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2957 Nucleotide Diversity and Bacterial Endosymbionts of the Black Cherry Aphid Myzus cerasi (Fabricus, 1775) (Hemiptera: Aphididae) from Turkey
Authors: Burcu Inal, Irfan Kandemir
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Sequences of mitochondrial cytochrome oxidase I (COI) gene of twenty-five Turkish and one Greek Myzus cerasi (Fabricus) (Hemiptera: Aphididae) in populations were collected from Prunus avium and Prunus cerasus. The partial coding region of COI studied is 605 bp for all the populations, from which 565 nucleotides were conserved, 40 were variable, 37 were singleton, and 3 sites were parsimony-informative. Four haplotypes were identified based on nucleotide substitutions, and the mean of intraspecific divergence was calculated to be 0.3%. Phylogenetic trees were constructed using Maximum Likelihood, Minimum Evolution, Neighbor-joining, and Unweighed Pair Group Method of Arithmetic Averages (UPGMA) and Myzus persicae (Sulzer) and Myzus borealis Ossiannilson were included as outgroups. The population of M. cerasi from Isparta diverged from the rest of the groups and formed a clade (Haplotype B) with Myzus borealis. The rest of the haplotype diversity includes Haplotype A and Haplotype C with individuals characterized as Myzus cerasi pruniavium and Haplotype D with Myzus cerasi cerasi. M. cerasi diverge into two subspecies and it must be reevaluated whether this pest is monophagous or oligophagous in terms of plant type dependence. The obligated endosymbiont Buchnera aphidicola was also found during this research, but no facultative symbionts could be found. It is expected further studies will be required for a complete barcoding and diversity of bacterial endosymbionts present.Keywords: bacterial endosymbionts, barcoding, black cherry aphid, nucleotide diversity
Procedia PDF Downloads 1732956 Selection of Strategic Suppliers for Partnership: A Model with Two Stages Approach
Authors: Safak Isik, Ozalp Vayvay
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Strategic partnerships with suppliers play a vital role for the long-term value-based supply chain. This strategic collaboration keeps still being one of the top priority of many business organizations in order to create more additional value; benefiting mainly from supplier’s specialization, capacity and innovative power, securing supply and better managing costs and quality. However, many organizations encounter difficulties in initiating, developing and managing those partnerships and many attempts result in failures. One of the reasons for such failure is the incompatibility of members of this partnership or in other words wrong supplier selection which emphasize the significance of the selection process since it is the beginning stage. An effective selection process of strategic suppliers is critical to the success of the partnership. Although there are several research studies to select the suppliers in literature, only a few of them is related to strategic supplier selection for long-term partnership. The purpose of this study is to propose a conceptual model for the selection of strategic partnership suppliers. A two-stage approach has been used in proposed model incorporating first segmentation and second selection. In the first stage; considering the fact that not all suppliers are strategically equal and instead of a long list of potential suppliers, Kraljic’s purchasing portfolio matrix can be used for segmentation. This supplier segmentation is the process of categorizing suppliers based on a defined set of criteria in order to identify types of suppliers and determine potential suppliers for strategic partnership. In the second stage, from a pool of potential suppliers defined at first phase, a comprehensive evaluation and selection can be performed to finally define strategic suppliers considering various tangible and intangible criteria. Since a long-term relationship with strategic suppliers is anticipated, criteria should consider both current and future status of the supplier. Based on an extensive literature review; strategical, operational and organizational criteria have been determined and elaborated. The result of the selection can also be used to determine suppliers who are not ready for a partnership but to be developed for strategic partnership. Since the model is based on multiple criteria for both stages, it provides a framework for further utilization of Multi-Criteria Decision Making (MCDM) techniques. The model may also be applied to a wide range of industries and involve managerial features in business organizations.Keywords: Kraljic’s matrix, purchasing portfolio, strategic supplier selection, supplier collaboration, supplier partnership, supplier segmentation
Procedia PDF Downloads 2392955 Non-Linear Finite Element Investigation on the Behavior of CFRP Strengthened Steel Square HSS Columns under Eccentric Loading
Authors: Tasnuba Binte Jamal, Khan Mahmud Amanat
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Carbon Fiber-Reinforced Polymer (CFRP) composite materials have proven to have valuable properties and suitability to be used in the construction of new buildings and in upgrading the existing ones due to its effectiveness, ease of implementation and many more. In the present study, a numerical finite element investigation has been conducted using ANSYS 18.1 to study the behavior of square HSS AISC sections under eccentric compressive loading strengthened with CFRP materials. A three-dimensional finite element model for square HSS section using shell element was developed. Application of CFRP strengthening was incorporated in the finite element model by adding an additional layer of shell elements. Both material and geometric nonlinearities were incorporated in the model. The developed finite element model was applied to simulate experimental studies done by past researchers and it was found that good agreement exists between the current analysis and past experimental results, which established the acceptability and validity of the developed finite element model to carry out further investigation. Study was then focused on some selected non-compact AISC square HSS columns and the effects of number of CFRP layers, amount of eccentricities and cross-sectional geometry on the strength gain of those columns were observed. Load was applied at a distance equal to the column dimension and twice that of column dimension. It was observed that CFRP strengthening is comparatively effective for smaller eccentricities. For medium sized sections, strengthening tends to be effective at smaller eccentricities as well. For relatively large AISC square HSS columns, with increasing number of CFRP layers (from 1 to 3 layers) the gain in strength is approximately 1 to 38% to that of unstrengthened section for smaller eccentricities and slenderness ratio ranging from 27 to 54. For medium sized square HSS sections, effectiveness of CFRP strengthening increases approximately by about 12 to 162%. The findings of the present study provide a better understanding of the behavior of HSS sections strengthened with CFRP subjected to eccentric compressive load.Keywords: CFRP strengthening, eccentricity, finite element model, square hollow section
Procedia PDF Downloads 1442954 Entrepreneurship Skills Acquisition through Education: Impact of the Nurturance of Knowledge, Skills, and Attitude on New Venture Creation
Authors: Satya Ranjan Acharya, Yamini Chandra
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Entrepreneurship through higher education has taken a paradigm shift from traditional classroom lecture series method to a modern approach, which lay emphasis on nurturing competencies, enhancing knowledge, skills, attitudes/abilities (KSA), which has positive impact on the development of core capabilities. The present paper was focused on the analysis of entrepreneurship education as a pedagogical intervention for the post-graduate program offered at the Entrepreneurship Development Institute of India, Gujarat, India. The study is focused on a model with special emphasis on developing KSA and its effect on nurturing entrepreneurial spirit within students. The findings represent demographic and thematic assessment of the implemented pedagogical model with an outcome of students choosing a career in new venture creation or growth/diversification of family owned businesses. This research will be helpful for academicians, research scholars, potential entrepreneurs, ecosystem enablers and students to infer the effectiveness of nurturing entrepreneurial skills and bringing more changes in personal attitudes by the way of enhancing the knowledge and skills required for the execution of an entrepreneurial career. This research is original in nature as it provides an in-depth insight into an implemented model of curriculum, focused on the development and nurturance of basic skills and its impact on the career choice of students.Keywords: attitude, entrepreneurship education, knowledge, new venture creation, pedagogical intervention, skills
Procedia PDF Downloads 1932953 Enhancing Cooperation Between LEAs and Citizens: The INSPEC2T Approach
Authors: George Leventakis, George Kokkinis, Nikos Moustakidis, George Papalexandratos, Ioanna Vasiliadou
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Enhancing the feeling of public safety and crime prevention are tasks customarily assigned to the Police. Police departments have, however, recognized that traditional ways of policing methods are becoming obsolete; Community Policing (CP) philosophy; however, when applied appropriately, leads to seamless collaboration between various stakeholders like the Police, NGOs and the general public and provides the opportunity to identify risks, assist in solving problems of crime, disorder, safety and crucially contribute to improving the quality of life for everyone in a community. Social Media, on the other hand, due to its high level of infiltration in modern life, constitutes a powerful mechanism which offers additional and direct communication channels to reach individuals or communities. These channels can be utilized to improve the citizens’ perception of the Police and to capture individual and community needs, when their feedback is taken into account by Law Enforcement Agencies (LEAs) in a structured and coordinated manner. This paper presents research conducted under INSPEC2T (Inspiring CitizeNS Participation for Enhanced Community PoliCing AcTions), a project funded by the European Commission’s research agenda to bridge the gap between CP as a philosophy and as an organizational strategy, capitalizing on the use of Social Media. The project aims to increase transparency, trust, police accountability, and the role of civil society. It aspires to build strong, trusting relationships between LEAs and the public, supporting two-way, contemporary communication while at the same time respecting anonymity of all affected parties. Results presented herein summarize the outcomes of four online multilingual surveys, focus group interviews, desktop research and interviews with experts in the field of CP practices. The above research activities were conducted in various EU countries aiming to capture requirements of end users from diverse backgrounds (social, cultural, legal and ethical) and determine public expectations regarding CP, community safety and crime prevention.Keywords: community partnerships, next generation community policing, social media, public safety
Procedia PDF Downloads 3462952 Reducing Friction Associated with Commercial Use of Biomimetics While Increasing the Potential for Using Eco Materials and Design in Industry
Authors: John P. Ulhøi
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Firms are faced with pressure to stay innovative and entrepreneurial while at the same time leaving lighter ecological footprints. Traditionally inspiration for new product development (NPD) has come from the creative in-house staff and from the marketplace. Often NPD offered by this approach has proven to be (far from) optimal for its purpose or highly (resource and energy) efficient. More recently, a bio-inspired NPD approach has surfaced under the banner of biomimetics. Biomimetics refers to inspiration from and translations of designs, systems, processes, and or specific properties that exist in nature. The principles and structures working in nature have evolved over a long period of time enable them to be optimized for the purpose and resource and energy-efficient. These characteristics reflect the raison d'être behind the field of biomimetics. While biological expertise is required to understand and explain such natural and biological principles and structures, engineers are needed to translate biological design and processes into synthetic applications. It can, therefore, hardly be surprising, biomimetics long has gained a solid foothold in both biology and engineering. The commercial adoption of biomimetic applications in new production development (NDP) in industry, however, does not quite reflect a similar growth. Differently put, this situation suggests that something is missing in the biomimetic-NPD-equation, thus acting as a brake towards the wider commercial application of biomimetics and thus the use of eco-materials and design in the industry. This paper closes some of that gap. Before concluding, avenues for future research and implications for practice will be briefly sketched out.Keywords: biomimetics, eco-materials, NPD, commercialization
Procedia PDF Downloads 1632951 Flipped Classroom Instruction: Reflecting on the Experiences of Teachers and Students at Undergraduate University Level
Authors: Mubeshera Tufail
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The purpose of the study was to explore the experiences and challenges faced by teachers and students with Flipped Classroom Instruction (FCI) for an undergraduate course at university level. The Flipped Classroom lesson plan consisted of two components: one was out-of-class component consisting of learning material for reading for students and other was within-class component involving a class quiz, class activity and the feedback/further reading task. Besides, experiences, the research study also covered the adaptations made to improve their experiences with Flipped Classroom during the study. The phenomenological research strategy was used for this research study. The data consisted of weekly reflective journals documented by class teacher and students. The reflective journals were recorded by teacher and students while working in Flipped Classroom for an undergraduate course at university level. The main challenges highlighted by teacher were related to effort and time required for planning, time management and students' guidance for shift of their role from passive to independent learner. The main challenges found in reflective journals of students were personal computers issue, electricity and internet speed issue. It is recommended to adapt to some locally useful lesson planning and classroom management techniques to enhance the effectiveness of Flipped Classroom Instruction in an undergraduate university level course.Keywords: flipped classroom instruction, undergraduate students, independent learner, technology-integrated classroom
Procedia PDF Downloads 1622950 Lessons Learned in Developing a Clinical Information System and Electronic Health Record (EHR) System That Meet the End User Needs and State of Qatar's Emerging Regulations
Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath
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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics
Procedia PDF Downloads 3622949 Investigating the Pedestrian Willingness to Pay to Choose Appropriate Policies for Improving the Safety of Pedestrian Facilities
Authors: Babak Mirbaha, Mahmoud Saffarzadeh, Fatemeh Mohajeri
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Road traffic accidents lead to a higher rate of death and injury, especially in vulnerable road users such as pedestrians. Improving the safety of facilities for pedestrians is a major concern for policymakers because of the high number of pedestrian fatalities and direct and indirect costs which are imposed to the society. This study focuses on the idea of determining the willingness to pay of pedestrians for increasing their safety while crossing the street. In this study, three different scenarios including crossing the street with zebra crossing facilities, crossing the street with zebra crossing facilities and installing a pedestrian traffic light and constructing a pedestrian bridge with escalator are presented. The research was conducted based on stated preferences method. The required data were collected from a questionnaire that consisted of three parts: pedestrian’s demographic characteristics, travel characteristics and scenarios. Four different payment amounts are presented for each scenario and a logit model has been built for each proposed payment. The results show that sex, age, education, average household income and individual salary have significant effect on choosing a scenario. Among the policies that have been mentioned through the questionnaire scenarios, the scenario of crossing the street with zebra crossing facilities and installing a traffic lights is the most frequent, with willingness to pay 10,000 Rials and the scenario of crossing the street with a zebra crossing with a willingness to pay 100,000 Rials having the least frequency. For all scenarios, as the payment is increasing, the willingness to pay decreases.Keywords: pedestrians, willingness to pay, safety, immunization
Procedia PDF Downloads 1562948 Multi-Objective Optimization of a Solar-Powered Triple-Effect Absorption Chiller for Air-Conditioning Applications
Authors: Ali Shirazi, Robert A. Taylor, Stephen D. White, Graham L. Morrison
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In this paper, a detailed simulation model of a solar-powered triple-effect LiBr–H2O absorption chiller is developed to supply both cooling and heating demand of a large-scale building, aiming to reduce the fossil fuel consumption and greenhouse gas emissions in building sector. TRNSYS 17 is used to simulate the performance of the system over a typical year. A combined energetic-economic-environmental analysis is conducted to determine the system annual primary energy consumption and the total cost, which are considered as two conflicting objectives. A multi-objective optimization of the system is performed using a genetic algorithm to minimize these objectives simultaneously. The optimization results show that the final optimal design of the proposed plant has a solar fraction of 72% and leads to an annual primary energy saving of 0.69 GWh and annual CO2 emissions reduction of ~166 tonnes, as compared to a conventional HVAC system. The economics of this design, however, is not appealing without public funding, which is often the case for many renewable energy systems. The results show that a good funding policy is required in order for these technologies to achieve satisfactory payback periods within the lifetime of the plant.Keywords: economic, environmental, multi-objective optimization, solar air-conditioning, triple-effect absorption chiller
Procedia PDF Downloads 2382947 A Protocol for Usability of Teaching to Students with Learning Difficulties at University: An Italian Research
Authors: Tamara Zappaterra
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The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching
Procedia PDF Downloads 2832946 Role of Pulp Volume Method in Assessment of Age and Gender in Lucknow, India, an Observational Study
Authors: Anurag Tripathi, Sanad Khandelwal
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Age and gender determination are required in forensic for victim identification. There is secondary dentine deposition throughout life, resulting in decreased pulp volume and size. Evaluation of pulp volume using Cone Beam Computed Tomography (CBCT)is a noninvasive method to evaluate the age and gender of an individual. The study was done to evaluate the efficacy of pulp volume method in the determination of age and gender.Aims/Objectives: The study was conducted to estimate age and determine sex by measuring tooth pulp volume with the help of CBCT. An observational study of one year duration on CBCT data of individuals was conducted in Lucknow. Maxillary central incisors (CI) and maxillary canine (C) of the randomly selected samples were assessed for measurement of pulp volume using a software. Statistical analysis: Chi Square Test, Arithmetic Mean, Standard deviation, Pearson’s Correlation, Linear & Logistic regression analysis. Results: The CBCT data of Ninety individuals with age range between 18-70 years was evaluated for pulp volume of central incisor and canine (CI & C). The Pearson correlation coefficient between the tooth pulp volume (CI & C) and chronological age suggested that pulp volume decreased with age. The validation of the equations for sex determination showed higher prediction accuracy for CI (56.70%) and lower for C (53.30%).Conclusion: Pulp volume obtained from CBCT is a reliable indicator for age estimation and gender prediction.Keywords: forensic, dental age, pulp volume, cone beam computed tomography
Procedia PDF Downloads 992945 A Combined Activated Sludge-Filtration-Ozonation Process for Abattoir Wastewater Treatment
Authors: Pello Alfonso-Muniozguren, Madeleine Bussemaker, Ralph Chadeesingh, Caryn Jones, David Oakley, Judy Lee, Devendra Saroj
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Current industrialized livestock agriculture is growing every year leading to an increase in the generation of wastewater that varies considerably in terms of organic content and microbial population. Therefore, suitable wastewater treatment methods are required to ensure the wastewater quality meet regulations before discharge. In the present study, a combined lab scale activated sludge-filtration-ozonation system was used to treat a pre-treated abattoir wastewater. A hydraulic retention time of 24 hours and a solid retention time of 13 days were used for the activated sludge process, followed by a filtration step (4-7 µm) and using ozone as tertiary treatment. An average reduction of 93% and 98% was achieved for Chemical Oxygen Demand (COD) and Biological Oxygen Demand (BOD), respectively, obtaining final values of 128 mg/L COD and 12 mg/L BOD. For the Total Suspended Solids (TSS), the average reduction increased to 99% in the same system, reducing the final value down to 3 mg/L. Additionally, 98% reduction in Phosphorus (P) and a complete inactivation of Total Coliforms (TC) was obtained after 17 min ozonation time. For Total Viable Counts (TVC), a drastic reduction was observed with 30 min ozonation time (6 log inactivation) at an ozone dose of 71 mg O3/L. Overall, the combined process was sufficient to meet discharge requirements without further treatment for the measured parameters (COD, BOD, TSS, P, TC, and TVC).Keywords: abattoir waste water, activated sludge, ozone, waste water treatment
Procedia PDF Downloads 2802944 Error Analysis of Pronunciation of French by Sinhala Speaking Learners
Authors: Chandeera Gunawardena
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The present research analyzes the pronunciation errors encountered by thirty Sinhala speaking learners of French on the assumption that the pronunciation errors were systematic and they reflect the interference of the native language of the learners. The thirty participants were selected using random sampling method. By the time of the study, the subjects were studying French as a foreign language for their Bachelor of Arts Degree at University of Kelaniya, Sri Lanka. The participants were from a homogenous linguistics background. All participants speak the same native language (Sinhala) thus they had completed their secondary education in Sinhala medium and during which they had also learnt French as a foreign language. A battery operated audio tape recorder and a 120-minute blank cassettes were used for recording. A list comprised of 60 words representing all French phonemes was used to diagnose pronunciation difficulties. Before the recording process commenced, the subjects were requested to familiarize themselves with the words through reading them several times. The recording was conducted individually in a quiet classroom and each recording approximately took fifteen minutes. Each subject was required to read at a normal speed. After the completion of recording, the recordings were replayed to identify common errors which were immediately transcribed using the International Phonetic Alphabet. Results show that Sinhala speaking learners face problems with French nasal vowels and French initial consonants clusters. The learners also exhibit errors which occur because of their second language (English) interference.Keywords: error analysis, pronunciation difficulties, pronunciation errors, Sinhala speaking learners of French
Procedia PDF Downloads 2112943 Methylphenidate and Placebo Effect on Brain Activity and Basketball Free Throw: A Randomized Controlled Trial
Authors: Mohammad Khazaei, Reza Rostami, Hasan Gharayagh Zandi, Rouhollah Basatnia, Mahbubeh Ghayour Najafabadi
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Objective: Methylphenidate has been demonstrated to enhance attention and cognitive processes, and placebo treatments have also been found to improve attention and cognitive processes. Additionally, methylphenidate may have positive effects on motion perception and sports performance. Nevertheless, additional research is needed to fully comprehend the neural mechanisms underlying the effects of methylphenidate and placebo on cognitive and motor functions. Methods: In this randomized controlled trial, 18 young semi-professional basketball players aged 18-23 years were randomly and equally assigned to either a Ritalin or Placebo group. The participants performed 20 consecutive free throws; their scores were recorded on a 0-3 scale. The participants’ brain activity was recorded using electroencephalography (EEG) for 5 minutes seated with their eyes closed. The Ritalin group received a 10 mg dose of methylphenidate, while the Placebo group received a 10mg dose of placebo. The EEG was obtained 90 minutes after the drug was administere Results: There was no significant difference in the absolute power of brain waves between the pre-test and post-tests in the Placebo group. However, in the Ritalin group, a significant difference in the absolute power of brain waves was observed in the Theta band (5-6 Hz) and Beta band (21-30 Hz) between pre- and post-tests in Fp2, F8, and Fp1. In these areas, the absolute power of Beta waves was higher during the post-test than during the pre-test. The Placebo group showed a more significant difference in free throw scores than the Ritalin group. Conclusions: In conclusion, these results suggest that Ritalin effect on brain activity in areas associated with attention and cognitive processes, as well as improve basketball free throws. However, there was no significant placebo effect on brain activity performance, but it significantly affected the improvement of free throws. Further research is needed to fully understand the effects of methylphenidate and placebo on cognitive and motor functions.Keywords: methylphenidate, placebo effect, electroencephalography, basketball free throw
Procedia PDF Downloads 792942 Designing Ecologically and Economically Optimal Electric Vehicle Charging Stations
Authors: Y. Ghiassi-Farrokhfal
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The number of electric vehicles (EVs) is increasing worldwide. Replacing gas fueled cars with EVs reduces carbon emission. However, the extensive energy consumption of EVs stresses the energy systems, requiring non-green sources of energy (such as gas turbines) to compensate for the new energy demand caused by EVs in the energy systems. To make EVs even a greener solution for the future energy systems, new EV charging stations are equipped with solar PV panels and batteries. This will help serve the energy demand of EVs through the green energy of solar panels. To ensure energy availability, solar panels are combined with batteries. The energy surplus at any point is stored in batteries and is used when there is not enough solar energy to serve the demand. While EV charging stations equipped with solar panels and batteries are green and ecologically optimal, they might not be financially viable solutions, due to battery prices. To make the system viable, we should size the battery economically and operate the system optimally. This is, in general, a challenging problem because of the stochastic nature of the EV arrivals at the charging station, the available solar energy, and the battery operating system. In this work, we provide a mathematical model for this problem and we compute the return on investment (ROI) of such a system, which is designed to be ecologically and financially optimal. We also quantify the minimum required investment in terms of battery and solar panels along with the operating strategy to ensure that a charging station has enough energy to serve its EV demand at any time.Keywords: solar energy, battery storage, electric vehicle, charging stations
Procedia PDF Downloads 2232941 Performance Gap and near Zero Energy Buildings Compliance of Monitored Passivhaus in Northern Ireland, the Republic of Ireland and Italy
Authors: S. Colclough, V. Costanzo, K. Fabbri, S. Piraccini, P. Griffiths
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The near Zero Energy Building (nZEB) standard is required for all buildings from 2020. The Passive House (PH) standard is a well-established low-energy building standard, having been designed over 25 years ago, and could potentially be used to achieve the nZEB standard in combination with renewables. By comparing measured performance with design predictions, this paper considers if there is a performance gap for a number of monitored properties and assesses if the nZEB standard can be achieved by following the well-established PH scheme. Analysis is carried out based on monitoring results from real buildings located in Northern Ireland, the Republic of Ireland and Italy respectively, with particular focus on the indoor air quality including the assumed and measured indoor temperature and heating periods for both standards as recorded during a full annual cycle. An analysis is carried out also on the energy performance certificates of each of the dwellings to determine if they meet the near Zero Energy Buildings primary energy consumption targets set in the respective jurisdictions. Each of the dwellings is certified as complying with the passive house standard, and accordingly have very good insulation levels, heat recovery and ventilation systems of greater than 75% efficiency and an airtightness of less than 0.6 air changes per hour at 50 Pa. It is found that indoor temperature and relative humidity were within the comfort boundaries set in the design stage, while carbon dioxide concentrations are sometimes higher than the values suggested by EN 15251 Standard for comfort class I especially in bedrooms.Keywords: monitoring campaign, nZEB (near zero energy buildings), Passivhaus, performance gap
Procedia PDF Downloads 1522940 Text as Reader Device Improving Subjectivity on the Role of Attestation between Interpretative Semiotics and Discursive Linguistics
Authors: Marco Castagna
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Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.Keywords: attestation, meaning, reader, text
Procedia PDF Downloads 2372939 Sensitivity Based Robust Optimization Using 9 Level Orthogonal Array and Stepwise Regression
Authors: K. K. Lee, H. W. Han, H. L. Kang, T. A. Kim, S. H. Han
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For the robust optimization of the manufacturing product design, there are design objectives that must be achieved, such as a minimization of the mean and standard deviation in objective functions within the required sensitivity constraints. The authors utilized the sensitivity of objective functions and constraints with respect to the effective design variables to reduce the computational burden associated with the evaluation of the probabilities. The individual mean and sensitivity values could be estimated easily by using the 9 level orthogonal array based response surface models optimized by the stepwise regression. The present study evaluates a proposed procedure from the robust optimization of rubber domes that are commonly used for keyboard switching, by using the 9 level orthogonal array and stepwise regression along with a desirability function. In addition, a new robust optimization process, i.e., the I2GEO (Identify, Integrate, Generate, Explore and Optimize), was proposed on the basis of the robust optimization in rubber domes. The optimized results from the response surface models and the estimated results by using the finite element analysis were consistent within a small margin of error. The standard deviation of objective function is decreasing 54.17% with suggested sensitivity based robust optimization. (Business for Cooperative R&D between Industry, Academy, and Research Institute funded Korea Small and Medium Business Administration in 2017, S2455569)Keywords: objective function, orthogonal array, response surface model, robust optimization, stepwise regression
Procedia PDF Downloads 2882938 Experimental Investigation to Produce an Optimum Mix Ratio of Micro-Concrete
Authors: Shofiq Ahmed, Rakibul Hassan, Raquib Ahsan
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Concrete is one of the basic elements of RCC structure and also the most crucial one. In recent years, a lot of researches have been conducted to develop special types of concrete for special purposes. Micro-concrete is one of them which has high compressive strength and is mainly used for retrofitting. Micro-concrete is a cementitious based composition formulated for use in repairs of areas where the concrete is damaged & the area is confined in movement making the placement of conventional concrete difficult. According to recent statistics, a large number of structures in the major cities of Bangladesh are vulnerable to collapse. Retrofitting may thus be required for a sustainable solution, and for this purpose, the utilization of micro-concrete can be considered as the most effective solution. For that reason, the aim of this study was to produce micro-concrete using indigenous materials in low cost. Following this aim, the experimental data were observed for five mix ratios with varied amount of cement, fine aggregate, coarse aggregate, water, and admixture. The investigation criteria were a compressive strength, tensile strength, slump and the cost of different mix ratios. Finally, for a mix ratio of 1:1:1.5, the compressive strength was achieved as 7820 psi indicating highest strength among all the samples with the reasonable tensile strength of 1215 psi. The slump of 6.9 inches was also found for this specimen indicating it’s high flowability and making it’s convenient to use as micro-concrete. Moreover, comparing with the cost of foreign products of micro-concrete, it was observed that foreign products were almost four to five times costlier than this local product.Keywords: indigenous, micro-concrete, retrofitting, vulnerable
Procedia PDF Downloads 3272937 Classification of Manufacturing Data for Efficient Processing on an Edge-Cloud Network
Authors: Onyedikachi Ulelu, Andrew P. Longstaff, Simon Fletcher, Simon Parkinson
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The widespread interest in 'Industry 4.0' or 'digital manufacturing' has led to significant research requiring the acquisition of data from sensors, instruments, and machine signals. In-depth research then identifies methods of analysis of the massive amounts of data generated before and during manufacture to solve a particular problem. The ultimate goal is for industrial Internet of Things (IIoT) data to be processed automatically to assist with either visualisation or autonomous system decision-making. However, the collection and processing of data in an industrial environment come with a cost. Little research has been undertaken on how to specify optimally what data to capture, transmit, process, and store at various levels of an edge-cloud network. The first step in this specification is to categorise IIoT data for efficient and effective use. This paper proposes the required attributes and classification to take manufacturing digital data from various sources to determine the most suitable location for data processing on the edge-cloud network. The proposed classification framework will minimise overhead in terms of network bandwidth/cost and processing time of machine tool data via efficient decision making on which dataset should be processed at the ‘edge’ and what to send to a remote server (cloud). A fast-and-frugal heuristic method is implemented for this decision-making. The framework is tested using case studies from industrial machine tools for machine productivity and maintenance.Keywords: data classification, decision making, edge computing, industrial IoT, industry 4.0
Procedia PDF Downloads 1822936 Tribological Behavior of PTFE Composites Used for Guide Rings of Hydraulic Actuating Cylinders under Oil-Lubricated Condition
Authors: Trabelsi Mohamed, Kharrat Mohamed, Dammak Maher
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Guide rings play an important role in the performance and durability of hydraulic actuating cylinders. In service, guide rings surfaces are subjected to friction and wear against steel counterface. A good mastery of these phenomena is required for the improvement of the energy safeguard and the durability of the actuating cylinder. Polytetrafluoroethylene (PTFE) polymer is extensively used in guide rings thanks to its low coefficient of friction, its good resistance to solvents as well as its high temperature stability. In this study, friction and wear behavior of two PTFE composites filled with bronze and bronze plus MoS2 were evaluated under oil-lubricated condition, aiming as guide rings for hydraulic actuating cylinder. Wear tests of the PTFE composite specimen sliding against steel ball were conducted using reciprocating linear tribometer. The wear mechanisms of the composites under the same sliding condition were discussed, based on Scanning Electron Microscopy examination of the worn composite surface and the optical micrographs of the steel counter surface. As for the results, comparative friction behaviors of the PTFE composites and lower friction coefficients were recorded under oil lubricated condition. The wear behavior was considerably improved to compare with this in dry sliding, while the oil adsorbed layer limited the transfer of the PTFE to the steel counter face during the sliding test.Keywords: PTFE, composite, bronze, MoS2, friction, wear, oil-lubrication
Procedia PDF Downloads 3002935 An Immersive Serious Game for Firefighting and Evacuation Training in Healthcare Facilities
Authors: Anass Rahouti, Guillaume Salze, Ruggiero Lovreglio, Sélim Datoussaïd
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In healthcare facilities, training the staff for firefighting and evacuation in real buildings is very challenging due to the presence of a vulnerable population in such an environment. In a standard environment, traditional approaches, such as fire drills, are often used to train the occupants and provide them with information about fire safety procedures. However, those traditional approaches may be inappropriate for a vulnerable population and can be inefficient from an educational viewpoint as it is impossible to expose the occupants to scenarios similar to a real emergency. Immersive serious games could be used as an alternative to traditional approaches to overcome their limitations. Serious games are already being used in different safety domains such as fires, earthquakes and terror attacks for several building types (e.g., office buildings, train stations, tunnels, etc.). In this study, we developed an immersive serious game to improve the fire safety skills of staff in healthcare facilities. An accurate representation of the healthcare environment was built in Unity3D by including visual and audio stimuli inspired from those employed in commercial action games. The serious game is organised in three levels. In each of them, the trainee is presented with a specific fire emergency and s/he can perform protective actions (e.g., firefighting, helping non-ambulant occupants, etc.) or s/he can ignore the opportunity for action and continue the evacuation. In this paper, we describe all the steps required to develop such a prototype, as well as the key questions that need to be answered, to develop a serious game for firefighting and evacuation in healthcare facilities.Keywords: fire safety, healthcare, serious game, training
Procedia PDF Downloads 4532934 Simulating Elevated Rapid Transit System for Performance Analysis
Authors: Ran Etgar, Yuval Cohen, Erel Avineri
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One of the major challenges of transportation in medium sized inner-cities (such as Tel-Aviv) is the last-mile solution. Personal rapid transit (PRT) seems like an applicable candidate for this, as it combines the benefits of personal (car) travel with the operational benefits of transit. However, the investment required for large area PRT grid is significant and there is a need to economically justify such investment by correctly evaluating the grid capacity. PRT main elements are small automated vehicles (sometimes referred to as podcars) operating on a network of specially built guideways. The research is looking at a specific concept of elevated PRT system. Literature review has revealed the drawbacks PRT modelling and simulation approaches, mainly due to the lack of consideration of technical and operational features of the system (such as headways, acceleration, safety issues); the detailed design of infrastructure (guideways, stations, and docks); the stochastic and sessional characteristics of demand; and safety regulations – all of them have a strong effect on the system performance. A highly detailed model of the system, developed in this research, is applying a discrete event simulation combined with an agent-based approach, to represent the system elements and the podecars movement logic. Applying a case study approach, the simulation model is used to study the capacity of the system, the expected throughput of the system, the utilization, and the level of service (journey time, waiting time, etc.).Keywords: capacity, productivity measurement, PRT, simulation, transportation
Procedia PDF Downloads 1662933 Assessing the Sheltering Response in the Middle East: Studying Syrian Camps in Jordan
Authors: Lara A. Alshawawreh, R. Sean Smith, John B. Wood
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This study focuses on the sheltering response in the Middle East, specifically through reviewing two Syrian refugee camps in Jordan, involving Zaatari and Azraq. Zaatari camp involved the rapid deployment of tents and shelters over a very short period of time and Azraq was purpose built and pre-planned over a longer period. At present, both camps collectively host more than 133,000 occupants. Field visits were taken to both camps and the main issues and problems in the sheltering response were highlighted through focus group discussions with camp occupants and inspection of shelter habitats. This provided both subjective and objective research data sources. While every case has its own significance and deployment to meet humanitarian needs, there are some common requirements irrespective of geographical region. The results suggest that there is a gap in the suitability of the required habitat needs and what has been provided. It is recommended that the global international response and support could be improved in relation to the habitat form, construction type, layout, function and critically the cultural aspects. Services, health and hygiene are key elements to the shelter habitat provision. The study also identified the amendments to shelters undertaken by the beneficiaries providing insight into their key main requirements. The outcomes from this study could provide an important learning opportunity to develop improved habitat response for future shelters.Keywords: culture, post-disaster, refugees, shelters
Procedia PDF Downloads 4882932 Diagnosis of the Heart Rhythm Disorders by Using Hybrid Classifiers
Authors: Sule Yucelbas, Gulay Tezel, Cuneyt Yucelbas, Seral Ozsen
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In this study, it was tried to identify some heart rhythm disorders by electrocardiography (ECG) data that is taken from MIT-BIH arrhythmia database by subtracting the required features, presenting to artificial neural networks (ANN), artificial immune systems (AIS), artificial neural network based on artificial immune system (AIS-ANN) and particle swarm optimization based artificial neural network (PSO-NN) classifier systems. The main purpose of this study is to evaluate the performance of hybrid AIS-ANN and PSO-ANN classifiers with regard to the ANN and AIS. For this purpose, the normal sinus rhythm (NSR), atrial premature contraction (APC), sinus arrhythmia (SA), ventricular trigeminy (VTI), ventricular tachycardia (VTK) and atrial fibrillation (AF) data for each of the RR intervals were found. Then these data in the form of pairs (NSR-APC, NSR-SA, NSR-VTI, NSR-VTK and NSR-AF) is created by combining discrete wavelet transform which is applied to each of these two groups of data and two different data sets with 9 and 27 features were obtained from each of them after data reduction. Afterwards, the data randomly was firstly mixed within themselves, and then 4-fold cross validation method was applied to create the training and testing data. The training and testing accuracy rates and training time are compared with each other. As a result, performances of the hybrid classification systems, AIS-ANN and PSO-ANN were seen to be close to the performance of the ANN system. Also, the results of the hybrid systems were much better than AIS, too. However, ANN had much shorter period of training time than other systems. In terms of training times, ANN was followed by PSO-ANN, AIS-ANN and AIS systems respectively. Also, the features that extracted from the data affected the classification results significantly.Keywords: AIS, ANN, ECG, hybrid classifiers, PSO
Procedia PDF Downloads 4422931 Cytology Is a Promising Tool for the Diagnosis of High-Grade Serous Ovarian Carcinoma from Ascites
Authors: Miceska Simona, Škof Erik, Frković Grazio Snježana, Jeričević Anja, Smrkolj Špela, Cvjetićanin Branko, Novaković Srdjan, Grčar Kuzmanov Biljana, Kloboves-Prevodnik Veronika
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Objectives: High-grade serous ovarian cancer (HGSOC) is characterized by the dissemination of the tumor cells (TC) in the peritoneal cavity forming malignant ascites at the time of diagnosis or recurrence. Still, cytology itself has been underutilized as a modality for the diagnosis of HGSOC from ascites, and histological examination from the tumor tissue is yet the only validated method used. The objective of this study was to evaluate the reliability of cytology in the diagnosis of HGSOC in relation to the histopathological examination. Methods: The study included 42 patients with histologically confirmed HGSOC, accompanied by malignant ascites. To confirm the malignancy of the TC in the ascites and to define their immunophenotype, immunohistochemical reaction (IHC) of the following antigens: Calretinin, MOC, WT1, PAX8, p53, p16 & Ki-67 was evaluated on ascites cytospins and tissue blocks. For complete cytological determination of HGSOC, BRCA 1/2 gene mutation was determined from ascites, tissue block, and blood. BRCA1/2 mutation from blood was performed to define the type of mutation, somatic vs germline. Results: Among 42 patients, the immunophenotype of HGSOC from ascites was confirmed in 36 cases (86%). For more profound analysis, the patients were divided in 3 groups regarding the number of TC present in the ascites: patients with less than 10% TC, 10% TC, and more than 10% TC. From all included patients, in the group with less than 10% TC, there were 10 cases, and only 5 of them(50%) showed HGSOC phenotype; 12 cases had equally 10% of TC, and 11 cases (92%) showed HGSOC phenotype; 20 cases had more than 10% TC and all of them (100%) confirmed the HGSOC immunophenotype from ascites. Only 33 patients were eligible for further BRCA1/2 analysis. Eleven BRCA1/2 mutations were detected from thetissue block: 6 germline and 5 somatic. In 2 cases with less than 10% TC, BRCA1/2 mutation was not detected; 4 cases had 10% TC, and 2 of them (50%) confirmed the mutation; 4 cases had more than 10% TC, and all showed 100% reliability with the tumor tissue. Conclusions: Cytology is a highly reliable method for determining the immunophenotype of HGSOC and BRCA1/2 mutation if more than 10% of tumor cells are present in the ascites. This may present an additional non-invasive clinical approach for fast and effective diagnose in the future, especially in inoperable conditions or relapses.Keywords: cytology, ascites, high-grade serous ovarian cancer, immunophenotype, BRCA1/2
Procedia PDF Downloads 1882930 The Preventive Effect of Metformin on Paclitaxel-Induced Peripheral Neuropathy
Authors: AliAkbar Hafezi, Jamshid Abedi, Jalal Taherian, Behnam Kadkhodaei, Mahsa Elahi
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Background. Peripheral neuropathy is a common side effect of the administration of neurotoxic chemotherapy agents. This adverse effect is a major dose-limiting factor of many commonly used chemotherapy drugs. Currently, there are no Food and Drug Administration (FDA) approved medications for the prevention or treatment of chemotherapy-induced peripheral neuropathy. Therefore, this study was performed to investigate the efficacy and safety of metformin on paclitaxel-induced peripheral neuropathy (PIPN). Methods. In this randomized clinical trial, cancer patients who were candidates for chemotherapy with paclitaxel referred to the radiation oncology departments in Iran from 2022 to 2023 were studied. Patients were randomly divided into two groups; 1- Case group (n = 30) received metformin 500 mg orally twice a day after meals during chemotherapy with paclitaxel, and 2- Control group (30 people) received chemotherapy without metformin or any additional medication. Patients were visited in terms of numbness or other neurological symptoms two weeks before chemotherapy, 1-2 days before and weekly during chemotherapy, and at the end of the study. They were assessed by nerve conduction study (NCS) before intervention and one week after the end of chemotherapy. The primary outcome was the efficacy in reducing PIPN and the secondary outcome was adverse effects. Eventually, the outcomes were compared between the two groups of patients. Results. A total of 60 female cancer patients receiving chemotherapy with paclitaxel were evaluated in two groups. The groups were matched in terms of age, body mass index, fasting blood sugar, smoking, pathologic stage, and creatinine levels. The results showed that 18 patients (60.0 %) in the case group and 23 patients (76.6 %) in the control group had PIPN clinically (P = 0.267), and NCS showed 11 patients (36.6 %) in the case group and 15 patients (50.0 %) in the control group suffered from PIPN which no significant difference was observed between the two groups (P = 0.435). Diarrhea (n = 3; 10.0 %) and nausea (n = 3; 10.0 %) were the most common side effects of metformin in the case group and no serious side effects (lactic acidosis and anemia) were found in these patients. Conclusion. This study indicated that metformin did not significantly prevent PIPN in cancer patients receiving chemotherapy, although the frequency of peripheral neuropathy in the case group was lower than in the control group. The use of metformin in the patients had acceptable safety and no serious side effects were reported.Keywords: peripheral neuropathy, chemotherapy, paclitaxel, metformin
Procedia PDF Downloads 452929 Improving Access to Palliative Care for Heart Failure Patients in England Using a Health Systems Approach
Authors: Alex Hughes
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Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.Keywords: access, health systems, heart failure, palliative care
Procedia PDF Downloads 1282928 Endoscopic Treatment of Patients with Large Bile Duct Stones
Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev
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Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP
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