Search results for: resource estimation
436 Challenging Clinical Scenario of Blood Stream Candida Infections – An Indian Experience
Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon
Abstract:
Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida
Procedia PDF Downloads 456435 Machine Learning Prediction of Diabetes Prevalence in the U.S. Using Demographic, Physical, and Lifestyle Indicators: A Study Based on NHANES 2009-2018
Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei
Abstract:
To develop a machine learning model to predict diabetes (DM) prevalence in the U.S. population using demographic characteristics, physical indicators, and lifestyle habits, and to analyze how these factors contribute to the likelihood of diabetes. We analyzed data from 23,546 participants aged 20 and older, who were non-pregnant, from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The dataset included key demographic (age, sex, ethnicity), physical (BMI, leg length, total cholesterol [TCHOL], fasting plasma glucose), and lifestyle indicators (smoking habits). A weighted sample was used to account for NHANES survey design features such as stratification and clustering. A classification machine learning model was trained to predict diabetes status. The target variable was binary (diabetes or non-diabetes) based on fasting plasma glucose measurements. The following models were evaluated: Logistic Regression (baseline), Random Forest Classifier, Gradient Boosting Machine (GBM), Support Vector Machine (SVM). Model performance was assessed using accuracy, F1-score, AUC-ROC, and precision-recall metrics. Feature importance was analyzed using SHAP values to interpret the contributions of variables such as age, BMI, ethnicity, and smoking status. The Gradient Boosting Machine (GBM) model outperformed other classifiers with an AUC-ROC score of 0.85. Feature importance analysis revealed the following key predictors: Age: The most significant predictor, with diabetes prevalence increasing with age, peaking around the 60s for males and 70s for females. BMI: Higher BMI was strongly associated with a higher risk of diabetes. Ethnicity: Black participants had the highest predicted prevalence of diabetes (14.6%), followed by Mexican-Americans (13.5%) and Whites (10.6%). TCHOL: Diabetics had lower total cholesterol levels, particularly among White participants (mean decline of 23.6 mg/dL). Smoking: Smoking showed a slight increase in diabetes risk among Whites (0.2%) but had a limited effect in other ethnic groups. Using machine learning models, we identified key demographic, physical, and lifestyle predictors of diabetes in the U.S. population. The results confirm that diabetes prevalence varies significantly across age, BMI, and ethnic groups, with lifestyle factors such as smoking contributing differently by ethnicity. These findings provide a basis for more targeted public health interventions and resource allocation for diabetes management.Keywords: diabetes, NHANES, random forest, gradient boosting machine, support vector machine
Procedia PDF Downloads 12434 Construction and Validation of Allied Bank-Teller Aptitude Test
Authors: Muhammad Kashif Fida
Abstract:
In the bank, teller’s job (cash officer) is highly important and critical as at one end it requires soft and brisk customer services and on the other side, handling cash with integrity. It is always challenging for recruiters to hire competent and trustworthy tellers. According to author’s knowledge, there is no comprehensive test available that may provide assistance in recruitment in Pakistan. So there is a dire need of a psychometric battery that could provide support in recruitment of potential candidates for the teller’ position. So, the aim of the present study was to construct ABL-Teller Aptitude Test (ABL-TApT). Three major phases have been designed by following American Psychological Association’s guidelines. The first phase was qualitative, indicators of the test have been explored by content analysis of the a) teller’s job descriptions (n=3), b) interview with senior tellers (n=6) and c) interview with HR personals (n=4). Content analysis of above yielded three border constructs; i). Personality, ii). Integrity/honesty, iii). Professional Work Aptitude. Identified indicators operationalized and statements (k=170) were generated using verbatim. It was then forwarded to the five experts for review of content validity. They finalized 156 items. In the second phase; ABL-TApT (k=156) administered on 323 participants through a computer application. The overall reliability of the test shows significant alpha coefficient (α=.81). Reliability of subscales have also significant alpha coefficients. Confirmatory Factor Analysis (CFA) performed to estimate the construct validity, confirms four main factors comprising of eight personality traits (Confidence, Organized, Compliance, Goal-oriented, Persistent, Forecasting, Patience, Caution), one Integrity/honesty factor, four factors of professional work aptitude (basic numerical ability and perceptual accuracy of letters, numbers and signature) and two factors for customer services (customer services, emotional maturity). Values of GFI, AGFI, NNFI, CFI, RFI and RMSEA are in recommended range depicting significant model fit. In third phase concurrent validity evidences have been pursued. Personality and integrity part of this scale has significant correlations with ‘conscientiousness’ factor of NEO-PI-R, reflecting strong concurrent validity. Customer services and emotional maturity have significant correlations with ‘Bar-On EQI’ showing another evidence of strong concurrent validity. It is concluded that ABL-TAPT is significantly reliable and valid battery of tests, will assist in objective recruitment of tellers and help recruiters in finding a more suitable human resource.Keywords: concurrent validity, construct validity, content validity, reliability, teller aptitude test, objective recruitment
Procedia PDF Downloads 230433 Application of 2D Electrical Resistivity Tomographic Imaging Technique to Study Climate Induced Landslide and Slope Stability through the Analysis of Factor of Safety: A Case Study in Ooty Area, Tamil Nadu, India
Authors: S. Maniruzzaman, N. Ramanujam, Qazi Akhter Rasool, Swapan Kumar Biswas, P. Prasad, Chandrakanta Ojha
Abstract:
Landslide is one of the major natural disasters in South Asian countries. Applying 2D Electrical Resistivity Tomographic Imaging estimation of geometry, thickness, and depth of failure zone of the landslide can be made. Landslide is a pertinent problem in Nilgris plateau next to Himalaya. Nilgris range consists of hard Archean metamorphic rocks. Intense weathering prevailed during the Pre-Cambrian time had deformed the rocks up to 45m depth. The landslides are dominant in the southern and eastern part of plateau of is comparatively smaller than the northern drainage basins, as it has low density of drainage; coarse texture permitted the more of infiltration of rainwater, whereas in the northern part of the plateau entombed with high density of drainage pattern and fine texture with less infiltration than run off, and low to the susceptible to landslide. To get comprehensive information about the landslide zone 2D Electrical Resistivity Tomographic imaging study with CRM 500 Resistivity meter are used in Coonoor– Mettupalyam sector of Nilgiris plateau. To calculate Factor of Safety the infinite slope model of Brunsden and Prior is used. Factor of Safety can be expressed (FS) as the ratio of resisting forces to disturbing forces. If FS < 1 disturbing forces are larger than resisting forces and failure may occur. The geotechnical parameters of soil samples are calculated on the basis upon the apparent resistivity values for litho units of measured from 2D ERT image of the landslide zone. Relationship between friction angles for various soil properties is established by simple regression analysis from apparent resistivity data. Increase of water content in slide zone reduces the effectiveness of the shearing resistance and increase the sliding movement. Time-lapse resistivity changes to slope failure is determined through geophysical Factor of Safety which depends on resistivity and site topography. This ERT technique infers soil property at variable depths in wider areas. This approach to retrieve the soil property and overcomes the limit of the point of information provided by rain gauges and porous probes. Monitoring of slope stability without altering soil structure through the ERT technique is non-invasive with low cost. In landslide prone area an automated Electrical Resistivity Tomographic Imaging system should be installed permanently with electrode networks to monitor the hydraulic precursors to monitor landslide movement.Keywords: 2D ERT, landslide, safety factor, slope stability
Procedia PDF Downloads 320432 Fuzzy Availability Analysis of a Battery Production System
Authors: Merve Uzuner Sahin, Kumru D. Atalay, Berna Dengiz
Abstract:
In today’s competitive market, there are many alternative products that can be used in similar manner and purpose. Therefore, the utility of the product is an important issue for the preferability of the brand. This utility could be measured in terms of its functionality, durability, reliability. These all are affected by the system capabilities. Reliability is an important system design criteria for the manufacturers to be able to have high availability. Availability is the probability that a system (or a component) is operating properly to its function at a specific point in time or a specific period of times. System availability provides valuable input to estimate the production rate for the company to realize the production plan. When considering only the corrective maintenance downtime of the system, mean time between failure (MTBF) and mean time to repair (MTTR) are used to obtain system availability. Also, the MTBF and MTTR values are important measures to improve system performance by adopting suitable maintenance strategies for reliability engineers and practitioners working in a system. Failure and repair time probability distributions of each component in the system should be known for the conventional availability analysis. However, generally, companies do not have statistics or quality control departments to store such a large amount of data. Real events or situations are defined deterministically instead of using stochastic data for the complete description of real systems. A fuzzy set is an alternative theory which is used to analyze the uncertainty and vagueness in real systems. The aim of this study is to present a novel approach to compute system availability using representation of MTBF and MTTR in fuzzy numbers. Based on the experience in the system, it is decided to choose 3 different spread of MTBF and MTTR such as 15%, 20% and 25% to obtain lower and upper limits of the fuzzy numbers. To the best of our knowledge, the proposed method is the first application that is used fuzzy MTBF and fuzzy MTTR for fuzzy system availability estimation. This method is easy to apply in any repairable production system by practitioners working in industry. It is provided that the reliability engineers/managers/practitioners could analyze the system performance in a more consistent and logical manner based on fuzzy availability. This paper presents a real case study of a repairable multi-stage production line in lead-acid battery production factory in Turkey. The following is focusing on the considered wet-charging battery process which has a higher production level than the other types of battery. In this system, system components could exist only in two states, working or failed, and it is assumed that when a component in the system fails, it becomes as good as new after repair. Instead of classical methods, using fuzzy set theory and obtaining intervals for these measures would be very useful for system managers, practitioners to analyze system qualifications to find better results for their working conditions. Thus, much more detailed information about system characteristics is obtained.Keywords: availability analysis, battery production system, fuzzy sets, triangular fuzzy numbers (TFNs)
Procedia PDF Downloads 226431 Education as a Factor Which Reduces Poverty
Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina
Abstract:
Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.Keywords: poverty, education, human capital, quality of life
Procedia PDF Downloads 323430 My Perfect Partner: Creative Methods in Relationship Education
Authors: Janette Porter, Kay Standing
Abstract:
The paper presents our experiences of working in both mainstream and Special Education Needs and Disabilities (SEND) schools in England from 2012-2019, using creative methodologies to deliver and evaluate healthy relationship education. It aims to explore to explore how young people's perceptions of relationships and their "perfect partner" are mediated by factors such as gender, body image, and social media. It will be an interactive session, inviting participants to reflect on their own experiences of relationship education, and to take part in an example of a classroom activity of 'a perfect partner'. Young people aged 16-25 are most at risk of relationship abuse and intimate partner violence. This can be enacted both on the body, through physical and sexual violence, but also emotional and psychological abuse. In England and Wales relationship education became compulsory in schools in September 2020. There is increasing recognition for the need for whole school approaches to prevent gender-based violence, in particular domestic abuse, from happening in the first place and for equipping schools to feel more confident supporting young people affected by gender-based violence. The project used creative methods, including arts, drama, music, poetry, song, and creative writing, to engage participants in sensitive topics related to relationship education. Interactive workshops with pupils aged 11-19 enabled young people to express themselves freely, pupils then used drama to share their knowledge with their peer group. We co-produced material with young people, including an accessible resource pack for use in SEND schools, particularly for children with visual and sensory impairments. The project was evaluated by questionnaires and interviews with pupils. The paper also reflects on the ethical issues involved in the research. After the project, young people had a better understanding of healthy and unhealthy relationships, improved knowledge of the early warning signs of abuse and knew where to go to for help and advice. It found that creative methods are an effective way to engage young people in relationship education and sensitive topics. We argue that age and ability appropriate relationship education should be compulsory across the curriculum and that implementing creative and art-based approaches to address sensitive topics can enhance the effectiveness of relationship education programs in promoting healthy relationships and preventing abuse. The paper provides academic and practitioner perspectives, providing a reflection on our research, looking at practical, methodological, and ethical issues involved in research on Gender Based Violence with young people in a school setting.Keywords: relationship education, healthy relationships, creative methods, young people
Procedia PDF Downloads 58429 Technology Road Mapping in the Fourth Industrial Revolution: A Comprehensive Analysis and Strategic Framework
Authors: Abdul Rahman Hamdan
Abstract:
The Fourth Industrial Revolution (4IR) has brought unprecedented technological advancements that have disrupted many industries worldwide. In keeping up with the technological advances and rapid disruption by the introduction of many technological advancements brought forth by the 4IR, the use of technology road mapping has emerged as one of the critical tools for organizations to leverage. Technology road mapping can be used by many companies to guide them to become more adaptable and anticipate future transformation and innovation, and avoid being redundant or irrelevant due to the rapid changes in technological advancement. This research paper provides a comprehensive analysis of technology road mapping within the context of the 4IR. The objectives of the paper are to provide companies with practical insights and a strategic framework of technology road mapping for them to navigate the fast-changing nature of the 4IR. This study also contributes to the understanding and practice of technology road mapping in the 4IR and, at the same time, provides organizations with the necessary tools and critical insight to navigate the 4IR transformation by leveraging technology road mapping. Based on the literature review and case studies, the study analyses key principles, methodologies, and best practices in technology road mapping and integrates them with the unique characteristics and challenges of the 4IR. The research paper gives the background of the fourth industrial revolution. It explores the disruptive potential of technologies in the 4IR and the critical need for technology road mapping that consists of strategic planning and foresight to remain competitive and relevant in the 4IR era. It also highlights the importance of technology road mapping as an organisation’s proactive approach to align the organisation’s objectives and resources to their technology and product development in meeting the fast-evolving technological 4IR landscape. The paper also includes the theoretical foundations of technology road mapping and examines various methodological approaches, and identifies external stakeholders in the process, such as external experts, stakeholders, collaborative platforms, and cross-functional teams to ensure an integrated and robust technological roadmap for the organisation. Moreover, this study presents a comprehensive framework for technology road mapping in the 4IR by incorporating key elements and processes such as technology assessment, competitive intelligence, risk analysis, and resource allocation. It provides a framework for implementing technology road mapping from strategic planning, goal setting, and technology scanning to road mapping visualisation, implementation planning, monitoring, and evaluation. In addition, the study also addresses the challenges and limitations related to technology roadmapping in 4IR, including the gap analysis. In conclusion of the study, the study will propose a set of practical recommendations for organizations that intend to leverage technology road mapping as a strategic tool in the 4IR in driving innovation and becoming competitive in the current and future ecosystem.Keywords: technology management, technology road mapping, technology transfer, technology planning
Procedia PDF Downloads 71428 Potential of Aerodynamic Feature on Monitoring Multilayer Rough Surfaces
Authors: Ibtissem Hosni, Lilia Bennaceur Farah, Saber Mohamed Naceur
Abstract:
In order to assess the water availability in the soil, it is crucial to have information about soil distributed moisture content; this parameter helps to understand the effect of humidity on the exchange between soil, plant cover and atmosphere in addition to fully understanding the surface processes and the hydrological cycle. On the other hand, aerodynamic roughness length is a surface parameter that scales the vertical profile of the horizontal component of the wind speed and characterizes the surface ability to absorb the momentum of the airflow. In numerous applications of the surface hydrology and meteorology, aerodynamic roughness length is an important parameter for estimating momentum, heat and mass exchange between the soil surface and atmosphere. It is important on this side, to consider the atmosphere factors impact in general, and the natural erosion in particular, in the process of soil evolution and its characterization and prediction of its physical parameters. The study of the induced movements by the wind over soil vegetated surface, either spaced plants or plant cover, is motivated by significant research efforts in agronomy and biology. The known major problem in this side concerns crop damage by wind, which presents a booming field of research. Obviously, most models of soil surface require information about the aerodynamic roughness length and its temporal and spatial variability. We have used a bi-dimensional multi-scale (2D MLS) roughness description where the surface is considered as a superposition of a finite number of one-dimensional Gaussian processes each one having a spatial scale using the wavelet transform and the Mallat algorithm to describe natural surface roughness. We have introduced multi-layer aspect of the humidity of the soil surface, to take into account a volume component in the problem of backscattering radar signal. As humidity increases, the dielectric constant of the soil-water mixture increases and this change is detected by microwave sensors. Nevertheless, many existing models in the field of radar imagery, cannot be applied directly on areas covered with vegetation due to the vegetation backscattering. Thus, the radar response corresponds to the combined signature of the vegetation layer and the layer of soil surface. Therefore, the key issue of the numerical estimation of soil moisture is to separate the two contributions and calculate both scattering behaviors of the two layers by defining the scattering of the vegetation and the soil blow. This paper presents a synergistic methodology, and it is for estimating roughness and soil moisture from C-band radar measurements. The methodology adequately represents a microwave/optical model which has been used to calculate the scattering behavior of the aerodynamic vegetation-covered area by defining the scattering of the vegetation and the soil below.Keywords: aerodynamic, bi-dimensional, vegetation, synergistic
Procedia PDF Downloads 271427 Screening of Osteoporosis in Aging Populations
Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi
Abstract:
Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.Keywords: osteoporosis, prevention, public health, screening
Procedia PDF Downloads 123426 Compression-Extrusion Test to Assess Texture of Thickened Liquids for Dysphagia
Authors: Jesus Salmeron, Carmen De Vega, Maria Soledad Vicente, Mireia Olabarria, Olaia Martinez
Abstract:
Dysphagia or difficulty in swallowing affects mostly elder people: 56-78% of the institutionalized and 44% of the hospitalized. Liquid food thickening is a necessary measure in this situation because it reduces the risk of penetration-aspiration. Until now, and as proposed by the American Dietetic Association in 2002, possible consistencies have been categorized in three groups attending to their viscosity: nectar (50-350 mPa•s), honey (350-1750 mPa•s) and pudding (>1750 mPa•s). The adequate viscosity level should be identified for every patient, according to her/his impairment. Nevertheless, a systematic review on dysphagia diet performed recently indicated that there is no evidence to suggest that there is any transition of clinical relevance between the three levels proposed. It was also stated that other physical properties of the bolus (slipperiness, density or cohesiveness, among others) could influence swallowing in affected patients and could contribute to the amount of remaining residue. Texture parameters need to be evaluated as possible alternative to viscosity. The aim of this study was to evaluate the instrumental extrusion-compression test as a possible tool to characterize changes along time in water thickened with various products and in the three theoretical consistencies. Six commercial thickeners were used: NM® (NM), Multi-thick® (M), Nutilis Powder® (Nut), Resource® (R), Thick&Easy® (TE) and Vegenat® (V). All of them with a modified starch base. Only one of them, Nut, also had a 6,4% of gum (guar, tara and xanthan). They were prepared as indicated in the instructions of each product and dispensing the correspondent amount for nectar, honey and pudding consistencies in 300 mL of tap water at 18ºC-20ºC. The mixture was stirred for about 30 s. Once it was homogeneously spread, it was dispensed in 30 mL plastic glasses; always to the same height. Each of these glasses was used as a measuring point. Viscosity was measured using a rotational viscometer (ST-2001, Selecta, Barcelona). Extrusion-compression test was performed using a TA.XT2i texture analyzer (Stable Micro Systems, UK) with a 25 mm diameter cylindrical probe (SMSP/25). Penetration distance was set at 10 mm and a speed of 3 mm/s. Measurements were made at 1, 5, 10, 20, 30, 40, 50 and 60 minutes from the moment samples were mixed. From the force (g)–time (s) curves obtained in the instrumental assays, maximum force peak (F) was chosen a reference parameter. Viscosity (mPa•s) and F (g) showed to be highly correlated and had similar development along time, following time-dependent quadratic models. It was possible to predict viscosity using F as an independent variable, as they were linearly correlated. In conclusion, compression-extrusion test could be an alternative and a useful tool to assess physical characteristics of thickened liquids.Keywords: compression-extrusion test, dysphagia, texture analyzer, thickener
Procedia PDF Downloads 370425 Applications of Multi-Path Futures Analyses for Homeland Security Assessments
Authors: John Hardy
Abstract:
A range of future-oriented intelligence techniques is commonly used by states to assess their national security and develop strategies to detect and manage threats, to develop and sustain capabilities, and to recover from attacks and disasters. Although homeland security organizations use future's intelligence tools to generate scenarios and simulations which inform their planning, there have been relatively few studies of the methods available or their applications for homeland security purposes. This study presents an assessment of one category of strategic intelligence techniques, termed Multi-Path Futures Analyses (MPFA), and how it can be applied to three distinct tasks for the purpose of analyzing homeland security issues. Within this study, MPFA are categorized as a suite of analytic techniques which can include effects-based operations principles, general morphological analysis, multi-path mapping, and multi-criteria decision analysis techniques. These techniques generate multiple pathways to potential futures and thereby generate insight into the relative influence of individual drivers of change, the desirability of particular combinations of pathways, and the kinds of capabilities which may be required to influence or mitigate certain outcomes. The study assessed eighteen uses of MPFA for homeland security purposes and found that there are five key applications of MPFA which add significant value to analysis. The first application is generating measures of success and associated progress indicators for strategic planning. The second application is identifying homeland security vulnerabilities and relationships between individual drivers of vulnerability which may amplify or dampen their effects. The third application is selecting appropriate resources and methods of action to influence individual drivers. The fourth application is prioritizing and optimizing path selection preferences and decisions. The fifth application is informing capability development and procurement decisions to build and sustain homeland security organizations. Each of these applications provides a unique perspective of a homeland security issue by comparing a range of potential future outcomes at a set number of intervals and by contrasting the relative resource requirements, opportunity costs, and effectiveness measures of alternative courses of action. These findings indicate that MPFA enhances analysts’ ability to generate tangible measures of success, identify vulnerabilities, select effective courses of action, prioritize future pathway preferences, and contribute to ongoing capability development in homeland security assessments.Keywords: homeland security, intelligence, national security, operational design, strategic intelligence, strategic planning
Procedia PDF Downloads 139424 Wildlife Trade and Bushmeat Consumption in Benin City, Southern Nigeria: Conservation Implications and Threats to Biodiversity Sustainability
Authors: Sylvia O. Ogoanah, Khalifa Mustapha, Joshua E. Emedo
Abstract:
Despite the call for wildlife conservation and sustainability, wildlife trade and bushmeat consumption seem to have reached an all-time high in Benin City, Southern Nigeria. This necessitated the survey of wildlife trade, otherwise called bushmeat, in selected markets in Benin City, Southern Nigeria, between December 2015 and May 2016 (dry season) and June to September (rainy season). Although the eight markets randomly selected within the urban and peri-urban areas operate daily, visits were made weekly to prevent double counting of the same live specimen. On each visit, counts were made of live specimens seen while those cut in parts and dried were identified by the vendors before photographing and recording. Quantitative data analysis was done using SPSS 14 software programs. A total of two thousand five hundred and eighty-nine (2589) bushmeat specimens comprising six mammals and a reptile were recorded for the rainy season. These included the grasscutter (Thryonomis swinderianus) with an abundance of 37.9%, duikers (Sylvicapra grimma) 31.8%, porcupines (Artherurus africanus) 25.0 %, alligators (Alligator mississipienus) 3.2%, pangolins (Manis tricuspis) 0.85%, bush-pig (Potachoerus porcus) 0.7%, and the white-throated monkey (Cercopithecus erythrogaster) 0.5%, respectively. The dry season sampling recorded nine thousand seven hundred and ninety-three (9793) specimens comprising four mammals and one reptile. Species recorded included Thryonomis swinderianus (grasscutters) 35.8%, Artherurus africanus (porcupine) 30.1%, Sylvicapra grimmia (duikers) 21.8%, Alligator mississipiensis (alligators) 6.18% with juveniles 2.27% and Manis tricuspis (pangolin) 3.58%, The designated Central bush meat market as well as markets in the peri-urban areas recorded the highest number of specimens. The three dominant species in both rainy and dry seasons were the grasscutters, porcupines, and duikers, with the grasscutter having the highest dominance of 37.9% and 35.8%, respectively. There was a significant difference between the rainy and dry season samplings p=0.001. The increase in specimens collected in the dry season could be due to greater exposure due to reduced vegetation cover. The high number of specimens arising from weekly sampling from markets that operate daily could be used as an estimation of wildlife specimens captured over the period. This poses a great threat to wildlife conservation as juveniles, as well as endangered species, are hunted indiscriminately. Educating the people with emphasis on the importance of sustainability and conservation, rearing of the grasscutter, which is in high demand and enforcement of existing laws on wildlife trade offenses would help in reducing threats to wildlife conservation.Keywords: bushmeat consumption, conservation implications, Southern Nigeria, threats, wildlife trade
Procedia PDF Downloads 30423 Feeding Value Improvement of Rice Straw Fermented by Spent Mushroom Substrate on Growth and Lactating Performance of Dairy Goat
Authors: G. J. Fan, T. T. Lee, M. H. Chen, T. F. Shiao, B. Yu, C. F. Lee
Abstract:
Rice straw with poor feed quality and spent mushroom substrate are both the most abundant agricultural residues in Taiwan. Edible mushrooms from white rot fungi possess lignocellulase activity. It was expected to improve the feeding value of rice straw for ruminant by solid-state fermentation pretreatment using spent mushroom substrate. Six varieties or subspecies of spent edible mushrooms (Pleurotus ostreatus (blue or white color), P. sajor-caju, P. citrinopileatus, P. eryngii and Ganoderma lucidium) substrate were evaluated in solid-state fermentation process with rice straw for 8 wks. Quality improvement of fermented rice straw was determined by its in vitro digestibility, lignocellulose degradability, and cell wall breakdown checked by scanning electron microscope. Results turned out that Pleurotus ostreatus (white color) and P. sajor-caju had the better lignocellulose degradation effect than the others and was chosen for advance in vivo study. Rice straw fermented with spent Pleurotus ostreatus or Pleurotus sajor-caju mushroom substrate 8 wks was prepared for growing and lactating feeding trials of dairy goat, respectively. Pangolagrass hay at 15% diet dry matter was the control diet. Fermented or original rice straw was added to substitute pangolagrass hay in both feeding trials. A total of 30 head of Alpine castrated ram were assigned into three groups for 11 weeks, 5 pens (2 head/pen) each group. A total of 21 head of Saanen and Alpine goats were assigned into three treatments and individually fed in two repeat lactating trials with 28-d each. In castrated ram study, results showed that fermented rice straw by spent Pleurotus ostreatus mushroom substrate attributed the higher daily dry matter intakes (DMI, 1.53 vs. 1.20 kg) and body weight gain (138 vs. 101 g) than goats fed original rice straw. DMI (2.25 vs. 1.81 kg) and milk yield (3.31 vs. 3.02 kg) of lactating goats fed control pangolagrass diet and fermented rice straw by spent Pleurotus sajor-caju mushroom substrate were also higher than those fed original rice straw diet (P < 0.05). Milk compositions, milk fat, protein, total solid and lactose, were similar among treatments. In conclusion, solid-state fermentation by spent Pleurotus ostreatus or Pleurotus sajor-caju mushroom substrate could effectively improve the feeding value of rice straw. Fermented rice straw is a good alternative fiber feed resource for growing and lactating dairy goats and 15% in diet dry matter is recommended.Keywords: feeding value, fermented rice straw, growing and lactating dairy goat, spent Pleurotus ostreatus and Pleurotus sajor-caju mushroom substrate
Procedia PDF Downloads 174422 Real-Time Working Environment Risk Analysis with Smart Textiles
Authors: Jose A. Diaz-Olivares, Nafise Mahdavian, Farhad Abtahi, Kaj Lindecrantz, Abdelakram Hafid, Fernando Seoane
Abstract:
Despite new recommendations and guidelines for the evaluation of occupational risk assessments and their prevention, work-related musculoskeletal disorders are still one of the biggest causes of work activity disruption, productivity loss, sick leave and chronic work disability. It affects millions of workers throughout Europe, with a large-scale economic and social burden. These specific efforts have failed to produce significant results yet, probably due to the limited availability and high costs of occupational risk assessment at work, especially when the methods are complex, consume excessive resources or depend on self-evaluations and observations of poor accuracy. To overcome these limitations, a pervasive system of risk assessment tools in real time has been developed, which has the characteristics of a systematic approach, with good precision, usability and resource efficiency, essential to facilitate the prevention of musculoskeletal disorders in the long term. The system allows the combination of different wearable sensors, placed on different limbs, to be used for data collection and evaluation by a software solution, according to the needs and requirements in each individual working environment. This is done in a non-disruptive manner for both the occupational health expert and the workers. The creation of this solution allows us to attend different research activities that require, as an essential starting point, the recording of data with ergonomic value of very diverse origin, especially in real work environments. The software platform is here presented with a complimentary smart clothing system for data acquisition, comprised of a T-shirt containing inertial measurement units (IMU), a vest sensorized with textile electronics, a wireless electrocardiogram (ECG) and thoracic electrical bio-impedance (TEB) recorder and a glove sensorized with variable resistors, dependent on the angular position of the wrist. The collected data is processed in real-time through a mobile application software solution, implemented in commercially available Android-based smartphones and tablet platforms. Based on the collection of this information and its analysis, real-time risk assessment and feedback about postural improvement is possible, adapted to different contexts. The result is a tool which provides added value to ergonomists and occupational health agents, as in situ analysis of postural behavior can assist in a quantitative manner in the evaluation of work techniques and the occupational environment.Keywords: ergonomics, mobile technologies, risk assessment, smart textiles
Procedia PDF Downloads 119421 The Effect of the Precursor Powder Size on the Electrical and Sensor Characteristics of Fully Stabilized Zirconia-Based Solid Electrolytes
Authors: Olga Yu Kurapova, Alexander V. Shorokhov, Vladimir G. Konakov
Abstract:
Nowadays, due to their exceptional anion conductivity at high temperatures cubic zirconia solid solutions, stabilized by rare-earth and alkaline-earth metal oxides, are widely used as a solid electrolyte (SE) materials in different electrochemical devices such as gas sensors, oxygen pumps, solid oxide fuel cells (SOFC), etc. Nowadays the intensive studies are carried out in a field of novel fully stabilized zirconia based SE development. The use of precursor powders for SE manufacturing allows predetermining the microstructure, electrical and sensor characteristics of zirconia based ceramics used as SE. Thus the goal of the present work was the investigation of the effect of precursor powder size on the electrical and sensor characteristics of fully stabilized zirconia-based solid electrolytes with compositions of 0,08Y2O3∙0,92ZrO2 (YSZ), 0,06Ce2O3∙ 0,06Y2O3∙0,88ZrO2 and 0,09Ce2O3∙0,06Y2O3-0,85ZrO2. The synthesis of precursors powders with different mean particle size was performed by sol-gel synthesis in the form of reversed co-precipitation from aqueous solutions. The cakes were washed until the neutral pH and pan-dried at 110 °С. Also, YSZ ceramics was obtained by conventional solid state synthesis including milling into a planetary mill. Then the powder was cold pressed into the pellets with a diameter of 7.2 and ~4 mm thickness at P ~16 kg/cm2 and then hydrostatically pressed. The pellets were annealed at 1600 °С for 2 hours. The phase composition of as-synthesized SE was investigated by X-Ray photoelectron spectroscopy ESCA (spectrometer ESCA-5400, PHI) X-ray diffraction analysis - XRD (Shimadzu XRD-6000). Following galvanic cell О2 (РО2(1)), Pt | SE | Pt, (РО2(2) = 0.21 atm) was used for SE sensor properties investigation. The value of РО2(1) was set by mixing of O2 and N2 in the defined proportions with the accuracy of 5%. The temperature was measured by Pt/Pt-10% Rh thermocouple, The cell electromotive force (EMF) measurement was carried out with ± 0.1 mV accuracy. During the operation at the constant temperature, reproducibility was better than 5 mV. Asymmetric potential measured for all SE appeared to be negligible. It was shown that the resistivity of YSZ ceramics decreases in about two times upon the mean agglomerates decrease from 200-250 to 40 nm. It is likely due to the both surface and bulk resistivity decrease in grains. So the overall decrease of grain size in ceramic SE results in the significant decrease of the total ceramics resistivity allowing sensor operation at lower temperatures. For the SE manufactured the estimation of oxygen ion transfer number tion was carried out in the range 600-800 °С. YSZ ceramics manufactured from powders with the mean particle size 40-140 nm, shows the highest values i.e. 0.97-0.98. SE manufactured from precursors with the mean particle size 40-140 nm shows higher sensor characteristic i.e. temperature and oxygen concentration EMF dependencies, EMF (ENernst - Ereal), tion, response time, then ceramics, manufactured by conventional solid state synthesis.Keywords: oxygen sensors, precursor powders, sol-gel synthesis, stabilized zirconia ceramics
Procedia PDF Downloads 284420 Community Singing, a Pathway to Social Capital: A Cross-Cultural Comparative Assessment of the Benefits of Singing Communities in South Tyrol and South Africa
Authors: Johannes Van Der Sandt
Abstract:
This quantitative study investigates different approaches of community singing, in building social capital in South Tyrol, Italy, and South Africa. The impact of the various approaches of community singing is examined by investigating the main components of social capital, namely, social norms and obligations, social networks and associations and trust, and how these components are manifested in two different societies. The research is based on the premise that community singing is an important agent for the development of social capital. It seeks to establish in what form community singing can best enhance the social capital of communities in South Tyrol that are undergoing significant changes in the ways in which social capital is generally being generated on account of demographic, economic, technological and cultural changes. South Tyrol and South Africa share some similarities in the management of their multi-cultural composition. By comparing the different approaches to community singing in two multi-cultural societies, it is hoped to gain insight, and an understanding of the connections between culture, social cohesion, identity and therefore to be able to add to the understanding of the building of social capital through community singing. Participation in music contributes to the growth of social capital in communities, this is amongst others the finding of an ever increasing amount of research. In sociological discourses on social capital generation, the dimension of community music making is recognized as an important factor. Trust and mutual cooperation are products when people listen to each other, when they work or play together, and when they care about each other. This is how social capital develops as an important shared resource. Scholars of Community Music still do not agree on a short and concise definition for Community Music. For the purpose of this research, the author concurs with the definition of Community Music of the Community Music Activity commission of the International Society of Music Education as having the following characteristics: decentralization, accessibility, equal opportunity, and active participation in music-making. These principles are social and political ones, and there can be no doubt that community music activity is more than a purely musical one. Trust, shared norms and values civic and community involvement, networks, knowledge resources, contact with families and friends, and fellowship are key components in fostering group cohesion and social capital development in a community. The research will show that there is no better place for these factors to flourish than in a community singing group. Through this comparative study, it is the aim to identify, analyze and explain similarities and differences in approaches to community across societies that find themselves in a rapid transition from traditional cultural to global cultural habits characterized by a plurality of orientation points, with the aim to gain a better understanding of the various directions South Tyrolean singing culture can take.Keywords: community music, multicultural, singing, social capital
Procedia PDF Downloads 285419 Airon Project: IoT-Based Agriculture System for the Optimization of Irrigation Water Consumption
Authors: África Vicario, Fernando J. Álvarez, Felipe Parralejo, Fernando Aranda
Abstract:
The irrigation systems of traditional agriculture, such as gravity-fed irrigation, produce a great waste of water because, generally, there is no control over the amount of water supplied in relation to the water needed. The AIRON Project tries to solve this problem by implementing an IoT-based system to sensor the irrigation plots so that the state of the crops and the amount of water used for irrigation can be known remotely. The IoT system consists of a sensor network that measures the humidity of the soil, the weather conditions (temperature, relative humidity, wind and solar radiation) and the irrigation water flow. The communication between this network and a central gateway is conducted by means of long-range wireless communication that depends on the characteristics of the irrigation plot. The main objective of the AIRON project is to deploy an IoT sensor network in two different plots of the irrigation community of Aranjuez in the Spanish region of Madrid. The first plot is 2 km away from the central gateway, so LoRa has been used as the base communication technology. The problem with this plot is the absence of mains electric power, so devices with energy-saving modes have had to be used to maximize the external batteries' use time. An ESP32 SOC board with a LoRa module is employed in this case to gather data from the sensor network and send them to a gateway consisting of a Raspberry Pi with a LoRa hat. The second plot is located 18 km away from the gateway, a range that hampers the use of LoRa technology. In order to establish reliable communication in this case, the long-term evolution (LTE) standard is used, which makes it possible to reach much greater distances by using the cellular network. As mains electric power is available in this plot, a Raspberry Pi has been used instead of the ESP32 board to collect sensor data. All data received from the two plots are stored on a proprietary server located at the irrigation management company's headquarters. The analysis of these data by means of machine learning algorithms that are currently under development should allow a short-term prediction of the irrigation water demand that would significantly reduce the waste of this increasingly valuable natural resource. The major finding of this work is the real possibility of deploying a remote sensing system for irrigated plots by using Commercial-Off-The-Shelf (COTS) devices, easily scalable and adaptable to design requirements such as the distance to the control center or the availability of mains electrical power at the site.Keywords: internet of things, irrigation water control, LoRa, LTE, smart farming
Procedia PDF Downloads 88418 A Conceptual Framework of the Individual and Organizational Antecedents to Knowledge Sharing
Authors: Muhammad Abdul Basit Memon
Abstract:
The importance of organizational knowledge sharing and knowledge management has been documented in numerous research studies in available literature, since knowledge sharing has been recognized as a founding pillar for superior organizational performance and a source of gaining competitive advantage. Built on this, most of the successful organizations perceive knowledge management and knowledge sharing as a concern of high strategic importance and spend huge amounts on the effective management and sharing of organizational knowledge. However, despite some very serious endeavors, many firms fail to capitalize on the benefits of knowledge sharing because of being unaware of the individual characteristics, interpersonal, organizational and contextual factors that influence knowledge sharing; simply the antecedent to knowledge sharing. The extant literature on antecedents to knowledge sharing, offers a range of antecedents mentioned in a number of research articles and research studies. Some of the previous studies about antecedents to knowledge sharing, studied antecedents to knowledge sharing regarding inter-organizational knowledge transfer; others focused on inter and intra organizational knowledge sharing and still others investigated organizational factors. Some of the organizational antecedents to KS can relate to the characteristics and underlying aspects of knowledge being shared e.g., specificity and complexity of the underlying knowledge to be transferred; others relate to specific organizational characteristics e.g., age and size of the organization, decentralization and absorptive capacity of the firm and still others relate to the social relations and networks of organizations such as social ties, trusting relationships, and value systems. In the same way some researchers have highlighted on only one aspect like organizational commitment, transformational leadership, knowledge-centred culture, learning and performance orientation and social network-based relationships in the organizations. A bulk of the existing research articles on antecedents to knowledge sharing has mainly discussed organizational or environmental factors affecting knowledge sharing. However, the focus, later on, shifted towards the analysis of individuals or personal determinants as antecedents for the individual’s engagement in knowledge sharing activities, like personality traits, attitude and self efficacy etc. For example, employees’ goal orientations (i.e. learning orientation or performance orientation is an important individual antecedent of knowledge sharing behaviour. While being consistent with the existing literature therefore, the antecedents to knowledge sharing can be classified as being individual and organizational. This paper is an endeavor to discuss a conceptual framework of the individual and organizational antecedents to knowledge sharing in the light of the available literature and empirical evidence. This model not only can help in getting familiarity and comprehension on the subject matter by presenting a holistic view of the antecedents to knowledge sharing as discussed in the literature, but can also help the business managers and especially human resource managers to find insights about the salient features of organizational knowledge sharing. Moreover, this paper can help provide a ground for research students and academicians to conduct both qualitative as well and quantitative research and design an instrument for conducting survey on the topic of individual and organizational antecedents to knowledge sharing.Keywords: antecedents to knowledge sharing, knowledge management, individual and organizational, organizational knowledge sharing
Procedia PDF Downloads 326417 Ultra-Sensitive Point-Of-Care Detection of PSA Using an Enzyme- and Equipment-Free Microfluidic Platform
Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang
Abstract:
Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive
Procedia PDF Downloads 113416 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions
Authors: Nisa Mohan
Abstract:
Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.Keywords: adverse drug events, clinical coders, decision making, hospital admissions
Procedia PDF Downloads 121415 Prediction of Endotracheal Tube Size in Children by Predicting Subglottic Diameter Using Ultrasonographic Measurement versus Traditional Formulas
Authors: Parul Jindal, Shubhi Singh, Priya Ramakrishnan, Shailender Raghuvanshi
Abstract:
Background: Knowledge of the influence of the age of the child on laryngeal dimensions is essential for all practitioners who are dealing with paediatric airway. Choosing the correct endotracheal tube (ETT) size is a crucial step in pediatric patients because a large-sized tube may cause complications like post-extubation stridor and subglottic stenosis. On the other hand with a smaller tube, there will be increased gas flow resistance, aspiration risk, poor ventilation, inaccurate monitoring of end-tidal gases and reintubation may also be required with a different size of the tracheal tube. Recent advancement in ultrasonography (USG) techniques should now allow for accurate and descriptive evaluation of pediatric airway. Aims and objectives: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. Methods: After obtaining approval from Institute’s Ethical and Research committee, and parental written and informed consent, the study was conducted on 100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anesthesia requiring endotracheal intubation. The same experienced radiologist performed ultrasonography. The transverse diameter was measured at the level of cricoids cartilage by USG. After USG, general anesthesia was administered using standard techniques followed by the institute. An experienced anesthesiologist performed the endotracheal intubations with uncuffed endotracheal tube (Portex Tracheal Tube Smiths Medical India Pvt. Ltd.) with Murphy’s eye. He was unaware of the finding of the ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm H₂O of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by ultrasonography, various age, height, weight-based formulas and diameter of right and left little finger. The correlation of the size of the endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained. The comparison of the mean size of the endotracheal tube by ultrasonography and by traditional formula was done by the Friedman’s test and Wilcoxon sign-rank test. Results: The predicted tube size was equal to best fit and best determined by ultrasonography (100%) followed by comparison to left little finger (98%) and right little finger (97%) and age-based formula (95%) followed by multivariate formula (83%) and body length (81%) formula. According to Pearson`s correlation, there was a moderate correlation of best fit endotracheal tube with endotracheal tube size by age-based formula (r=0.743), body length based formula (r=0.683), right little finger based formula (r=0.587), left little finger based formula (r=0.587) and multivariate formula (r=0.741). There was a strong correlation with ultrasonography (r=0.943). Ultrasonography was the most sensitive (100%) method of prediction followed by comparison to left (98%) and right (97%) little finger and age-based formula (95%), the multivariate formula had an even lesser sensitivity (83%) whereas body length based formula was least sensitive with a sensitivity of 78%. Conclusion: USG is a reliable method of estimation of subglottic diameter and for prediction of ETT size in children.Keywords: endotracheal intubation, pediatric airway, subglottic diameter, traditional formulas, ultrasonography
Procedia PDF Downloads 241414 The Growth Role of Natural Gas Consumption for Developing Countries
Authors: Tae Young Jin, Jin Soo Kim
Abstract:
Carbon emissions have emerged as global concerns. Intergovernmental Panel of Climate Change (IPCC) have published reports about Green House Gases (GHGs) emissions regularly. United Nations Framework Convention on Climate Change (UNFCCC) have held a conference yearly since 1995. Especially, COP21 held at December 2015 made the Paris agreement which have strong binding force differently from former COP. The Paris agreement was ratified as of 4 November 2016, they finally have legal binding. Participating countries set up their own Intended Nationally Determined Contributions (INDC), and will try to achieve this. Thus, carbon emissions must be reduced. The energy sector is one of most responsible for carbon emissions and fossil fuels particularly are. Thus, this paper attempted to examine the relationship between natural gas consumption and economic growth. To achieve this, we adopted the Cobb-Douglas production function that consists of natural gas consumption, economic growth, capital, and labor using dependent panel analysis. Data were preprocessed with Principal Component Analysis (PCA) to remove cross-sectional dependency which can disturb the panel results. After confirming the existence of time-trended component of each variable, we moved to cointegration test considering cross-sectional dependency and structural breaks to describe more realistic behavior of volatile international indicators. The cointegration test result indicates that there is long-run equilibrium relationship between selected variables. Long-run cointegrating vector and Granger causality test results show that while natural gas consumption can contribute economic growth in the short-run, adversely affect in the long-run. From these results, we made following policy implications. Since natural gas has positive economic effect in only short-run, the policy makers in developing countries must consider the gradual switching of major energy source, from natural gas to sustainable energy source. Second, the technology transfer and financing business suggested by COP must be accelerated. Acknowledgement—This work was supported by the Energy Efficiency & Resources Core Technology Program of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (No. 20152510101880) and by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-205S1A3A2046684).Keywords: developing countries, economic growth, natural gas consumption, panel data analysis
Procedia PDF Downloads 237413 Life Cycle Assessment-Based Environmental Assessment of the Production and Maintenance of Wooden Windows
Authors: Pamela Del Rosario, Elisabetta Palumbo, Marzia Traverso
Abstract:
The building sector plays an important role in addressing pressing environmental issues such as climate change and resource scarcity. The energy performance of buildings is considerably affected by the external envelope. In fact, a considerable proportion of the building energy demand is due to energy losses through the windows. Nevertheless, according to literature, to pay attention only to the contribution of windows to the building energy performance, i.e., their influence on energy use during building operation, could result in a partial evaluation. Hence, it is important to consider not only the building energy performance but also the environmental performance of windows, and this not only during the operational stage but along its complete life cycle. Life Cycle Assessment (LCA) according to ISO 14040:2006 and ISO 14044:2006+A1:2018 is one of the most adopted and robust methods to evaluate the environmental performance of products throughout their complete life cycle. This life-cycle based approach avoids the shift of environmental impacts of a life cycle stage to another, allowing to allocate them to the stage in which they originated and to adopt measures that optimize the environmental performance of the product. Moreover, the LCA method is widely implemented in the construction sector to assess whole buildings as well as construction products and materials. LCA is regulated by the European Standards EN 15978:2011, at the building level, and EN 15804:2012+A2:2019, at the level of construction products and materials. In this work, the environmental performance of wooden windows was assessed by implementing the LCA method and adopting primary data. More specifically, the emphasis is given to embedded and operational impacts. Furthermore, correlations are made between these environmental impacts and aspects such as type of wood and window transmittance. In the particular case of the operational impacts, special attention is set on the definition of suitable maintenance scenarios that consider the potential climate influence on the environmental impacts. For this purpose, a literature review was conducted, and expert consultation was carried out. The study underlined the variability of the embedded environmental impacts of wooden windows by considering different wood types and transmittance values. The results also highlighted the need to define appropriate maintenance scenarios for precise assessment results. It was found that both the service life and the window maintenance requirements in terms of treatment and its frequency are highly dependent not only on the wood type and its treatment during the manufacturing process but also on the weather conditions of the place where the window is installed. In particular, it became evident that maintenance-related environmental impacts were the highest for climate regions with the lowest temperatures and the greatest amount of precipitation.Keywords: embedded impacts, environmental performance, life cycle assessment, LCA, maintenance stage, operational impacts, wooden windows
Procedia PDF Downloads 236412 Mathematical Modelling of Bacterial Growth in Products of Animal Origin in Storage and Transport: Effects of Temperature, Use of Bacteriocins and pH Level
Authors: Benjamin Castillo, Luis Pastenes, Fernando Cordova
Abstract:
The pathogen growth in animal source foods is a common problem in the food industry, causing monetary losses due to the spoiling of products or food intoxication outbreaks in the community. In this sense, the quality of the product is reflected by the population of deteriorating agents present in it, which are mainly bacteria. The factors which are likely associated with freshness in animal source foods are temperature and processing, storage, and transport times. However, the level of deterioration of products depends, in turn, on the characteristics of the bacterial population, causing the decomposition or spoiling, such as pH level and toxins. Knowing the growth dynamics of the agents that are involved in product contamination allows the monitoring for more efficient processing. This means better quality and reasonable costs, along with a better estimation of necessary time and temperature intervals for transport and storage in order to preserve product quality. The objective of this project is to design a secondary model that allows measuring the impact on temperature bacterial growth and the competition for pH adequacy and release of bacteriocins in order to describe such phenomenon and, thus, estimate food product half-life with the least possible risk of deterioration or spoiling. In order to achieve this objective, the authors propose an analysis of a three-dimensional ordinary differential which includes; logistic bacterial growth extended by the inhibitory action of bacteriocins including the effect of the medium pH; change in the medium pH levels through an adaptation of the Luedeking-Piret kinetic model; Bacteriocin concentration modeled similarly to pH levels. These three dimensions are being influenced by the temperature at all times. Then, this differential system is expanded, taking into consideration the variable temperature and the concentration of pulsed bacteriocins, which represent characteristics inherent of the modeling, such as transport and storage, as well as the incorporation of substances that inhibit bacterial growth. The main results lead to the fact that temperature changes in an early stage of transport increased the bacterial population significantly more than if it had increased during the final stage. On the other hand, the incorporation of bacteriocins, as in other investigations, proved to be efficient in the short and medium-term since, although the population of bacteria decreased, once the bacteriocins were depleted or degraded over time, the bacteria eventually returned to their regular growth rate. The efficacy of the bacteriocins at low temperatures decreased slightly, which equates with the fact that their natural degradation rate also decreased. In summary, the implementation of the mathematical model allowed the simulation of a set of possible bacteria present in animal based products, along with their properties, in various transport and storage situations, which led us to state that for inhibiting bacterial growth, the optimum is complementary low constant temperatures and the initial use of bacteriocins.Keywords: bacterial growth, bacteriocins, mathematical modelling, temperature
Procedia PDF Downloads 139411 Social Entrepreneurship Core Dimensions and Influential Perspectives: An Exploratory Study
Authors: Filipa Lancastre, Carmen Lages, Filipe Santos
Abstract:
The concept of social entrepreneurship (SE) remains ambiguous and deprived of a widely accepted operational definition. We argue that an awareness about the consensual constituent elements of SE from all key players from its ecosystem as well as a deeper understanding of apparently divergent perspectives will allow the different stakeholders (social entrepreneurs, corporations, investors, policymakers, the beneficiaries themselves) to bridge and cooperate for societal value co-creation in trying to solve our most pressing societal issues. To address our research question –what are the dimensions of SE that are consensual and controversial across existing perspectives? – We designed a two-step qualitative study. In a first step, we conducted an extensive literature review, collecting and analyzing 155 different SE definitions. From this initial step, we extracted and characterized three consensual and six controversial dimensions of the SE concept. In a second step, we conducted 20 semi-structured interviews with practitioners that are actively involved in the SE field. The goal of this second step was to verify if the literature did not capture any key dimension, understand how the dimensions related to each other and to understand the rationale behind them. The dimensions of the SE concept were extracted based on the relevance of each theme and on the theoretical relationship among them. To identify the relevance, we used as a proxy the frequency of each theme was referred to in our sample of definitions. To understand relationships, as identified in the previous section, we included concepts from both the management and psychology literature, such as the Entrepreneurial Orientation concept from the entrepreneurship literature, the Subjective Well Being construct from psychology literature, and the Resource-Based Theory from the strategy literature. This study has two main contributions; First, the identification of (consensual and controversial) dimensions of SE that exist across scattered definitions from the academic and practitioner literature. Second, a framework that parsimoniously synthesizes four dominant perspectives of SE and relates them with the SE dimensions. Assuming the contested nature of the SE concept, it is not expected that these views will be reconciled at the academic or practitioner field level. In future research, academics can, however, be aware of the existence of different understandings of SE and avoid bias towards a single view, developing holistic studies on SE phenomena or comparing differences by studying their underlying assumptions. Additionally, it is important that researchers make explicit the perspective they are embracing to ensure consistency among the research question, sampling procedures and implications of results. At the practitioner level, individuals or groups following different logics are predictably mutually suspicious and might benefit from taking stock of other perspectives on SE, building bridges and fostering cross-fertilization to the benefit of the SE ecosystem for which all contribute.Keywords: social entrepreneurship, conceptualization, dimensions, perspectives
Procedia PDF Downloads 178410 Nephroprotective Effect of Aqueous Extract of Plectranthus amboinicus (Roxb.) Leaves in Adriamycin Induced Acute Renal Failure in Wistar Rats: A Biochemical and Histopathological Assessment
Authors: Ampe Mohottige Sachinthi Sandaruwani Amarasiri, Anoja Priyadarshani Attanayake, Kamani Ayoma Perera Wijewardana Jayatilaka, Lakmini Kumari Boralugoda Mudduwa
Abstract:
The search for alternative pharmacological therapies based on natural extracts for renal failure has become an urgent need, due to paucity of effective pharmacotherapy. The current study was undertaken to evaluate the acute nephroprotective effect of aqueous leaf extract of Plectranthus amboinicus (Roxb.) (Family: Lamiaceae), a medicinal plant used in traditional Ayurvedic medicine for the management of renal diseases in Sri Lanka. The study was performed in adriamycin (ADR) induced nephrotoxic in Wistar rats. Wistar rats were randomly divided into four groups each with six rats. A single dose of ADR (20 mg/kg body wt., ip) was used for the induction of nephrotoxicity in all groups of rats except group one. The treatments were started 24 hours after induction of nephrotoxicity and continued for three days. Group one and two served as healthy and nephrotoxic control rats and were administered equivalent volumes of normal saline (0.9% NaCl) orally. Group three and four nephrotoxic rats were administered the lyophilized powder of the aqueous extract of P. amboinicus (400 mg/ kg body wt.; equivalent human therapeutic dose) and the standard drug, fosinopril sodium (0.09 mg/ kg body wt.) respectively. Urine and blood samples were collected from rats in each group at the end of the period of intervention for the estimation of selected renal parameters. H and E stained sections of the kidney tissues were examined for histopathological changes. Rats treated with the plant extract showed significant improvement in biochemical parameters and histopathological changes compared to ADR induced nephrotoxic group. The elevation of serum concentrations of creatinine and β2-microglobulin were decreased by 38%, and 66% in plant extract treated nephrotoxic rats respectively (p < 0.05). In addition, serum concentrations of total protein and albumin were significantly increased by 25% and 14% in rats treated with P. amboinicus respectively (p < 0.05). The results of β2 –microglobulin and serum total protein demonstrated a significant reduction in the elevated values in rats administered with the plant extract (400 mg/kg) compared to that of fosinopril (0.09 mg/kg). Urinary protein loss in 24hr urine samples was significantly decreased in rats treated with both fosinopril (86%) and P. ambonicus (56%) at the end of the intervention (p < 0.01). Accordingly, an attenuation of morphological destruction was observed in the H and E stained sections of the kidney with the treatments of plant extract and fosinopril. The results of the present study revealed that the aqueous leaf extract of P. amboinicus possesses significant nephroprotective activity at the equivalent therapeutic dose of 400 mg/ kg against adriamycin induced acute nephrotoxicity.Keywords: biochemical assessment, histopathological assessment, nephroprotective activity, Plectranthus amboinicus
Procedia PDF Downloads 148409 Motives for Reshoring from China to Europe: A Hierarchical Classification of Companies
Authors: Fabienne Fel, Eric Griette
Abstract:
Reshoring, whether concerning back-reshoring or near-reshoring, is a quite recent phenomenon. Despite the economic and political interest of this topic, academic research questioning determinants of reshoring remains rare. Our paper aims at contributing to fill this gap. In order to better understand the reasons for reshoring, we conducted a study among 280 French firms during spring 2016, three-quarters of which sourced, or source, in China. 105 firms in the sample have reshored all or part of their Chinese production or supply in recent years, and we aimed to establish a typology of the motives that drove them to this decision. We asked our respondents about the history of their Chinese supplies, their current reshoring strategies, and their motivations. Statistical analysis was performed with SPSS 22 and SPAD 8. Our results show that change in commercial and financial terms with China is the first motive explaining the current reshoring movement from this country (it applies to 54% of our respondents). A change in corporate strategy is the second motive (30% of our respondents); the reshoring decision follows a change in companies’ strategies (upgrading, implementation of a CSR policy, or a 'lean management' strategy). The third motive (14% of our sample) is a mere correction of the initial offshoring decision, considered as a mistake (under-estimation of hidden costs, non-quality and non-responsiveness problems). Some authors emphasize that developing a short supply chain, involving geographic proximity between design and production, gives a competitive advantage to companies wishing to offer innovative products. Admittedly 40% of our respondents indicate that this motive could have played a part in their decision to reshore, but this reason was not enough for any of them and is not an intrinsic motive leading to leaving Chinese suppliers. Having questioned our respondents about the importance given to various problems leading them to reshore, we then performed a Principal Components Analysis (PCA), associated with an Ascending Hierarchical Classification (AHC), based on Ward criterion, so as to point out more specific motivations. Three main classes of companies should be distinguished: -The 'Cost Killers' (23% of the sample), which reshore their supplies from China only because of higher procurement costs and so as to find lower costs elsewhere. -The 'Realists' (50% of the sample), giving equal weight or importance to increasing procurement costs in China and to the quality of their supplies (to a large extend). Companies being part of this class tend to take advantage of this changing environment to change their procurement strategy, seeking suppliers offering better quality and responsiveness. - The 'Voluntarists' (26% of the sample), which choose to reshore their Chinese supplies regardless of higher Chinese costs, to obtain better quality and greater responsiveness. We emphasize that if the main driver for reshoring from China is indeed higher local costs, it is should not be regarded as an exclusive motivation; 77% of the companies in the sample, are also seeking, sometimes exclusively, more reactive suppliers, liable to quality, respect for the environment and intellectual property.Keywords: China, procurement, reshoring, strategy, supplies
Procedia PDF Downloads 328408 Effects of Learner-Content Interaction Activities on the Context of Verbal Learning Outcomes in Interactive Courses
Authors: Alper Tolga Kumtepe, Erdem Erdogdu, M. Recep Okur, Eda Kaypak, Ozlem Kaya, Serap Ugur, Deniz Dincer, Hakan Yildirim
Abstract:
Interaction is one of the most important components of open and distance learning. According to Moore, who proposed one of the keystones on interaction types, there are three basic types of interaction: learner-teacher, learner-content, and learner-learner. From these interaction types, learner-content interaction, without doubt, can be identified as the most fundamental one on which all education is based. Efficacy, efficiency, and attraction of open and distance learning systems can be achieved by the practice of effective learner-content interaction. With the development of new technologies, interactive e-learning materials have been commonly used as a resource in open and distance learning, along with the printed books. The intellectual engagement of the learners with the content that is course materials may also affect their satisfaction for the open and distance learning practices in general. Learner satisfaction holds an important place in open and distance learning since it will eventually contribute to the achievement of learning outcomes. Using the learner-content interaction activities in course materials, Anadolu University, by its Open Education system, tries to involve learners in deep and meaningful learning practices. Especially, during the e-learning material design and production processes, identifying appropriate learner-content interaction activities within the context of learning outcomes holds a big importance. Considering the lack of studies adopting this approach, as well as its being a study on the use of e-learning materials in Open Education system, this research holds a big value in open and distance learning literature. In this respect, the present study aimed to investigate a) which learner-content interaction activities included in interactive courses are the most effective in learners’ achievement of verbal information learning outcomes and b) to what extent distance learners are satisfied with these learner-content interaction activities. For this study, the quasi-experimental research design was adopted. The 120 participants of the study were from Anadolu University Open Education Faculty students living in Eskişehir. The students were divided into 6 groups randomly. While 5 of these groups received different learner-content interaction activities as a part of the experiment, the other group served as the control group. The data were collected mainly through two instruments: pre-test and post-test. In addition to those tests, learners’ perceived learning was assessed with an item at the end of the program. The data collected from pre-test and post-test were analyzed by ANOVA, and in the light of the findings of this approximately 24-month study, suggestions for the further design of e-learning materials within the context of learner-content interaction activities will be provided at the conference. The current study is planned to be an antecedent for the following studies that will examine the effects of activities on other learning domains.Keywords: interaction, distance education, interactivity, online courses
Procedia PDF Downloads 194407 The Language of Science in Higher Education: Related Topics and Discussions
Authors: Gurjeet Singh, Harinder Singh
Abstract:
In this paper, we present "The Language of Science in Higher Education: Related Questions and Discussions". Linguists have written and researched in depth the role of language in science. On this basis, it is clear that language is not just a medium or vehicle for communicating knowledge and ideas. Nor are there mere signs of language knowledge and conversion of ideas into code. In the process of reading and writing, everyone thinks deeply and struggles to understand concepts and make sense. Linguistics play an important role in achieving concepts. In the context of such linguistic diversity, there is no straightforward and simple answer to the question of which language should be the language of advanced science and technology. Many important topics related to this issue are as follows: Involvement in practical or Deep theoretical issues. Languages for the study of science and other subjects. Language issues of science to be considered separate from the development of science, capitalism, colonial history, the worldview of the common man. The democratization of science and technology education in India is possible only by providing maximum reading/resource material in regional languages. The scientific research should be increase to chances of understanding the subject. Multilingual instead or monolingual. As far as deepening the understanding of the subject is concerned, we can shed light on it based on two or three experiences. An attempt was made to make the famous sociological journal Economic and Political Weekly Hindi almost three decades ago. There were many obstacles in this work. The original articles written in Hindi were not found, and the papers and articles of the English Journal were translated into Hindi, and a journal called Sancha was taken out. Equally important is the democratization of knowledge and the deepening of understanding of the subject. However, the question is that if higher education in science is in Hindi or other languages, then it would be a problem to get job. In fact, since independence, English has been dominant in almost every field except literature. There are historical reasons for this, which cannot be reversed. As mentioned above, due to colonial rule, even before independence, English was established as a language of communication, the language of power/status, the language of higher education, the language of administration, and the language of scholarly discourse. After independence, attempts to make Hindi or Hindustani the national language in India were unsuccessful. Given this history and current reality, higher education should be multilingual or at least bilingual. Translation limits should also be increased for those who choose the material for translation. Writing in regional languages on science, making knowledge of various international languages available in Indian languages, etc., is equally important for all to have opportunities to learn English.Keywords: language, linguistics, literature, culture, ethnography, punjabi, gurmukhi, higher education
Procedia PDF Downloads 92