation, excess ballast is often present in the ballast shoulders. Based on 3D laser scans, a Digital Terrain Model (DTM) was generated and automatic extraction of the ballast profiles from this data is carried out. The surplus in ballast is then estimated by performing a comparison between this ballast profile obtained empirically, and a geometric modelization of the theoretical ballast profile thresholds as dictated by maintenance standards. Ideally, this excess should be removed prior to renewal works and recycled to optimize the output of the ballast renewal machine. Based on these parameters, an application has been developed to allow the automatic measurement of ballast profiles. We evaluated the method on a 108 kilometers segment of railroad LiDAR scans, and the results show that the proposed algorithm detects ballast surplus that amounts to values close to the total quantities of spoil ballast excavated.

Keywords: ballast, railroad, LiDAR , cloud point, track ballast, 3D point

Procedia PDF Downloads 107

Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

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In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, AUV, computational fluid dynamics, flow fields, pressure, turbulence, drag

Procedia PDF Downloads 89

Authors: Kanti Sapkota, Do Hyun Lee, Sung Soo Han

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Nanocomposites have been widely used in various fields such as electronics, catalysis, and in chemical, biological, biomedical and optical fields. They display broad biomedical properties like antidiabetic, anticancer, antioxidant, antimicrobial and antibacterial activities. Moreover, nanomaterials have been used for wastewater treatment. Particularly, bimetallic hybrid nanocomposites exhibit unique features as compared to their monometallic components. Hybrid nanomaterials not only afford the multifunctionality endowed by their constituents but can also show synergistic properties. In addition, these hybrid nanomaterials have noteworthy catalytic and optical properties. Notably, Au−Ag based nanoparticles can be employed in sensor and catalysis due to their characteristic composition-tunable plasmonic properties. Due to their importance and usefulness, various efforts were developed for their preparation. Generally, chemical methods have been described to synthesize such bimetallic nanocomposites. In such chemical synthesis, harmful and hazardous chemicals cause environmental contamination and increase toxicity levels. Therefore, ecologically benevolent processes for the synthesis of nanomaterials are highly desirable to diminish such environmental and safety concerns. In this regard, here we disclose a simple, cost-effective, external additive free and eco-friendly method for the synthesis of Au-Ag@AgCl nanocomposites using Nephrolepis cordifolia root extract. Au-Ag@AgCl NCs were obtained by the simultaneous reduction of cationic Ag and Au into AgCl in the presence of plant extract. The particle size of 10 to 50 nm was observed with the average diameter of 30 nm. The synthesized nanocomposite was characterized by various modern characterization techniques. For example, UV−visible spectroscopy was used to determine the optical activity of the synthesized NCs, and Fourier transform infrared (FT-IR) spectroscopy was employed to investigate the functional groups present in the biomolecules that were responsible for both reducing and capping agents during the formation of nanocomposites. Similarly, powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), thermogravimetric analysis (TGA) and energy-dispersive X-ray (EDX) spectroscopy were used to determine crystallinity, size, oxidation states, thermal stability and weight loss of the synthesized nanocomposites. As a synthetic application, the synthesized nanocomposite exhibited excellent catalytic activity for the multicomponent synthesis of biologically interesting quinoline molecules via domino annulation-aromatization reaction of aniline, arylaldehyde, and phenyl acetylene derivatives. Interestingly, the nanocatalyst was efficiently recycled for five times without substantial loss of catalytic properties.

Keywords: nanoparticles, catalysis, multicomponent, quinoline

Procedia PDF Downloads 126

Authors: Mike Wei, Mario Cedillo, Jiahui Lin, Carol Lorraine Storey-Johnson, Carla Boutin-Foster

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Purpose: The extent to which health insurance enrollment succeeds under the Affordable Care Act (ACA) rests heavily on the ability to reach the uninsured and motivate them to enroll. We sought to identify perceptions about the ACA among uninsured patients at a free clinic in New York City. Background: The ACA holds tremendous promise for reducing the number of uninsured Americans. As of April 2014, nearly 8 million people had signed up for health insurance through the Health Insurance Marketplace. Despite this early success, future and continued enrollment rests heavily on the degree of public awareness. Reaching eligible individuals and increasing their awareness and understanding remains a fundamental challenge to realizing the full potential of the ACA. Reaching out to uninsured patients who are seeking care through safety net facilities such as free clinics may provide important avenues for reaching potential enrollees. This project focuses on the experience at the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic (WCCC), and seeks to understand perceptions about the ACA among its patient population. Methods: This was a cross-sectional study of all patients who visited the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic, from July 2013 to May 2014. Patients who provided informed consent at their visit and completed a semi-structured questionnaire were included (N=62). The questionnaire comprised of questions about demographic characteristics and open-ended questions about their knowledge and perception of the impact of the ACA. Descriptive statistics were used to characterize the population demographics. Qualitative coding techniques were used for open-ended items. Results: Approximately one third of patients surveyed never had health insurance. Of the remaining 65%, 20% lost their insurance within the past year. Only 55% had heard about the ACA, and only 10% knew about the Health Benefits Exchange. Of those who had heard about the ACA, sentiments were tinged with optimistic misperceptions, such as “it will be free health care for all.” While optimistic, most of the responses focused on the economic implications of the ACA. Conclusions: These findings reveal the immense amount of misconception and lack of understanding with regards to the ACA. As such, the study highlights the need to educate and address the concerns of those who remain skeptical or uncertain about the implications of the ACA.

Keywords: Affordable Care Act, demographics, free clinics, underserved.

Procedia PDF Downloads 387

Authors: Jason Gica, Yi-Hsieng Samuel Wu, Deng-Jye Yang, Yi-Chen Chen

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Mycotoxins, harmful secondary metabolites produced by certain fungi species, pose significant risks to animals and humans worldwide. Their stable properties lead to contamination during grain harvesting, transportation, and storage, as well as in processed food products. The prevalence of mycotoxin contamination has attracted significant attention due to its adverse impact on food safety and global trade. The secondary contamination pathway from animal products has been identified as an important route of exposure, posing health risks for livestock and humans consuming contaminated products. Pork, one of the highly consumed meat products in Taiwan according to the National Food Consumption Database, plays a critical role in the nation's diet and economy. Given its substantial consumption, pork processing products are a significant component of the food supply chain and a potential source of mycotoxin contamination. This study is paramount for formulating effective regulations and strategies to mitigate mycotoxin-related risks in the food supply chain. By establishing a reliable analytical method, this research contributes to safeguarding public health and enhancing the quality of pork processing products. The findings will serve as valuable guidance for policymakers, food industries, and consumers to ensure a safer food supply chain in the face of emerging mycotoxin challenges. An innovative and efficient analytical approach is proposed using Ultra-High Performance Liquid Chromatography coupled with Temperature Control Fluorescence Detector Light (UHPLC-TCFLD) to determine multiple mycotoxins in pork meat samples due to its exceptional capacity to detect multiple mycotoxins at the lowest levels of concentration, making it highly sensitive and reliable for comprehensive mycotoxin analysis. Additionally, its ability to simultaneously detect multiple mycotoxins in a single run significantly reduces the time and resources required for analysis, making it a cost-effective solution for monitoring mycotoxin contamination in pork processing products. The research aims to optimize the efficient mycotoxin QuEChERs extraction method and rigorously validate its accuracy and precision. The results will provide crucial insights into mycotoxin levels in pork processing products.

Keywords: multiple-mycotoxin analysis, pork processing products, QuEChERs, UHPLC-TCFLD, validation

Procedia PDF Downloads 67

Authors: Henrry Vicente Rojas Asuero, Holger Manuel Benavides Muñoz

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Approximately 80% of the energy consumed worldwide is generated from fossil sources, which are responsible for the emission of a large volume of greenhouse gases. For this reason, the global trend, at present, is the widespread use of energy produced from renewable sources. This seeks safety and diversification of energy supply, based on social cohesion, economic feasibility and environmental protection. In this scenario, small hydropower systems (P ≤ 10MW) stand out due to their high efficiency, economic competitiveness and low environmental impact. Small hydropower systems, along with wind and solar energy, are expected to represent a significant percentage of the world's energy matrix in the near term. Among the various technologies present in the state of the art, relating to small hydropower systems, is the Gravitational Water Vortex Power Plant, a recent technology that excels because of its versatility of operation, since it can operate with jumps in the range of 0.70 m-2.00 m and flow rates from 1 m3/s to 20 m3/s. Its operating system is based on the utilization of the energy of rotation contained within a large water vortex artificially induced. This paper presents the study and experimental design of an optimal hydraulic structure with the capacity to induce the artificial formation of a gravitational water vortex trough a system of easy application and high efficiency, able to operate in conditions of very low head and minimum flow. The proposed structure consists of a channel, with variable base, vortex inductor, tangential flow generator, coupled to a circular tank with a conical transition bottom hole. In the laboratory test, the angular velocity of the water vortex was related to the geometric characteristics of the inductor channel, as well as the influence of the conical transition bottom hole on the physical characteristics of the water vortex. The results show angular velocity values of greater magnitude as a function of depth, in addition the presence of the conical transition in the bottom hole of the circular tank improves the water vortex formation conditions while increasing the angular velocity values. Thus, the proposed system is a sustainable solution for the energy supply of rural areas near to watercourses.

Keywords: experimental model, gravitational water vortex power plant, renewable energy, small hydropower

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Authors: Andrew Green, Jiaming Liu, Kellathur Srinivasan, Raymond Chua

Abstract:

Introduction: The size of Singapore’s online health product (HP) market (e-commerce) is largely unknown. However, it is recognized that a large majority comes from overseas and thus, unregulated. As buying HP from unauthorized sources significantly compromises public health safety, understanding e-commerce users’ demographics and their perceptions on online HP purchasing becomes a pivotal first step to form a basis for recommendations in Singapore’s pharmacovigilance efforts. Objective: To assess the prevalence of online HP purchasing behaviour among Singaporean e-commerce users. Methodology: This is a cross-sectional study targeting Singaporean e-commerce users recruited from various local websites and online forums. Participants were not randomized into study arms but instead stratified by random sampling method based on participants’ age. A self-administered anonymous questionnaire was used to explore participants' demographics, online HP purchasing behaviour, knowledge and attitude. The association of different variables with online HP purchasing behaviour was analysed using logistic regression statistics. Main outcome measures: Prevalence of HP e-commerce users in Singapore (%) and variables that contribute to the prevalence (adjusted prevalent ratio). Results: The study recruited 372 complete and valid responses. The prevalence of online HP consumers among e-commerce users in Singapore is estimated to be 55.9% (1.7 million consumers). Online purchasing of complementary HP (46.9%) was the most prevalent, followed by medical devices (21.6%) and Western medicine (20.5%). Multivariate analysis showed that age is an independent variable that correlates with the likelihood of buying HP online. The prevalence of HP e-commerce users is highest in the 35-44 age group (64.1%) and lowest among the 16-24 age group (36.4%). The most bought HP through the internet are vitamins and minerals (21.5%), non-herbal (15.9%), herbal (13.9%), weight loss (8.7%) and sports (8.4%) supplements. While the top 3 products are distributed equally between the genders, there is a skew towards female respondents (12.4% in females vs. 4.9% in males) for weight loss supplements and towards males (13.2% in males vs. 3.7% in females) for sports supplements. Even though online consumers are in the younger age brackets, our study found that up to 72.0% of HP bought online are bought for others (buyer’s family and/or friends). Multivariate analysis showed a statistically significant association between purchasing HP through online means and the perceptions that 'internet is safe' (adjusted Prevalence Ratio=1.15, CI 1.03-1.28), 'buying HP online is time saving' (PR=1.17, CI 1.01-1.36), and 'recognition of HP brand' (PR=1.21 CI 1.06-1.40). Conclusions: This study has provided prevalence data for online HP market in Singapore, and has allowed the country’s regulatory body to formulate a targeted pharmacovigilance approach to this growing problem.

Keywords: e-commerce, pharmaceuticals, pharmacovigilance, Singapore

Procedia PDF Downloads 363

Authors: Siddhi Deshpande, Jo Jo Chacko Eapen

Abstract:

Despite almost half of India’s female population engages in watching sports, their experiences in the sports fandom are concealed by ‘traditional masculinity,’ leading to potential exclusion and harassment. To explore these experiences in-depth, this qualitative study aims to understand what coping strategies Indian women fans employ, to sustain their team identification. Employing criterion sampling, participants were screened using The Sports Spectators Identification Scale (SSIS) to assess team identification and a Brief Sexism Questionnaire to confirm participants’ experience with sexism as it aligns with the purpose of the study. The participants were Indian women who had been following any sport for more than eight years, were fluent in English, and were not professionals in Sports. Ten highly identified fans with gendered experiences were recruited for one-on-one semi-structured, in-depth interviews. The data was analyzed using Interpretive Phenomenological Analysis (IPA) to understand the lived-in experiences of women fans experiencing sexism and gender stereotypes, revealing superordinate themes of (1) Ontogenesis and Emotional Investment; (2) Gendered Expectations and Sexism; (3) Coping Strategies and Resilience; (4) Identity, Femininity, Empowerment; (5) Advocacy for Equality and Inclusivity. The findings reflect that Indian women fans experience social exclusion, harassment, sexualization, and commodification, in both online and offline fandoms, where they are disproportionately targeted with threats, misogynistic comments, and attraction-based assumptions, questioning their ‘authenticity’ as fans due to their gender. Women fans interchange between proactive strategies of assertiveness, humor, and knowledge demonstration with defensive strategies of selective engagement, self-regulatory censorship, and desensitization to deal with sexism. In this interplay, the integration of women’s ‘fan identity’ with their self-concept showcases how being a sports fan adds meaning to their lives, despite the constant scrutiny in a male-dominated space, reflecting that femininity and sports should coexist. As a result, they find refuge in female fan communities due to their similar experiences in the fandom and advocate for an equal and inclusive environment where sports are above gender, and not the other way around. A key practical implication of this research is enabling sports organizations to develop inclusive fan engagement policies that actively encourage female fan participation. This includes sensitizing stadium staff and security personnel, promoting gender-neutral language, and, most importantly, establishing safety protocols to protect female fans from adverse experiences in the fandom.

Keywords: coping strategies, female sports fans, femininity, gendered experiences, team identification

Procedia PDF Downloads 40