Search results for: procedure established by law
5114 Ureteral Stents with Extraction Strings: Patient-Reported Outcomes
Authors: Rammah Abdlbagi, Similoluwa Biyi, Aakash Pai
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Introduction: Short-term ureteric stents are commonly placed after ureteroscopy procedures. The removal usually entails having a flexible cystoscopy, which entails a further invasive procedure. There are often delays in removing the stent as departments have limited cystoscopy availability. However, if stents with extraction strings are used, the patient or a clinician can remove them. The aim of the study is to assess the safety and effectiveness of the use of a stent with a string. Method: A retrospective, single-institution study was conducted over a three-month period. Twenty consecutive patients had ureteric stents with string insertion. Ten of the patients had a stent removal procedure previously with flexible cystoscopy. A validated questionnaire was used to assess outcomes. Primary outcomes included: dysuria, hematuria, urinary frequency, and disturbance of the patient’s daily activities. Secondary outcomes included pain experience during the stent removal. Result: Fifteen patients (75%) experienced hematuria and frequency. Two patients experienced pain and discomfort during the stent removal (10%). Two patients had experienced a disturbance in their daily activity (10%). All patients who had stent removal before using flexible cystoscopy preferred the removal of the stent using a string. None of the patients had stent displacement. The median stent dwell time was five days. Conclusion: Patient reported outcomes measures for the indwelling period of a stent with extraction string are equivalent to the published data on stents. Extraction strings mean that the stent dwell time can be reduced. The removal of the stent on extraction strings is more tolerable than the conventional stent.Keywords: ureteric stent, string flexible cystoscopy, stent symptoms, validated questionnaire
Procedia PDF Downloads 945113 Matching Law in Autoshaped Choice in Neural Networks
Authors: Giselle Maggie Fer Castañeda, Diego Iván González
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The objective of this work was to study the autoshaped choice behavior in the Donahoe, Burgos and Palmer (DBP) neural network model and analyze it under the matching law. Autoshaped choice can be viewed as a form of economic behavior defined as the preference between alternatives according to their relative outcomes. The Donahoe, Burgos and Palmer (DBP) model is a connectionist proposal that unifies operant and Pavlovian conditioning. This model has been used for more than three decades as a neurobehavioral explanation of conditioning phenomena, as well as a generator of predictions suitable for experimental testing with non-human animals and humans. The study consisted of different simulations in which, in each one, a ratio of reinforcement was established for two alternatives, and the responses (i.e., activations) in each of them were measured. Choice studies with animals have demonstrated that the data generally conform closely to the generalized matching law equation, which states that the response ratio equals proportionally to the reinforcement ratio; therefore, it was expected to find similar results with the neural networks of the Donahoe, Burgos and Palmer (DBP) model since these networks have simulated and predicted various conditioning phenomena. The results were analyzed by the generalized matching law equation, and it was observed that under some contingencies, the data from the networks adjusted approximately to what was established by the equation. Implications and limitations are discussed.Keywords: matching law, neural networks, computational models, behavioral sciences
Procedia PDF Downloads 745112 Assessment of Airtightness Through a Standardized Procedure in a Nearly-Zero Energy Demand House
Authors: Mar Cañada Soriano, Rafael Royo-Pastor, Carolina Aparicio-Fernández, Jose-Luis Vivancos
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The lack of insulation, along with the existence of air leakages, constitute a meaningful impact on the energy performance of buildings. Both of them lead to increases in the energy demand through additional heating and/or cooling loads. Additionally, they cause thermal discomfort. In order to quantify these uncontrolled air currents, pressurization and depressurization tests can be performed. Among them, the Blower Door test is a standardized procedure to determine the airtightness of a space which characterizes the rate of air leakages through the envelope surface, calculating to this purpose an air flow rate indicator. In this sense, the low-energy buildings complying with the Passive House design criteria are required to achieve high levels of airtightness. Due to the invisible nature of air leakages, additional tools are often considered to identify where the infiltrations take place. Among them, the infrared thermography entails a valuable technique to this purpose since it enables their detection. The aim of this study is to assess the airtightness of a typical Mediterranean dwelling house located in the Valencian orchad (Spain) restored under the Passive House standard using to this purpose the blower-door test. Moreover, the building energy performance modelling tools TRNSYS (TRaNsient System Simulation program) and TRNFlow (TRaNsient Flow) have been used to determine its energy performance, and the infiltrations’ identification was carried out by means of infrared thermography. The low levels of infiltrations obtained suggest that this house may comply with the Passive House standard.Keywords: airtightness, blower door, trnflow, infrared thermography
Procedia PDF Downloads 1235111 Mesenteric Vasculitis Causing Perforated Diverticulitis Mimicking Abdominal Sepsis
Authors: Christopher Leung, Assad Zahid
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Mesenteric vasculitis can often mimic abdominal sepsis in a postoperative setting leading to a predicament where steroids could improve mesenteric vasculitis whilst worsening abdominal sepsis. Here this study presents a unique and rare case of perforated sigmoid diverticulitis secondary to systemic vasculitis. A 68-year-old gentleman presented with perforated sigmoid diverticulitis requiring an emergency Hartmann’s procedure. Early in his postoperative course, he had painful and asymmetrical neuropathy that, after a careful history and examination, revealed a patient with mono neuritis multiplex on a background history of longstanding rheumatoid arthritis. On day seven of his postoperative course, he had rising inflammatory markers and a CT abdomen and pelvis showing fluid around the mesentery. Whilst contamination from sigmoid perforation was somewhat congruent with these signs, a diagnosis of polyarteritis nodosa, a common cause of mononeuritis multiplex, is also possible, although involvement of the large bowel in polyarteritis nodosa is extremely rare. The histopathology from the initial Hartmann’s procedure was re-examined, showing medium vessel disease vasculitis. Given his lack of fevers, absence of abdominal pain, and worsening neurology, he was given a provisional diagnosis of polyarteritis nodosa and was treated successfully, not on IV antibiotics but on steroids. Large bowel involvement of polyarteritis nodosa is extremely rare and this is the first case of polyarteritis nodosa causing perforated diverticulitis. The learning point here is to obtain a good clinical picture of a patient to identify mesenteric vasculitis as compared to abdominal sepsis as the treatment of one worsens the other.Keywords: abdominal sepsis, diverticulitis, mesenteric vasculitis, polyarteritis nodosa
Procedia PDF Downloads 2525110 A Tuning Method for Microwave Filter via Complex Neural Network and Improved Space Mapping
Authors: Shengbiao Wu, Weihua Cao, Min Wu, Can Liu
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This paper presents an intelligent tuning method of microwave filter based on complex neural network and improved space mapping. The tuning process consists of two stages: the initial tuning and the fine tuning. At the beginning of the tuning, the return loss of the filter is transferred to the passband via the error of phase. During the fine tuning, the phase shift caused by the transmission line and the higher order mode is removed by the curve fitting. Then, an Cauchy method based on the admittance parameter (Y-parameter) is used to extract the coupling matrix. The influence of the resonant cavity loss is eliminated during the parameter extraction process. By using processed data pairs (the amount of screw variation and the variation of the coupling matrix), a tuning model is established by the complex neural network. In view of the improved space mapping algorithm, the mapping relationship between the actual model and the ideal model is established, and the amplitude and direction of the tuning is constantly updated. Finally, the tuning experiment of the eight order coaxial cavity filter shows that the proposed method has a good effect in tuning time and tuning precision.Keywords: microwave filter, scattering parameter, coupling matrix, intelligent tuning
Procedia PDF Downloads 3115109 Speciation, Preconcentration, and Determination of Iron(II) and (III) Using 1,10-Phenanthroline Immobilized on Alumina-Coated Magnetite Nanoparticles as a Solid Phase Extraction Sorbent in Pharmaceutical Products
Authors: Hossein Tavallali, Mohammad Ali Karimi, Gohar Deilamy-Rad
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The proposed method for speciation, preconcentration and determination of Fe(II) and Fe(III) in pharmaceutical products was developed using of alumina-coated magnetite nanoparticles (Fe3O4/Al2O3 NPs) as solid phase extraction (SPE) sorbent in magnetic mixed hemimicell solid phase extraction (MMHSPE) technique followed by flame atomic absorption spectrometry analysis. The procedure is based on complexation of Fe(II) with 1, 10-phenanthroline (OP) as complexing reagent for Fe(II) that immobilized on the modified Fe3O4/Al2O3 NPs. The extraction and concentration process for pharmaceutical sample was carried out in a single step by mixing the extraction solvent, magnetic adsorbents under ultrasonic action. Then, the adsorbents were isolated from the complicated matrix easily with an external magnetic field. Fe(III) ions determined after facility reduced to Fe(II) by added a proper reduction agent to sample solutions. Compared with traditional methods, the MMHSPE method simplified the operation procedure and reduced the analysis time. Various influencing parameters on the speciation and preconcentration of trace iron, such as pH, sample volume, amount of sorbent, type and concentration of eluent, were studied. Under the optimized operating conditions, the preconcentration factor of the modified nano magnetite for Fe(II) 167 sample was obtained. The detection limits and linear range of this method for iron were 1.0 and 9.0 - 175 ng.mL−1, respectively. Also the relative standard deviation for five replicate determinations of 30.00 ng.mL-1 Fe2+ was 2.3%.Keywords: Alumina-Coated magnetite nanoparticles, Magnetic Mixed Hemimicell Solid-Phase Extraction, Fe(ΙΙ) and Fe(ΙΙΙ), pharmaceutical sample
Procedia PDF Downloads 2925108 A Finite Element/Finite Volume Method for Dam-Break Flows over Deformable Beds
Authors: Alia Alghosoun, Ashraf Osman, Mohammed Seaid
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A coupled two-layer finite volume/finite element method was proposed for solving dam-break flow problem over deformable beds. The governing equations consist of the well-balanced two-layer shallow water equations for the water flow and a linear elastic model for the bed deformations. Deformations in the topography can be caused by a brutal localized force or simply by a class of sliding displacements on the bathymetry. This deformation in the bed is a source of perturbations, on the water surface generating water waves which propagate with different amplitudes and frequencies. Coupling conditions at the interface are also investigated in the current study and two mesh procedure is proposed for the transfer of information through the interface. In the present work a new procedure is implemented at the soil-water interface using the finite element and two-layer finite volume meshes with a conservative distribution of the forces at their intersections. The finite element method employs quadratic elements in an unstructured triangular mesh and the finite volume method uses the Rusanove to reconstruct the numerical fluxes. The numerical coupled method is highly efficient, accurate, well balanced, and it can handle complex geometries as well as rapidly varying flows. Numerical results are presented for several test examples of dam-break flows over deformable beds. Mesh convergence study is performed for both methods, the overall model provides new insight into the problems at minimal computational cost.Keywords: dam-break flows, deformable beds, finite element method, finite volume method, hybrid techniques, linear elasticity, shallow water equations
Procedia PDF Downloads 1815107 Water Desalination by Membrane Distillation with MFI Zeolite Membranes
Authors: Angelo Garofalo, Laura Donato, Maria Concetta Carnevale, Enrico Drioli, Omar Alharbi, Saad Aljlil, Alessandra Criscuoli, Catia Algieri
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Nowadays, water scarcity may be considered one of the most important and serious questions concerning our community: in fact, there is a remarkable mismatch between water supply and water demand. Exploitation of natural fresh water resources combined with higher water demand has led to an increased requirement for alternative water resources. In this context, desalination provides such an alternative source, offering water otherwise not accessible for irrigational, industrial and municipal use. Considering the various drawbacks of the polymeric membranes, zeolite membranes represent a potential device for water desalination owing to their high thermal and chemical stability. In this area wide attention was focused on the MFI (silicalite, ZSM-5) membranes, having a pore size lower (about 5.5 Å) than the major kinetic diameters of hydrated ions. In the present work, a scale-up for the preparation of supported silicalite membranes was performed. Therefore, tubular membranes 30 cm long were synthesized by using the secondary growth method coupled with the cross flow seeding procedure. The secondary growth presents two steps: seeding and growth of zeolite crystals on the support. This process, decoupling zeolite nucleation from crystals growth, permits to control the conditions of each step separately. The seeding procedure consists of a cross-flow filtration through a porous support coupled with the support rotation and tilting. The combination of these three different aspects allows a homogeneous and uniform coverage of the support with the zeolite seeds. After characterization by scanning electron microscope (SEM), X-ray diffractometry (XRD) and Energy-dispersive X-ray (EDX) analysis, the prepared membranes were tested by means of single gas permeation and then by Vacuum Membrane Distillation (VMD) using both deionized water and NaCl solutions. The experimental results evidenced the possibility to perform the scale up for the preparation of almost defect free silicalite membranes. VMD tests indicated the possibility to prepare membranes that exhibit interesting performance in terms of fluxes and salt rejections for concentrations from 0.2 M to 0.9 M. Furthermore, it was possible to restore the original performance of the membrane after an identified cleaning procedure. Acknowledgements: The authors gratefully acknowledge the support of the King Abdulaziz City for Science and Technology (KACST) for funding the research Project 895/33 entitled ‘Preparation and Characterization of Zeolite Membranes for Water Treatment’.Keywords: desalination, MFI membranes, secondary growth, vacuum membrane distillation
Procedia PDF Downloads 2555106 Study of Expatriation as Countermeasure to Citizenship-Based Taxation
Authors: Gabriele Palumbo
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This research empirically examines some of the reasons behind the fact that recently the number of people giving up their American citizenship for tax purposes has recently increased drastically. The United States Jurisdiction represents a unicum in the practice of taxing worldwide income not only to residents of the United States but also to U.S. citizens living abroad. The worldwide income taxation also affects people defined as “Accidental Americans” who are unaware that they are U.S. citizens. Those people are considered Americans even though they have not been to the United States. American residents abroad can rely on United States income tax treaties and some national law provisions, such as the exclusion of foreign income and foreign tax credits, which are designed specifically to avoid double taxation. However, this mechanism may prove unsatisfactory for people who have not been linked anymore or individuals who have never had relations with the United States. U.S. citizens who are determined to cut all of the ties between themselves and the United States, especially those that involve tax implications, can renounce their U.S. citizenship with the expatriation procedure. The expatriation process represents the extrema ratio and implicates several steps which must be followed carefully. This paper shows the complexity of the procedure that a U.S. citizen who is resident in a foreign country would have to follow to relinquish U.S. citizenship for tax purposes. The mechanism is intended to discourage people from renounce. Going beyond the question of whether U.S. tax regulation is fair or not, this principle nowadays characterizes a popular topic that many scholars and lawyers are discussing. The outcome provides interesting implications that could induce the Congress to rethink the definition of citizenship for both fiscal and nationality law purposes. Indeed, even if a sort of checks and balances has the task of mitigating the renunciation of U.S. citizenship, more and more U.S. citizens desire to get rid of their citizenship.Keywords: double taxation, expatriation tax, international taxation, relinquishment of United States citizenship
Procedia PDF Downloads 1125105 Childhood Apraxia of Speech and Autism: Interaction Influences and Treatment
Authors: Elad Vashdi
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It is common to find speech deficit among children diagnosed with Autism. It can be found in the clinical field and recently in research. One of the DSM-V criteria suggests a speech delay (Delay in, or total lack of, the development of spoken language), but doesn't explain the cause of it. A common perception among professionals and families is that the inability to talk results from the autism. Autism is a name for a syndrome which just describes a phenomenon and is defined behaviorally. Since it is not based yet on a physiological gold standard, one can not conclude the nature of a deficit based on the name of the syndrome. A wide retrospective research (n=270) which included children with motor speech difficulties was conducted in Israel. The study analyzed entry evaluations in a private clinic during the years 2006-2013. The data was extracted from the reports. High percentage of children diagnosed with Autism (60%) was found. This result demonstrates the high relationship between Autism and motor speech problem. It also supports recent findings in research of Childhood apraxia of speech (CAS) occurrence among children with ASD. Only small percentage of the participants in this research (10%) were diagnosed with CAS even though their verbal deficits well fitted the guidelines for CAS diagnosis set by ASHA in 2007. This fact raises questions regarding the diagnostic procedure in Israel. The understanding that CAS might highly exist within Autism and can have a remarkable influence on the course of early development should be a guiding tool within the diagnosis procedure. CAS can explain the nature of the speech problem among some of the autistic children and guide the treatment in a more accurate way. Calculating the prevalence of CAS which includes the comorbidity with ASD reveals new numbers and suggests treating differently the CAS population.Keywords: childhood apraxia of speech, Autism, treatment, speech
Procedia PDF Downloads 2755104 Memory Consolidation: Application of Retrieval Strategies in the Classroom
Authors: Eric Tardif, Nicolas Meylan
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Recent studies suggest that the consolidation of episodic memory is better achieved through repeated retrieval than with the use of concept mapping or repeated study. Although such laboratory results highly appeal to educationalists, it remains to be shown whether they can be directly used in a classroom setting. Forty-five college students (42 girls; mean age 16.1 y/o) were asked to remember pairs of biology-related words (e.g. mitochondria-energy) in two configurations. The first configuration consisted of a three-minute study of pairs of words followed by a final one-minute test in which the first word of a pair was shown and the subject asked to write down the second associated word. This procedure was repeated three times. The second configuration consisted of a one-minute study of a list of pairs of words, which was immediately followed by a one-minute test. This procedure was repeated 6 times. Subjects filled out a small questionnaire assessing their general mood, level of fatigue, stress and motivation to do the exercise. One week later, subjects were given a final test using the same words. A total of 8 lists of words were studied and tested during the semester. Results showed that subjects recalled more correct words when using the second configuration, both within the study period and one week later, confirming laboratory findings. However, the general performance (mean items recalled) as well as the motivation to do the exercise gradually decreased during the semester. Motivation was positively correlated with performance (r=0.77, p<0.05). The results suggest that laboratory findings may provide some applications in education but other variables inherent to the classroom setting must also be considered.Keywords: long-term, episodic memory, consolidation, retrieval, school setting
Procedia PDF Downloads 3395103 To Improve or Not to Improve Reflections from Jerash Urban Improvement Project, Jordan
Authors: Dina Dahood Dabash
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Palestine Refugee Camps have never been settings that can be overlooked; they even became (as physical settings) a cornerstone topic of negotiations whenever Palestinian matters are on the table (specifically in Jordan). Consequently, maintaining the familiar face of the camp with its dilapidated shelters and narrow streets that rarely allowed its residents to extinguish a fire or evacuate a building safely has become a fundamental method to protect the “right of the return” from the perspective of various stakeholders. When the Infrastructure and Camp Improvement Programme (ICIP) was established in 2007 as an additional UNRWA program, some concerns were raised around the newly established section, mainly due to its direct impact on the “image” of the camp through a provision of a relatively nonconventional service that differs from what the Agency used to provide in the past seventy years. By presenting the Urban Improvement Project in Jerash camp (UIP) -Jordan, this paper aims to contribute to the ongoing discussion around enduring the improvement of Palestine refugee camps “programmatically” in UNRWA or not. The UIP as a co-product by UNRWA and the camp’s community within one of the most vulnerable refugee camps in Jordan offers a remarkable opportunity to excerpt lessons that can contribute to the strategic shaping of the ICIP. The paper concludes with five mine uptakes mainly related to community engagement, power structures and UNRWA's role in camps.Keywords: camp improvement program, Jerash camp, Palestine refugee camps, UNRWA.
Procedia PDF Downloads 2065102 Essential Factors of Risk Perception Crucial in Efficient Construction Management
Authors: Francis Edum-Fotwe, Tony Thorpe, Charles Afetornu
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Risk perception informs the outcome of how issues are responded to in either solving or overcoming a problem or improving a situation. Risk perception is established to be affected by some key factors reflecting in the varying ways in which work is done as well as the level of efficiency achieved. These factors potentially would influence risk perception to different extents. Such that if these factors are said to determine risk perception, how does a change in any affect risk perception. Since the ability to address risk is influenced by risk perception, establishing and developing awareness of that perception should enable construction professionals to make viable decisions. Any act to improve the construction industry cannot be overemphasised, considering its contribution to national development. A survey questionnaire was conducted in Ghana to elicit data that measures the risk perception and the essential factors as well as the necessary demographics of the respondents, who are construction professionals. This study finds out the sensitivity of the critical factors of risk perception. It uses the Relative Importance Index analysis tool to investigate the differential effect of these essential factors on risk perception, such that a slight change in a factor makes a significant change in risk perception, having established that it is influenced by essential factors. The findings can lead to policy formation for employers on the prioritisation factors to undertake to improve the risk perception of employees. Other areas in which this study can be useful in team formation for sensitive and complex projects where efficient risk management is critical.Keywords: construction industry, risk, risk management, risk perception
Procedia PDF Downloads 1435101 An Analytical Approach of Computational Complexity for the Method of Multifluid Modelling
Authors: A. K. Borah, A. K. Singh
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In this paper we deal building blocks of the computer simulation of the multiphase flows. Whole simulation procedure can be viewed as two super procedures; The implementation of VOF method and the solution of Navier Stoke’s Equation. Moreover, a sequential code for a Navier Stoke’s solver has been studied.Keywords: Bi-conjugate gradient stabilized (Bi-CGSTAB), ILUT function, krylov subspace, multifluid flows preconditioner, simple algorithm
Procedia PDF Downloads 5285100 Inversion of the Spectral Analysis of Surface Waves Dispersion Curves through the Particle Swarm Optimization Algorithm
Authors: A. Cerrato Casado, C. Guigou, P. Jean
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In this investigation, the particle swarm optimization (PSO) algorithm is used to perform the inversion of the dispersion curves in the spectral analysis of surface waves (SASW) method. This inverse problem usually presents complicated solution spaces with many local minima that make difficult the convergence to the correct solution. PSO is a metaheuristic method that was originally designed to simulate social behavior but has demonstrated powerful capabilities to solve inverse problems with complex space solution and a high number of variables. The dispersion curve of the synthetic soils is constructed by the vertical flexibility coefficient method, which is especially convenient for soils where the stiffness does not increase gradually with depth. The reason is that these types of soil profiles are not normally dispersive since the dominant mode of Rayleigh waves is usually not coincident with the fundamental mode. Multiple synthetic soil profiles have been tested to show the characteristics of the convergence process and assess the accuracy of the final soil profile. In addition, the inversion procedure is applied to multiple real soils and the final profile compared with the available information. The combination of the vertical flexibility coefficient method to obtain the dispersion curve and the PSO algorithm to carry out the inversion process proves to be a robust procedure that is able to provide good solutions for complex soil profiles even with scarce prior information.Keywords: dispersion, inverse problem, particle swarm optimization, SASW, soil profile
Procedia PDF Downloads 1855099 An Interrogation of Lecturer’s Skills in Assisting Visually Impaired Students during the COVID-19 Lockdown Era in Selected Universities in Zimbabwe
Authors: Esther Mafunda
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The present study interrogated the lecturer’s skills in supporting visually impaired students during the Covid-19 era at the University of Zimbabwe. It particularly assesses how the Covid-19 pandemic affected the learning experience of visually impaired students and which skills the lecturers possessed in order to assist the visually impaired students during online learning. Data was collected from lecturers and visually impaired students at the University of Zimbabwe Disability Resource Centre. Data was collected through the use of interviews and questionnaires. Using content analysis, it was established that visually impaired students faced challenges of lack of familiarity with the Moodle learning platform, marginalization, lack of professional training, and lack of training for parents and guardians. Lecturers faced challenges of lack of training, the curriculum, access, and technical know-how deficit. It was established that lecturers had to resort to social media platforms in order to assist visually impaired students. Visually impaired students also received assistance from their friends and family members. On the basis of the results of the research, it can be concluded that lecturers needed in-service training to be provided with the necessary skills and knowledge to teach students with visual impairments and provide quality education to students with visual impairments.Keywords: visual impairment, disability, covid-19, inclusive learning
Procedia PDF Downloads 925098 Analyzing the Nutritional Challenges in Old People with Diabetes
Authors: Maedeh Gharazi
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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.Keywords: diabetes, nutritious necessities, insulin resistance, glucose control
Procedia PDF Downloads 3325097 Bilateral Retinitis in Q Fever
Authors: Carl Eiselen, Stephen O’Hagan
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Background: Q fever, caused by the obligate intracellular bacterium Coxiella burnetii, is an infectious disease with variable systemic manifestations. Its potential to cause ocular complications has not been reported before in Australia. This case study explores the unusual presentation of asymptomatic acute multifocal retinitis (AMR) in a patient with acute Q fever endocarditis and hepatitis in rural Queensland, Australia. Case Presentation: A 48-year-old male gardener presented with flu-like symptoms, weight loss, and encephalopathy. Despite systemic malaise, he had no ocular symptoms. Laboratory investigations confirmed acute Q fever, and imaging studies identified hepatic involvement and endocarditis. The retinal screening revealed asymptomatic AMR, corroborated by fundus examination and SD-OCT. Following treatment with Doxycycline and hydroxychloroquine, both systemic and ocular manifestations improved. Discussion: This is the first documented case of asymptomatic AMR associated with Q fever. The patient’s lack of autoantibodies challenges the established understanding of Q fever endocarditis and suggests potential alternative mechanisms. Conclusion: This case report expands our understanding of the multi-systemic impact of Q fever, highlighting the need for comprehensive clinical evaluation and including retinal screening in the setting of acute infection. The disease's underlying mechanism for ocular involvement is not yet established.Keywords: Coxiella Burnetti, Q fever, ocular manifestation, acute multifocal retintis, endocarditis
Procedia PDF Downloads 565096 3D-printing for Ablation Planning in Patients Undergoing Atrial Fibrillation Ablation: 3D-GALA Trial
Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos
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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing
Procedia PDF Downloads 1785095 Towards Binder-Free and Self Supporting Flexible Supercapacitor from Carbon Nano-Onions and Their Composite with CuO Nanoparticles
Authors: Debananda Mohapatra, Subramanya Badrayyana, Smrutiranjan Parida
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Recognizing the upcoming era of carbon nanostructures and their revolutionary applications, we investigated the formation and supercapacitor application of highly pure and hydrophilic carbon nano-onions (CNOs) by economical one-step flame-synthesis procedure. The facile and scalable method uses easily available organic carbon source such as clarified butter, restricting the use of any catalyst, sophisticated instrumentation, high vacuum and post processing purification procedure. The active material was conformally coated onto a locally available cotton wipe by “sonicating and drying” process to obtain novel, lightweight, inexpensive, flexible, binder-free electrodes with strong adhesion between nanoparticles and porous wipe. This interesting electrode with CNO as the active material delivers a specific capacitance of 102.16 F/g, the energy density of 14.18 Wh/kg and power density of 2448 W/kg which are the highest values reported so far in symmetrical two electrode cell configuration with 1M Na2SO4 as an electrolyte. Incorporation of CuO nanoparticles to these functionalized CNOs by one-step hydrothermal method add up to a significant specific capacitance of 420 F/g with deliverable energy and power density at 58.33 Wh/kg and 4228 W/kg, respectively. The free standing CNOs, as well as CNO-CuO composite electrode, showed an excellent cyclic performance and stability retaining 95 and 90% initial capacitance even after 5000 charge-discharge cycles at a current density of 5 A/g. This work presents a new platform for high performance supercapacitors for next generation wearable electronic devices.Keywords: binder-free, flame synthesis, flexible, carbon nano-onion
Procedia PDF Downloads 1975094 Water Resources Green Efficiency in China: Evaluation, Spatial Association Network Structure Analysis, and Influencing Factors
Authors: Tingyu Zhang
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This paper utilizes the Super-SBM model to assess water resources green efficiency (WRGE) among provinces in China and investigate its spatial and temporal features, based on the characteristic framework of “economy-environment-society.” The social network analysis is employed to examine the network pattern and spatial interaction of WRGE. Further, the quadratic assignment procedure method is utilized for examining the influencing factors of the spatial association of WRGE regarding “relationship.” The study reveals that: (1) the spatial distribution of WRGE demonstrates a distribution pattern of Eastern>Western>Central; (2) a remarkable spatial association exists among provinces; however, no strict hierarchical structure is observed. The internal structure of the WRGE network is characterized by the feature of "Eastern strong and Western weak". The block model analysis discovers that the members of the “net spillover” and “two-way spillover” blocks are mostly in the eastern and central provinces; “broker” block, which plays an intermediary role, is mostly in the central provinces; and members of the “net beneficiary” block are mostly in the western region. (3) Differences in economic development, degree of urbanization, water use environment, and water management have significant impacts on the spatial connection of WRGE. This study is dedicated to the realization of regional linkages and synergistic enhancement of WRGE, which provides a meaningful basis for building a harmonious society of human and water coexistence.Keywords: water resources green efficiency, super-SBM model, social network analysis, quadratic assignment procedure
Procedia PDF Downloads 615093 The Terminology of Mandatory Mediation on Commercial Disputes in Türkiye and the Differences from England and Wales’s Approaches
Authors: Sevgi Karaca
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Since December 6, 2018, mediation has become mandatory for commercial disputes under the Turkish Commercial Code. Mandatory mediation became one of the “causes of action”, and being compulsory means starting the mediation process before going to court. As it contemplates looking at “the causes of the action”, the terminology may lead to misinterpretation of the core of the phrases. However, the terms pertain to a prerequisite for starting the lawsuit. The court will examine failure to comply with such requirements, and the case will be dismissed without further action. Türkiye’s use of obligatory mediation is highly unusual. It is neither judge-led nor judge-assisted mediation but rather a mediation conducted outside of court with the participation of a third party (mediators). What distinguishes it is the incorporation of obligatory mediation into the causes of actions listed in the Code of Civil Procedure. Being one of the causes of action in a legal case implies that the absence of any of them may result in the procedural dismissal of the case without any further action. The case must be presented to the mediator first, and if the parties are unable to reach an agreement, they must deliver the results of the mediation session. Other than submitting the minutes, parties are ineligible to file a lawsuit. However, despite a lengthy history of use in England and Wales, there are considerable reservations about making mediation mandatory. The Civil Procedure Code does not explicitly mention making mediation mandatory. For the time being, there is no Mediation Code, and case law limits the growth of obligatory mediation. Some renowned judges voiced their desire to re-evaluate the notion of required mediation, prompting the Civil Justice Council to release a study in 2021 on the significance of amending case law and the high value of mandatory mediation. By contrasting the approaches to mandatory mediation in England and Wales, the study will investigate the method of controlled mandatory mediation and its effects on the success of mediation in Türkiye.Keywords: alternative dispute resolution, case law, cause of action, litigation process, mandatory mediation
Procedia PDF Downloads 785092 Public Environmental Investment Analysis of Japan
Authors: K. Y. Chen, H. Chua, C. W. Kan
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Japan is a well-developed country but the environmental issues are still a hot issue. In this study, we will analyse how the environmental investment affects the sustainable development in Japan. This paper will first describe the environmental policy of Japan and the effort input by the Japan government. Then, we will collect the yearly environmental data and also information about the environmental investment. Based on the data collected, we try to figure out the relationship between environmental investment and sustainable development in Japan. In addition, we will analyse the SWOT of environmental investment in Japan. Based on the economic information collected, Japan established a sound material-cycle society through changes in business and life styles. A comprehensive legal system for this kind of society was established in Japan. In addition, other supporting measures, such as financial measures, utilization of economic instruments, implementation of research and promotion of education and science and technology, help Japan to cope with the recent environmental challenges. Japan’s excellent environmental technologies changed its socioeconomic system. They are at the highest global standards. This can be reflected by the number of patents registered in Japan which has been on the steady growth. Country by country comparison in the application for patents on environmental technologies also indicates that Japan ranks high in such areas as atmospheric pollution and water quality management, solid waste management and renewable energy. This is a result of the large expenditure invested on research and development.Keywords: Japan, environmental investment, sustainable development, analysis
Procedia PDF Downloads 2685091 Investigation of Bubble Growth During Nucleate Boiling Using CFD
Authors: K. Jagannath, Akhilesh Kotian, S. S. Sharma, Achutha Kini U., P. R. Prabhu
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Boiling process is characterized by the rapid formation of vapour bubbles at the solid–liquid interface (nucleate boiling) with pre-existing vapour or gas pockets. Computational fluid dynamics (CFD) is an important tool to study bubble dynamics. In the present study, CFD simulation has been carried out to determine the bubble detachment diameter and its terminal velocity. Volume of fluid method is used to model the bubble and the surrounding by solving single set of momentum equations and tracking the volume fraction of each of the fluids throughout the domain. In the simulation, bubble is generated by allowing water-vapour to enter a cylinder filled with liquid water through an inlet at the bottom. After the bubble is fully formed, the bubble detaches from the surface and rises up during which the bubble accelerates due to the net balance between buoyancy force and viscous drag. Finally when these forces exactly balance each other, it attains a constant terminal velocity. The bubble detachment diameter and the terminal velocity of the bubble are captured by the monitor function provided in FLUENT. The detachment diameter and the terminal velocity obtained is compared with the established results based on the shape of the bubble. A good agreement is obtained between the results obtained from simulation and the equations in comparison with the established results.Keywords: bubble growth, computational fluid dynamics, detachment diameter, terminal velocity
Procedia PDF Downloads 3855090 Visual Outcome After 360-Degree Retinectomy in Total Rhegmatogenous Retinal Detachment with Advanced Proliferative Vitreoretinopathy: A Case Series
Authors: Andriati Nadhilah Widyarini, Ezra Margareth
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Introduction: Rhegmatogenous retinal detachment is a condition where there’s a break in the retina, which allows the vitreous to directly enter the subretinal space. Proliferative vitreoretinopathy (PVR) may develop due to this condition and can result in a new break, which could cause traction on the previously detached retina. Various methods of therapy can be done to treat this complication. Case: This case series involved 2 eyes of 2 patients who had total retinal detachment with advanced PVR. Pars plana vitrectomy was performed, and a 360-degree retinectomy procedure with perfluorocarbon liquid usage was done. This was followed by endo laser retinopexy to surround the border of retinectomy. 5000 cs silicone oil was used in 1 eye, whereas 12% of perfluoropropane gas was used in the other eye as a tamponade. These procedures were performed with meticulous attention to prevent any fluid from entering the subretinal space. Postoperative examination showed attachment of the retina and improvement of the patient’s visual acuity. Both eyes’ intraocular pressure was in the normal range. One eye developed retinal displacement, but no other complications occurred. Discussion: Rhegmatogenous retinal detachment with advanced PVR is a complex situation for vitreoretinal surgeons. PVR is characterized by the growth and migration of preretinal or subretinal membranes. PVR is the most common cause of retinal reattachment failure. A 360-degree retinectomy is an alternative surgical method to overcome this condition. Objectives of this procedure are releasing retinal traction caused by PVR, reducing the recurrence rate of PVR, and reattaching the retina to the pigment epithelial surface. Conclusion: 360-degree retinectomy provides satisfactory retinal reattachment and visual outcome improvement in rhegmatogenous retinal detachment with advanced PVR.Keywords: RRD, retinectomy, pars plana, advanced PVR
Procedia PDF Downloads 475089 Educational Institutional Approach for Livelihood Improvement and Sustainable Development
Authors: William Kerua
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The PNG University of Technology (Unitech) has mandatory access to teaching, research and extension education. Given such function, the Agriculture Department has established the ‘South Pacific Institute of Sustainable Agriculture and Rural Development (SPISARD)’ in 2004. SPISARD is established as a vehicle to improve farming systems practiced in selected villages by undertaking pluralistic extension method through ‘Educational Institutional Approach’. Unlike other models, SPISARD’s educational institutional approach stresses on improving the whole farming systems practiced in a holistic manner and has a two-fold focus. The first is to understand the farming communities and improve the productivity of the farming systems in a sustainable way to increase income, improve nutrition and food security as well as livelihood enhancement trainings. The second is to enrich the Department’s curriculum through teaching, research, extension and getting inputs from farming community. SPISARD has established number of model villages in various provinces in Papua New Guinea (PNG) and with many positive outcome and success stories. Adaption of ‘educational institutional approach’ thus binds research, extension and training into one package with the use of students and academic staff through model village establishment in delivering development and extension to communities. This centre (SPISARD) coordinates the activities of the model village programs and linkages. The key to the development of the farming systems is establishing and coordinating linkages, collaboration, and developing partnerships both within and external institutions, organizations and agencies. SPISARD has a six-point step strategy for the development of sustainable agriculture and rural development. These steps are (i) establish contact and identify model villages, (ii) development of model village resource centres for research and trainings, (iii) conduct baseline surveys to identify problems/needs of model villages, (iv) development of solution strategies, (v) implementation and (vi) evaluation of impact of solution programs. SPISARD envisages that the farming systems practiced being improved if the villages can be made the centre of SPISARD activities. Therefore, SPISARD has developed a model village approach to channel rural development. The model village when established become the conduit points where teaching, training, research, and technology transfer takes place. This approach is again different and unique to the existing ones, in that, the development process take place in the farmers’ environment with immediate ‘real time’ feedback mechanisms based on the farmers’ perspective and satisfaction. So far, we have developed 14 model villages and have conducted 75 trainings in 21 different areas/topics in 8 provinces to a total of 2,832 participants of both sex. The aim of these trainings is to directly participate with farmers in the pursuit to improving their farming systems to increase productivity, income and to secure food security and nutrition, thus to improve their livelihood.Keywords: development, educational institutional approach, livelihood improvement, sustainable agriculture
Procedia PDF Downloads 1545088 UCP1 Regulates Cardiolipin Metabolism and Mediates Mitochondrial Homeostasis Maintenance of ANXA1 in Diabetic Nephropathy
Authors: Zi-Han Li, Lu Fang, Liang Wu, Dong-Yuan Chang, Manyuan Dong, Liang Ji, Qi Zhang, Ming-Hui Zhao, Sydney C. W. Tang, Lemin Zheng, Min Chen
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Uncoupling of mitochondrial respiration by chemical uncouplers has proven effective in ameliorating obesity, insulin resistance, and hyperglycemia, which were risk factors for diabetic nephropathy (DN). Recently, we found that ANXA1 could improve mitochondrial function to mitigate DN progression. However, the underlying mechanism is not fully clear yet. Here, we identified uncoupling protein 1 (UCP1), an inner membrane protein of mitochondria, as a key to mitochondrial homeostasis improved by ANXA1. Specifically, ANXA1 attenuated mitochondrial dysfunction via appropriately upregulating UCP1 by stabilizing its transcription factor GATA binding protein 3 (GATA3) by combining it with thioredoxin. Moreover, specific overexpression of UCP1 in the renal cortex rescued renal injuries in diabetic Anxa1-KO mice. UCP1 deletion aggravated renal injuries in HFD/STZ-induced diabetic mice. Mechanistically, UCP1 reduced mitochondrial fission through the aristaless-related homeobox (ARX)/cardiolipin synthase 1 (CRLS1) pathway. Therapeutically, CL316243, a UCP1 agonist, could attenuate established DN in db/db mice. This work established an alternative principle to harness the power of uncouplers for the treatment of DN.Keywords: diabetic nephropathy, uncoupling protein 1, mitochondrial homeostasis, cardiolipin metabolism
Procedia PDF Downloads 755087 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control
Authors: Gorazd Karer
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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol
Procedia PDF Downloads 2175086 To Compare the Visual Outcome, Safety and Efficacy of Phacoemulsification and Small-Incision Cataract Surgery (SICS) at CEITC, Bangladesh
Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam
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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS
Procedia PDF Downloads 3485085 A Leadership Approach for the Sake of Organizations: Human-Oriented Leadership
Authors: Eser Bingül
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The leadership and leaders, also having been a privileged subject of scientific researches in the last century, have become influential in shaping the destiny of the states since the first examples of the warfare history. The issue of leadership, finding a place in the management science, can also be defined as an integration of function within the aspect of leader. In this description, the relationship has come to the foreground which is established between the development of leadership theories and the elements of function which are leader, followers, and condition. While one reason of this analysis in leadership is to keep a lens to the historical background, the main reason has been a questioning the traits and education of leaders who have still affected the nation’s and organization’s fate. The links and analysis established in the definition of leadership have put forward the necessity of solving the unpredictable structure of human nature and behaviors in the focus of leadership approach. On the other hand becoming a model that meets the today’s needs of any system has given a clue that the leaders should turn towards the people. Being aware of this necessity, human-oriented leadership approach aims to gain both followers and their abilities to the system with giving them a deserved esteem and create the team spirit based on mutual trust. Ultimately this approach, with the determined leadership qualities consisting of charisma, ability of communication and trust, will be able to produce the solutions to the instant and long-term problems and uncertainties, derived from the variables of function, for the sake of systems.Keywords: human nature, leadership, human-oriented approach, social sciences and humanities
Procedia PDF Downloads 319