Search results for: “IntelSymb” software

Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

Procedia PDF Downloads 138

Authors: Ardalan Sabamehr, Ashutosh Bagchi

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Recently, Structural Health Monitoring (SHM) based on the vibration of structures has attracted the attention of researchers in different fields such as: civil, aeronautical and mechanical engineering. Operational Modal Analysis (OMA) have been developed to identify modal properties of infrastructure such as bridge, building and so on. Frequency Domain Decomposition (FDD), Stochastic Subspace Identification (SSI) and Continuous Wavelet Transform (CWT) are the three most common methods in output only modal identification. FDD, SSI, and CWT operate based on the frequency domain, time domain, and time-frequency plane respectively. So, FDD and SSI are not able to display time and frequency at the same time. By the way, FDD and SSI have some difficulties in a noisy environment and finding the closed modes. CWT technique which is currently developed works on time-frequency plane and a reasonable performance in such condition. The other advantage of wavelet transform rather than other current techniques is that it can be applied for the non-stationary signal as well. The aim of this paper is to compare three most common modal identification techniques to find modal properties (such as natural frequency, mode shape, and damping ratio) of three story steel frame which was built in Concordia University Lab by use of ambient vibration. The frame has made of Galvanized steel with 60 cm length, 27 cm width and 133 cm height with no brace along the long span and short space. Three uniaxial wired accelerations (MicroStarin with 100mv/g accuracy) have been attached to the middle of each floor and gateway receives the data and send to the PC by use of Node Commander Software. The real-time monitoring has been performed for 20 seconds with 512 Hz sampling rate. The test is repeated for 5 times in each direction by hand shaking and impact hammer. CWT is able to detect instantaneous frequency by used of ridge detection method. In this paper, partial derivative ridge detection technique has been applied to the local maxima of time-frequency plane to detect the instantaneous frequency. The extracted result from all three methods have been compared, and it demonstrated that CWT has the better performance in term of its accuracy in noisy environment. The modal parameters such as natural frequency, damping ratio and mode shapes are identified from all three methods.

Keywords: ambient vibration, frequency domain decomposition, stochastic subspace identification, continuous wavelet transform

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Authors: Anusha Jain, Santosh Vishwanathan, Praveen K. Gupta, Shwetha S., Kavitha S. N.

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Agriculture has a major impact on the Indian economy, with the highest employment ratio than any sector of the country. Currently, most of the traditional agricultural practices and farming methods are manual, which results in farmers not realizing their maximum productivity often due to increasing in labour cost, inefficient use of water sources leading to wastage of water, inadequate soil moisture content, subsequently leading to food insecurity of the country. This research paper aims to solve this problem by developing a full-fledged web application-based platform that has the capacity to associate itself with a Microcontroller-based Automated Irrigation System which schedules the irrigation of crops based on real-time soil moisture content employing soil moisture sensors centric to the crop’s requirements using WSN (Wireless Sensor Networks) and M2M (Machine To Machine Communication) concepts, thus optimizing the use of the available limited water resource, thereby maximizing the crop yield. This robust automated irrigation system provides end-to-end automation of Irrigation of crops at any circumstances such as droughts, irregular rainfall patterns, extreme weather conditions, etc. This platform will also be capable of achieving a nationwide united farming community and ensuring the welfare of farmers. This platform is designed to equip farmers with prerequisite knowledge on tech and the latest farming practices in general. In order to achieve this, the MailChimp mailing service is used through which interested farmers/individuals' email id will be recorded and curated articles on innovations in the world of agriculture will be provided to the farmers via e-mail. In this proposed system, service is enabled on the platform where nearby crop vendors will be able to enter their pickup locations, accepted prices and other relevant information. This will enable farmers to choose their vendors wisely. Along with this, we have created a blogging service that will enable farmers and agricultural enthusiasts to share experiences, helpful knowledge, hardships, etc., with the entire farming community. These are some of the many features that the platform has to offer.

Keywords: WSN (wireless sensor networks), M2M (M/C to M/C communication), automation, irrigation system, sustainability, SAAS (software as a service), soil moisture sensor

Procedia PDF Downloads 106

Authors: Waraporn Boonchieng, Ekkarat Boonchieng, Wilawan Senaratana, Jaras Singkaew

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Geographical information system (GIS) is a designated system widely used for collecting and analyzing geographical data. Since the introduction of ultra-mobile, 'smart' devices, investigators, clinicians, and even the general public have had powerful new tools for collecting, uploading and accessing information in the field. Epidemiology paired with GIS will increase the efficacy of preventive health care services. The objective of this study is to apply GPS location services that are available on the common mobile device with district health systems, storing data on our private cloud system. The mobile application has been developed for use on iOS, Android, and web-based platforms. The system consists of two parts of district health information, including recorded resident data forms and individual health recorded data forms, which were developed and approved by opinion sharing and public hearing. The application's graphical user interface was developed using HTML5 and PHP with MySQL as a database management system (DBMS). The reporting module of the developed software displays data in a variety of views, from traditional tables to various types of high-resolution, layered graphics, incorporating map location information with street views from Google Maps. Multi-extension exporting is also supported, utilizing standard platforms such as PDF, PNG, JPG, and XLS. The data were collected in the database beginning in March 2013, by district health volunteers and district youth volunteers who had completed the application training program. District health information consisted of patients’ household coordinates, individual health data, social and economic information. This was combined with Google Street View data, collected in March 2014. Studied groups consisted of 16,085 (67.87%) and 47,811 (59.87%) of the total 23,701 households and 79,855 people were collected by the system respectively, in Saraphi district, Chiang Mai Province. The report generated from the system has had a major benefit directly to the Saraphi District Hospital. Healthcare providers are able to use the basic health data to provide a specific home health care service and also to create health promotion activities according to medical needs of the people in the community.

Keywords: health, public health, GIS, geographic information system

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Authors: B. Mendonça, D. Sandwell

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The Metropolitan Region of Sao Paulo (MRSP) has suffered from serious water scarcity. Consequently, the most convenient solution has been building wells to extract groundwater from local aquifers. However, it requires constant vigilance to prevent over extraction and future events that can pose serious threat to the population, such as subsidence. Radar imaging techniques (InSAR) have allowed continuous investigation of such phenomena. The analysis of data in the present study consists of 23 SAR images dated from October 2007 to March 2011, obtained by the ALOS-1 spacecraft. Data processing was made with the software GMTSAR, by using the InSAR technique to create pairs of interferograms with ground displacement during different time spans. First results show a correlation between the location of 102 wells registered in 2009 and signals of ground displacement equal or lower than -90 millimeters (mm) in the region. The longest time span interferogram obtained dates from October 2007 to March 2010. As a result, from that interferogram, it was possible to detect the average velocity of displacement in millimeters per year (mm/y), and which areas strong signals have persisted in the MRSP. Four specific areas with signals of subsidence of 28 mm/y to 40 mm/y were chosen to investigate the phenomenon: Guarulhos (Sao Paulo International Airport), the Greater Sao Paulo, Itaquera and Sao Caetano do Sul. The coverage area of the signals was between 0.6 km and 1.65 km of length. All areas are located above a sedimentary type of aquifer. Itaquera and Sao Caetano do Sul showed signals varying from 28 mm/y to 32 mm/y. On the other hand, the places most likely to be suffering from stronger subsidence are the ones in the Greater Sao Paulo and Guarulhos, right beside the International Airport of Sao Paulo. The rate of displacement observed in both regions goes from 35 mm/y to 40 mm/y. Previous investigations of the water use at the International Airport highlight the risks of excessive water extraction that was being done through 9 deep wells. Therefore, it is affirmed that subsidence events are likely to occur and to cause serious damage in the area. This study could show a situation that has not been explored with proper importance in the city, given its social and economic consequences. Since the data were only available until 2011, the question that remains is if the situation still persists. It could be reaffirmed, however, a scenario of risk at the International Airport of Sao Paulo that needs further investigation.

Keywords: ground subsidence, Interferometric Satellite Aperture Radar (InSAR), metropolitan region of Sao Paulo, water extraction

Procedia PDF Downloads 332

Authors: Mahdieh Zamzamzadeh, Ahmad Abdullah Saifizul, Rahizar Ramli

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The road accidents involving heavy vehicles have been showing worrying trends and, year after year, have increased the concern and awareness levels on safety of roads and transportations especially in developing countries like Malaysia. Statistics of road crashes continue to show that there are many contributing factors on the capability of a heavy vehicle to stop on safe distance and ultimately prevent traffic crashes. However, changes in the road condition due to weather variations and the vehicle dynamic specifications such as loading conditions and speed are the main risk factors because they will affect a heavy vehicle’s braking performance due to losing control and not being able to stop the vehicle, and in many cases will cause wheel lock up and accordingly skidding. Predicting heavy vehicle skidding distance is crucial for accident reconstruction and roadside safety engineers. Despite this, formal tools to study heavy vehicle skidding distance before stopping completely are totally limited, and most researchers have only considered braking distance in their studies. As a possible new tool, this work presents the iterative use of vehicle dynamic simulations to study heavy vehicle-roadway interaction in order to predict wheel lock up effects on skidding distance and safety. This research addresses the influence of the vehicle and road conditions on skidding distance after wheel lock up and presents a precise analysis of skidding phenomenon. The vehicle speed, vehicle loading condition and road friction parameters were all varied in a simulation-based analysis. In order to simulate the wheel lock up situation, a heavy vehicle model was constructed and simulated using multibody vehicle dynamics simulation software, and careful analysis was made on the conditions which caused the skidding distance to increase or decrease through a method using to predict skidding distance as part of braking distance. By applying many simulations, the results were quite revealing relation between the heavy vehicles loading condition, various sets of speed and road coefficient of friction and their interaction effect on the skidding distance. A number of results are presented which illustrate how the heavy vehicle overloading can seriously affect the skidding distance. Moreover, the results of simulation give the skid mark length, which is a necessary input data during accident reconstruction involving emergency braking.

Keywords: accident reconstruction, Braking, heavy vehicle, skidding distance, skid mark, wheel lock up

Procedia PDF Downloads 478

Authors: Castillo-Acevedo J, Mena-Rivero R, Silva-Poot H

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In Mexico, as largely of the developing countries, the rural housing is a study object, since the diversity of constructive idiosyncrasies for locality, involves various factors that make it vulnerable; an important aspect of study is the progressive deterioration that is seen in the rural housing. Various social programs, contribute financial resources in the field of housing to provide support for families living in rural areas, however, they do not provide a coordination with the self-construction that is usually the way in which is built in these areas. The present study, exposes the physical situation and an economic assessment that presents the rural self-constructed housing in three rural communities in the south of the state of Quintana Roo, Mexico, which were built with funding from federal social programs. The information compilation was carried out in a period of seven months in which there was used the intentional sampling of typical cases, where the object study was the housing constructed with supports of the program “Rural Housing” between the year 2009 and 2014. Instruments were used as the interview, ballot papers of observation, ballot papers of technical verification and various measuring equipment laboratory for the classification of pathologies; for the determination of some pathologies constructive Mexican standards were applied how NMX-C-192-ONNCCE, NMX-C-111-ONNCCE, NMX-C-404-ONNCCE and finally used the software of Opus CMS ® with the help of tables of the National Consumer Price Index (CPI) for update of costs and wages according to the line of being applied in Mexico, were used for an economic valuation. The results show 11 different constructive pathologies and exposes greater presence with the 22.50% to the segregation of the concrete; the economic assessment shows that 80% of self-constructed housing, exceed the cost of construction it would have compared to a similar dwelling built by a construction company; It is also exposed to the 46.10% of the universe of study represent economic losses in materials to the social activities by houses not built. The system of self-construction used by the social programs, affect to some extent the program objectives applied in underserved areas, as implicit and additional costs affect the economic capacity of beneficiaries who invest time and effort in an activity that are not specialists, which this research provides foundations for sustainable alternatives or possibly eliminate the practice of self-construction of implemented social programs in marginalized rural communities in the south of state of Quintana Roo, Mexico.

Keywords: economic valuation, pathologies constructive, rural housing, social programs

Procedia PDF Downloads 515

Authors: Ljiljana Stojković, Manja Zec, Maja Zivkovic, Maja Bundalo, Marija Glibetić, Dragan Alavantić, Aleksandra Stankovic

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Cardiovascular disease (CVD) is associated with alterations in DNA methylation, the latter modulated by dietary polyphenols. The present pilot study (part of the original clinical study registered as NCT02800967 at www.clinicaltrials.gov) aimed to investigate the impact of 4-week daily consumption of polyphenol-rich Aronia melanocarpa juice on Long Interspersed Nucleotide Element-1 (LINE-1) methylation in peripheral blood leukocytes, in subjects (n=34, age of 41.1±6.6 years) at moderate CVD risk, including an increased body mass index, central obesity, high normal blood pressure and/or dyslipidemia. The goal was also to examine whether factors known to affect DNA methylation, such as folate intake levels, MTHFR C677T gene variant, as well as the anthropometric and metabolic parameters, modulated the LINE-1 methylation levels upon consumption of polyphenol-rich Aronia juice. The experimental analysis of LINE-1 methylation was done by the MethyLight method. MTHFR C677T genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Folate intake was assessed by processing the data from the food frequency questionnaire and repeated 24-hour dietary recalls. Serum lipid profile was determined by using Roche Diagnostics kits. The statistical analyses were performed using the Statistica software package. In women, after vs. before the treatment period, a significant decrease in LINE-1 methylation levels was observed (97.54±1.50% vs. 98.39±0.86%, respectively; P=0.01). The change (after vs. before treatment) in LINE-1 methylation correlated directly with MTHFR 677T allele presence, average daily folate intake and the change in serum low-density lipoprotein cholesterol, while inversely with the change in serum triacylglycerols (R=0.72, R2=0.52, adjusted R2=0.36, P=0.03). The current results imply potential cardioprotective effects of habitual polyphenol-rich Aronia juice consumption achieved through the modifications of DNA methylation pattern in subjects at CVD risk, which should be further confirmed. Hence, the precision nutrition-driven modulations of DNA methylation may become targets for new approaches in the prevention and treatment of CVD.

Keywords: Aronia melanocarpa, cardiovascular risk, LINE-1, methylation, peripheral blood leukocytes, polyphenol

Procedia PDF Downloads 177

Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

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Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

Procedia PDF Downloads 66

Authors: Samantha A. Cintron, Janet Pierce, Mihaela E. Sardiu, Diane Mahoney, Jill Peltzer, Bhanu Gupta, Qiuhua Shen

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High output heart failure (HOHF) is characterized a high output state resulting from an underlying disease process and is commonly caused by obesity. As obesity levels increase, more individuals will be at risk for obesity-related HOHF. However, the underlying pathophysiologic mechanisms of obesity-related HOHF are not well understood and need further research. The aim of the study was to describe the differences in leukocyte transcriptomes of morbidly obese patients with HOHF and those with non-HOHF. In this cross-sectional study, the study team collected blood samples, demographics, and clinical data of six patients with morbid obesity and HOHF and six patients with morbid obesity and non-HOHF. The study team isolated the peripheral blood leukocyte RNA and applied stranded total RNA sequencing. Differential gene expression was calculated, and Ingenuity Pathway Analysis software was used to interpret the canonical pathways, functional changes, upstream regulators, and mechanistic and causal networks that were associated with the significantly different leukocyte transcriptomes. The study team identified 116 differentially expressed genes; 114 were upregulated, and 2 were downregulated in the HOHF group (Benjamini-Hochberg adjusted p-value ≤ 0.05 and log2(fold-change) of ±1). The differentially expressed genes were involved with cell proliferation, mitochondrial function, erythropoiesis, erythrocyte stability, and apoptosis. The top upregulated canonical pathways associated with differentially expressed genes were autophagy, adenosine monophosphate-activated protein kinase signaling, and senescence pathways. Upstream regulator GATA Binding Protein 1 (GATA1) and a network associated with nuclear factor kappa-light chain-enhancer of activated B cells (NF-kB) were also identified based on the different leukocyte transcriptomes of morbidly obese patients with HOHF and non-HOHF. To the author’s best knowledge, this is the first study that reported the differential gene expression in patients with obesity-related HOHF and demonstrated the unique pathophysiologic mechanisms underlying the disease. Further research is needed to determine the role of cellular function and maintenance, inflammation, and iron homeostasis in obesity-related HOHF.

Keywords: cardiac output, heart failure, obesity, transcriptomics

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Authors: Subramanyam Devarakonda Hanumantharao, Udayendu Prakash Sharma, Mahesh Garg

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Introduction: Gomabai Netralaya a reputed eye hospital is located in Neemuch a small city of Madhya Pradesh, India. The hospital is established in 1992 by Late. G.D Agrawal a renowned educationist, freedom fighter and philanthropist. The eye hospital was established to serve all sections of the society in affordable manner. To provide comprehensive eye care services to the rural poor the hospital started organizing outreach camps since 1994. Purpose: To study the cost effectiveness of outreach eye camps for addressing the sustainability issues of the outreach program. Methods: One year statistics of outreach eye camps were collected from Hospital Management Information System software to analyze the productivity of camps. Income and expenses report was collected from outreach department records to analyze per camp expenses and per patient expenses against the income generated. All current year records were analyzed to have accuracy of information and results. Information was collected in two ways: 1)Actual camp performance records and expenses from book of accounts. 2)Cross verification was done through one to one discussion with outreach staff. Results: Total 17534 outpatients were examined through 52 outreach eye camps. Total 6042 (34% of total outpatients) patients were advised with cataracts and 4651 (77% of advice) operations were performed. The average OPD per camp was 337 and per camp 116 patients was advised for cataract surgery and 89 surgeries were performed per camp. Total 18200 US$ incurred on organizing 52 outreach camps in the radius of 100 k.ms. Considering the total outpatients screened through camps the screening cost per patient was 1.00 US$ and considering the surgical output the per surgery expenses was 4.00 US$. The cost recovery of the total expenses was through Government grant of US$ 16.00 per surgery (that includes surgical grant). All logistics cost of camps and patients transportation cost was taken care by local donors. Conclusion: The present study demonstrates that with people’s participation, successful high volume outreach eye camps can be organized. The cost effectiveness of the outreach camps is totally depended on volume of outpatient’s turn-up at camp site and per camp surgical output. The only solution to sustainability of outreach eye camps is sharing of cost with local donors and increasing productivity.

Keywords: camps, outreach, productivity, sustainable

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Authors: Zhang Tao, Si Tang, Zhang Yufeng, Jin Jiahua

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Work pressure is an emerging research of organizational behavior. Many factors associated with this study also attracted the interest of scholars. Macao is surrounding by open micro-capitalist economy which has a high internationalization level and Mature operation system. And there is no doubt that tourism and hotel service industry is the pillar of the Macao economy with the developing of the mainland individual tourist visa. More and more cities are willing to inclusive culture diversity which lead to the amount of inbound tourists present high-speed up trend cause the hotel industry has a strong customer base and development space. At the same time, the hotel staff is an important role in the service. However, affected by some adverse factors, the hotel staff face a variety of pressures. This study combs the concept and theory of pressures relevant influencing factors and puts forward the purpose of this research. The focus of this study will be organizational supported by work efficiency and work pressure, using qualitative and quantitative research methods. Through questionnaires and interviews, 10 hotels in Macao were selected and 500 questionnaires were distributed to the employees. Statistical analysis software SPSS was used for descriptive statistics. By exploratory factor analysis and confirmatory factor analysis, effect. And the relevant practitioners on behalf of the interview content analysis. The innovation of this research lies in the empirical study of the relationship between the working pressure, organizational support and working efficiency of Macau hotel practitioners, and constructs and validates the structural model of the relationship among them. This model will be helpful for people to use more research methods to study hotel practitioners pressure in the future. At the same time, we can draw the following conclusions: 1. There is a significant negative correlation between salary level and job stress; 2. There is a significant negative correlation between job stress and performance; 3. Different organizational support can interfere the relationship between job stress and performance; 4. Put forward the strategy of relevance adjustment, which provides a reference value for the hotel industry in human resource management. It would be helpful to improve their service standard by training their practitioners more scientifically and rationally.

Keywords: Macau, perceived organizational support, work stress, work efficiency

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Authors: William Kelly, Sorelle Veigne, Xianhua Li, Zuyi Huang, Shyamsundar Subramanian, Eugene Schaefer

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The ambr15™ bioreactor is a single-use microbioreactor for cell line development and process optimization. The ambr system offers fully automatic liquid handling with the possibility of fed-batch operation and automatic control of pH and oxygen delivery. With operating conditions for large scale biopharmaceutical production properly scaled down, micro bioreactors such as the ambr15™ can potentially be used to predict the effect of process changes such as modified media or different cell lines. In this study, gassing rates and dilution rates were varied for a semi-continuous cell culture system in the ambr15™ bioreactor. The corresponding changes to metabolite production and consumption, as well as cell growth rate and therapeutic protein production were measured. Conditions were identified in the ambr15™ bioreactor that produced metabolic shifts and specific metabolic and protein production rates also seen in the corresponding larger (5 liter) scale perfusion process. A Dynamic Flux Balance model was employed to understand and predict the metabolic changes observed. The DFB model-predicted trends observed experimentally, including lower specific glucose consumption when CO₂ was maintained at higher levels (i.e. 100 mm Hg) in the broth. A Computational Fluid Dynamic (CFD) model of the ambr15™ was also developed, to understand transfer of O₂ and CO₂ to the liquid. This CFD model predicted gas-liquid flow in the bioreactor using the ANSYS software. The two-phase flow equations were solved via an Eulerian method, with population balance equations tracking the size of the gas bubbles resulting from breakage and coalescence. Reasonable results were obtained in that the Carbon Dioxide mass transfer coefficient (kLa) and the air hold up increased with higher gas flow rate. Volume-averaged kLa values at 500 RPM increased as the gas flow rate was doubled and matched experimentally determined values. These results form a solid basis for optimizing the ambr15™, using both CFD and FBA modelling approaches together, for use in microscale simulations of larger scale cell culture processes.

Keywords: cell culture, computational fluid dynamics, dynamic flux balance analysis, microbioreactor

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Authors: Azin Zargham, Gholamreza Rouhi, Allahyar Geramy

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One of the most prevalent types of alveolar bone loss is horizontal bone loss (HBL) in which the bone height around teeth is reduced homogenously. In the presence of HBL the magnitudes of forces during orthodontic treatment should be altered according to the degree of HBL, in a way that without further bone loss, desired tooth movement can be obtained. In order to investigate the appropriate orthodontic force system in the presence of HBL, a three-dimensional numerical model capable of the simulation of orthodontic tooth movement was developed. The main goal of this research was to evaluate the effect of different degrees of HBL on a long-term orthodontic tooth movement. Moreover, the effect of different force magnitudes on orthodontic tooth movement in the presence of HBL was studied. Five three-dimensional finite element models of a maxillary lateral incisor with 0 mm, 1.5 mm, 3 mm, 4.5 mm and 6 mm of HBL were constructed. The long-term orthodontic tooth tipping movements were attained during a 4-weeks period in an iterative process through the external remodeling of the alveolar bone based on strains in periodontal ligament as the bone remodeling mechanical stimulus. To obtain long-term orthodontic tooth movement in each iteration, first the strains in periodontal ligament under a 1-N tipping force were calculated using finite element analysis. Then, bone remodeling and the subsequent tooth movement were computed in a post-processing software using a custom written program. Incisal edge, cervical, and apical area displacement in the models with different alveolar bone heights (0, 1.5, 3, 4.5, 6 mm bone loss) in response to a 1-N tipping force were calculated. Maximum tooth displacement was found to be 2.65 mm at the top of the crown of the model with a 6 mm bone loss. Minimum tooth displacement was 0.45 mm at the cervical level of the model with a normal bone support. Tooth tipping degrees of models in response to different tipping force magnitudes were also calculated for models with different degrees of HBL. Degrees of tipping tooth movement increased as force level was increased. This increase was more prominent in the models with smaller degrees of HBL. By using finite element method and bone remodeling theories, this study indicated that in the presence of HBL, under the same load, long-term orthodontic tooth movement will increase. The simulation also revealed that even though tooth movement increases with increasing the force, this increase was only prominent in the models with smaller degrees of HBL, and tooth models with greater degrees of HBL will be less affected by the magnitude of an orthodontic force. Based on our results, the applied force magnitude must be reduced in proportion of degree of HBL.

Keywords: bone remodeling, finite element method, horizontal bone loss, orthodontic tooth movement.

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Authors: Jhoga Parth, T. Nasar, K. V. Anand

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An idealized definition of shoreline is that it is the zone of coincidence of three spheres such as atmosphere, lithosphere, and hydrosphere. Despite its apparent simplicity, this definition in practice a challenge to apply. In reality, the shoreline location deviates continually through time, because of various dynamic factors such as wave characteristics, currents, coastal orientation and the bathymetry, which makes the shoreline volatile. This necessitates us to monitor the shoreline in a temporal basis. If shoreline’s nature is understood at particular coastal stretch, it need not be the same trend at the other location, though belonging to the same sea front. Shoreline change is hence a local phenomenon and has to be studied with great intensity considering as many factors involved as possible. Erosion and accretion of sediment are such natures of a shoreline, which needs to be quantified by comparing with its predeceasing variations and understood before implementing any coastal projects. In recent years, advent of Global Positioning System (GPS) and Geographic Information System (GIS) acts as an emerging tool to quantify the intra and inter annual sediment rate getting accreted or deposited compared to other conventional methods in regards with time was taken and man power. Remote sensing data, on the other hand, paves way to acquire historical sets of data where field data is unavailable with a higher resolution. Short term and long term period shoreline change can be accurately tracked and monitored using a software residing in GIS - Digital Shoreline Analysis System (DSAS) developed by United States Geological Survey (USGS). In the present study, using DSAS, End Point Rate (EPR) is calculated analyze the intra-annual changes, and Linear Rate Regression (LRR) is adopted to study inter annual changes of shoreline. The shoreline changes are quantified for the scenario during the construction of breakwater in Ponnani river inlet along Kerala coast, India. Ponnani is a major fishing and landing center located 10°47’12.81”N and 75°54’38.62”E in Malappuram district of Kerala, India. The rate of erosion and accretion is explored using satellite and field data. The full paper contains the rate of change of shoreline, and its analysis would provide us understanding the behavior of the inlet at the study area during the construction of the training walls.

Keywords: DSAS, end point rate, field measurements, geo-informatics, shoreline variation

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Authors: Annamarie Rannou, Horace Bartilow

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Global concerns about xenophobic activity are on the rise across developed and developing countries. And yet, social science scholarship has almost exclusively examined xenophobia as a prejudice of advanced western nations. This research argues that the fields of study related to xenophobia must be re-conceptualized within a framework of ethnicity in order to level the playing field for cross-regional inquiry. This study develops a new concept of ethnic xenophobia and integrates existing explanations of anti-migrant expression into theories of ethnic threat. We argue specifically that political elites convert economic, political, and social threats at the national level into ethnic xenophobic activity in order to gain or maintain political advantage among their native selectorate. We expand on Stuart Kaufman’s theory of symbolic politics to underscore the methods of mobilization used against migrants and the power of elite discourse in moments of national crises. An original dataset is used to examine over 35,000 cases of ethnic xenophobic activity targeting refugees. Wordscores software is used to develop a unique measure of anti-migrant elite rhetoric which captures the symbolic discourse of elites in their mobilization of ethnic xenophobic activism. We use a Structural Equation Model (SEM) to test the causal pathways of the theory across seventy-two developed and developing countries from 1990 to 2016. A framework of Most Different Systems Design (MDSD) is also applied to two pairs of developed-developing country cases, including Kenya and the Netherlands and Lebanon and the United States. This study sheds tremendous light on an underrepresented area of comparative research in migration studies. It shows that the causal elements of anti-migrant activity are far more similar than existing research suggests which has major implications for policy makers, practitioners, and academics in fields of migration protection and advocacy. It speaks directly to the mobilization of myths surrounding refugees, in particular, and the nationalization of narratives of migration that may be neutralized by the development of deeper associational relationships between natives and migrants.

Keywords: refugees, ethnicity, symbolic politics, elites, migration, comparative politics

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Authors: Imran Hanif, Amanda Persdotter, Sedigheh Bigdeli, Jesper Liske, Torbjorn Jonsson

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Renewable fuels such as biomass/waste for power production is an attractive alternative to fossil fuels in order to achieve a CO₂ -neutral power generation. However, the combustion results in the release of corrosive species. This puts high demands on the corrosion resistance of the alloys used in the boiler. Stainless steels containing nickel and/or nickel containing coatings are regarded as suitable corrosion resistance material especially in the superheater regions. However, the corrosive environment in the boiler caused by the presence of water vapour and reactive alkali very rapidly breaks down the primary protection, i.e., the Cr-rich oxide scale formed on stainless steels. The lifetime of the components, therefore, relies on the properties of the oxide scale formed after breakaway, i.e., the secondary protection. The aim of the current study is to investigate the role of varying nickel content (0–82%) on the high-temperature corrosion of model alloys with 18% Cr (Fe in balance) in the laboratory mimicking industrial conditions at 600°C. The influence of nickel is investigated on both the primary protection and especially the secondary protection, i.e., the scale formed after breakaway, during the oxidation/corrosion process in the dry O₂ (primary protection) and more aggressive environment such as H₂O, K₂CO₃ and KCl (secondary protection). All investigated alloys experience a very rapid loss of the primary protection, i.e., the Cr-rich (Cr, Fe)₂O₃, and the formation of secondary protection in the aggressive environments. The microstructural investigation showed that secondary protection of all alloys has a very similar microstructure in all more aggressive environments consisting of an outward growing iron oxide and inward growing spinel-oxide (Fe, Cr, Ni)₃O₄. The oxidation kinetics revealed that it is possible to influence the protectiveness of the scale formed after breakaway (secondary protection) through the amount of nickel in the alloy. The difference in oxidation kinetics of the secondary protection is linked to the microstructure and chemical composition of the complex spinel-oxide. The detailed microstructural investigations were carried out using the extensive analytical techniques such as electron back scattered diffraction (EBSD), energy dispersive X-rays spectroscopy (EDS) via the scanning and transmission electron microscopy techniques and results are compared with the thermodynamic calculations using the Thermo-Calc software.

Keywords: breakaway corrosion, EBSD, high-temperature oxidation, SEM, TEM

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Authors: Rute Martins, Margarida Mascarenhas, Elsa Pereira

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The importance between sport and the natural environment was researched through a systematic literature in order to analyse the available scientific articles on the association of sport -angling also the physical activity, active leisure and recreation- and environmental behaviour. The collected data were gathered within the last five years (from 2013 to April 2018) in the Scopus, Web of Science, ScienceDirect, Sage, Green Leaf Online Library, GreenFile (EBSCO) and Wiley online Library databases. The content analysis based on the qualitative methods employed in this study was made with Nvivo software. Regarding only the inclusion of scientific articles, more than half of the collected papers highlighted tourism as the main area where sports is being researched with regard to the environmental theme. Thus, it is possible to extract a perspective of the orientations of the ecological concerns in the sports tourism industry. As such, in the winter sports, the climate change is already an identified issue, wondering about the impact of the environment on the sports practice. In this context, there is a focus on the possible adaptative strategies, researching the characteristics of the sports tourist and the winter sports industry. Regarding the natural parks and protected areas (such as reefs), most of the research is on the environmental impact of the sports tourism, choosing the conservation and the protection of nature as the core topics. The research of the sports tourist profile is addressed by many articles, where the motives for practice and the environmental values are being scanned, and relations to the recreation specialization, environmental responsibility, environmental education, and place-attachment concepts are being made. Regarding the sustainable management, the sports tourism study area is approaching the research in a more holistic way; exploring the stakeholder’s interconnection, focusing on landscape planning and environmentally sustainable practices of sport tourism organizations. The natural parks, protected areas, coral reefs, and snow areas serve as the preferred case-studies for investigating the environmental impact and the ecotourism, in particular, studied through hiking and diving in the great majority. The results of the study are a valuable resource to understand the importance of the sports tourism in the environmental and sustainable action along with the need of embracing all stakeholders within the relationship between the sport and the natural environment.

Keywords: ecotourism, environmental behaviour, outdoor recreation, sport tourism

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Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. Ladier, S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

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An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: nuclear decommissioning, logistical optimization, decision-support framework, waste management

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Authors: Mohammad Mahdi Mozaffari, Mehdi Ajalli, Delaram Jafargholi

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The main purpose of this study is to investigate the impact of the system of ERP (Enterprise Resource Planning) and SCM (Supply Chain Management) on the competitive advantage and performance of Mamot Company. The methods for collecting information in this study are library studies and field research. A questionnaire was used to collect the data needed to determine the relationship between the variables of the research. This questionnaire contains 38 questions. The direction of the current research is applied. The statistical population of this study consists of managers and experts who are familiar with the SCM system and ERP. Number of statistical society is 210. The sampling method is simple in this research. The sample size is 136 people. Also, among the distributed questionnaires, Reliability of the Cronbach's Alpha Cronbach's Questionnaire is evaluated and its value is more than 70%. Therefore, it confirms reliability. And formal validity has been used to determine the validity of the questionnaire, and the validity of the questionnaire is confirmed by the fact that the score of the impact is greater than 1.5. In the present study, one variable analysis was used for central indicators, dispersion and deviation from symmetry, and a general picture of the society was obtained. Also, two variables were analyzed to test the hypotheses; measure the correlation coefficient between variables using structural equations, SPSS software was used. Finally, multivariate analysis was used with statistical techniques related to the SPLS structural equations to determine the effects of independent variables on the dependent variables of the research to determine the structural relationships between the variables. The results of the test of research hypotheses indicate that: 1. Supply chain management practices have a positive impact on the competitive advantage of the Mammoth industrial complex. 2. Supply chain management practices have a positive impact on the performance of the Mammoth industrial complex. 3. Planning system Organizational resources have a positive impact on the performance of the Mammoth industrial complex. 4. The system of enterprise resource planning has a positive impact on Mamot's competitive advantage. 5.The competitive advantage has a positive impact on the performance of the Mammoth industrial complex 6.The system of enterprise resource planning Mamot Industrial Complex Supply Chain Management has a positive impact. The above results indicate that the system of enterprise resource planning and supply chain management has an impact on the competitive advantage and corporate performance of Mamot Company.

Keywords: enterprise resource planning, supply chain management, competitive advantage, Mamot company performance

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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Authors: Elvis Enowbeyang Tarkang

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Background: Since students in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these students might be exposed to sexual risk behaviours. Sexual risk behaviours include engaging in unprotected sexual intercourse, early sexual debut, multiple sexual partners and coerced or forced sex, and these behaviours might predispose youth to HIV transmission. However, little has been explored on the sexual risk behaviours of high school learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school students in an urban town of Cameroon. Method: A quantitative cross sectional design was adopted, using a self-administered questionnaire to collect data from a disproportional stratified simple random sample of 480 (240 male and 240 female) grade 10 to grade 12 students from two participating secondary school in Limbe in the Southwest region of Cameroon August 2014. Descriptive and Chi square statistics were calculated using statistical Package for Social Sciences (SPSS) version 20 software program at the level 0.05. Results: Majority of the respondents, 63.4% reported being sexually active, of whom only 33.2% used condoms consistently. Up to 37% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 23% had multiple sexual partners during the study period. The mean age of first sex was 15.4 years. Among Christians, Pentecostals, 17 (58.6%) were more likely to have experienced sexual coercion than non-Pentecostals, 111 (42.2%) (p= 0.000). Christians, 41 (10.3%) were more likely to have been forced into first sex than Muslims, 0 (0.0%); while among the Christians, Pentecostals, 6 (15.0%) were more likely to have been forced into first sex than non-Pentecostals, 35 (10.9%) (p=0.004). Among the Christians, Pentecostals, 16 (66.7%) were more likely to have experienced sex by age 16 years than non-Pentecostals, 125 (64.1%) (p= 0.000). Students who lived in rented places, 32 (22.7%) were more likely to have had multiple sexual partners than those who lived in their parents’ houses, 35 (18.1%) (p= 0.000). Males, 36 (16.0%) were likely to have had multiple concurrent sexual partners than females, 14 (6.0%) (p=0.002). Students who used condoms consistently, 25 (33.3%) were more likely to have a higher perception of risk of contracting HIV than those who did not use condoms consistently, 38 (29.9%) (p=0.002). Students who lived in their parents’ houses, 35 (35.4%) were more likely to use condoms consistently during sex, than those who lived in rented places, 31 (29.8%) (p=0.021). Students who passed their examinations, 57 (30.9%) were more likely to have used condoms consistently than those with low academic profiles, 24 (27.9%) (p= 0.034). Conclusions and Recommendations: Gender, lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors associated with sexual risk behaviours among students in urban Cameroon. The findings indicate that sexual risk behaviours exist among high school students in Limbe urban town of Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.

Keywords: Cameroon, high school students, HIV/AIDS, Limbe urban town, sexual risk behaviours

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Authors: Edwin Calderon-Mendoza, Patrick Schweitzer, Serge Weber

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Series arc faults appear frequently and unpredictably in low voltage distribution systems. Many methods have been developed to detect this type of faults and commercial protection systems such AFCI (arc fault circuit interrupter) have been used successfully in electrical networks to prevent damage and catastrophic incidents like fires. However, these devices do not allow series arc faults to be located on the line in operating mode. This paper presents a location algorithm for series arc fault in a low-voltage indoor power line in an AC 230 V-50Hz home network. The method is validated through simulations using the MATLAB software. The fault location method uses electrical parameters (resistance, inductance, capacitance, and conductance) of a 49 m indoor power line. The mathematical model of a series arc fault is based on the analysis of the V-I characteristics of the arc and consists basically of two antiparallel diodes and DC voltage sources. In a first step, the arc fault model is inserted at some different positions across the line which is modeled using lumped parameters. At both ends of the line, currents and voltages are recorded for each arc fault generation at different distances. In the second step, a fault map trace is created by using signature coefficients obtained from Kirchhoff equations which allow a virtual decoupling of the line’s mutual capacitance. Each signature coefficient obtained from the subtraction of estimated currents is calculated taking into account the Discrete Fast Fourier Transform of currents and voltages and also the fault distance value. These parameters are then substituted into Kirchhoff equations. In a third step, the same procedure described previously to calculate signature coefficients is employed but this time by considering hypothetical fault distances where the fault can appear. In this step the fault distance is unknown. The iterative calculus from Kirchhoff equations considering stepped variations of the fault distance entails the obtaining of a curve with a linear trend. Finally, the fault distance location is estimated at the intersection of two curves obtained in steps 2 and 3. The series arc fault model is validated by comparing current registered from simulation with real recorded currents. The model of the complete circuit is obtained for a 49m line with a resistive load. Also, 11 different arc fault positions are considered for the map trace generation. By carrying out the complete simulation, the performance of the method and the perspectives of the work will be presented.

Keywords: indoor power line, fault location, fault map trace, series arc fault

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Authors: Sareh Edalati, Nasrin Omidvar, Arezoo Haghighian Roudsari, Delaram Ghodsi, Azizollaah Zargaran

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Background and aim: Improving consumer’s food choices and providing a healthy food environment by governments is one of the essential approaches to prevent non-communicable diseases and to fulfill the sustainable development goals (SDGs). The present study aimed to provide an analysis of the nutrition labeling policy as one of the main components of the healthy food environment to provide learning lessons for the country and other low and middle-income countries. Methods: Data were collected by reviewing documents and conducting semi-structured interviews with stakeholders. Respondents were selected through purposive and snowball sampling and continued until data saturation. MAXQDA software was used to manage data analysis. A deductive content analysis was used by applying the Kingdon multiple streams and the policy triangulation framework. Results: Iran is the first country in the Middle East and North Africa region, which has implemented nutrition traffic light labeling. The implementation process has gone through two phases: voluntary and mandatory. In the voluntary labeling, volunteer food manufacturers who chose to have the labels would receive an honorary logo and this helped to reduce the food-sector resistance gradually. After this phase, the traffic light labeling became mandatory. Despite these efforts, there has been poor involvement of media for public awareness and sensitization. Also, the inconsistency of nutrition traffic light colors which are based on food standard guidelines, lack of consistency between nutrition traffic light colors, the healthy/unhealthy nature of some food products such as olive oil and diet cola and the absence of a comprehensive evaluation plan were among the pitfalls and policy challenges identified. Conclusions: Strengthening the governance through improving collaboration within health and non-health sectors for implementation, more transparency of truthfulness of nutrition traffic labeling initiating with real ingredients, and applying international and local scientific evidence or any further revision of the program is recommended. Also, developing public awareness campaigns and revising school curriculums to improve students’ skills on nutrition label applications should be highly emphasized.

Keywords: nutrition labeling, policy analysis, food environment, Iran

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Authors: Veronica Kembabazi, Arnold Tigaiza, Juliet Aweko, Charles Opio, Michael Ediau, Elizabeth Ekirapa, Andrew Tusubira, Peter Waiswa

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Background: Digital payments have been branded as key in solving health payment challenges, evidence on their adoptability is still limited especially among Community Health Workers (CHWs), yet vital for ensuring sustainability. We therefore assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda. Methods: In December 2022, we conducted a convergent parallel mixed-methods study among 150 randomly selected CHWs in Wakiso district. Supplementary qualitative data were collected from the Digital payment coordinators as Key Informants (KIs). We adopted the Technology Acceptance Model (TAM) framework to assess the adoptability of digital payments among CHWS. Factor analysis was performed to extract composite variables from the original constituting variables. Kaiser-Meyer-Olkin statistics were assessed for each construct to determine appropriateness for data reduction. Using logistic regression for multivariate analysis, we assessed the association between adoptability constructs and the CHW intention to use digital payments. Quantitative data was analyzed using STATA, while qualitative data was transcribed verbatim and analyzed using ATLAS.ti software. Results: Overall, 150 respondents were interviewed and nearly all participants (98.0%) had previously received payments through mobile money, a digital-payment method. The majority (52%) of CHWs said they intend to use digital payment modalities. Perceived risk had an 83% negative influence on the adoptability of digital payment modalities (OR= 0.167, p < 0.01), perceived trust had an almost three times positive influence on the adoptability of digital payment modalities (OR= 2.823, p < 0.01). Qualitative interviews showed that most CHWs reported good experiences in their use of digital health payment modalities except for delays associated with mobile money payments. Mobile money was reported to be easy to use, in addition to fostering financial responsibility compared to cash. Conclusion: CHWs in Wakiso district intend to use digital payment modalities, particularly mobile money/e-cash, and the perceived risk of the payment method and trust are key determinants of its adoptability. Synergized efforts by both payment providers and service operators to manage payment delays and identified risks among mobile money operators could attenuate perceived risk and build trust in digital payment modalities.

Keywords: digital health payments, community health workers, adoptability, technology acceptance model

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Authors: Choupani Andisheh, Temucin Elif Sevval, Bediz Bekir

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Due to their various advantages compared to many other drug delivery systems such as hypodermic injections and oral medications, microneedle arrays (MNAs) are a promising drug delivery system. To achieve enhanced performance of the MN, it is crucial to develop numerical models, optimization methods, and simulations. Accordingly, in this work, the optimized design of dissolvable MNAs, as well as their manufacturing, is investigated. For this purpose, a mechanical model of a single MN, having the geometry of an obelisk, is developed using commercial finite element software. The model considers the condition in which the MN is under pressure at the tip caused by the reaction force when penetrating the skin. Then, a multi-objective optimization based on non-dominated sorting genetic algorithm II (NSGA-II) is performed to obtain geometrical properties such as needle width, tip (apex) angle, and base fillet radius. The objective of the optimization study is to reach a painless and effortless penetration into the skin along with minimizing its mechanical failures caused by the maximum stress occurring throughout the structure. Based on the obtained optimal design parameters, master (male) molds are then fabricated from PMMA using a mechanical micromachining process. This fabrication method is selected mainly due to the geometry capability, production speed, production cost, and the variety of materials that can be used. Then to remove any chip residues, the master molds are cleaned using ultrasonic cleaning. These fabricated master molds can then be used repeatedly to fabricate Polydimethylsiloxane (PDMS) production (female) molds through a micro-molding approach. Finally, Polyvinylpyrrolidone (PVP) as a dissolvable polymer is cast into the production molds under vacuum to produce the dissolvable MNAs. This fabrication methodology can also be used to fabricate MNAs that include bioactive cargo. To characterize and demonstrate the performance of the fabricated needles, (i) scanning electron microscope images are taken to show the accuracy of the fabricated geometries, and (ii) in-vitro piercing tests are performed on artificial skin. It is shown that optimized MN geometries can be precisely fabricated using the presented fabrication methodology and the fabricated MNAs effectively pierce the skin without failure.

Keywords: microneedle, microneedle array fabrication, micro-manufacturing structural optimization, finite element analysis

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Authors: Bita Rabbani, Hossein Chiti, Faranak Sharifi, Saeedeh Mazloomzadeh

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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity, are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as changes in diet and physical activity, on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels of elementary, middle, and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers, and parents, changes in food services, and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles, and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software version 16.0. Results: Overall, 589 individuals (252 male, 337 female) entered the case group, and 803 individuals (344 male, 459 female) entered the control group. After two years of intervention, mean waist circumference (63.8 ± 10.9) and diastolic BP (63.8 ± 10.4) were significantly lower; however, mean systolic BP (10.1.0 ± 12.5), food score (25.0 ± 5.0) and drinking score (12.1 ± 2.3) were higher in the intervention group (p<0.001). Comparing components of metabolic syndrome between the second year and at time of recruitment within the intervention group showed that although number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are two major components of metabolic syndrome, are much higher in our study than in other regions of country. However, interventions for modification of diet and increase in physical activity are effective in lowering their prevalence.

Keywords: metabolic syndrome, obesity, life style, nutrition, hypertension

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Umair Shoukat Ali, Kamil Zafar, Rashna Hoshang Sukhia, Mubassar Fida, Aqeel Ahmed

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Objective: This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (Hawley and Essix retainer) in terms of improvement in occlusal settling (occlusal contact points/areas) after orthodontic treatment. Search Method: We searched the Cochrane Library, CINAHL Plus, PubMed, Web of Science, Orthodontic journals, and Google scholar for eligible studies. We included randomized control trials (RCT) along with Cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the RCTs Cochrane risk of bias tool was utilized, whereas Newcastle-Ottawa Scale was used for assessing the quality of cohort studies. Data analysis: The data analysis was limited to reporting mean values of occlusal contact points/areas with different retention methods. By utilizing the RevMan software V.5.3, a meta-analysis was performed for all the studies with the quantitative data. For the computation of the summary effect, a random effect model was utilized in case of high heterogeneity. I2 statistics were utilized to assess the heterogeneity among the selected studies. Results: We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating them based on duplication, titles, and objectives. We found significant differences between fixed and removable retainers in terms of occlusal settling within the included studies. Bonded retainer (BR) allowed faster and better posterior tooth settling as compared to Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. Essix retainer showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BR and removable retainers. Conclusions: HR allowed better overall occlusal settling as compared to other retainers in comparison. However, BR allowed faster settling in the posterior teeth region. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.

Keywords: orthodontic retainers, occlusal contact, Hawley, fixed, vacuum-formed

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Authors: Arlan S. Freitas, Leila M. Carvalho, Adriana L. Soares, Arnoud Neto, Marta S. Madruga, Elza I. Ida, Massami Shimokomaki

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The objective of this work was to evaluate the influence of microclimatic profile of broiler transport trucks under commercial conditions over the breast meat quality and DOA (Death On Arrival) in a tropical Brazilian regions as the North East where routinely the season is divided into dry and wet seasons. The temperature remains fairly constant and obviously the relative humidity changes accordingly. Three loads of 4,100 forty seven days old broiler were monitored from farm to slaughterhouse in a distance of 4.3 km, morning period of October 2015 rainy days. The profile of the environmental variables inside the container truck throughout the journey was obtained by the installation of thermo anemometers in 6 different locations by monitoring the heat index (HI), air velocity (AV), temperature (T), and relative humidity (RH). Meat qualities were evaluated by determining the occurrence of PSE (pale, soft, exudative) meat and DFD (dark, firm dry) meat. The percentage of birds DOA per loaded truck was determined by counting the dead broiler during the hanging step at the slaughtering plant. The analysis of variance was performed using statistical software (Statistica 8 for windows, Statsoft 2007, Tulsa, OK, USA). The Tukey significance test (P<0.05) was applied to compare means from microenvironmental data, PSE, DFD and DOA. Fillet samples were collected at 24h post mortem for pH e color (L*, a* e b*) determination through the CIELAB system. Results showed the occurrence of 2.98% of PSE and 0.66% de DFD and only 0.016% of DOA and overall the most uncomfortable container location was at the truck frontal inferior presenting 6.25% of PSE. DFD of 2.0% were obtained from birds located at central and inferior rear locations. These values were unexpected in comparison to other results obtained in our laboratories in previous experiments carried out within the country south state. The results reported herein were lower in every aspect. Reasonable explanation would be the shorter distance, wet conditions throughout around 15-20 min journeys and lower T and RH values as observed in samples taken from the rear location as higher DFD values were obtained. These facts mean the animals were not under heat stressful condition but in fact under cold stress conditions as the result of DFD suggested in association to the lower number of DOA.

Keywords: cold stress, DFD, microclimatic profile, PSE

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