Search results for: skin quality
6516 For a Poetic Clinic: Experimentations at Risk on the Images in Performances
Authors: Juliana Bom-Tempo
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The proposed composition occurs between images, performances, clinics and philosophies. For this enterprise we depart for what is not known beforehand, so with a question as a compass: "would it be in the creation, production and implementation of images in a performance a 'when' for the event of a poetic clinic?” In light of this, there are, in order to think a 'when' of the event of a poetic clinic, images in performances created, produced and executed in partnerships with the author of this text. Faced with this composition, we built four indicators to find spatiotemporal coordinates that would spot that "when", namely: risk zones; the mobilizations of the signs; the figuring of the flesh and an education of the affections. We dealt with the images in performances; Crútero; Flesh; Karyogamy and the risk of abortion; Egg white; Egg-mouth; Islands, threads, words ... germs; Egg-Mouth-Debris, taken as case studies, by engendering risks areas to promote individuations, which never actualize thoroughly, thus always something of pre-individual and also individuating a environment; by mobilizing the signs territorialized by the ordinary, causing them to vary the language and the words of order dictated by the everyday in other compositions of sense, other machinations; by generating a figure of flesh, disarranging the bodies, isolating them in the production of a ground force that causes the body to leak out and undo the functionalities of the organs; and, finally, by producing an education of affections, by placing the perceptions in becoming and disconnecting the visible in the production of small deserts that call for the creation of a people yet to come. The performance is processed as a problematizing of the images fixed by the ordinary, producing gestures that precipitate the individuation of images in performance, strange to the configurations that gather bodies and spaces in what we call common. Lawrence proposes to think of "people" who continually use umbrellas to protect themselves from chaos. These have the function of wrapping up the chaos in visions that create houses, forms and stabilities; they paint a sky at the bottom of the umbrella, where people march and die. A chaos, where people live and wither. Pierce the umbrella for a desire of chaos; a poet puts himself as an enemy of the convention, to be able to have an image of chaos and a little sun that burns his skin. The images in performances presented, thereby, were moving in search for the power of producing a spatio-temporal "when" putting the territories in risk areas, mobilizing the signs that format the day-to-day, opening the bodies to a disorganization and the production of an education of affections for the event of a poetic clinic.Keywords: Experimentations , Images in Performances, Poetic Clinic, Risk
Procedia PDF Downloads 1156515 The Examination And Assurance Of The Microbiological Safety Pertaining To Raw Milk And its Derived Processed Products
Authors: Raana Babadi Fathipour
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The production of dairy holds significant importance in the sustenance of billions of individuals worldwide, as they rely on milk and its derived products for daily consumption. In addition to being a source of essential nutrients crucial for human well-being, such as proteins, fats, vitamins, and minerals; dairy items are witnessing an increasing demand worldwide. Amongst all the factors contributing to the quality and safety assurance of dairy products, the strong focus lies on maintaining high standards in raw milk procurement. Raw milk serves as an externally nutritious medium for various microorganisms due to its inherent properties. This poses a considerable challenge for the dairy industry in ensuring that microbial contamination is minimized throughout every stage of the value chain. Despite implementing diverse process technologies—both conventional and innovative—the occurrence of microbial spoilage still results in substantial losses within this industry context. Moreover, milk and dairy products have been associated with numerous cases of foodborne illnesses across the globe. Various pathogens such as Salmonella serovars, Campylobacter spp., Shiga toxin-producing Escherichia coli, Listeria monocytogenes, and enterotoxin producing Staphylococcus aureus are commonly identified as the culprits behind these outbreaks in the dairy industry. The effective management of food safety within this sector necessitates a proactive and risk-based approach to reform. However, this strategy presents difficulties for developing nations where informal value chains dominate the dairy sector. Whether operating on a small or large scale or falling within formal or informal realms, it is imperative that the dairy industry adheres to principles of good hygiene practices and good manufacturing practices. Additionally, identifying and managing potential sources of contamination is crucial in mitigating challenges pertaining to quality and safety precautions.Keywords: dairy value chain, microbial contamination, food safety, hygiene
Procedia PDF Downloads 756514 Optimizing Pavement Construction Procedures in the Southern Desert of Libya
Authors: Khlifa El Atrash, Gabriel Assaf
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Libya uses a volumetric analysis in designing asphalt mixtures, which can also be upgraded in hot, arid weather. However, in order to be effective, it should include many important aspects which are materials, environment, and method of construction. However, the quality of some roads was below a satisfactory level. This paper examines the factors that contribute to low quality of road performance in Libya. To evaluate these factors, a questionnaire survey and a laboratory comparative study were performed for a few mixes under-represented of temperature and traffic load. In laboratory, rutting test conducted on two different asphalt mixture, these mixes included, an asphalt concrete mix using local aggregate and asphalt binder B(60/70) at the optimum Marshall asphalt content, another mixes designed using Superpave design procedure with the same materials and performance asphalt binder grade PG (70-10). In the survey, the questionnaire was distributed to 55 engineers and specialists in this field. The interview was conducted to a few others, and the factors that were leading to poor performance of asphalt roads were listed as; 1) Owner Experience and technical staff 2) Asphalt characteristics 3) Updating and development of Asphalt Mix Design methods 4) Lack of data collection by authorization Agency 5) Construction and compaction process 6) Mentoring and controlling mixing procedure. Considering and improving these factors will play an important role to improve the pavement performances, longer service life, and lower maintenance costs. This research summarized some recommendations for making asphalt mixtures used in hot, dry areas. Such asphalt mixtures should use asphalt binder which is less affected by pavement temperature change and traffic load. The properties of the mixture, such as durability, deformation, air voids, and performance, largely depend on the type of materials, environment, and mixing method. These properties, in turn, affect the pavement performance.Keywords: volumetric analysis, pavement performances, hot climate, traffic load, pavement temperature, asphalt mixture, environment, design and construction
Procedia PDF Downloads 2746513 Policy Evaluation of Republic Act 9502 “Universally Accessible Cheaper and Quality Medicines Act of 2008”
Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban
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To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502
Procedia PDF Downloads 476512 Investigating the Role and Position of Tuka Sabz Manufacturing Service Company in Supplying Human Resources to Mobarakeh Steel Company
Authors: Mohammad Abbas Nejad
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Tuka Sabz service production company (private shares), with more than 30 years of history, is considered as one of the first holding companies of Tuka Foulad, which takes steps in the direction of increasing service quality and customer satisfaction. Manpower supply is one of the most important activities of Tuka Sabz company, in addition to car supply services; light and heavy transportation services; management of entertainment, sports, tourism and accommodation centers; design, creation and maintenance services of land space; preparing, cooking, distributing and serving all kinds of personal and ceremonial foods; design, construction, repair and reconstruction of non-industrial buildings; industrial laundry services; public and industrial cleaning services are also among other activities of Tuka Sabz. This company has a high capacity of specialized and committed human resources as the main pillar of its success and spent most of its years of activity in Mobarakeh steel company as one of the reliable contractors in the field of automotive service contracts, green space, industrial cleaning, management cultural, recreational and tourism places, consulting, maintenance and repair of buildings and facilities, industrial laundry, management of cooking centers and personnel transportation. The final result of this article states that Tuka Sabz company is trying to get the satisfaction of three main groups of stakeholders, i.e., employees, customers, and shareholders, for this purpose, by improving the competence and competence of employees, trying to establish a system of meritocracy and respecting the human status of employees. On the one hand, the implementation of quality management and assurance to employers with the timely and favorable implementation of contracts takes a step in this direction.Keywords: Mubarakeh steel company, Tuka Sabz company, human resources, industrial laundry services
Procedia PDF Downloads 606511 Effects of Branched-Chain Amino Acid Supplementation on Sarcopenic Patients with Liver Cirrhosis
Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar
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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life
Procedia PDF Downloads 1386510 Application of Ground Penetrating Radar and Light Falling Weight Deflectometer in Ballast Quality Assessment
Authors: S. Cafiso, B. Capace, A. Di Graziano, C. D’Agostino
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Systematic monitoring of the trackbed is necessary to assure safety and quality of service in the railway system. Moreover, to produce effective management of the maintenance treatments, the assessment of bearing capacity of the railway trackbed must include ballast, sub-ballast and subgrade layers at different depths. Consequently, there is an increasing interest in obtaining a consistent measure of ballast bearing capacity with no destructive tests (NDTs) able to work in the physical and time restrictions of railway tracks in operation. Moreover, in the case of the local railway with reduced gauge, the use of the traditional high-speed track monitoring systems is not feasible. In that framework, this paper presents results from in site investigation carried out on ballast and sleepers with Ground Penetrating Radar (GPR) and Light Falling Weight Deflectometer (LWD). These equipment are currently used in road pavement maintenance where they have shown their reliability and effectiveness. Application of such Non-Destructive Tests in railway maintenance is promising but in the early stage of the investigation. More specifically, LWD was used to estimate the stiffness of ballast and sleeper support, as well. LWD, despite the limited load (6 kN in the trial test) applied directly on the sleeper, was able to detect defects in the bearing capacity at the Sleeper/Ballast interface. A dual frequency GPR was applied to detect the presence of layers’ discontinuities at different depths due to fouling phenomena that are the main causes of changing in the layer dielectric proprieties within the ballast thickness. The frequency of 2000Mhz provided high-resolution data to approximately 0.4m depth, while frequency of 600Mhz showed greater depth penetration up to 1.5 m. In the paper literature review and trial in site experience are used to identify Strengths, Weaknesses, Opportunities, and Threats (SWOT analysis) of the application of GPR and LWD for the assessment of bearing capacity of railway track-bed.Keywords: bearing capacity, GPR, LWD, no destructive test, railway track
Procedia PDF Downloads 1316509 A Retrospective Analysis of the Impact of the Choosing Wisely Canada Campaign on Emergency Department Imaging Utilization for Head Injuries
Authors: Sameer Masood, Lucas Chartier
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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.Keywords: choosing wisely, emergency department, head injury, quality improvement
Procedia PDF Downloads 2276508 Advancing Inclusive Curriculum Development for Special Needs Education in Africa
Authors: Onosedeba Mary Ayayia
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Inclusive education has emerged as a critical global imperative, aiming to provide equitable educational opportunities for all, regardless of their abilities or disabilities. In Africa, the pursuit of inclusive education faces significant challenges, particularly concerning the development and implementation of inclusive curricula tailored to the diverse needs of students with disabilities. This study delves into the heart of this issue, seeking to address the pressing problem of exclusion and marginalization of students with disabilities in mainstream educational systems across the continent. The problem is complex, entailing issues of limited access to tailored curricula, shortages of qualified teachers in special needs education, stigmatization, limited research and data, policy gaps, inadequate resources, and limited community awareness. These challenges perpetuate a system where students with disabilities are systematically excluded from quality education, limiting their future opportunities and societal contributions. This research proposes a comprehensive examination of the current state of inclusive curriculum development and implementation in Africa. Through an innovative and explicit exploration of the problem, the study aims to identify effective strategies, guidelines, and best practices that can inform the development of inclusive curricula. These curricula will be designed to address the diverse learning needs of students with disabilities, promote teacher capacity building, combat stigmatization, generate essential data, enhance policy coherence, allocate adequate resources, and raise community awareness. The goal of this research is to contribute to the advancement of inclusive education in Africa by fostering an educational environment where every student, regardless of ability or disability, has equitable access to quality education. Through this endeavor, the study aligns with the broader global pursuit of social inclusion and educational equity, emphasizing the importance of inclusive curricula as a foundational step towards a more inclusive and just society.Keywords: inclusive education, special education, curriculum development, Africa
Procedia PDF Downloads 656507 Development of a Risk Governance Index and Examination of Its Determinants: An Empirical Study in Indian Context
Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav
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Risk management has been gaining extensive focus from international organizations like Committee of Sponsoring Organizations and Financial Stability Board, and, the foundation of such an effective and efficient risk management system lies in a strong risk governance structure. In view of this, an attempt (perhaps a first of its kind) has been made to develop a risk governance index, which could be used as proxy for quality of risk governance structures. The index (normative framework) is based on eleven variables, namely, size of board, board diversity in terms of gender, proportion of executive directors, executive/non-executive status of chairperson, proportion of independent directors, CEO duality, chief risk officer (CRO), risk management committee, mandatory committees, voluntary committees and existence/non-existence of whistle blower policy. These variables are scored on a scale of 1 to 5 with the exception of the variables, namely, status of chairperson and CEO duality (which have been scored on a dichotomous scale with the score of 3 or 5). In case there is a legal/statutory requirement in respect of above-mentioned variables and there is a non-compliance with such requirement a score of one has been envisaged. Though there is no legal requirement, for the larger part of study, in context of CRO, risk management committee and whistle blower policy, still a score of 1 has been assigned in the event of their non-existence. Recognizing the importance of these variables in context of risk governance structure and the fact that the study basically focuses on risk governance, the absence of these variables has been equated to non-compliance with a legal/statutory requirement. Therefore, based on this the minimum score is 15 and the maximum possible is 55. In addition, an attempt has been made to explore the determinants of this index. For this purpose, the sample consists of non-financial companies (429) that constitute S&P CNX500 index. The study covers a 10 years period from April 1, 2005 to March 31, 2015. Given the panel nature of data, Hausman test was applied, and it suggested that fixed effects regression would be appropriate. The results indicate that age and size of firms have significant positive impact on its risk governance structures. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of governance structures. In contrast, profitability (positive relationship), leverage (negative relationship) and growth (negative relationship) do not have significant impact on quality of risk governance structures. The value of rho indicates that about 77.74% variation in risk governance structures is due to firm specific factors. Given the fact that each firm is unique in terms of its risk exposure, risk culture, risk appetite, and risk tolerance levels, it appears reasonable to assume that the specific conditions and circumstances that a company is beset with, could be the biggest determinants of its risk governance structures. Given the recommendations put forth in the paper (particularly for regulators and companies), the study is expected to be of immense utility in an important yet neglected aspect of risk management.Keywords: corporate governance, ERM, risk governance, risk management
Procedia PDF Downloads 2546506 Evaluating Radiation Dose for Interventional Radiologists Performing Spine Procedures
Authors: Kholood A. Baron
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While radiologist numbers specialized in spine interventional procedures are limited in Kuwait, the number of patients demanding these procedures is increasing rapidly. Due to this high demand, the workload of radiologists is increasing, which might represent a radiation exposure concern. During these procedures, the doctor’s hands are in very close proximity to the main radiation beam/ if not within it. The aim of this study is to measure the radiation dose for radiologists during several interventional procedures for the spine. Methods: Two doctors carrying different workloads were included. (DR1) was performing procedures in the morning and afternoon shifts, while (DR2) was performing procedures in the morning shift only. Comparing the radiation exposures that the hand of each doctor is receiving will assess radiation safety and help to set up workload regulations for radiologists carrying a heavy schedule of such procedures. Entrance Skin Dose (ESD) was measured via TLD (ThermoLuminescent Dosimetry) placed at the right wrist of the radiologists. DR1 was covering the morning shift in one hospital (Mubarak Al-Kabeer Hospital) and the afternoon shift in another hospital (Dar Alshifa Hospital). The TLD chip was placed in his gloves during the 2 shifts for a whole week. Since DR2 was covering the morning shift only in Al Razi Hospital, he wore the TLD during the morning shift for a week. It is worth mentioning that DR1 was performing 4-5 spine procedures/day in the morning and the same number in the afternoon and DR2 was performing 5-7 procedures/day. This procedure was repeated for 4 consecutive weeks in order to calculate the ESD value that a hand receives in a month. Results: In general, radiation doses that the hand received in a week ranged from 0.12 to 1.12 mSv. The ESD values for DR1 for the four consecutive weeks were 1.12, 0.32, 0.83, 0.22 mSv, thus for a month (4 weeks), this equals 2.49 mSv and calculated to be 27.39 per year (11 months-since each radiologist have 45 days of leave in each year). For DR2, the weekly ESD values are 0.43, 0.74, 0.12, 0.61 mSv, and thus, for a month, this equals 1.9 mSv, and for a year, this equals 20.9 mSv /year. These values are below the standard level and way below the maximum limit of 500 mSv per year (set by ICRP = International Council of Radiation Protection). However, it is worth mentioning that DR1 was a senior consultant and hence needed less fluoro-time during each procedure. This is evident from the low ESD values of the second week (0.32) and the fourth week (0.22), even though he was performing nearly 10-12 procedures in a day /5 days a week. These values were lower or in the same range as those for DR2 (who was a junior consultant). This highlighted the importance of increasing the radiologist's skills and awareness of fluoroscopy time effect. In conclusion, the radiation dose that radiologists received during spine interventional radiology in our setting was below standard dose limits.Keywords: radiation protection, interventional radiology dosimetry, ESD measurements, radiologist radiation exposure
Procedia PDF Downloads 606505 Correlation Between the Toxicity Grade of the Adverse Effects in the Course of the Immunotherapy of Lung Cancer and Efficiency of the Treatment in Anti-PD-L1 and Anti-PD-1 Drugs - Own Clinical Experience
Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk
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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors
Procedia PDF Downloads 926504 One Health Approach: The Importance of Improving the Identification of Waterborne Bacteria in Austrian Water
Authors: Aurora Gitto, Philipp Proksch
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The presence of various microorganisms (bacteria, fungi) in surface water and groundwater represents an important issue for human health worldwide. The matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) has emerged as a promising and reliable tool for bacteria identification in clinical diagnostic microbiology and environmental strains thanks to an ionization technique that uses a laser energy absorbing matrix to create ions from large molecules with minimal fragmentation. The study aims first to conceptualise and set up library information and create a comprehensive database of MALDI-TOF-MS spectra from environmental water samples. The samples were analysed over a year (2021-2022) using membrane filtration methodology (0.45 μm and 0.22 μm) and then isolated on R2A agar for a period of 5 days and Yeast extract agar growing at 22 °C up to 4 days and 37 °C for 48 hours. The undetected organisms by MALDI-TOF-MS were analysed by PCR and then sequenced. The information obtained by the sequencing was further implemented in the MALDI-TOF-MS library. Among the culturable bacteria, the results show how the incubator temperature affects the growth of some genera instead of others, as demonstrated by Pseudomonas sp., which grows at 22 °C, compared to Bacillus sp., which is abundant at 37 °C. The bacteria community shows a variation in composition also between the media used, as demonstrated with R2A agar which has been defined by a higher presence of organisms not detected compared to YEA. Interesting is the variability of the Genus over one year of sampling and how the seasonality impacts the bacteria community; in fact, in some sampling locations, we observed how the composition changed, moving from winter to spring and summer. In conclusion, the bacteria community in groundwater and river bank filtration represents important information that needs to be added to the library to simplify future water quality analysis but mainly to prevent potential risks to human health.Keywords: water quality, MALDI-TOF-MS, sequencing, library
Procedia PDF Downloads 846503 Comparison of Inexpensive Cell Disruption Techniques for an Oleaginous Yeast
Authors: Scott Nielsen, Luca Longanesi, Chris Chuck
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Palm oil is obtained from the flesh and kernel of the fruit of oil palms and is the most productive and inexpensive oil crop. The global demand for palm oil is approximately 75 million metric tonnes, a 29% increase in global production of palm oil since 2016. This expansion of oil palm cultivation has resulted in mass deforestation, vast biodiversity destruction and increasing net greenhouse gas emissions. One possible alternative is to produce a saturated oil, similar to palm, from microbes such as oleaginous yeast. The yeasts can be cultured on sugars derived from second-generation sources and do not compete with tropical forests for land. One highly promising oleaginous yeast for this application is Metschnikowia pulcherrima. However, recent techno-economic modeling has shown that cell lysis and standard lipid extraction are major contributors to the cost of the oil. Typical cell disruption techniques to extract either single cell oils or proteins have been based around bead-beating, homogenization and acid lysis. However, these can have a detrimental effect on lipid quality and are energy-intensive. In this study, a vortex separator, which produces high sheer with minimal energy input, was investigated as a potential low energy method of lysing cells. This was compared to four more traditional methods (thermal lysis, acid lysis, alkaline lysis, and osmotic lysis). For each method, the yeast loading was also examined at 1 g/L, 10 g/L and 100 g/L. The quality of the cell disruption was measured by optical cell density, cell counting and the particle size distribution profile comparison over a 2-hour period. This study demonstrates that the vortex separator is highly effective at lysing the cells and could potentially be used as a simple apparatus for lipid recovery in an oleaginous yeast process. The further development of this technology could potentially reduce the overall cost of microbial lipids in the future.Keywords: palm oil substitute, metschnikowia pulcherrima, cell disruption, cell lysis
Procedia PDF Downloads 2076502 A Sustainable Supplier Selection and Order Allocation Based on Manufacturing Processes and Product Tolerances: A Multi-Criteria Decision Making and Multi-Objective Optimization Approach
Authors: Ravi Patel, Krishna K. Krishnan
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In global supply chains, appropriate and sustainable suppliers play a vital role in supply chain development and feasibility. In a larger organization with huge number of suppliers, it is necessary to divide suppliers based on their past history of quality and delivery of each product category. Since performance of any organization widely depends on their suppliers, well evaluated selection criteria and decision-making models lead to improved supplier assessment and development. In this paper, SCOR® performance evaluation approach and ISO standards are used to determine selection criteria for better utilization of supplier assessment by using hybrid model of Analytic Hierchchy Problem (AHP) and Fuzzy Techniques for Order Preference by Similarity to Ideal Solution (FTOPSIS). AHP is used to determine the global weightage of criteria which helps TOPSIS to get supplier score by using triangular fuzzy set theory. Both qualitative and quantitative criteria are taken into consideration for the proposed model. In addition, a multi-product and multi-time period model is selected for order allocation. The optimization model integrates multi-objective integer linear programming (MOILP) for order allocation and a hybrid approach for supplier selection. The proposed MOILP model optimizes order allocation based on manufacturing process and product tolerances as per manufacturer’s requirement for quality product. The integrated model and solution approach are tested to find optimized solutions for different scenario. The detailed analysis shows the superiority of proposed model over other solutions which considered individual decision making models.Keywords: AHP, fuzzy set theory, multi-criteria decision making, multi-objective integer linear programming, TOPSIS
Procedia PDF Downloads 1726501 Sustainable Zero Carbon Communities: The Role of Community-Based Interventions in Reducing Carbon Footprint
Authors: Damilola Mofikoya
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Developed countries account for a large proportion of greenhouse gas emissions. In the last decade, countries including the United States and China have made a commitment to cut down carbon emissions by signing the Paris Climate Agreement. However, carbon neutrality is a challenging issue to tackle at the country level because of the scale of the problem. To overcome this challenge, cities are at the forefront of these efforts. Many cities in the United States are taking strategic actions and proposing programs and initiatives focused on renewable energy, green transportation, less use of fossil fuel vehicles, etc. There have been concerns about the implications of those strategies and a lack of community engagement. This paper is focused on community-based efforts that help actualize the reduction of carbon footprint through sustained and inclusive action. Existing zero-carbon assessment tools are examined to understand variables and indicators associated with the zero-carbon goals. Based on a broad, systematic review of literature on community strategies, and existing zero-carbon assessment tools, a dashboard was developed to help simplify and demystify carbon neutrality goals at a community level. The literature was able to shed light on the key contributing factors responsible for the success of community efforts in carbon neutrality. Stakeholder education is discussed as one of the strategies to help communities take action and generate momentum. The community-based efforts involving individuals and residents, such as reduction of food wastages, shopping preferences, transit mode choices, and healthy diets, play an important role in the context of zero-carbon initiatives. The proposed community-based dashboard will emphasize the importance of sustained, structured, and collective efforts at a communal scale. Finally, the present study discusses the relationship between life expectancy and quality of life and how it affects carbon neutrality in communities.Keywords: carbon footprint, communities, life expectancy, quality of life
Procedia PDF Downloads 906500 Development and Validation of a HPLC Method for Standardization of Methanolic Extract of Hypericum sinaicum Hochst
Authors: Taghreed A. Ibrahim, Atef A. El-Hela, Hala M. El-Hefnawy
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The chromatographic profile of methanol extract of Hypericum sinaicum was determined using HPLC-DAD. Apigenin was used as an external standard in the development and validation of the HPLC method. The proposed method is simple, rapid and reliable and can be successfully applied for standardization of Hypericum sinaicum methanol extract.Keywords: quality control, standardization, falvonoids, methanol extract
Procedia PDF Downloads 5056499 Changes in the Demand of Waterway Passengers During COVID-19 Pandemic: Case Study of Belém-Marajó Island, in Brazil
Authors: Maisa Sales Gama Tobias, Humberto de Paiva Junior, Luciano Silva Brito, Rui António Rodrigues Ramos
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Waterway transport in the Amazon was the first means of access and occupation in the region. For the economic and social matter of high importance, still nowadays one of the main transport modes to several places in the region. To some places, still the only transport mode. With the advent of the pandemic, transport companies that already faced management challenges began to experience unprecedented structural changes and trends in trade and global supply chains. Thus, companies need operational reorganization to maintain the sustainability of the service under the penalty of loss of demand. Allied to this fact, it was observed that the demand presented behavior changes to adapt to this new moment. However, the lack of information about these changes makes it difficult to find solutions to maintain the quality of service. This work aimed to characterize the changes in the demand of waterway passengers through an empirical study with field research involving interviews with users and crew, on-board journeys, and visits to the waterway service company. The case study is the route Belém-Camara, on Marajó Island, in the state of Pará. This line is traditionally the only means of transport for this route, besides air transport on a much smaller scale. The collected data had a descriptive and analytical statistical treatment presented in this work. As the main result, the COVID-19 pandemic has caused significant changes, mainly in trip time and motives and, in the perception itself on service quality by part of the demand, with the increase of trip time and the feeling of insecurity. In conclusion, the service operator must review cost management and business survival strategies and tactics. The viability of the service and the social guarantee of transport proved to be threatened, putting at risk the service to the riverside populations.Keywords: demand of waterway transport passengers, data analysis, COVID-19, amazonia
Procedia PDF Downloads 1146498 Breast Cancer Incidence Estimation in Castilla-La Mancha (CLM) from Mortality and Survival Data
Authors: C. Romero, R. Ortega, P. Sánchez-Camacho, P. Aguilar, V. Segur, J. Ruiz, G. Gutiérrez
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Introduction: Breast cancer is a leading cause of death in CLM. (2.8% of all deaths in women and 13,8% of deaths from tumors in womens). It is the most tumor incidence in CLM region with 26.1% from all tumours, except nonmelanoma skin (Cancer Incidence in Five Continents, Volume X, IARC). Cancer registries are a good information source to estimate cancer incidence, however the data are usually available with a lag which makes difficult their use for health managers. By contrast, mortality and survival statistics have less delay. In order to serve for resource planning and responding to this problem, a method is presented to estimate the incidence of mortality and survival data. Objectives: To estimate the incidence of breast cancer by age group in CLM in the period 1991-2013. Comparing the data obtained from the model with current incidence data. Sources: Annual number of women by single ages (National Statistics Institute). Annual number of deaths by all causes and breast cancer. (Mortality Registry CLM). The Breast cancer relative survival probability. (EUROCARE, Spanish registries data). Methods: A Weibull Parametric survival model from EUROCARE data is obtained. From the model of survival, the population and population data, Mortality and Incidence Analysis MODel (MIAMOD) regression model is obtained to estimate the incidence of cancer by age (1991-2013). Results: The resulting model is: Ix,t = Logit [const + age1*x + age2*x2 + coh1*(t – x) + coh2*(t-x)2] Where: Ix,t is the incidence at age x in the period (year) t; the value of the parameter estimates is: const (constant term in the model) = -7.03; age1 = 3.31; age2 = -1.10; coh1 = 0.61 and coh2 = -0.12. It is estimated that in 1991 were diagnosed in CLM 662 cases of breast cancer (81.51 per 100,000 women). An estimated 1,152 cases (112.41 per 100,000 women) were diagnosed in 2013, representing an increase of 40.7% in gross incidence rate (1.9% per year). The annual average increases in incidence by age were: 2.07% in women aged 25-44 years, 1.01% (45-54 years), 1.11% (55-64 years) and 1.24% (65-74 years). Cancer registries in Spain that send data to IARC declared 2003-2007 the average annual incidence rate of 98.6 cases per 100,000 women. Our model can obtain an incidence of 100.7 cases per 100,000 women. Conclusions: A sharp and steady increase in the incidence of breast cancer in the period 1991-2013 is observed. The increase was seen in all age groups considered, although it seems more pronounced in young women (25-44 years). With this method you can get a good estimation of the incidence.Keywords: breast cancer, incidence, cancer registries, castilla-la mancha
Procedia PDF Downloads 3136497 Effective Budget Utilization for the Production of Better Health Professionals
Authors: Tesfahiwot Abay Weldearegay
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Ethiopian Federal ministry of health, in collaboration with different partners, provides financial support from sustainable development grants and global fund budget sources to Regional health science colleges through the regional health bureau to improve the quality of training and avail professionals based on the regional health bureau demand from the year of 2012 to 2019EC. It was mainly focused on health extension workers (HEW) Level III&IV, Health Information technicians (HIT), Emergency Medical technicians (EMT), laboratory technicians, Pharmacy technicians, Anesthesia Level V, Radiography, midwifery, Environmental health and biomedical equipment technician. Laboratory technician, Radiography and Pharmacy technician, was retooling program. The study aims at assessing the Utilization and outcome of budgets transferred through regional health bureau to regional health science colleges. The study used both quantitative and qualitative approaches to develop sufficient data to explain the utilization of the budget, and outcomes obtained from the transferred budget and to identify the gaps. The data for the study were obtained through structured questionnaires and interviews was conducted to increase the reliability of the data. Nationally, students enrolled in different disciplines at RHSC through budget support for RHB to improve the quality of training were 87 840 students and the total Budget transferred, according to MOU was 895,752,038 Ethiopian birr. Among the students enrolled nationally in different disciplines at RHSC through budget support only 72% of students have graduated from different disciplines. In Hareri and Addis Ababa, all enrolled students were graduated (100%). At the same time, Oromia 69%, Amara 77%, SNNP 58% students graduated, respectively. The demand of the regional health bureau and the enrollment capacity of health science colleges increased from year to year. The financial support added great value to the HSCs to cop with problems related to student fees, skill lab materials and renovation.Keywords: emergency medical technician, radiography, Biomedical, health extension
Procedia PDF Downloads 876496 Optimization of SOL-Gel Copper Oxide Layers for Field-Effect Transistors
Authors: Tomas Vincze, Michal Micjan, Milan Pavuk, Martin Weis
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In recent years, alternative materials are gaining attention to replace polycrystalline and amorphous silicon, which are a standard for low requirement devices, where silicon is unnecessarily and high cost. For that reason, metal oxides are envisioned as the new materials for these low-requirement applications such as sensors, solar cells, energy storage devices, or field-effect transistors. Their most common way of layer growth is sputtering; however, this is a high-cost fabrication method, and a more industry-suitable alternative is the sol-gel method. In this group of materials, many oxides exhibit a semiconductor-like behavior with sufficiently high mobility to be applied as transistors. The sol-gel method is a cost-effective deposition technique for semiconductor-based devices. Copper oxides, as p-type semiconductors with free charge mobility up to 1 cm2/Vs., are suitable replacements for poly-Si or a-Si:H devices. However, to reach the potential of silicon devices, a fine-tuning of material properties is needed. Here we focus on the optimization of the electrical parameters of copper oxide-based field-effect transistors by modification of precursor solvent (usually 2-methoxy ethanol). However, to achieve solubility and high-quality films, a better solvent is required. Since almost no solvents have both high dielectric constant and high boiling point, an alternative approach was proposed with blend solvents. By mixing isopropyl alcohol (IPA) and 2-methoxy ethanol (2ME) the precursor reached better solubility. The quality of the layers fabricated using mixed solutions was evaluated in accordance with the surface morphology and electrical properties. The IPA:2ME solution mixture reached optimum results for the weight ratio of 1:3. The cupric oxide layers for optimal mixture had the highest crystallinity and highest effective charge mobility.Keywords: copper oxide, field-effect transistor, semiconductor, sol-gel method
Procedia PDF Downloads 1376495 Management of Small-Scale Companies in Nigeria. Case Study of Problems Faced by Entrepreneurs
Authors: Aderemi, Moses Aderibigbe
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The supply chain of a manufacturing company can be classified into three categories, namely: 1) supplier chain, these are a network of suppliers of raw materials, machinery, and other requirements for daily operations for the company; 2) internal chain, which are departmental or functional relationships within the organization like production, finance, marketing, logistic and quality control departments all interacting together to achieve the goals and objective of the company; and 3) customer chain; these are networks used for products distribution to the final consumer which includes the product distributors and retailers in the marketplace as may be applicable. In a developing country like Nigeria, where government infrastructures are poor or, in some cases, none in existence, the survival of a small-scale manufacturing company often depends on how effectively its supply chain is managed. In Nigeria, suppliers of machinery and raw materials to most manufacturing companies are from low-cost but high-tech countries like China or India. The problem with the supply chain from these countries apart from the language barrier between these countries and Nigeria, is also that of product quality and after-sales support services. The internal chain also requires funding to employ an experienced and trained workforce to deliver the company’s goals and objectives effectively and efficiently, which is always a challenge for small-scale manufacturers, including product marketing. In Nigeria, the management of the supply chain by small-scale manufacturers is further complicated by unfavourable government policies. This empirical research is a review and analysis of the supply chain management of a small-scale manufacturing company located in Lagos, Nigeria. The company's performance for the past five years has been on the decline and company management thinks there is a need for a review of its supply chain management for business survival. The company’s supply chain is analyzed and compared with best global practices in this research, and recommendations are made to the company management. The research outcome justifies the company’s need for a strategic change in its supply chain management for business sustainability and provides a learning point to small-scale manufacturing companies from developing countries in AfricaKeywords: management, small scale, supply chain, companies, leaders
Procedia PDF Downloads 266494 Improving Paper Mechanical Properties and Printing Quality by Using Carboxymethyl Cellulose as a Strength Agent
Authors: G. N. Simonian, R. F. Basalah, F. T. Abd El Halim, F. F. Abd El Latif, A. M. Adel, A. M. El Shafey.
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Carboxymethyl cellulose (CMC) is an anionic water soluble polymer that has been introduced in paper coating as a strength agent. One of the main objectives of this research is to investigate the influence of CMC concentration in improving the strength properties of paper fiber. In this work, we coated the paper sheets; Xerox paper sheets by different concentration of carboxymethyl cellulose solution (0.1, 0.5, 1, 1.5, 2, 3%) w/v. The mechanical properties; breaking length and tearing resistance (tear factor) were measured for the treated and untreated paper specimens. The retained polymer in the coated paper samples were also calculated. The more the concentration of the coating material; CMC increases, the more the mechanical properties; breaking length and tear factor increases. It can be concluded that CMC enhance the improvement of the mechanical properties of paper sheets result in increasing paper stability. The aim of the present research was also to study the effects on the vessel element structure and vessel picking tendency of the coated paper sheets. In addition to the improved strength properties of the treated sheet, a significant decrease in the vessel picking tendency was expected whereas refining of the original paper sheets (untreated paper sheets) improved mainly the bonding ability of fibers, CMC effectively enhanced the bonding of vessels as well. Moreover, film structures were formed in the fibrillated areas of the coated paper specimens, and they were concluded to reinforce the bonding within the sheet. Also, fragmentation of vessel elements through CMC modification was found to be important and results in a decreasing picking tendency which reflects in a good printability. Moreover, Scanning – Electron Microscope (SEM) images are represented to specifically explain the improved bonding ability of vessels and fibers after CMC modification. Finally, CMC modification enhance paper mechanical properties and print quality.Keywords: carboxymethyl cellulose (CMC), breaking length, tear factor, vessel picking, printing, concentration
Procedia PDF Downloads 4256493 Coordinated Multi-Point Scheme Based on Channel State Information in MIMO-OFDM System
Authors: Su-Hyun Jung, Chang-Bin Ha, Hyoung-Kyu Song
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Recently, increasing the quality of experience (QoE) is an important issue. Since performance degradation at cell edge extremely reduces the QoE, several techniques are defined at LTE/LTE-A standard to remove inter-cell interference (ICI). However, the conventional techniques have disadvantage because there is a trade-off between resource allocation and reliable communication. The proposed scheme reduces the ICI more efficiently by using channel state information (CSI) smartly. It is shown that the proposed scheme can reduce the ICI with less resources.Keywords: adaptive beamforming, CoMP, LTE-A, ICI reduction
Procedia PDF Downloads 4706492 Field Management Solutions Supporting Foreman Executive Tasks
Authors: Maroua Sbiti, Karim Beddiar, Djaoued Beladjine, Romuald Perrault
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Productivity is decreasing in construction compared to the manufacturing industry. It seems that the sector is suffering from organizational problems and have low maturity regarding technological advances. High international competition due to the growing context of globalization, complex projects, and shorter deadlines increases these challenges. Field employees are more exposed to coordination problems than design officers. Execution collaboration is then a major issue that can threaten the cost, time, and quality completion of a project. Initially, this paper will try to identify field professional requirements as to address building management process weaknesses such as the unreliability of scheduling, the fickleness of monitoring and inspection processes, the inaccuracy of project’s indicators, inconsistency of building documents and the random logistic management. Subsequently, we will focus our attention on providing solutions to improve scheduling, inspection, and hours tracking processes using emerging lean tools and field mobility applications that bring new perspectives in terms of cooperation. They have shown a great ability to connect various field teams and make informations visual and accessible to planify accurately and eliminate at the source the potential defects. In addition to software as a service use, the adoption of the human resource module of the Enterprise Resource Planning system can allow a meticulous time accounting and thus make the faster decision making. The next step is to integrate external data sources received from or destined to design engineers, logisticians, and suppliers in a holistic system. Creating a monolithic system that consolidates planning, quality, procurement, and resources management modules should be our ultimate target to build the construction industry supply chain.Keywords: lean, last planner system, field mobility applications, construction productivity
Procedia PDF Downloads 1176491 Influence of IL-1β on Hamster Blastocyst Hatching via Regulation of Hatching Associated Proteases
Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa
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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.Keywords: Blastocyst, Cytokines, Hatching, Interleukin
Procedia PDF Downloads 1466490 Development of an Instrument Assessing Participants’ Motivation on Assigning Monetary Value to Quality of Life
Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras
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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay
Procedia PDF Downloads 1396489 A Lung Cancer Patients with Septic Shock Nursing Experience
Authors: Syue-Wen Lin
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Objective: This article explores the nursing experience of an 84-year-old male lung cancer patient who underwent a thoracoscopic right lower lobectomy and treatment. The patient has multiple medical histories, including hypertension and diabetes. The nursing process involved cancer treatment, postoperative pain management, as well as wound care and healing. Methods: The nursing period is from February 10 to February 17, 2024. During the nursing process, pain management strategies are implemented, including morphine drugs and non-drug methods, and music therapy, essential oil massage, and extended reception time are used to make patients feel physically and mentally comfortable so as to reduce postoperative pain and encourage active participation in rehabilitation. Strict sterile wound dressing procedures and advanced wound care techniques are used to promote wound healing and prevent infection. Due to septic shock, dialysis is used to relieve worsening symptoms. Taking into account the patient's cancer status, the nursing team provides comprehensive cancer care based on the patient's physical and psychological needs. Given the complexity of the patient's condition, including advanced cancer, palliative care is also incorporated throughout the care process to relieve discomfort and provide psychological support. Results: Through comprehensive health assessment, the nursing team fully understood the patient's condition and developed a personalized care plan based on the patient's condition. The interprofessional critical care team provides respiratory therapy and lung expansion exercises to reduce muscle loss while addressing the patient's psychological status, pain management, and vital sign stabilization needs, resulting in a comprehensive approach to care. Lung expansion exercises and the use of a high-frequency chest wall oscillation vest successfully improved sputum drainage and facilitated weaning from mechanical ventilation. In addition, helping patients stabilize their vital signs and the integration of cancer care, pain management, wound care and palliative care helps the patient be fully supported throughout the recovery process, ultimately improving his quality of life. Conclusion: Lung cancer and septic shock present significant challenges to patients, and the nursing team not only provides critical care but also addresses the unique needs of patients through comprehensive infection control, cancer care, pain management, wound care, and palliative care interventions. These measures effectively improve patients' quality of life, promote recovery, and provide compassionate palliative care for terminally ill patients. Nursing staff work closely with family members to develop a comprehensive care plan to ensure that patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.Keywords: septic shock, lung cancer, palliative care, nursing experience
Procedia PDF Downloads 256488 Multi-Objectives Genetic Algorithm for Optimizing Machining Process Parameters
Authors: Dylan Santos De Pinho, Nabil Ouerhani
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Energy consumption of machine-tools is becoming critical for machine-tool builders and end-users because of economic, ecological and legislation-related reasons. Many machine-tool builders are seeking for solutions that allow the reduction of energy consumption of machine-tools while preserving the same productivity rate and the same quality of machined parts. In this paper, we present the first results of a project conducted jointly by academic and industrial partners to reduce the energy consumption of a Swiss-Type lathe. We employ genetic algorithms to find optimal machining parameters – the set of parameters that lead to the best trade-off between energy consumption, part quality and tool lifetime. Three main machining process parameters are considered in our optimization technique, namely depth of cut, spindle rotation speed and material feed rate. These machining process parameters have been identified as the most influential ones in the configuration of the Swiss-type machining process. A state-of-the-art multi-objective genetic algorithm has been used. The algorithm combines three fitness functions, which are objective functions that permit to evaluate a set of parameters against the three objectives: energy consumption, quality of the machined parts, and tool lifetime. In this paper, we focus on the investigation of the fitness function related to energy consumption. Four different energy consumption related fitness functions have been investigated and compared. The first fitness function refers to the Kienzle cutting force model. The second fitness function uses the Material Removal Rate (RMM) as an indicator of energy consumption. The two other fitness functions are non-deterministic, learning-based functions. One fitness function uses a simple Neural Network to learn the relation between the process parameters and the energy consumption from experimental data. Another fitness function uses Lasso regression to determine the same relation. The goal is, then, to find out which fitness functions predict best the energy consumption of a Swiss-Type machining process for the given set of machining process parameters. Once determined, these functions may be used for optimization purposes – determine the optimal machining process parameters leading to minimum energy consumption. The performance of the four fitness functions has been evaluated. The Tornos DT13 Swiss-Type Lathe has been used to carry out the experiments. A mechanical part including various Swiss-Type machining operations has been selected for the experiments. The evaluation process starts with generating a set of CNC (Computer Numerical Control) programs for machining the part at hand. Each CNC program considers a different set of machining process parameters. During the machining process, the power consumption of the spindle is measured. All collected data are assigned to the appropriate CNC program and thus to the set of machining process parameters. The evaluation approach consists in calculating the correlation between the normalized measured power consumption and the normalized power consumption prediction for each of the four fitness functions. The evaluation shows that the Lasso and Neural Network fitness functions have the highest correlation coefficient with 97%. The fitness function “Material Removal Rate” (MRR) has a correlation coefficient of 90%, whereas the Kienzle-based fitness function has a correlation coefficient of 80%.Keywords: adaptive machining, genetic algorithms, smart manufacturing, parameters optimization
Procedia PDF Downloads 1496487 Evaluation of the Irritation Potential of Three Topical Formulations of Minoxidil 5% + Finasteride 0.1% Using Patch Test
Authors: Joshi Rajiv, Shah Priyank, Thavkar Amit, Rohira Poonam, Mehta Suyog
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Topical formulation containing minoxidil and finasteride helps hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare the irritation potential of three conventional formulations of minoxidil 5% + finasteride 0.1% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 53 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulations of minoxidil 5% + finasteride 0.1% topical solution. Products tested included aqueous based minoxidil 5% + finasteride 0.1% (AnasureTM-F, Sun Pharma, India – Brand A), lipid based minoxidil 5% + finasteride 0.1% (Brand B) and aqueous based minoxidil 5% + finasteride 0.1% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24 hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using the Draize scale (0-4 points scale for erythema/dryness//wrinkles and for oedema). Follow-up was scheduled after one week to confirm recovery for any reaction. A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and a score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and a score above 4.0/8.0 indicates “irritant”. The procedure of the patch test followed the principles outlined by the Bureau of Indian Standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty three subjects with mean age 31.9 years (25 males and 28 females) participated in the study. The combined mean score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.92 ± 0.47 (positive control) and 0.0 ± 0.0 (Negative control). This means the score of Brand A (Sun Pharma product) was significantly lower than that of Brand B (p=0.001) and that of Brand C (p=0.001). The combined mean erythema score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.09 ± 0.4 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.001) and that of Brand C (p=0.001). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulations of minoxidil 5% + finasteride 0.1% were non-irritant. Brand A of minoxidil 5% + finasteride 0.1% (Sun Pharma) was found to be the least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011:2018Keywords: erythema, finasteride, irritation, minoxidil, patch test
Procedia PDF Downloads 86