Search results for: satisfaction of patients

Authors: Royia Soliman, Salma ElAnsary, Akram Amin Abdellatif, Florian Holzapfel

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Model-Based Safety Analysis (MBSA) is an approach in which the system and safety engineers share a common system model created using a model-based development process. The model can also be extended by the failure modes of the system components. There are two famous approaches for the addition of fault behaviors to system models. The first one is to enclose the failure into the system design directly. The second approach is to develop a fault model separately from the system model, thus combining both independent models for safety analysis. This paper introduces a hybrid approach of MBSA. The approach tries to use informal abstracted models to investigate failure behaviors. The approach will combine various concepts such as directed graph traversal, event lists and Constraint Satisfaction Problems (CSP). The approach is implemented using an Object Oriented programming language. The components are abstracted to its failure logic and relationships of connected components. The implemented approach is tested on various flight control systems, including electrical and multi-domain examples. The various tests are analyzed, and a comparison to different approaches is represented.

Keywords: flight control systems, model based safety analysis, safety assessment analysis, system modelling

Procedia PDF Downloads 164

Authors: Hassidou Saidou, Soulé Aminou

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As in many towns of African countries, the waste management, in particularly solid constitutes a major problem for the municipal authorities of Maradi. The aim of this study is to make a diagnosis of the present system of waste management in the town of Maradi. The approach was consisted to some interviews with the municipal authorities, cleaning up and health technicians and some housewives investigations. According to the health technicians of the town, the causes due to the problem of waste management in Maradi town are: collecting capacity insufficient, lack of effective sensitization of people, undeveloped and uncontrolled rubbish dumps, lack of gutter and its maintenance, and insufficient and unqualified human resources. As to the authorities, they denounce always the attitude and the behavior of citizens on the waste issue. The waste evacuation is doing by municipal collecting or by depositing in wild rubbish dump. Some people eliminate their waste by burning or duping in the streets or in their houses. According to our investigations, 52% of population evacuates their waste daily. The satisfaction rate of municipal collecting is for 32%. The analysis showed that the present system of waste management in Maradi town is failing. As solutions, we proposed to equip the technical offices with appropriated material and financial means, reinforce the involved actor’s capacities and making in application the operatives regulations for the waste management.

Keywords: maradi, municipal authorities, Niger Republic, solid waste management

Procedia PDF Downloads 369

Authors: Abrar Abuzaid, Maha Alaaeddine, Haya Alesayi

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This project is centered around understanding the usage and impact of Alexa, Amazon's popular virtual assistant, in everyday life. Alexa, known for its integration into devices like Amazon Echo, offers functionalities such as voice interaction, media control, providing real-time information, and managing smart home devices. Our primary focus is to conduct a straightforward survey aimed at uncovering how people use Alexa in their daily routines. We plan to reach out to a wide range of individuals to get a diverse perspective on how Alexa is being utilized for various tasks, the frequency and context of its use, and the overall user experience. The survey will explore the most common uses of Alexa, its impact on daily life, features that users find most beneficial, and improvements they are looking for. This project is not just about collecting data but also about understanding the real-world applications of a technology like Alexa and how it fits into different lifestyles. By examining the responses, we aim to gain a practical understanding of Alexa's role in homes and possibly in workplaces. This project will provide insights into user satisfaction and areas where Alexa could be enhanced to meet the evolving needs of its users. It’s a step towards connecting technology with everyday life, making it more accessible and user-friendly

Keywords: Amazon Alexa, artificial intelligence, smart speaker, natural language processing

Procedia PDF Downloads 63

Authors: Masoud Swalehe, Semra Günay

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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

Procedia PDF Downloads 261

Authors: Isomar Lima da Silva, Alcilene Batalha Pontes, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Context: Mechanical ventilators are medical devices that help provide oxygen and ventilation to patients with respiratory difficulties. This equipment consists of a manual breathing unit that can be operated by a doctor or nurse and a mechanical ventilator that controls the airflow and pressure in the patient's respiratory system. This type of ventilator is commonly used in emergencies and intensive care units where it is necessary to provide breathing support to critically ill or injured patients. Objective: In this context, this work aims to develop a reliable and low-cost mechanical ventilator to meet the demand of hospitals in treating people affected by Covid-19 and other severe respiratory diseases, offering a chance of treatment as an alternative to mechanical ventilators currently available in the market. Method: The project presents the development of a low-cost auxiliary ventilator with a controlled ventilatory system assisted by integrated hardware and firmware for respiratory cycle control in non-invasive mechanical ventilation treatments using a manual artificial respiration unit. The hardware includes pressure sensors capable of identifying positive expiratory pressure, peak inspiratory flow, and injected air volume. The embedded system controls the data sent by the sensors. It ensures efficient patient breathing through the operation of the sensors, microcontroller, and actuator, providing patient data information to the healthcare professional (system operator) through the graphical interface and enabling clinical parameter adjustments as needed. Results: The test data of the developed mechanical ventilator presented satisfactory results in terms of performance and reliability, showing that the equipment developed can be a viable alternative to commercial mechanical ventilators currently available, offering a low-cost solution to meet the increasing demand for respiratory support equipment.

Keywords: mechanical fans, breathing, medical equipment, COVID-19, intensive care units

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Authors: Fiona Soraya Addai-Sundiata, Ernest Yeboah Acheampong, Ralph Frimpong

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The rationale of this study is to examine the career experiences of elite female football coaches in Ghana. More importantly, it focus on their motives, the challenges of football coaching and their experiences along their career paths. The study draws from literature on female coaches in football to understand their experiences and reflections in their chosen careers. The findings of the study relied on in-depth semi-structured interviews with five elite female football coaches aged between 28 and 50 years. Participants’ responses reveal that both intrinsic and extrinsic motives drive them into football coaching, including learning experiences from abroad, a strong desire to break the gendered hegemony of coaching in Ghana, serving as role models, enjoyment, satisfaction and passion for their chosen careers. Results indicate that they encountered sociocultural, organisational, personal and interpersonal challenges. Also, they experience gender stereotyping, limited career mobility, sexism and marginalisation, which prevent them from becoming elite coaches. The study provides useful data for stakeholders, including Ghana Football Association (GFA), to use effective strategies (e.g., special incentives for women coaches) to attract and retain women in the football coaching space.

Keywords: elite female football coaches, career experiences, gender, motives, trajectories

Procedia PDF Downloads 69

Authors: Fiona Soraya Addai-Sundiata, Ernest Yeboah Acheampong, Ralph Frimpong

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The rationale of this study is to examine the career experiences of elite female football coaches in Ghana. More importantly, it focus on their motives, the challenges of football coaching and their experiences along their career paths. The study draws from literature on female coaches in football to understand their experiences and reflections in their chosen careers. The findings of the study relied on in-depth semi-structured interviews with five elite female football coaches aged between 28 and 50 years. Participants’ responses reveal that both intrinsic and extrinsic motives drive them into football coaching including learning experiences from abroad, a strong desire to break the gendered hegemony of coaching in Ghana, serving as role models, enjoyment, satisfaction and passion for their chosen careers. Results indicate that they encountered sociocultural, organisational, personal and interpersonal challenges. Also, they experience gender stereotyping, limited career mobility, sexism and marginalisation, which prevent them from becoming elite coaches. The study provides useful data for stakeholders including Ghana Football Association (GFA) to use effective strategies (e.g., special incentives for women coaches) to attract and retain women in the football coaching space.

Keywords: elite female football coaches, career experiences, gender, motives, trajectories

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Authors: Menelik Tilahun Alemu

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Customs administrations are now increasingly regarded as the key border agencies responsible for all transactions related to issues arising from the border crossings of goods and people. Raising revenue has traditionally been high on the agenda of governments, represented by the Ministry of Finance (MOF), because of the critical importance of import duties as a source of budget revenue for many developing countries. Most of these functions are undertaken in close cooperation with other national agencies. Due to the need to make structural reforms that consider the nature of business activities in the world and the needs of consumers, the institution was previously divided into the Ministry of Revenue and the Customs Commission. Accordingly, the Ministry of Revenue is primarily responsible for administering and collecting local taxes, while the Customs Commission is responsible for administering customs matters; It supports exports and collects revenue from it. The National Import and Export Trade Service System is working to make the world more transparent and standardized and adapt to the current situation by formulating various guidelines, rules and procedures to provide a clear, simple, predictable and accessible service to customers. As a result, the commission will be able to streamline the business process by enabling Paperless customer service to support the service delivery technology and eliminate the customer iteration without having to incur unnecessary costs and inconveniences.

Keywords: business, consumers, adapt, transparent

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Authors: A. Raj Kumar, S. Bilaloglu

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Stroke is a leading cause of adult disability worldwide. We depend on our hands for our activities of daily living(ADL). Although many patients regain the ability to walk, they continue to experience long-term hand motor impairments. As the number of individuals with young stroke is increasing, there is a critical need for effective approaches for rehabilitation of hand function post-stroke. Motor relearning for dexterity requires task-specific kinesthetic, tactile and visual feedback. However, when a stroke results in both sensory and motor impairment, it becomes difficult to ascertain when and what type of sensory substitutions can facilitate motor relearning. In an ideal situation, real-time task-specific data on the ability to learn and data-driven feedback to assist such learning will greatly assist rehabilitation for dexterity. We have found that kinesthetic and tactile information from the unaffected hand can assist patients re-learn the use of optimal fingertip forces during a grasp and lift task. Measurement of fingertip grip force (GF), load forces (LF), their corresponding rates (GFR and LFR), and other metrics can be used to gauge the impairment level and progress during learning. Currently ATI mini force-torque sensors are used in research settings to measure and compute the LF, GF, and their rates while grasping objects of different weights and textures. Use of the ATI sensor is cost prohibitive for deployment in clinical or at-home rehabilitation. A cost effective mechatronic device is developed to quantify GF, LF, and their rates for stroke rehabilitation purposes using off-the-shelf components such as load cells, flexi-force sensors, and an Arduino UNO microcontroller. A salient feature of the device is its integration with an interactive gaming environment to render a highly engaging user experience. This paper elaborates the integration of kinesthetic and tactile sensing through computation of LF, GF and their corresponding rates in real time, information processing, and interactive interfacing through augmented reality for visual feedback.

Keywords: feedback, gaming, kinesthetic, rehabilitation, tactile

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Authors: Ali Abdi Kordani, Meysam Rooyintan, Sid Mohammad Boroomandrad

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Nowadays, one the most important problems in megacities is public transportation and satisfying citizens from this system in order to decrease the traffic congestions and air pollution. Accordingly, to improve the transit passengers and increase the travel safety, new transportation systems such as Bus Rapid Transit (BRT), tram, and monorail have expanded that each one has different merits and demerits. That is why comparing different systems for a systematic selection of public transportation systems in a big city like Tehran, which has numerous problems in terms of traffic and pollution, is essential. In this paper, it is tried to investigate the advantages and feasibility of using monorail, tram and BRT systems, which are widely used in most of megacities in all over the world. In Tehran, by using SPSS statistical analysis software and TOPSIS method, these three modes are compared to each other and their results will be assessed. Experts, who are experienced in the transportation field, answer the prepared matrix questionnaire to select each public transportation mode (tram, monorail, and BRT). The results according to experts’ judgments represent that monorail has the first priority, Tram has the second one, and BRT has the third one according to the considered indices like execution costs, wasting time, depreciation, pollution, operation costs, travel time, passenger satisfaction, benefit to cost ratio and traffic congestion.

Keywords: BRT, costs, monorail, pollution, tram

Procedia PDF Downloads 177

Authors: Wong Ka Fai

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Introduction: Many students are worried before an examination; that is a common picture worldwide. Health problems from stress before examination were insomnia, tiredness, isolation, stomach upset, and anxiety. Nursing students experienced high stress from the examination. Guided imagery is a healing process of applying imagination to help the body heal, survive, or live well. It can bring about significant physiological and biochemical changes, which can trigger the recovery process. A study of nursing students improving their anxiety before examination with guided imagery was proposed. Aim: The aim of this study was to explore the outcome of guided imagery on nursing students’ anxiety before examination in Hong Kong. Method: The qualitative study method was used. 16 first-year students studying nursing programme were invited to practice guided imagery to improve their anxiety before the examination period. One week before the examination, the semi-structured interviews with these students were carried out by the researcher. Result: From the content analysis of interview data, these nursing students showed considerable similarities in their anxiety perception. Nursing students’ perceived improved anxiety was evidenced by a reduction of stressful feelings, improved physical health, satisfaction with daily activities, and enhanced skills for solving problems and upcoming situations. Conclusion: This study indicated that guided imagery can be used as an alternative measure to improve students’ anxiety and psychological problems.

Keywords: nursing students, perception, anxiety, guided imagery

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Authors: Buhari Samaila, Buhari Maidamma

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Background: The use of ionizing radiation in medical diagnostics and treatment is indispensable for accurate imaging and effective cancer therapies. However, radiation exposure carries inherent risks, necessitating strict protection measures to safeguard both patients and healthcare workers. This review critically examines the existing radiation protection measures in diagnostic radiology and radiotherapy, highlighting technological advancements, regulatory frameworks, and challenges. Objective: The objective of this review is to critically evaluate the effectiveness of current radiation protection measures in diagnostic and therapeutic radiology, focusing on minimizing patient and staff exposure to ionizing radiation while ensuring optimal clinical outcomes and propose future directions for improvement. Method: A comprehensive literature review was conducted, covering scientific studies, regulatory guidelines, and international standards on radiation protection in both diagnostic radiology and radiotherapy. Emphasis was placed on ALARA principles, dose optimization techniques, and protective measures for both patients and healthcare workers. Results: Radiation protection measures in diagnostic radiology include the use of shielding devices, minimizing exposure times, and employing advanced imaging technologies to reduce dose. In radiotherapy, accurate treatment planning and image-guided techniques enhance patient safety, while shielding and dose monitoring safeguard healthcare personnel. Challenges such as limited infrastructure in low-income settings and gaps in healthcare worker training persist, impacting the overall efficacy of protection strategies. Conclusion: While significant advancements have been made in radiation protection, challenges remain in optimizing safety, especially in resource-limited settings. Future efforts should focus on enhancing training, investing in advanced technologies, and strengthening regulatory compliance to ensure continuous improvement in radiation safety practices.

Keywords: radiation protection, diagnostic radiology, radiotherapy, ALARA, patient safety, healthcare worker safety

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Authors: Saima Saleem, Zubair Abbasi, Abdul Hameed, Mansoor Ahmed Khan, Navid Rashid Qureshi, Abid Azhar

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Oral Squamous Cell Carcinoma (OSCC) is the leading cause of death in the developing countries like Pakistan. This problem aggravates because of the excessive use of available chewing products. In spite of widespread information on their use and purported legislations against their use the Pakistani markets are classical examples of selling chewable carcinogenic mutagens. Reported studies indicated that these products are rich in reactive oxygen species (ROS) and polyphenols. TP53 gene is involved in the suppression of tumor. It has been reported that somatic mutations caused by TP53 gene are the foundation of the cancer. This study aims to find the loss of TP53 functions due to mutation/polymorphism caused by genomic alteration and interaction with tobacco and its related ingredients. Total 260 tissues and blood specimens were collected from OSCC patients and compared with age and sex matched controls. Mutations in exons 2-11 of TP53 were examined by PCR-SSCP. Samples showing mobility shift were directly sequenced. Two mutations were found in exon 4 at nucleotide position 108 and 215 and one in exon 7 at nucleotide position 719 of the coding sequences in patient’s tumor samples. These results show that substitution of proline with arginine at codon 72 and serine with threonine at codon 240 of p53 protein. These polymorphic changes, found in tumor samples of OSCC, could be involved in loss of heterozygocity and apoptotic activity in the binding domain of TP53. The model of the mutated TP53 gene elaborated a nonfunctional unfolded p53 protein, suggesting an important role of these mutations in p53 protein inactivation and malfunction. This nonfunctional 3D model also indicates that exogenous tobacco related carcinogens may act as DNA-damaging agents affecting the structure of DNA. The interpretations could be helpful in establishing the pathways responsible for tumor formation in OSCC patients.

Keywords: TP53 mutation/polymorphism, OSCC, PCR-SSCP, direct DNA sequencing, 3D structure

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Authors: Lara F. Horani, Shurong Tong

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Identification of customer requirements and their preferences are the starting points in the process of product design. Most of design methodologies focus on traditional requirements. But in the previous decade, the green products and the environment requirements have increasingly attracted the attention with the constant increase in the level of consumer awareness towards environmental problems (such as green-house effect, global warming, pollution and energy crisis, and waste management). Determining the importance weights for the customer requirements is an essential and crucial process. This paper used the analytic hierarchy process (AHP) approach to evaluate and rate the customer requirements for green products. With respect to the ultimate goal of customer satisfaction, surveys are conducted using a five-point scale analysis. With the help of this scale, one can derive the weight vectors. This approach can improve the imprecise ranking of customer requirements inherited from studies based on the conventional AHP. Furthermore, the AHP with extent analysis is simple and easy to implement to prioritize customer requirements. The research is based on collected data through a questionnaire survey conducted over a sample of 160 people belonging to different age, marital status, education and income groups in order to identify the customer preferences for green product requirements.

Keywords: analytic hierarchy process (AHP), green product, customer requirements for green design, importance weights for the customer requirements

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Authors: Francisco José Plácido da Cunha, Tassio Ferenzini Martins Sirqueira, Marx Leles Viana, Carlos José Pereira de Lucena

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Open Multiagent Systems (MASs) are societies in which heterogeneous and independently designed entities (agents) work towards similar, or different ends. Software agents are autonomous and the diversity of interests among different members living in the same society is a fact. In order to deal with this autonomy, these open systems use mechanisms of social control (norms) to ensure a desirable social order. This paper considers the following types of norms: (i) obligation — agents must accomplish a specific outcome; (ii) permission — agents may act in a particular way, and (iii) prohibition — agents must not act in a specific way. All of these characteristics mean to encourage the fulfillment of norms through rewards and to discourage norm violation by pointing out the punishments. Once the software agent decides that its priority is the satisfaction of its own desires and goals, each agent must evaluate the effects associated to the fulfillment of one or more norms before choosing which one should be fulfilled. The same applies when agents decide to violate a norm. This paper also introduces a framework for the development of MASs that provide support mechanisms to the agent’s decision-making, using norm-based reasoning. The applicability and validation of this approach is demonstrated applying a traffic intersection scenario.

Keywords: BDI agent, BDI4JADE framework, multiagent systems, normative agents

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Authors: Vinod Kumar

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Background: Tissue Plasminogen Activator (tPA) showed a level 1 benefit in acute stroke (within 3-6 hrs). Intracarotid sodium nitroprusside (ICSNP) has been studied in this context with a wide treatment window, fast recovery and affordability. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. a)Retrograde Neurotransmission (acute cases): 1)Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS) on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS) travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT) via retrograde neurotransmission (RNT). Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits > 10,000-fold higher affinity for NO than for oxygen (the 10,000-fold effect) and is completed in 20 msec. 2)Pathological conditions: normal synaptic activity, including both ANT and RNT, is absent. A NO donor (SNP) releases NO from NOS in the postsynaptic region. NO travels backward across a chemical synapse to bind to the heme of a NO receptor in the axon terminal of a presynaptic neuron, generating an impulse, as under normal conditions. b)Vasospasm: (acute cases) Perforators show vasospastic activity. NO vasodilates the perforators via the NO-cAMP pathway. c)Long-Term Potentıatıon (LTP): (chronic cases) The NO–cGMP-pathway plays a role in LTP at many synapses throughout the CNS and at the neuromuscular junction. LTP has been reviewed both generally and with respect to brain regions specific for memory/learning. Aims/Study Des’gn: The principles of “generation of impulses from the presynaptic region to the postsynaptic region by very potent RNT (10,000-fold effect)” and “vasodilation of arteriolar perforators” are the basis of the authors’ hypothesis to treat stroke cases. Case-control prospective study. Mater’als And Methods: The experimental population included 82 stroke patients (10 patients were given control treatments without superfusion or with 5% dextrose superfusion, and 72 patients comprised the ICSNP group). The mean time for superfusion was 9.5 days post-stroke. Pre- and post-ICSNP status was monitored by NIHSS, MRI and TCD. Results: After 90 seconds in the ICSNP group, the mean change in the NIHSS score was a decrease of 1.44 points, or 6.55%; after 2 h, there was a decrease of 1.16 points; after 24 h, there was an increase of 0.66 points, 2.25%, compared to the control-group increase of 0.7 points, or 3.53%; at 7 days, there was an 8.61-point decrease, 44.58%, compared to the control-group increase of 2.55 points, or 22.37%; at 2 months in ICSNP, there was a 6.94-points decrease, 62.80%, compared to the control-group decrease of 2.77 points, or 8.78%. TCD was documented and improvements were noted. Conclusions: ICSNP is a swift-acting drug in the treatment of stroke, acting within 90 seconds on day 9.5 post-stroke with a small decrease after 24 hours. The drug recovers from this decrease quickly.

Keywords: brain infarcts, intracarotid sodium nitroprusside, perforators, vasodilatıons, retrograde transmission, the 10, 000-fold effect

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Authors: Fernanda S. Oliveira

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The architectural science of lighting has been mainly concerned with technical aspects and has tended to ignore the psychophysical. There is a growing evidence that adopting passive design solutions may contribute to higher satisfaction. This is even more important in countries with higher solar radiation, which should take advantage of favourable daylighting conditions. However, in art museums, the same light that stimulates vision can also cause permanent damage to the exhibits. Not only the visitors want to see the objects, but also to understand their nature and the artist’s intentions. This paper examines the hypothesis that the more varied and exciting the lighting (and particularly the daylight) in museums rooms, over space and time, the more likely it is that visitors will stay longer, enjoy their experience and be willing to return. This question is not often considered in museums that privilege artificial lighting neglecting the various qualities of daylight other than its capacity to illuminate spaces. The findings of this paper show that daylight plays an important role in museum design, affecting how visitors perceive the exhibition space, as well as contributing to their overall enjoyment in the museum. Rooms with high luminance means were considered more pleasant (r=.311, p<.05) and cheerful (r=.349, p<.05). Lighting conditions also have a direct effect on the phenomenon of museum fatigue with the overall room quality showing an effect on how tired visitors reported to be (r=.421, p<.01). The control and distribution of daylight in museums can therefore contribute to create pleasant conditions for learning, entertainment and amusement, so that visitors are willing to return.

Keywords: daylight, comfort, museums, luminance, visitor

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Authors: A. Chtourou, K. Ben Youssef, M. Friel, T. Leicht

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These Place attributes and destination images associated with tourism destinations are often crucial important for tourist travel decisions and choice behavior. Understanding the interactions between them is fundamental for developing sustainable place brands. Despite their extensive use on an empirical ground, little research has been done in terms of analyzing the constructs that determine the sense of place in the marketing of cultural heritage sites and on how tourist experiences at such places influence tourist motivations to revisit destinations. By referring to the Italian city of Vicenza, internationally renowned for its gold jewelry production and for the Palladian architectures and buildings which have been recognized World Heritage by the UNESCO, the paper aims to identify how destination image, place familiarity and travel satisfaction influence tourists’ motivations to revisit Vicenza. After an introduction and literature review, the paper investigates the importance of the core constructs that determine the sense of place in the tourist practice. In accordance with previous research, the results provide evidence that favorable travel experiences influence revisit intentions positively. The managerial implications and recommendations for the city of Vicenza are discussed.

Keywords: consumer behavior, heritage tourism, sense of place, place branding, territorial marketing

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Authors: Eisha Vienna M. Fernandez, Cristan Q. Cabanilla, Hiyasmin Lim, John Donnie A. Ramos

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Allergy is a multifactorial disease affecting a significant proportion of the population. It is developed through the interaction of allergens and the presence of certain polymorphisms in various susceptibility genes. In this study, the correlation of the 105A/C single nucleotide polymorphism (SNP) of the IL-18 gene and house dust mite-specific IgE among Filipino allergic and non-allergic population was investigated. Atopic status was defined by serum total IgE concentration of ≥100 IU/mL, while house dust mite allergy was defined by specific IgE value ≥ +1SD of IgE of nonatopic participants. Two hundred twenty match-paired Filipino cases and controls aged 6-60 were the subjects of this investigation. The level of total IgE and Specific IgE were measured using Enzyme-Linked Immunosorbent Assay (ELISA) while Polymerase Chain Reaction – Restriction Fragment Length Polymorphism (PCR-RFLP) analysis was used in the SNP detection. Sensitization profiles of the allergic patients revealed that 97.3% were sensitized to Blomia tropicalis, 40.0% to Dermatophagoides farinae, and 29.1% to Dermatophagoides pteronyssinus. Multiple sensitization to HDMs was also observed among the 47.27% of the atopic participants. Any of the allergy classes of the atopic triad were exhibited by the cases (allergic asthma: 48.18%; allergic rhinitis: 62.73%; atopic dermatitis: 19.09%), and two or all of these atopic states are concurrently occurring in 26.36% of the cases. A greater proportion of the atopic participants with allergic asthma and allergic rhinitis were sensitized to D. farinae, and D. pteronyssinus, while more of those with atopic dermatitis were sensitized to D. pteronyssinus than D. farinae. Results show that there is overrepresentation of the allele “A” of the 105A/C IL-18 gene SNP in both cases and control groups of the population. The genotype that predominate the population is the heterozygous “AC”, followed by the homozygous wild “AA”, and the homozygous variant “CC” being the least. The study confirmed a positive association between serum specific IgE against B. tropicalis and D. pteronyssinus and the allele “C” (Bt P=0.021, Dp P=0.027) and “AC” (Bt P=0.003, Dp P=0.026) genotype. Findings also revealed that the genotypes “AA” (OR:1.217; 95% CI: 0.701-2.113) and “CC” (OR, 3.5; 95% CI: 0.727-16.849) increase the risk of developing allergy. This indicates that the 105A/C IL-18 gene SNP is a candidate genetic marker for HDM allergy among Filipino patients.

Keywords: house dust mite allergy, interleukin-18 (IL-18), single nucleotide polymorphism,

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Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

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We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

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Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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Authors: Diego Luján Villarreal

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Visual prostheses are designed to repair some eyesight in patients blinded by photoreceptor diseases, such as retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Electrode-to-cell proximity has drawn attention due to its implications on secure single-localized stimulation. Yet, few techniques are available for understanding the relationship between the number of cells activated and the current injection. We propose an answering technique by solving the governing equation for time-dependent electrical currents using finite element discretization to obtain the volume of stimulation.

Keywords: visual prosthetic devices, volume for stimulation, FEM discretization, 3D simulation

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Authors: Soodabeh Dehghan, Siavash Hamidzadeh, Naqshbandi Seyyed Salahedin, Ali Mohammad Safania

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The present research with the aim of the relationship between organizational silence and organizational voice with quality of work-life among employees of the sport and youth departments of Tehran Province was done. The statistical population of this research includes all employees of the sport and youth departments of Tehran province, and considering the not very large number of society, the sample and society were considered to be the same, and the sample was considered as the whole number. To measure each of these variables, a questionnaire was used. The research questionnaire was presented in four sections. The results showed that, since the extension of the process of organizational silence is usually done by managers, their attitude and attitudes toward this phenomenon are prioritized and also because silence reduces learning due to lack of knowledge sharing, makes it less effective and makes changes more difficult, it is necessary to take steps to break the silence and to further urge the staff (employees) to express their beliefs (organizational voices) and to share them in the organization's fate individuals, whose beliefs are respected and so called taken into account in the organization, would be dependent on the organization and feel obliged to remain with the organization during the hardships. This affects employees' quality of work life and their satisfaction too much.

Keywords: organizational silence, organizational voice, quality of work life, the sports and youth departments of Tehran province

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Authors: Paulo Sergio Altman Ferreira

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Relationship development plays an essential role in every logistics company. Logistics companies are service-based businesses essentially performing the flow of materials, housing, and inventory management for a wide range of customers. The service encounter between the logistics provider’s personnel and the customers may form a connection that will demonstrate a strong impact, not only to the customers' overall satisfaction but may also provide the perception of individualized services. Logistics services must drive value. It also shows a close influence on the quality and costs of client-centered services. If we describe logistics value creation as the function of quality perception of the client divided by service costs, there is a requirement to better outline and explain the measures and analytics for logistics costs and relationship performance. This critical shift to understand logistics services is a relevant contribution to capture how relationship value can be quantified. This might involve changing our current perspective on logistics providers beyond uniquely measuring the services in terms of activities, personnel levels, and financial/costs ratios. This paper argues that measuring value creation accomplishments of logistics services needs to consider the relational improvements for the wider range of logistics companies. Accurate logistics value requires a description of the financial impact of the relational perspective of the service.

Keywords: logistics services providers, financial metrics, relationship management, value creation

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Authors: Behcet Al, Mustafa Bogan, Mehmet Murat Oktay, Suat Zengin, Hasan Bayram

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Objective: In the last two decades there is a strong scientific interest regarding the role of aerosols for the Earth’s climate and associated changes. Aerosol particles are very important to the Earth-atmosphere climate system playing a crucial role in cloud and precipitation processes, air quality and climate. Here, we evaluated the association between saharran dust and emergency department admission, hospitalization, and mortality. Method: The records of admission to emergency department of Gaziantep University and the dust stroms of 31 months were studied. Patients admitted to ED at dust strom with chronic obstructive lung disease (COLD), asthma bronchiale (AB), serebrovascular events (SVE), acute myocardial infarction (AMI), stabile and unstabile angina pectoris (SAAP andUSAP); and the days with and without dust stroms were included. The study was realized from March 2010 to October 2012. The admission of three days before strom (group 1), during strom days (group 2) and three days after strom (group 3) were determined. The mean level of dust PM10 particulate was calculated, and the results were compared. Results: 5864 patients with chronic obstructive lung disease, asthma bronchiale, serebrovascular events, acute myocardial infarction, stabile and unstabile angyina pectoris admitted during the days with and without dust stroms. 28 dust stroms ocurred during 31 months. The totaliy of stroms continiued 78 days. Of admissions, 35.5% (n=2075) were in group1, 29.8% (n=1746) in group 2, and 34.8% (n=2043) were in group 3. The mean of PM10 for groups (group 1, 2 and 3) were 78.53 mg/m3 (range 19–276) particulate, 108.7 mg/m3 (range 34–631) particulate, and 60.9 mg/m3 (range 17–160) particulate respectively. The mean admission per a day for groups were 24.86, 22.55, and 24.50 respectively. The mortality was 12 in group 1, 12 in group 2, and 17 in grou 3. The hospitalization ratio for groups were 0.24, 0.27, and 0.27 respectively. Conclusion: However, the mean level of PM10 particulate for groups 2 (in dust strom days) is significantly higher (p=0.001) than the days before (group 1) and after (group 3) dust stroms, the mean admissions/day, hostilalization and mortality related to deseases (COLD, AB, SVE, AMI, SAAP andUSA) for group 2 is lower than the group 1 and group 3.

Keywords: Saharran dust, PM10 particulate, emergency department admission, mortality

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Authors: Joseph Berlin P. Juanzon, Manuel M. Muhi

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Motivating SME-based construction firms to adopt different management systems is not a simple task, especially if they are not aware of the benefits that they will gain from the new process-based management system. The implementation of ISO 9001:2008, Quality Management System in the construction industry is an ongoing trend, more so in the Small and Medium Enterprise. However, the level of awareness and readiness of the construction industry in the Philippines is still low as compared to the neighboring countries in Asia and in the western countries where ISO 9001:2008 originated. The purpose of this research is to determine the significant factors that will motivate SME-based construction firms in the Philippines to implement ISO 9001:2008. A field study was conducted on SME based construction firms in the Philippines, wherein a total of 139 respondents out of the 613 SME-based construction firms in CALABARZON areas were surveyed. Results reveal that the three main factors that will motivate SME-based construction firms to implement ISO 9001:2008 are: - if required by their clients, - to qualify for bidding, and - to increase customer satisfaction. Therefore, based on the results and findings, a certification of ISO 9001:2008 from an accredited auditor shall be required by clients as a constituent in accrediting SME-based construction firms and to qualify for bidding.

Keywords: construction, ISO 9001:2008, quality management systems (QMS), small medium enterprise (SME)

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Authors: Seyed Reza Alvani, Norzarina Mohd Zaharim

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Diabetes mellitus is one of the chronic, progressive illnesses that has reached a widespread level all over the world and considered an extreme life-threatening condition in South East Asian countries region include Malaysia. Co-morbid psychological factors like diabetes-related distress and low level of psychological well-being are related to high levels of blood sugar and hypo/hyperglycemia complications. As a result, the implementation of any effective psychological interventions among diabetes patients is necessary. One such intervention is cognitive behavioural therapy (CBT) that is approved and suggested by many professionals as an empirically-supported technique of treatment for people how are suffering from diabetes around the world where there is no clear evidence of using this technique in Malaysia. The target of this study was to see whether or not participation in group CBT would end in an improvement of psychological well-being (by decreasing the levels of depression and anxiety) and diabetes-related distress followed by lower level of blood sugar level. The sample of the present study was 60 type 2 diabetes adults (ages 20-65) with HbA1c ≥ 7 from Universiti Sains Malaysia (USM) clinic. All participants were selected by the convenience sampling technique. Participants completed Well-Being Questionaire (W-BQ) and Distress Scale (DDS-17) after signing written consent form. Those participants who were interested to join CBT groups were placed to the experimental groups, and people who were not interested were assigned to the control group. The experimental groups (n = 30) received group CBT, whereas participants in the control group (n = 30) did not receive any kind of psychological intervention. For testing the effect of intervention, mixed between-within ANOVA used. The entire intervention program took three months, and a significant improvement in the level of psychological well-being and decline in the level of diabetes distress observed among participants from experimental group, but not for those in the control group. Additionally, the result of the study suggested that group CBT could help participants in experimental group achieve more acceptable HbA1c levels in comparison with those in the control group. Malaysian Ministry of Health, researcher and governors should give due interest and commitment to psychological care as a pathway to diabetes mitigation among Malaysian adults.

Keywords: cognitive behavioral therapy, diabetes related distress, diabetes type 2, Malaysia, well-being

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Authors: Lama Ajinah

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Luxury brands witnessed continuous growth which followed women’s desire towards individual distinctiveness and social glare. Bags are a woman’s best friend either for aesthetic or functional purposes when she leaves her home for leisure or work. One way of women constant aspiration for being distinguished while reflecting their wealth is through handbags. Subsequently, the demand and attraction by consumers towards the dazzle of luxurious brands for personal pleasure and social status have flourished. According to the literature review, a visual analysis on luxury brands has been explored yet a focus on bags was not discussed in details. Hence, a deep analysis will be dedicated on the two segments by showcasing examples of high-end bag advertising. The research is conducted to understand advertising strategies used in promoting for luxurious products. Furthermore, the paper explores the definition of the term luxury, the condition in which it is used in, and the visual language used along with the term. As luxury is an indicator of superior satisfaction, it is obtained on two levels: a personal and a social level. The examples of luxury brand ads are selected from the last five years to uncover the latest, most common strategies used to promote for luxurious brands. The methods employed in this paper consist of literature review, semiotic analysis, and content analysis. The researcher concludes with revealing the methods used in advertising while categorizing them into various themes.

Keywords: advertising, brands, fashion, graphic design, luxury, semiotic analysis, semiology, visual analysis, visual communication

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Authors: Chalermpol Tapsai

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The objectives of this research were to develop and find the efficiency of integrated online lessons by investigating the usage of online lessons, the relationship between learners’ background knowledge, and the achievement after learning with online lessons. The sample group in this study consisted of 97 students randomly selected from 121 students registering in 1/2012 at Trimitwittayaram Learning Center. The sample technique employed stratified sample technique of 4 groups according to their proficiency, i.e. high, moderate, low, and non-knowledge. The research instrument included online lessons in integration model on the topic of Java Programming, test after each lesson, the achievement test at the end of the course, and the questionnaires to find learners’ satisfaction. The results showed that the efficiency of online lessons was 90.20/89.18 with the achievement of after learning with the lessons higher than that before the lessons at the statistically significant level of 0.05. Moreover, the background knowledge of the learners on the programming showed the positive relationship with the achievement learning at the statistically significant level at 0.05. Learners with high background knowledge employed less exercises and samples than those with lower background knowledge. While learners with different background in the group of moderate and low did not show the significant difference in employing samples and exercises.

Keywords: integration model, online lessons, learners’ background knowledge, efficiency

Procedia PDF Downloads 359