Search results for: neonatal intensive care unit
2844 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada
Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach
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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence
Procedia PDF Downloads 1512843 Raising Awareness among Residents about the Exact Fate of Dirt in the Neighborhood of Porto Belo
Authors: Marie Oslène Honorat
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Porto Belo is a neighborhood in the city of Foz do Iguaçu / PR, located in the Vila C region of Brazil. It is a project that addresses the question of the dirt generated by the neighborhood community about how they dispose and recycle domestic waste. This project aimed at raising awareness among residents, on how important it is to preserve the environment and take care, especially of the space in which we are located. Living this way manages to minimize the exploitation of natural resources, soil and water pollution. After collecting information about what one saw, we questioned some people in the neighborhood to find out about selective collection, recycling, and the separation and final destination of garbage. From the study, it was possible to verify the importance of placing more trash cans on neighborhood streets, where garbage is discarded, and the importance of promoting environmental education to improve the environment and quality of life. The methodology used in this research was a qualitative methodology that seeks the principle of transforming reality through investigation.Keywords: awareness, recycling, selective collection, waste disposal
Procedia PDF Downloads 682842 Transesterification of Refined Palm Oil to Biodiesel in a Continuous Spinning Disc Reactor
Authors: Weerinda Appamana, Jirapong Keawkoon, Yamonporn Pacthong, Jirathiti Chitsanguansuk, Yanyong Sookklay
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In the present work, spinning disc reactor has been used for the intensification of synthesis of biodiesel from refined palm oil (RPO) based on the transesterification reaction. Experiments have been performed using different spinning disc surface and under varying operating parameters viz. molar ratio of oil to methanol (over the range of 1:4.5–1:9), rotational speed (over the range of 500–2,000 rpm), total flow rate (over the range of 260-520 ml/min), and KOH catalyst loading of 1.50% by weight of oil. Maximum FAME (fatty acid methyl esters) yield (97.5 %) of biodiesel from RPO was obtained at oil to methanol ratio of 1:6, temperature of 60 °C, and rotational speed of 1500 rpm and flow rate of 520 mL/min using groove disc at KOH catalyst loading of 1.5 wt%. Also, higher yield efficiency (biodiesel produced per unit energy consumed) was obtained for using the spinning disc reactor based approach as compared to the ultrasound hydrodynamic cavitation and conventional mechanical stirrer reactors. It obviously offers a significant reduction in the reaction time for the transesterification, especially when compared with the reaction time of 90 minutes required for the conventional mechanical stirrer. It can be concluded that the spinning disk reactor is a promising alternative method for continuous biodiesel production.Keywords: spinning disc reactor, biodiesel, process intensification, yield efficiency
Procedia PDF Downloads 1592841 Methanolic Extract of the Exudates of Aloe Otallensis and Its Effect on Leishmania Donovani Parasite
Authors: Zerihun Tesfaye Nigusse
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Objective: This study evaluates the antileishmanial activity of the methanolic extract of Aloe otallensis (A. otallensis) on the promastigote stage of Leishmaniadonovani (L. donovani) as compared to standard drugs and to screen its phytochemical constituents. Methods: Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves. The extract was also evaluated for in vitro antileishmanial activity against L. donavani, which is found in the Parasitology Unit of Black Lion Hospital. The result was compared to standard drugs of sodium stibogluconate, milfostin and paramomycin. Results: The extract has good antileishmanial activity with an IC50 of 0.123 0 μg/mL on L. donovani (AM 563). The experimental data showed that relatively, it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate. The data analyses were done by GraphPad Prism version 5 software after it was read by an ELISA reader at the wavelength of 650 nm. The phytochemical screening of the exudates of A. otallensis showed the presence of phenol, alkaloid and saponin. Conclusions: The methanol extract of the exudates of A.otallensishas a good anti- leishmaniasis activity and this may be attributed to phenol, alkaloid and saponin present in the plant. But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.Keywords: anti leshimaniasis, aloe otallensis, leshimania ethiopica, IC50
Procedia PDF Downloads 482840 (Re)Assessing Clinical Spaces: How Do We Critically Provide Mental Health and Disability Support and Effective Care for Young People Who Are Impacted by Structural Violence and Structural Racism?
Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey
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The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people
Procedia PDF Downloads 582839 Waste Utilization by Combustion in the Composition of Gel Fuels
Authors: Dmitrii Glushkov, Aleksandr G. Nigay, Olga S. Yashutina
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In recent years, due to the intensive development of the Arctic and Antarctic areas, the actual task is to develop technology for the effective utilization of solid and liquid combustible wastes in an environment with low temperatures. Firstly, such technology will help to prevent the dumping of waste into the World Ocean and reduce the risks of causing environmental damage to the Far North areas. Secondly, promising actions will help to prepare fuel compositions from the waste in the places of their production. Such kind of fuels can be used as energy resources. It will reduce waste utilization costs when transporting them to the mainland. In the present study, we suggest a solution to the problem of waste utilization by the preparation of gel fuels based on solid and liquid combustible components with the addition of the thickener. Such kind of fuels is characterized by ease of preparation, storage, transportation and use (as energy resources). The main regularities and characteristics of physical and chemical processes are established with varying parameters of gel fuels and heating sources in wide ranges. The obtained results let us conclude about the prospects of gel fuels practical application for combustible wastes utilization. Appropriate technology will be characterized by positive environmental, operational and economic effects. The composition of the gel fuels can vary in a wide range. The fuels preparation based on one type of a combustible liquid or a several liquids mixture with the finely dispersed components addition makes it possible to obtain compositions with predicted rheological, energy or environmental characteristics. Besides, gel fuels have a lower level of the fire hazard compared to common solid and liquid fuels. This makes them convenient for storage and transportation. In such conditions, it is not necessary to transport combustible wastes from the territory of the Arctic and the Antarctic to the mainland for processing, which is now quite an expensive procedure. The research was funded by the Russian Science Foundation (project No. 18-13-00031).Keywords: combustible liquid waste, gel fuel, ignition and combustion, utilization
Procedia PDF Downloads 1252838 Production of Hydrogen and Carbon Monoxide Fuel Gas From Pine Needles
Authors: Despina Vamvuka, Despina Pentari
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Forestry wastes are readily available in large quantities around the world. Based on European Green Deal for the deployment of renewable and decarbonized energy by 2050, as well as global energy crisis, energy recovery from such wastes reducing greenhouse gas emissions is very attractive. Gasification has superior environmental performance to combustion, producing a clean fuel gas utilized in internal combustion engines, gas turbines, solid oxide fuel cells, or for synthesis of liquid bio-fuels and value-added chemicals. In this work, pine needles, which are abundantly found in Mediterranean countries, were gasified by either steam or carbon dioxide via a two-step process to improve reactivity and eliminate tar, employing a fixed bed unit and a thermal analysis system. Solid, liquid and gaseous products from the whole process were characterized and their energy potential was determined. Thermal behaviour, reactivity, conversion and energy recovery were examined. The gasification process took place above 650°C. At 950°C conversion and energy recovery were 77% dry and 2 under a flow of steam and 85% dry and 2.9 under a flow of carbon dioxide, respectively. Organic matter was almost completely converted to syngas, the yield of which varied between 89% and 99%. The higher heating values of biochar, bio-oil and pyrolysis gas were 27.8 MJ/kg, 33.5 MJ/kg and 13.6 MJ/m3. Upon steam or carbon dioxide gasification, the higher heating value of syngas produced was 11.5 MJ/m3 and 12.7 MJ/m3, respectively.Keywords: gasification, biomass, steam, carbon dioxide
Procedia PDF Downloads 1022837 Improving the Logistic System to Secure Effective Food Fish Supply Chain in Indonesia
Authors: Atikah Nurhayati, Asep A. Handaka
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Indonesia is a world’s major fish producer which can feed not only its citizens but also the people of the world. Currently, the total annual production is 11 tons and expected to double by the year of 2050. Given the potential, fishery has been an important part of the national food security system in Indonesia. Despite such a potential, a big challenge is facing the Indonesians in making fish the reliable source for their food, more specifically source of protein intake. The long geographic distance between the fish production centers and the consumer concentrations has prevented effective supply chain from producers to consumers and therefore demands a good logistic system. This paper is based on our research, which aimed at analyzing the fish supply chain and is to suggest relevant improvement to the chain. The research was conducted in the Year of 2016 in selected locations of Java Island, where intensive transaction on fishery commodities occur. Data used in this research comprises secondary data of time series reports on production and distribution and primary data regarding distribution aspects which were collected through interviews with purposively selected 100 respondents representing fishers, traders and processors. The data were analyzed following the supply chain management framework and processed following logistic regression and validity tests. The main findings of the research are as follows. Firstly, it was found that improperly managed connectivity and logistic chain is the main cause for insecurity of availability and affordability for the consumers. Secondly, lack of quality of most local processed products is a major obstacle for improving affordability and connectivity. The paper concluded with a number of recommended strategies to tackle the problem. These include rationalization of the length of the existing supply chain, intensification of processing activities, and improvement of distribution infrastructure and facilities.Keywords: fishery, food security, logistic, supply chain
Procedia PDF Downloads 2462836 Commercial Surrogacy and Rights of the Children Born
Authors: Neha Tiwari
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Rights are prerequisite for individuals to pursue their aims and enrich themselves. Laski has said rights are, ‘conditions of social life without which no man can seek himself at his best.’ However with superior technology, rights of many individuals are at stake as well. One such sufferer is the babies born out of the practice of commercial surrogacy. Commercial surrogacy has emerged as the most viable option for the childless couples. The practice has garnered lot of debate in both academia and media. Some argue for a complete ban and some for strict rules and regulation. Most of the time the debate is regarding the rights of the surrogate, something which we cannot ignore. Equally important are the rights of the children born out of such arrangements. However, not much attention is being paid to them. Recently, a controversy emerged when a surrogate gave birth to twins. One of the babies, Gammy born with down syndrome was left behind by the couple. Gammy could die because his poor Thai surrogate mother may not be able to pay for his treatment. Even if he survives, he will never know his twin sister as her identity would never be disclosed. This is just one of many such cases where the future of such babies is being played with. If the rights of these children are not taken care of many of them will have to bear the brunt of society's ignorance and perhaps live with a scar which won't heal in their lifetime.Keywords: babies, commercial surrogacy, rights, technology
Procedia PDF Downloads 2892835 A Bayesian Approach for Analyzing Academic Article Structure
Authors: Jia-Lien Hsu, Chiung-Wen Chang
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Research articles may follow a simple and succinct structure of organizational patterns, called move. For example, considering extended abstracts, we observe that an extended abstract usually consists of five moves, including Background, Aim, Method, Results, and Conclusion. As another example, when publishing articles in PubMed, authors are encouraged to provide a structured abstract, which is an abstract with distinct and labeled sections (e.g., Introduction, Methods, Results, Discussions) for rapid comprehension. This paper introduces a method for computational analysis of move structures (i.e., Background-Purpose-Method-Result-Conclusion) in abstracts and introductions of research documents, instead of manually time-consuming and labor-intensive analysis process. In our approach, sentences in a given abstract and introduction are automatically analyzed and labeled with a specific move (i.e., B-P-M-R-C in this paper) to reveal various rhetorical status. As a result, it is expected that the automatic analytical tool for move structures will facilitate non-native speakers or novice writers to be aware of appropriate move structures and internalize relevant knowledge to improve their writing. In this paper, we propose a Bayesian approach to determine move tags for research articles. The approach consists of two phases, training phase and testing phase. In the training phase, we build a Bayesian model based on a couple of given initial patterns and the corpus, a subset of CiteSeerX. In the beginning, the priori probability of Bayesian model solely relies on initial patterns. Subsequently, with respect to the corpus, we process each document one by one: extract features, determine tags, and update the Bayesian model iteratively. In the testing phase, we compare our results with tags which are manually assigned by the experts. In our experiments, the promising accuracy of the proposed approach reaches 56%.Keywords: academic English writing, assisted writing, move tag analysis, Bayesian approach
Procedia PDF Downloads 3342834 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children
Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul
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Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.Keywords: children, diabetes, metabolic control, periodontal therapy
Procedia PDF Downloads 1662833 Comparison of Inexpensive Cell Disruption Techniques for an Oleaginous Yeast
Authors: Scott Nielsen, Luca Longanesi, Chris Chuck
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Palm oil is obtained from the flesh and kernel of the fruit of oil palms and is the most productive and inexpensive oil crop. The global demand for palm oil is approximately 75 million metric tonnes, a 29% increase in global production of palm oil since 2016. This expansion of oil palm cultivation has resulted in mass deforestation, vast biodiversity destruction and increasing net greenhouse gas emissions. One possible alternative is to produce a saturated oil, similar to palm, from microbes such as oleaginous yeast. The yeasts can be cultured on sugars derived from second-generation sources and do not compete with tropical forests for land. One highly promising oleaginous yeast for this application is Metschnikowia pulcherrima. However, recent techno-economic modeling has shown that cell lysis and standard lipid extraction are major contributors to the cost of the oil. Typical cell disruption techniques to extract either single cell oils or proteins have been based around bead-beating, homogenization and acid lysis. However, these can have a detrimental effect on lipid quality and are energy-intensive. In this study, a vortex separator, which produces high sheer with minimal energy input, was investigated as a potential low energy method of lysing cells. This was compared to four more traditional methods (thermal lysis, acid lysis, alkaline lysis, and osmotic lysis). For each method, the yeast loading was also examined at 1 g/L, 10 g/L and 100 g/L. The quality of the cell disruption was measured by optical cell density, cell counting and the particle size distribution profile comparison over a 2-hour period. This study demonstrates that the vortex separator is highly effective at lysing the cells and could potentially be used as a simple apparatus for lipid recovery in an oleaginous yeast process. The further development of this technology could potentially reduce the overall cost of microbial lipids in the future.Keywords: palm oil substitute, metschnikowia pulcherrima, cell disruption, cell lysis
Procedia PDF Downloads 2102832 A Low-Latency Quadratic Extended Domain Modular Multiplier for Bilinear Pairing Based on Non-Least Positive Multiplication
Authors: Yulong Jia, Xiang Zhang, Ziyuan Wu, Shiji Hu
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The calculation of bilinear pairing is the core of the SM9 algorithm, which relies on the underlying prime domain algorithm and the quadratic extension domain algorithm. Among the field algorithms, modular multiplication operation is the most time-consuming part. Therefore, the underlying modular multiplication algorithm is optimized to maximize the operation speed of bilinear pairings. This paper uses a modular multiplication method based on non-least positive (NLP) combined with Karatsuba and schoolbook multiplication to improve the Montgomery algorithm. At the same time, according to the characteristics of multiplication operation in quadratic extension domain, a quadratic extension domain FP2-NLP modular multiplication algorithm for bilinear pairings is proposed, which effectively reduces the operation time of modular multiplication in quadratic extension domain. The subexpanded domain 𝐹ₚ₂ -NLP modular multiplication algorithm effectively reduces the operation time of modular multiplication under the second-expanded domain. The multiplication unit in the quadratic extension domain is implemented using SMIC55nm process, and two different implementation architectures are designed to cope with different application scenarios. Compared with the existing related literature, the output latency of this design can reach a minimum of 15 cycles. The shortest time for calculating the (𝐴𝐵 + 𝐶𝐷)𝑟⁻¹ mod 𝑀 form is 37.5ns, and the comprehensive area-time product (AT) is 11400. The final R-ate pairing algorithm hardware accelerator consumes 2670k equivalent logic gates and 1.8ms computing time in 55nm process.Keywords: sm9, hardware, NLP, Montgomery
Procedia PDF Downloads 212831 Examining the Level of Compliance of Patients’ Rights in Physiotherapy Clinic
Authors: Hokuma Isgandarova, Khalil Aryanfar
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The patient's rights include all care items that the patient has the right to receive. Considering the growing importance of this important issue and its effect on improving treatment results and customer satisfaction, the present study was conducted with the aim of investigating the level of respect for patient rights in the physiotherapy clinic of the Faculty of Medicine University of Medical Sciences in 2023. In this study, the patients or companions who were referred to the clinic answered questions about the performance status of the clinic with respect to various aspects of the patient's rights. The aspects that were studied: choosing the service provider, having authority, respect, safety, prevention and access were found to have inappropriate performance scores. However, communication and interaction, continuity of service, quality of basic facilities and facilities, timely and immediate attention and trust had appropriate performance. Also, the results of the data analysis showed that there is no significant relationship between the total performance score and any of the demographic variables.Keywords: compliance, patients' rights, physiotherapy clinic, performance level
Procedia PDF Downloads 642830 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study
Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja
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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care
Procedia PDF Downloads 1042829 Income-Consumption Relationships in Pakistan (1980-2011): A Cointegration Approach
Authors: Himayatullah Khan, Alena Fedorova
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The present paper analyses the income-consumption relationships in Pakistan using annual time series data from 1980-81 to 2010-1. The paper uses the Augmented Dickey-Fuller test to check the unit root and stationarity in these two time series. The paper finds that the two time series are nonstationary but stationary at their first difference levels. The Augmented Engle-Granger test and the Cointegrating Regression Durbin-Watson test imply that the two time series of consumption and income are cointegrated and that long-run marginal propensity to consume is 0.88 which is given by the estimated (static) equilibrium relation. The paper also used the error correction mechanism to find out to model dynamic relationship. The purpose of the ECM is to indicate the speed of adjustment from the short-run equilibrium to the long-run equilibrium state. The results show that MPC is equal to 0.93 and is highly significant. The coefficient of Engle-Granger residuals is negative but insignificant. Statistically, the equilibrium error term is zero, which suggests that consumption adjusts to changes in GDP in the same period. The short-run changes in GDP have a positive impact on short-run changes in consumption. The paper concludes that we may interpret 0.93 as the short-run MPC. The pair-wise Granger Causality test shows that both GDP and consumption Granger cause each other.Keywords: cointegrating regression, Augmented Dickey Fuller test, Augmented Engle-Granger test, Granger causality, error correction mechanism
Procedia PDF Downloads 4202828 Prioritizing The Evaluation factors of Hospital Information System with The Analytical Hierarchy Process
Authors: F.Sadoughi, A. Sarsarshahi, L, Eerfannia, S.M.A. Khatami
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Hospital information systems with lots of ability would lead to health care quality improvement. Evaluation of this system has done according different method and criteria. The main goal of present study is to prioritize the most important factors which are influence these systems evaluation. At the first step, according relevant literature, three main factor and 29 subfactors extracted. Then, study framework was designed. Based on analytical hierarchical process (AHP), 28 paired comparisons with Saaty range, in a questionnaire format obtained. Questionnaires were filled by 10 experts in health information management and medical informatics field. Human factors with weight of 0.55 were ranked as the most important. Organization (0.25) and technology (0.14) were in next place. It seems MADM methods such as AHP have enough potential to use in health research and provide positive opportunities for health domain decision makers.Keywords: Analytical hierarchy process, Multiple criteria decision-making (MCDM), Hospital information system, Evaluation factors
Procedia PDF Downloads 4562827 Competitive Advantage Challenges in the Apparel Manufacturing Industries of South Africa: Application of Porter’s Factor Conditions
Authors: Sipho Mbatha, Anne Mastament-Mason
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South African manufacturing global competitiveness was ranked 22nd (out of 38 countries), dropped to 24th in 2013 and is expected to drop further to 25th by 2018. These impacts negatively on the industrialisation project of South Africa. For industrialization to be achieved through labour intensive industries like the Apparel Manufacturing Industries of South Africa (AMISA), South Africa needs to identify and respond to factors negatively impacting on the development of competitive advantage This paper applied factor conditions from Porter’s Diamond Model (1990) to understand the various challenges facing the AMISA. Factor conditions highlighted in Porter’s model are grouped into two groups namely, basic and advance factors. Two AMISA associations representing over 10 000 employees were interviewed. The largest Clothing, Textiles and Leather (CTL) apparel retail group was also interviewed with a government department implementing the industrialisation policy were interviewed The paper points out that while AMISA have basic factor conditions necessary for competitive advantage in the clothing and textiles industries, Advance factor coordination has proven to be a challenging task for the AMISA, Higher Education Institutions (HEIs) and government. Poor infrastructural maintenance has contributed to high manufacturing costs and poor quick response as a result of lack of advanced technologies. The use of Porter’s Factor Conditions as a tool to analyse the sector’s competitive advantage challenges and opportunities has increased knowledge regarding factors that limit the AMISA’s competitiveness. It is therefore argued that other studies on Porter’s Diamond model factors like Demand conditions, Firm strategy, structure and rivalry and Related and supporting industries can be used to analyse the situation of the AMISA for the purposes of improving competitive advantage.Keywords: compliance rule, apparel manufacturing industry, factor conditions, advance skills and South African industrial policy
Procedia PDF Downloads 3642826 Biopotential of Introduced False Indigo and Albizia’s Weevils in Host Plant Control and Duration of Its Development Stages in Southern Regions of Panonian Basin
Authors: Renata Gagić-Serdar, Miroslava Markovic, Ljubinko Rakonjac, Aleksandar Lučić
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The paper present the results of the entomological experimental studies of the biological, ecological, and (bionomic) insect performances, such as seasonal adaptation of introduced monophagous false indigo and albizias weevil’s Acanthoscelides pallidipennis Motschulsky. and Bruchidius terrenus (Sharp), Coleoptera: Chrysomelidae: Bruchinae, to phenological phases of aggressive invasive host plant Amorpha fruticosa L. and Albizia julibrissin (Fabales: Fabaceae) on the territory of Republic of Serbia with special attention on assessing and monitoring of new formed and detected inter species relations between autochthons parasite wasps from fauna (Hymenoptera: Chalcidoidea) and herbaceous seed weevil beetle. During 15 years (2006-2021), on approximately 30 localities, data analyses were done for observed experimental host plants from samples with statistical significance. Status of genera from families Hymenoptera: Chalcidoidea.: Pteromalidae and Eulophidae, after intensive investigations, has been trophicly identified. Recorded seed pest species of A. fruticosa or A. julibrissin (Fabales: Fabaceae) was introduced in Serbia and planted as ornamental trees, they also were put undergo different kinds of laboratory and field research tests during this period in a goal of collecting data about lasting each of develop stage of their seed beetles. Field generations in different stages were also monitored by continuous infested seed collecting and its disection. Established host plant-seed predator linkage was observed in correlation with different environment parameters, especially water level fluctuations in bank corridor formation stands and riparian cultures.Keywords: amorpha, albizia, chalcidoid wasp, invasiveness, weevils
Procedia PDF Downloads 992825 Heavy Metals and Carcinogenic Risk Assessment in Free-Ranged Livestock of Lead-Contaminated Goldmine Communities of Zamfara State, Northern Nigeria
Authors: Sulaiman Rabiu, Muazu Gusau Abubakar, Jafar Usman Zakari
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The consumption of meat is of great importance as it provides a good source of proteins and significant amount of essential trace element to the body. However, contamination of meat and meat products with heavy metals is becoming a serious threat to food safety and public health. Therefore, the present study is aimed to evaluate the concentration of some heavy metals in muscles and entrails of free-ranged cattle, sheep and goats. A total of sixty (60) fresh samples of muscles, liver, kidney, small intestines and stomach of free ranged cattle, sheep and goats were collected from abattoirs of different goldmine communities of Anka, Bukkuyum, Maru andTalata-Mafara Local Government Areas of Zamfara State, Nigeria. The samples were digested using 10 mL of a mixed 70% high grade concentration of HNO₃ and 65% HCl (4:1 v/v); the mixture was heated until dense fumes disappeared forming a clear transparent solution and diluted to 50 mL with deionized water. Actual concentrations of Cd, Cr, Cu, Co, As, Ni, Mn, Pb and Zn were determined using Microwave Plasma Atomic Emission Spectrophotometer (MP-AES). From the results obtained, goat liver had the highest mean concentration of lead, arsenic, cobalt and manganese (12.43± 0.31, 14.25±0.32, 3.47± 0.86 and 12.68± 0.92 mg/kg respectively) while goat kidney had the highest concentration of copper and zinc (10.08±0.61 and 24.16±1.30 mg/kg respectively). The highest concentrations of cadmium and nickel were recorded in sheep kidney (7.75± 0.65 and 2.08±0.10 mg/kg respectively). Cattle muscles had the highest chromium concentration than all the organs analysed. The target hazard quotients (THQs) for all the metals were below 1.0, but TR which is a risk indices for carcinogenicity indicates an alarming result that requires stringent control to protect public health.Therefore, intensive public health awareness on the risk associated with contamination of heavy metals in meat should be advocated.Keywords: contamination, goldmine, heavy metals, meat
Procedia PDF Downloads 1182824 A Case Study of Meningoencephalitis following Le Fort I Osteotomy
Authors: Ryan Goh, Nicholas Beech
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Introduction: Le Fort I Osteotomies, although are common procedures in Oral and Maxillofacial Surgery, carry a degree of risk of unfavourable propagation of the down-fracture of the maxilla. This may be the first reported case in the literature for meningoencephalitis to occur following a Le Fort I Osteotomy. Case: A 32-year-old female was brought into the Emergency Department four days after a Le Fort I Osteotomy, with a Glasgow Coma Scale (GCS) of 8 (E3V1M4). A Computed Tomography (CT) Head showed a skull base fracture at the right sphenoid sinus. Lumbar puncture was completed, and Klebsiella oxytoca was found in the Cerebrospinal Fluid (CSF). She was treated with Meropenem, and rapidly improved thereafter. CSF rhinorrhoea was identified when she was extubated, which was successfully managed via a continuous lumbar drain. She was discharged on day 14 without any neurological deficits. Conclusion: The most likely aspect of the Le Fort I Osteotomy to obtain a skull base fracture is during the pterygomaxillary disjunction. Care should always be taken to avoid significant risks of skull base fractures, CSF rhinorrhoea, meningitis and encephalitis.Keywords: meningitis, orthognathic surgery, post-operative complication, skull base, rhinorrhea
Procedia PDF Downloads 1282823 A Framework for Event-Based Monitoring of Business Processes in the Supply Chain Management of Industry 4.0
Authors: Johannes Atug, Andreas Radke, Mitchell Tseng, Gunther Reinhart
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In modern supply chains, large numbers of SKU (Stock-Keeping-Unit) need to be timely managed, and any delays in noticing disruptions of items often limit the ability to defer the impact on customer order fulfillment. However, in supply chains of IoT-connected enterprises, the ERP (Enterprise-Resource-Planning), the MES (Manufacturing-Execution-System) and the SCADA (Supervisory-Control-and-Data-Acquisition) systems generate large amounts of data, which generally glean much earlier notice of deviations in the business process steps. That is, analyzing these streams of data with process mining techniques allows the monitoring of the supply chain business processes and thus identification of items that deviate from the standard order fulfillment process. In this paper, a framework to enable event-based SCM (Supply-Chain-Management) processes including an overview of core enabling technologies are presented, which is based on the RAMI (Reference-Architecture-Model for Industrie 4.0) architecture. The application of this framework in the industry is presented, and implications for SCM in industry 4.0 and further research are outlined.Keywords: cyber-physical production systems, event-based monitoring, supply chain management, RAMI (Reference-Architecture-Model for Industrie 4.0)
Procedia PDF Downloads 2412822 Numerical Modeling of hybrid Photovoltaic-Thermoelectric Solar Unit by Applying Various Cross-Sections of Cooling Ducts
Authors: Ziba Khalili, Mohsen Sheikholeslami, Ladan Momayez
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Combining the photovoltaic/thermal (PVT) systems with a thermoelectric (TE) module can raise energy yields since the TE module boosts the system's energy conversion efficiency. In the current study, a PVT system integrated with a TE module was designed and simulated in ANSYS Fluent 19.2. A copper heat transfer tube (HTT) was employed for cooling the photovoltaic (PV) cells. Four different shapes of HTT cross-section, i.e., circular, square, elliptical, and triangular, with equal cross-section areas were investigated. Also, the influence of Cu-Al2O3/water hybrid nanofluid (0.024% volume concentration), fluid inlet velocity (uᵢ ), and amount of solar radiation (G), on the PV temperature (Tₚᵥ) and system performance were investigated. The ambient temperature (Tₐ), wind speed (u𝓌), and fluid inlet temperature (Tᵢ), were considered to be 25°C, 1 m/s, and 27°C, respectively. According to the obtained data, the triangular case had the greatest impact on reducing the compared to other cases. In the triangular case, examination of the effect of hybrid nanofluid showed that the use of hybrid nanofluid at 800 W/m2 led to a reduction of the TPV by 0.6% compared to water, at 0.19 m/s. Moreover, the thermal efficiency ( ) and the overall electrical efficiency (nₜ) of the system improved by 0.93% and 0.22%, respectively, at 0.19 m/s. In a triangular case where G and were 800 W/m2 and 19 m/s, respectively, the highest amount of, thermal power (Eₜ), and, were obtained as 72.76%, 130.84 W and 12.03%, respectively.Keywords: electrical performance, photovoltaic/thermal, thermoelectric, hybrid nanofluid, thermal efficiency
Procedia PDF Downloads 812821 Cladding Technology for Metal-Hybrid Composites with Network-Structure
Authors: Ha-Guk Jeong, Jong-Beom Lee
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Cladding process is very typical technology for manufacturing composite materials by the hydrostatic extrusion. Because there is no friction between the metal and the container, it can be easily obtained in uniform flow during the deformation. The general manufacturing process for a metal-matrix composite in the solid state, mixing metal powders and ceramic powders with a suited volume ratio, prior to be compressed or extruded at the cold or hot condition in a can. Since through a plurality of unit processing steps of dispersing the materials having a large difference in their characteristics and physical mixing, the process is complicated and leads to non-uniform dispersion of ceramics. It is difficult and hard to reach a uniform ideal property in the coherence problems at the interface between the metal and the ceramic reinforcements. Metal hybrid composites, which presented in this report, are manufactured through the traditional plastic deformation processes like hydrostatic extrusion, caliber-rolling, and drawing. By the previous process, the realization of uniform macro and microstructure is surely possible. In this study, as a constituent material, aluminum, copper, and titanium have been used, according to the component ratio, excellent characteristics of each material were possible to produce a metal hybrid composite that appears to maximize. MgB₂ superconductor wire also fabricated via the same process. It will be introduced to their unique artistic and thermal characteristics.Keywords: cladding process, metal-hybrid composites, hydrostatic extrusion, electronic/thermal characteristics
Procedia PDF Downloads 1852820 Application of Supervised Deep Learning-based Machine Learning to Manage Smart Homes
Authors: Ahmed Al-Adaileh
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Renewable energy sources, domestic storage systems, controllable loads and machine learning technologies will be key components of future smart homes management systems. An energy management scheme that uses a Deep Learning (DL) approach to support the smart home management systems, which consist of a standalone photovoltaic system, storage unit, heating ventilation air-conditioning system and a set of conventional and smart appliances, is presented. The objective of the proposed scheme is to apply DL-based machine learning to predict various running parameters within a smart home's environment to achieve maximum comfort levels for occupants, reduced electricity bills, and less dependency on the public grid. The problem is using Reinforcement learning, where decisions are taken based on applying the Continuous-time Markov Decision Process. The main contribution of this research is the proposed framework that applies DL to enhance the system's supervised dataset to offer unlimited chances to effectively support smart home systems. A case study involving a set of conventional and smart appliances with dedicated processing units in an inhabited building can demonstrate the validity of the proposed framework. A visualization graph can show "before" and "after" results.Keywords: smart homes systems, machine learning, deep learning, Markov Decision Process
Procedia PDF Downloads 2112819 Dental Management Particularities of Werner Syndrome: A Report of Two Cases
Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour
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Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management
Procedia PDF Downloads 572818 Harnessing of Electricity from Distillery Effluent and Simultaneous Effluent Treatment by Microbial Fuel Cell
Authors: Hanish Mohammed, C. H. Muthukumar Muthuchamy
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The advancement in the science and technology has made it possible to convert electrical energy into any desired form. It has given electrical energy a place of pride in the modern world. The survival of industrial undertakings and our social structure depends primarily upon low cost and uninterrupted supply of electrical energy. Microbial fuel cell (MFC) is a promising and emerging technique for sustainable bioelectricity generation and wastewater treatment. MFCs are devices which are capable of converting organic matter to electricity/hydrogen with help of microorganisms. Different kinds of wastewater could be used in this technique, distillery effluent is one of the most troublesome and complex and strong organic effluent with high chemical oxygen demand of 1,53,846 mg/L. A single cell MFC unit was designed and fabricated for the distillery effluent treatment and to generate electricity. Due to the high COD value of the distillery effluent helped in the production of energy for 74 days. The highest voltage got from the fuel cell is 206 mV on the 30th day. A maximum power density obtained from the MFC was 9.8 mW, treatment efficiency was evaluated in terms of COD removal and other parameters. COD removal efficiencies were around 68.5 % and other parameters such as Total Hardness (81.5%), turbidity (70 %), chloride (66%), phosphate (79.5%), Nitrate (77%) and sulphate (71%). MFC using distillery effluent is a promising new unexplored substrate for the power generation and sustainable treatment technique through harnessing of bioelectricity.Keywords: microbial fuel cell (MFC), bioelectricity, distillery effluent, wastewater treatment
Procedia PDF Downloads 2162817 Potentials of Additive Manufacturing: An Approach to Increase the Flexibility of Production Systems
Authors: A. Luft, S. Bremen, N. Balc
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The task of flexibility planning and design, just like factory planning, for example, is to create the long-term systemic framework that constitutes the restriction for short-term operational management. This is a strategic challenge since, due to the decision defect character of the underlying flexibility problem, multiple types of flexibility need to be considered over the course of various scenarios, production programs, and production system configurations. In this context, an evaluation model has been developed that integrates both conventional and additive resources on a basic task level and allows the quantification of flexibility enhancement in terms of mix and volume flexibility, complexity reduction, and machine capacity. The model helps companies to decide in early decision-making processes about the potential gains of implementing additive manufacturing technologies on a strategic level. For companies, it is essential to consider both additive and conventional manufacturing beyond pure unit costs. It is necessary to achieve an integrative view of manufacturing that incorporates both additive and conventional manufacturing resources and quantifies their potential with regard to flexibility and manufacturing complexity. This also requires a structured process for the strategic production systems design that spans the design of various scenarios and allows for multi-dimensional and comparative analysis. A respective guideline for the planning of additive resources on a strategic level is being laid out in this paper.Keywords: additive manufacturing, production system design, flexibility enhancement, strategic guideline
Procedia PDF Downloads 1302816 Charge Transport of Individual Thermoelectric Bi₂Te₃ Core-Poly(3,4-Ethylenedioxythiophene):Polystyrenesulfonate Shell Nanowires Determined Using Conductive Atomic Force Microscopy and Spectroscopy
Authors: W. Thongkham, K. Sinthiptharakoon, K. Tantisantisom, A. Klamchuen, P. Khanchaitit, K. Jiramitmongkon, C. Lertsatitthanakorn, M. Liangruksa
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Due to demands of sustainable energy, thermoelectricity converting waste heat into electrical energy has become one of the intensive fields of worldwide research. However, such harvesting technology has shown low device performance in the temperature range below 150℃. In this work, a hybrid nanowire of inorganic bismuth telluride (Bi₂Te₃) and organic poly(3,4-ethylenedioxythiophene):polystyrenesulfonate (PEDOT:PSS) synthesized using a simple in-situ one-pot synthesis, enhancing efficiency of the nanowire-incorporated PEDOT:PSS-based thermoelectric converter is highlighted. Since the improvement is ascribed to the increased electrical conductivity of the thermoelectric host material, the individual hybrid nanowires are investigated using voltage-dependent conductive atomic force microscopy (CAFM) and spectroscopy (CAFS) considering that the electrical transport measurement can be performed either on insulating or conducting areas of the sample. Correlated with detailed chemical information on the crystalline structure and compositional profile of the nanowire core-shell structure, an electrical transporting pathway through the nanowire and the corresponding electronic-band structure have been determined, in which the native oxide layer on the Bi₂Te₃ surface is not considered, and charge conduction on the topological surface states of Bi₂Te₃ is suggested. Analyzing the core-shell nanowire synthesized using the conventional mixing of as-prepared Bi₂Te₃ nanowire with PEDOT:PSS for comparison, the oxide-removal effect of the in-situ encapsulating polymeric layer is further supported. The finding not only provides a structural information for mechanistic determination of the thermoelectricity, but it also encourages new approach toward more appropriate encapsulation and consequently higher efficiency of the nanowire-based thermoelectric generation.Keywords: electrical transport measurement, hybrid Bi₂Te₃-PEDOT:PSS nanowire, nanoencapsulation, thermoelectricity, topological insulator
Procedia PDF Downloads 2072815 Geospatial Assessments on Impacts of Land Use Changes and Climate Change in Nigeria Forest Ecosystems
Authors: Samuel O. Akande
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The human-induced climate change is likely to have severe consequences on forest ecosystems in Nigeria. Recent discussions and emphasis on issues concerning the environment justify the need for this research which examined deforestation monitoring in Oban Forest, Nigeria using Remote Sensing techniques. The Landsat images from TM (1986), ETM+ (2001) and OLI (2015) sensors were obtained from Landsat online archive and processed using Erdas Imagine 2014 and ArcGIS 10.3 to obtain the land use/land cover and Normalized Differential Vegetative Index (NDVI) values. Ground control points of deforested areas were collected for validation. It was observed that the forest cover decreased in area by about 689.14 km² between 1986 and 2015. The NDVI was used to determine the vegetation health of the forest and its implications on agricultural sustainability. The result showed that the total percentage of the healthy forest cover has reduced to about 45.9% from 1986 to 2015. The results obtained from analysed questionnaires shown that there was a positive correlation between the causes and effects of deforestation in the study area. The coefficient of determination value was calculated as R² ≥ 0.7, to ascertain the level of anthropogenic activities, such as fuelwood harvesting, intensive farming, and logging, urbanization, and engineering construction activities, responsible for deforestation in the study area. Similarly, temperature and rainfall data were obtained from Nigerian Meteorological Agency (NIMET) for the period of 1986 to 2015 in the study area. It was observed that there was a significant increase in temperature while rainfall decreased over the study area. Responses from the administered questionnaires also showed that futile destruction of forest ecosystem in Oban forest could be reduced to its barest minimum if fuelwood harvesting is disallowed. Thus, the projected impacts of climate change on Nigeria’s forest ecosystems and environmental stability is better imagined than experienced.Keywords: deforestation, ecosystems, normalized differential vegetative index, sustainability
Procedia PDF Downloads 195