Search results for: optimal distance

Authors: Antonio Boggia, Luisa Paolotti, Gianluca Massei, Lucia Rocchi, Elaine Pace, Maria Attard

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The aim of this paper is to present a methodology and a computer model for sustainability assessment based on the integration of Multi-criteria Decision Analysis (MCDA) with a Geographic Information System (GIS). It presents the result of a study for the implementation of a model for measuring sustainability to address the policy actions for the improvement of sustainability at territory level. The aim is to rank areas in order to understand the specific technical and/or financial support that is required to develop sustainable growth. Assessing sustainable development is a multidimensional problem: economic, social and environmental aspects have to be taken into account at the same time. The tool for a multidimensional representation is a proper set of indicators. The set of indicators must be integrated into a model, that is an assessment methodology, to be used for measuring sustainability. The model, developed by the Environmental Laboratory of the University of Perugia, is called GeoUmbriaSUIT. It is a calculation procedure developed as a plugin working in the open-source GIS software QuantumGIS. The multi-criteria method used within GeoUmbriaSUIT is the algorithm TOPSIS (Technique for Order Preference by Similarity to Ideal Design), which defines a ranking based on the distance from the worst point and the closeness to an ideal point, for each of the criteria used. For the sustainability assessment procedure, GeoUmbriaSUIT uses a geographic vector file where the graphic data represent the study area and the single evaluation units within it (the alternatives, e.g. the regions of a country, or the municipalities of a region), while the alphanumeric data (attribute table), describe the environmental, economic and social aspects related to the evaluation units by means of a set of indicators (criteria). The use of the algorithm available in the plugin allows to treat individually the indicators representing the three dimensions of sustainability, and to compute three different indices: environmental index, economic index and social index. The graphic output of the model allows for an integrated assessment of the three dimensions, avoiding aggregation. The presence of separate indices and graphic output make GeoUmbriaSUIT a readable and transparent tool, since it doesn’t produce an aggregate index of sustainability as final result of the calculations, which is often cryptic and difficult to interpret. In addition, it is possible to develop a “back analysis”, able to explain the positions obtained by the alternatives in the ranking, based on the criteria used. The case study presented is an assessment of the level of sustainability in the six regions of Malta, an island state in the middle of the Mediterranean Sea and the southernmost member of the European Union. The results show that the integration of MCDA-GIS is an adequate approach for sustainability assessment. In particular, the implemented model is able to provide easy to understand results. This is a very important condition for a sound decision support tool, since most of the time decision makers are not experts and need understandable output. In addition, the evaluation path is traceable and transparent.

Keywords: GIS, multi-criteria analysis, sustainability assessment, sustainable development

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Authors: Zhenyu Zhang, Hsi-Hsien Wei

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Highway networks play a vital role in post-disaster recovery for disaster-damaged areas. Damaged bridges in such networks can disrupt the recovery activities by impeding the transportation of people, cargo, and reconstruction resources. Therefore, rapid restoration of damaged bridges is of paramount importance to long-term disaster recovery. In the post-disaster recovery phase, the key to restoration scheduling for a highway network is prioritization of bridge-repair tasks. Resilience is widely used as a measure of the ability to recover with which a network can return to its pre-disaster level of functionality. In practice, highways will be temporarily blocked during the downtime of bridge restoration, leading to the decrease of highway-network functionality. The failure to take downtime effects into account can lead to overestimation of network resilience. Additionally, post-disaster recovery of highway networks is generally divided into emergency bridge repair (EBR) in the response phase and long-term bridge repair (LBR) in the recovery phase, and both of EBR and LBR are different in terms of restoration objectives, restoration duration, budget, etc. Distinguish these two phases are important to precisely quantify highway network resilience and generate suitable restoration schedules for highway networks in the recovery phase. To address the above issues, this study proposes a novel resilience quantification method for the optimization of long-term bridge repair schedules (LBRS) taking into account the impact of EBR activities and restoration downtime on a highway network’s functionality. A time-dependent integer program with recursive functions is formulated for optimally scheduling LBR activities. Moreover, since uncertainty always exists in the LBRS problem, this paper extends the optimization model from the deterministic case to the stochastic case. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. The proposed methods are tested using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that, in this case, neglecting the bridge restoration downtime can lead to approximately 15% overestimation of highway network resilience. Moreover, accounting for the impact of EBR on network functionality can help to generate a more specific and reasonable LBRS. The theoretical and practical values are as follows. First, the proposed network recovery curve contributes to comprehensive quantification of highway network resilience by accounting for the impact of both restoration downtime and EBR activities on the recovery curves. Moreover, this study can improve the highway network resilience from the organizational dimension by providing bridge managers with optimal LBR strategies.

Keywords: disaster management, highway network, long-term bridge repair schedule, resilience, restoration downtime

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Authors: Tamam Albelwi, Robert Rogers, Hans-Peter Kubis

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Background: Exercise is widely acknowledged as a highly important health behavior, which reduces risks related to lifestyle diseases like type 2 diabetes, cardiovascular disease. However, exercise adherence is low in high-risk groups and sedentary lifestyle is more the norm than the exception. Expressed reasons for exercise participation are often based on delayed outcomes related to health threats and benefits but also enjoyment. Whether exercise is perceived as rewarding is well established in animal literature but the evidence is sparse in humans. Additionally, the question how stable any reward is perceived with time delays is an important question influencing decision-making (in favor or against a behavior). For the modality exercise, this has not been examined before. We, therefore, investigated the discounting of pre-established self-selected exercise compared with established rewards of food and money with a computer-based discounting paradigm. We hypothesized that exercise will be discounted like an established reward (food and money); however, we expect that the discounting rate is similar to a consumable reward like food. Additionally, we expected that individuals’ characteristics like preferred intensity, physical activity and body characteristics are associated with discount rates. Methods: 71 participants took part in four sessions. The sessions were designed to let participants select their preferred exercise intensity on a treadmill. Participants were asked to adjust their speed for optimizing pleasantness over an exercise period of up to 30 minutes, heart rate and pleasantness rating was measured. In further sessions, the established exercise intensity was modified and tested on perceptual validity. In the last exercise session rates of perceived exertion was measured on the preferred intensity level. Furthermore, participants filled in questionnaires related to physical activity, mood, craving, and impulsivity and answered choice questions on a bespoke computer task to establish discounting rates of their preferred exercise (kex), their favorite food (kfood) and a value-matching amount of money (kmoney). Results: Participants self-selected preferred speed was 5.5±2.24 km/h, at a heart rate of 120.7±23.5, and perceived exertion scale of 10.13±2.06. This shows that participants preferred a light exercise intensity with low to moderate cardiovascular strain based on perceived pleasantness. Computer assessment of discounting rates revealed that exercise was quickly discounted like a consumable reward, no significant difference between kfood and kex (kfood =0.322±0.263; kex=0.223±0.203). However, kmoney (kmoney=0.080±0.02) was significantly lower than the rates of exercise and food. Moreover, significant associations were found between preferred speed and kex (r=-0.302) and between physical activity levels and preferred speed (r=0.324). Outcomes show that participants perceived and discounted self-selected exercise like an established reward (food and money) but was discounted more like consumable rewards. Moreover, exercise discounting was quicker in individuals who preferred lower speeds, being less physically active. This may show that in a choice conflict between exercise and food the delay of exercise (because of distance) might disadvantage exercise as the chosen behavior particular in sedentary people. Conclusion: exercise can be perceived as a reward and is discounted quickly in time like food. Pleasant exercise experience is connected to low to moderate cardiovascular and perceptual strain.

Keywords: delay discounting, exercise, temporal discounting, time perspective

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Authors: Małgorzata Golonka, Jadwiga Laska

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Self-healing polymers are one of the most investigated groups of smart materials. As materials engineering has recently focused on the design, production and research of modern materials and future technologies, researchers are looking for innovations in structural, construction and coating materials. Based on available scientific articles, it can be concluded that most of the research focuses on the self-healing of cement, concrete, asphalt and anticorrosion resin coatings. In our study, a method of obtaining and testing the properties of several types of microcapsules for use in self-healing polymer materials was developed. A method to obtain microcapsules exhibiting various mechanical properties, especially compressive strength was developed. The effect was achieved by using various polymer materials to build the shell: urea-formaldehyde resin (UFR), melamine-formaldehyde resin (MFR), melamine-urea-formaldehyde resin (MUFR). Dicyclopentadiene (DCPD) was used as the core material due to the possibility of its polymerization according to the ring-opening olefin metathesis (ROMP) mechanism in the presence of a solid Grubbs catalyst showing relatively high chemical and thermal stability. The ROMP of dicyclopentadiene leads to a polymer with high impact strength, high thermal resistance, good adhesion to other materials and good chemical and environmental resistance, so it is potentially a very promising candidate for the self-healing of materials. The capsules were obtained by condensation polymerization of formaldehyde with urea, melamine or copolymerization with urea and melamine in situ in water dispersion, with different molar ratios of formaldehyde, urea and melamine. The fineness of the organic phase dispersed in water, and consequently the size of the microcapsules, was regulated by the stirring speed. In all cases, to establish such synthesis conditions as to obtain capsules with appropriate mechanical strength. The microcapsules were characterized by determining the diameters and their distribution and measuring the shell thickness using digital optical microscopy and scanning electron microscopy, as well as confirming the presence of the active substance in the core by FTIR and SEM. Compression tests were performed to determine mechanical strength of the microcapsules. The highest repeatability of microcapsule properties was obtained for UFR resin, while the MFR resin had the best mechanical properties. The encapsulation efficiency of MFR was much lower compared to UFR, though. Therefore, capsules with a MUFR shell may be the optimal solution. The chemical reaction between the active substance present in the capsule core and the catalyst placed outside the capsules was confirmed by FTIR spectroscopy. The obtained autonomous repair systems (microcapsules + catalyst) were introduced into polyethylene in the extrusion process and tested for the self-repair of the material.

Keywords: autonomic self-healing system, dicyclopentadiene, melamine-urea-formaldehyde resin, microcapsules, thermoplastic materials

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Authors: Biao Sun, Tejas Bhatelia, Vishnu Pareek, Ranjeet Utikar, Moses Tadé

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Additive manufacturing (AM), commonly known as 3D printing, with the continuing advances in parallel processing and computational modeling, has created a paradigm shift (with significant radical thinking) in the design and operation of chemical processing plants, especially LNG plants. With the rising energy demands, environmental pressures, and economic challenges, there is a continuing industrial need for disruptive technologies such as AM, which possess capabilities that can drastically reduce the cost of manufacturing and operations of chemical processing plants in the future. However, the continuing challenge for 3D printing is its lack of adaptability in re-designing the process plant equipment coupled with the non-existent theory or models that could assist in selecting the optimal candidates out of the countless potential fabrications that are possible using AM. One of the most common packings used in the LNG process is structured packing in the packed column (which is a unit operation) in the process. In this work, we present an example of an optimum strategy for the application of AM to this important unit operation. Packed columns use a packing material through which the gas phase passes and comes into contact with the liquid phase flowing over the packing, typically performing the necessary mass transfer to enrich the products, etc. Structured packing consists of stacks of corrugated sheets, typically inclined between 40-70° from the plane. Computational Fluid Dynamics (CFD) was used to test and model various geometries to study the governing hydrodynamic characteristics. The results demonstrate that the costly iterative experimental process can be minimized. Furthermore, they also improve the understanding of the fundamental physics of the system at the multiscale level. SpiroPak, patented by Curtin University, represents an innovative structured packing solution currently at a technology readiness level (TRL) of 5~6. This packing exhibits remarkable characteristics, offering a substantial increase in surface area while significantly enhancing hydrodynamic and mass transfer performance. Recent studies have revealed that SpiroPak can reduce pressure drop by 50~70% compared to commonly used commercial packings, and it can achieve 20~50% greater mass transfer efficiency (particularly in CO2 absorption applications). The implementation of SpiroPak has the potential to reduce the overall size of columns and decrease power consumption, resulting in cost savings for both capital expenditure (CAPEX) and operational expenditure (OPEX) when applied to retrofitting existing systems or incorporated into new processes. Furthermore, pilot to large-scale tests is currently underway to further advance and refine this technology.

Keywords: Additive Manufacturing (AM), 3D printing, Computational Fluid Dynamics (CFD, structured packing (SpiroPak)

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Authors: Gerald Gwamba

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Formation and oil well sand production is one of the greatest and oldest concerns for the Oil and gas industry. The production of sand particles may vary from very small and limited amounts to far elevated levels which has the potential to block or plug the pore spaces near the perforated points to blocking production from surface facilities. Therefore, the timely and reliable investigation of conditions leading to the onset or quantifying sanding while producing is imperative. The challenges of sand production are even more elevated while producing in Waxy and Heavy wells with Clay Fine sands (WHFC). Existing research argues that both waxy and heavy hydrocarbons exhibit far differing characteristics with waxy more paraffinic while heavy crude oils exhibit more asphaltenic properties. Moreover, the combined effect of WHFC conditions presents more complexity in production as opposed to individual effects that could be attributed to a consolidation of a surmountable opposing force. However, research on a combined high WHFC system could depict a better representation of the surmountable effect which in essence is more comparable to field conditions where a one-sided view of either individual effects on sanding has been argued to some extent misrepresentative of actual field conditions since all factors act surmountably. In recognition of the limited customized research on sand production studies with the combined effect of WHFC however, our research seeks to apply the Design of Experiments (DOE) methodology based on latest literature to analyze the relationship between various interparticle factors in relation to selected sand control methods. Our research aims to unearth a better understanding of how the combined effect of interparticle factors including: strength, cementation, particle size and production rate among others could better assist in the design of an optimal sand control system for the WHFC well conditions. In this regard, we seek to answer the following research question: How does the combined effect of interparticle factors affect the optimization of sand control systems for WHFC wells? Results from experimental data collection will inform a better justification for a sand control design for WHFC. In doing so, we hope to contribute to earlier contrasts arguing that sand production could potentially enable well self-permeability enhancement caused by the establishment of new flow channels created by loosening and detachment of sand grains. We hope that our research will contribute to future sand control designs capable of adapting to flexible production adjustments in controlled sand management. This paper presents results which are part of an ongoing research towards the authors' PhD project in the optimization of sand control systems for WHFC wells.

Keywords: waxy-heavy oils, clay-fine sands, sand control optimization, interparticle factors, design of experiments

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Authors: Bai-Chen Xie, Xian-Peng Chen

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China has become the world's largest energy producer and consumer, and its development of renewable energy is of great significance to global energy governance and the fight against climate change. The rapid growth of solar power in China could help achieve its ambitious carbon peak and carbon neutrality targets early. However, the non-technical costs of solar power in China are much higher than at international levels, meaning that inefficiencies are rooted in poor management and improper policy design and that efficiency distortions have become a serious challenge to the sustainable development of the renewable energy industry. Unlike fossil energy generation technologies, the output of solar power is closely related to the volatile solar resource, and the spatial unevenness of solar resource distribution leads to potential efficiency spatial distribution differences. It is necessary to develop an efficiency evaluation method that considers the volatility of solar resources and explores the mechanism of the influence of natural geography and social environment on the spatially varying characteristics of efficiency distribution to uncover the root causes of managing inefficiencies. The study sets solar resources as stochastic inputs, introduces a chance-constrained data envelopment analysis model combined with the directional distance function, and measures the solar resource utilization efficiency of 222 solar power plants in representative photovoltaic bases in northwestern China. By the meta-frontier analysis, we measured the characteristics of different power plant clusters and compared the differences among groups, discussed the mechanism of environmental factors influencing inefficiencies, and performed statistical tests through the system generalized method of moments. Rational localization of power plants is a systematic project that requires careful consideration of the full utilization of solar resources, low transmission costs, and power consumption guarantee. Suitable temperature, precipitation, and wind speed can improve the working performance of photovoltaic modules, reasonable terrain inclination can reduce land cost, and the proximity to cities strongly guarantees the consumption of electricity. The density of electricity demand and high-tech industries is more important than resource abundance because they trigger the clustering of power plants to result in a good demonstration and competitive effect. To ensure renewable energy consumption, increased support for rural grids and encouraging direct trading between generators and neighboring users will provide solutions. The study will provide proposals for improving the full life-cycle operational activities of solar power plants in China to reduce high non-technical costs and improve competitiveness against fossil energy sources.

Keywords: solar power plants, environmental factors, data envelopment analysis, efficiency evaluation

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Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

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early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

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Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million inhabitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely cover the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed an effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, north gaza

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Authors: María Cárdenas Gaudry, Gonzalo Ramces Fano Miranda

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Sediment removal is very important in the purification of water, not only for reasons of visual perception but also because of its association with odor and taste problems. The Cuchoquesera reservoir, which is in the Andean region of Ayacucho (Peru) at an altitude of 3,740 meters above sea level, visually presents suspended particles and organic impurities indicating that it contains water of dubious quality to deduce that it is suitable for direct consumption of human beings. In order to quantitatively know the degree of impurities, water quality monitoring was carried out from February to August 2018, in which four sampling stations were established in the reservoir. The selected measured parameters were electrical conductivity, total dissolved solids, pH, color, turbidity, and sludge volume. The indicators of the studied parameters exceed the permissible limits except for electrical conductivity (190 μS/cm) and total dissolved solids (255 mg/L). In this investigation, the best combination and the optimal doses of reagents were determined that allowed the removal of sediments from the waters of the Cuchoquesera reservoir, through the physicochemical process of coagulation-flocculation. In order to improve this process during the rainy season, six combinations of reagents were evaluated, made up of three coagulants (ferric chloride, ferrous sulfate, and aluminum sulfate) and two natural flocculants: prickly pear powder (Opuntia ficus-indica) and tara gum (Caesalpinia spinoza). For each combination of reagents, jar tests were developed following the central composite experimental design (CCED), where the design factors were the doses of coagulant and flocculant and the initial turbidity. The results of the jar tests were adjusted to mathematical models, obtaining that to treat the water from the Cuchoquesera reservoir, with a turbidity of 150 UTN and a color of 137 U Pt-Co, 27.9 mg/L of the coagulant aluminum sulfate with 3 mg/L of the natural tara gum flocculant to produce a purified water quality of 1.7 UTN of turbidity and 3.2 U Pt-Co of apparent color. The estimated cost of the dose of coagulant and flocculant found was 0.22 USD/m³. This is how “grey-green” technologies can be used as a combination in nature-based solutions in water treatment, in this case, to achieve potability, making it more sustainable, especially economically, if green technology is available at the site of application of the nature-based hybrid solution. This research is a demonstration of the compatibility of natural coagulants/flocculants with other treatment technologies in the integrated/hybrid treatment process, such as the possibility of hybridizing natural coagulants with other types of coagulants.

Keywords: prickly pear powder, tara gum, nature-based solutions, aluminum sulfate, jar test, turbidity, coagulation, flocculation

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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Authors: Ilija Kelepurovski, Stefan Lazorovski, Pece Petkovski, Marian Anakievski, Svetlana Petkovska

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition that affects men over the age of 50 and is characterized by an enlarged prostate gland that can cause lower urinary tract symptoms (LUTS). Uroflowmetry and cystoscopy are two commonly used diagnostic tests to evaluate LUTS and diagnose BPH. While both tests can be useful, there is a risk of overusing cystoscopy and underusing uroflowmetry in the evaluation of LUTS. The aim of this study was to compare the use of uroflowmetry and cystoscopy in a prospective cohort of 100 patients with suspected BPH or other urinary tract conditions and to assess the diagnostic yield of each test. Materials and Methods: This was a prospective study of 100 male patients over the age of 50 with suspected BPH or other urinary tract conditions who underwent uroflowmetry and cystoscopy for the evaluation of LUTS at a single tertiary care center. Inclusion criteria included male patients over the age of 50 with suspected BPH or other urinary tract conditions, while exclusion criteria included previous urethral or bladder surgery, active urinary tract infection, and significant comorbidities. The primary outcome of the study was the frequency of cystoscopy in the evaluation of LUTS, and the secondary outcome was the diagnostic yield of each test. Results: Of the 100 patients included in the study, 86 (86%) were diagnosed with BPH and 14 (14%) had other urinary tract conditions. The mean age of the study population was 67 years. Uroflowmetry was performed on all 100 patients, while cystoscopy was performed on 70 (70%) of the patients. The diagnostic yield of uroflowmetry was high, with a clear diagnosis made in 92 (92%) of the patients. The diagnostic yield of cystoscopy was also high, with a clear diagnosis made in 63 (90%) of the patients who underwent the procedure. There was no statistically significant difference in the diagnostic yield of uroflowmetry and cystoscopy (p = 0.20). Discussion: Our study found that uroflowmetry is an effective and well-tolerated diagnostic tool for evaluating LUTS and diagnosing BPH, with a high diagnostic yield and low risk of complications. Cystoscopy is also a useful diagnostic tool, but it is more invasive and carries a small risk of complications such as bleeding or urinary tract infection. Both tests had a high diagnostic yield, suggesting that either test can provide useful information in the evaluation of LUTS. However, the fact that 70% of the study population underwent cystoscopy raises concerns about the potential overuse of this test in the evaluation of LUTS. This is especially relevant given the focus on patient-centered care and the need to minimize unnecessary or invasive procedures. Our findings underscore the importance of considering the clinical context and using evidence-based guidelines. Conclusion: In this prospective study of 100 patients with suspected BPH or other urinary tract conditions, we found that uroflowmetry and cystoscopy were both valuable diagnostic tools for the evaluation of LUTS. However, the potential overuse of cystoscopy in this population warrants further investigation and highlights the need for careful consideration of the optimal use of diagnostic tests in the evaluation of LUTS and the diagnosis of BPH. Further research is needed to better understand the relative roles of uroflowmetry and cystoscopy in the diagnostic workup of patients with LUTS, and to develop evidence-based guidelines for their appropriate use.

Keywords: uroflowmetry, cystoscopy, LUTS, BPH

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Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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Authors: M. Szechynska-Hebda, M. Sobczak, E. Rozanska, J. Troczynska, Z. Banaszak, N. Hordyńska, M. Dyda, M. Wedzony

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Chloroplasts, as essential organelles for photosynthesis, play a critical role in plant development. However, disturbances in the proper functioning of chloroplasts, in the extreme case manifesting as albinism of tissues and whole plants, are a phenomenon often occurring in conditions deviating from natural (e.g., in vitro cultures applied in breeding programs). Using whole-transcriptome analysis (RNA-Seq) together with light, fluorescent and electron microscopy, it was shown, that development of chloroplasts and formation of green or albino plants in the androgenesis process are genotype-dependent; however, they could be modulated by sub-optimal temperature treatment. The reprogramming of the microspore development from gametophytic to sporophytic, and then regeneration of green plant can be positively regulated by cold stress (4 ⁰C). A high temperature stress (32 ⁰C) can induce androgenesis, but it is a factor negatively influencing green plant regeneration (promoting albinism). A similar effect on microspores, androgenesis, and subsequent chloroplast formation, is elicited as a result of postponing the date of spike collection from spring to summer in field conditions (natural temperature rise). It is determined in both environmental or genotypic manner. The delay of the sowing date (environmental effect) or growing of late genotypes (genotypic effect) result in spike maturation at higher temperatures and significantly enhance albino plant formation in androgenesis process. Such a temperature system (4 ⁰C vs. 32 ⁰C) was used to study the chloroplast biogenesis process in wheat and triticale. It was shown, that efficiency of physiological processes differentiates microspore development during cold reprograming in genotypes susceptible and resistant to androgenesis. Moreover, a great variation in developmental stages of the microspores in one anther is observed for susceptible genotypes. Microspores that are more physiologically active under cold conditions can activate signaling pathways and processes, which provide an appropriate supply of metabolites to cell compartments. This, in turn, fully correlates with the genotype-dependent efficiency of chloroplast formation (or different types of plastid) at particular steps of androgenesis. The effect obtained after applying a high temperature stress is different. High temperature causes a significant acceleration of microspore development and less variation in developmental stages at the end of the treatment. Therefore, the developmental diversity of the microspores in one anther seems to be a critical factor for subsequent cell and chloroplast differentiation. The work was financed by Ministry of Agriculture and Rural Development within Program: 'Biological Progress in Plant Production', project no HOR.hn.802.15.2018

Keywords: androgenesis, chloroplast biogenesis, temperature stress, wheat

Procedia PDF Downloads 142

Authors: Jollen Dai, Truman You, Xinyun Du, Katrina Liu

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Transportation is one of the leading sources of greenhouse gas emissions (GHG). Thus, to meet the Paris Agreement 2015, all countries must adopt a different and more sustainable transportation system. From bikes to Maglev, the world is slowly shifting to sustainable transportation. To develop a utility public transit system, a sustainable web of buses must be implemented. As of now, only a handful of cities have adopted a detailed plan to implement a full fleet of e-buses by the 2030s, with Shenzhen in the lead. Every change requires a detailed plan and a focused analysis of the impacts of the change. In this report, the economic implications and financial implications have been taken into consideration to develop a well-rounded 10-year plan for New York City. We also apply the same financial model to the other cities, LA and Chicago. We picked NYC, Chicago, and LA to conduct the comparative NPB analysis since they are all big metropolitan cities and have complex transportation systems. All three cities have started an action plan to achieve a full fleet of e-bus in the decades. Plus, their energy carbon footprint and their energy price are very different, which are the key factors to the benefits of electric buses. Using TCO (Total Cost Ownership) financial analysis, we developed a model to calculate NPB (Net Present Benefit) /and compare EBS (electric buses) to DBS (diesel buses). We have considered all essential aspects in our model: initial investment, including the cost of a bus, charger, and installation, government fund (federal, state, local), labor cost, energy (electricity or diesel) cost, maintenance cost, insurance cost, health and environment benefit, and V2G (vehicle to grid) benefit. We see about $1,400,000 in benefits for a 12-year lifetime of an EBS compared to DBS provided the government fund to offset 50% of EBS purchase cost. With the government subsidy, an EBS starts to make positive cash flow in 5th year and can pay back its investment in 5 years. Please remember that in our model, we consider environmental and health benefits, and every year, $50,000 is counted as health benefits per bus. Besides health benefits, the significant benefits come from the energy cost savings and maintenance savings, which are about $600,000 and $200,000 in 12-year life cycle. Using linear regression, given certain budget limitations, we then designed an optimal three-phase process to replace all NYC electric buses in 10 years, i.e., by 2033. The linear regression process is to minimize the total cost over the years and have the lowest environmental cost. The overall benefits to replace all DBS with EBS for NYC is over $2.1 billion by the year of 2033. For LA, and Chicago, the benefits for electrification of the current bus fleet are $1.04 billion and $634 million by 2033. All NPB analyses and the algorithm to optimize the electrification phase process are implemented in Python code and can be shared.

Keywords: financial modeling, total cost ownership, net present benefits, electric bus, diesel bus, NYC, LA, Chicago

Procedia PDF Downloads 41

Authors: Parminder Kaur Heer, Alexei Lapkin

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Due to global challenges of increased competition and demand for more sustainable products/processes, there is a rising pressure on the industry to develop innovative processes. Through Process Intensification (PI) the existing and new processes may be able to attain higher efficiency. However, very few PI options are generally considered. This is because processes are typically analysed at a unit operation level, thus limiting the search space for potential process options. PI performed at more detailed levels of a process can increase the size of the search space. The different levels at which PI can be achieved is unit operations, functional and phenomena level. Physical/chemical phenomena form the lowest level of aggregation and thus, are expected to give the highest impact because all the intensification options can be described by their enhancement. The objective of the current work is thus, generation of numerous process alternatives based on phenomena, and development of their corresponding computer aided models. The methodology comprises: a) automated generation of process options, and b) automated generation of process models. The process under investigation is disintegrated into functions viz. reaction, separation etc., and these functions are further broken down into the phenomena required to perform them. E.g., separation may be performed via vapour-liquid or liquid-liquid equilibrium. A list of phenomena for the process is formed and new phenomena, which can overcome the difficulties/drawbacks of the current process or can enhance the effectiveness of the process, are added to the list. For instance, catalyst separation issue can be handled by using solid catalysts; the corresponding phenomena are identified and added. The phenomena are then combined to generate all possible combinations. However, not all combinations make sense and, hence, screening is carried out to discard the combinations that are meaningless. For example, phase change phenomena need the co-presence of the energy transfer phenomena. Feasible combinations of phenomena are then assigned to the functions they execute. A combination may accomplish a single or multiple functions, i.e. it might perform reaction or reaction with separation. The combinations are then allotted to the functions needed for the process. This creates a series of options for carrying out each function. Combination of these options for different functions in the process leads to the generation of superstructure of process options. These process options, which are formed by a list of phenomena for each function, are passed to the model generation algorithm in the form of binaries (1, 0). The algorithm gathers the active phenomena and couples them to generate the model. A series of models is generated for the functions, which are combined to get the process model. The most promising process options are then chosen subjected to a performance criterion, for example purity of product, or via a multi-objective Pareto optimisation. The methodology was applied to a two-step process and the best route was determined based on the higher product yield. The current methodology can identify, produce and evaluate process intensification options from which the optimal process can be determined. It can be applied to any chemical/biochemical process because of its generic nature.

Keywords: Phenomena, Process intensification, Process models , Process options

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Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line and infiltration basins-IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme–RRS– to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m, and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery reuse scheme, infiltration basins, North Gaza

Procedia PDF Downloads 201

Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake

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One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.

Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology

Procedia PDF Downloads 222

Authors: I. Martinez-Conesa, E. Garcia-Meca, M. Barradas-Quiroz

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The objective of this study is to assess the impact on earnings management of latest two Hofstede cultural dimensions: long-term orientation and indulgence. Long-term orientation represents the alignment of a society towards the future and indulgence expresses the extent to which a society exhibits willingness, or restrain, to realise their impulses. Additionally, this paper tests if there are relevant differences by testing the moderating role of the legal tradition, Continental versus Anglo-Saxon. Our sample comprises 15 countries: Belgium, Canada, Germany, Spain, France, Great Britain, Hong Kong, India, Japan, Korea, Netherlands, Philippines, Portugal, Sweden, and Thailand, with a total of 12,936 observations from 2003 to 2013. Our results show that managers in countries with high levels of long-term orientation reduce their levels of discretionary accruals. The findings do not confirm the effect of indulgence on earnings management. In addition, our results confirm previous literature regarding the effect of individualism, noting that firms in countries with high levels of collectivism might be more inclined to use earnings discretion to protect the welfare of the collective group of firm stakeholders. Uncertainty avoidance results in downwards earnings management as well as high disclosure, suggesting that less manipulation takes place when transparency is higher. Indulgence is the cultural dimension that confronts wellbeing versus survival; dimension is formulated including happiness, the perception of live control and the importance of leisure. Indulgence shows a weak negative correlation with power distance indicating a slight tendency for more hierarchical societies to be less indulgent. Anglo-Saxon countries are a positive effect of individualism and a negative effect of masculinity, uncertainty avoidance, and disclosure. With respect to continental countries, we can see a significant and positive effect of individualism and a significant and negative effect of masculinity, long-term orientation, and indulgence. Therefore, we observe the negative effect on earnings management provoked by higher disclosure and uncertainty avoidance only happens in Anglo-Saxon countries. Meanwhile, the improvement in reporting quality motivated by higher long-term orientation and higher indulgence is dominant in Continental countries. Our results confirm that there is a moderating effect of the legal system in the association between culture and earnings management. This effect is especially relevant in the dimensions related to uncertainty avoidance, long term orientation, indulgence, and disclosure. The negative effect of long-term orientation on earnings management only happens in those countries set in continental legal systems because of the Anglo-Saxon legal systems is supported by the decisions of the courts and the traditions, so it already has long-term orientation. That does not occur in continental systems, depending mainly of contend of the law. Sensitivity analysis used with Jones modified CP model, Jones Standard model and Jones Standard CP model confirm the robustness of these results. This paper collaborates towards a better understanding on how earnings management, culture and legal systems relate to each other, and contribute to previous literature by examining the influence of the two latest Hofstede’s dimensions not previously studied in papers.

Keywords: Hofstede, long-term-orientation, earnings management, indulgence

Procedia PDF Downloads 235

Authors: Vivek Hokam, Vishrut Landge

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An ideal maintenance program for an industrial road network is one that would maintain all sections at a sufficiently high level of functional and structural conditions. However, due to various constraints such as budget, manpower and equipment, it is not possible to carry out maintenance on all the needy industrial road sections within a given planning period. A rational and systematic priority scheme needs to be employed to select and schedule industrial road sections for maintenance. Priority analysis is a multi-criteria process that determines the best ranking list of sections for maintenance based on several factors. In priority setting, difficult decisions are required to be made for selection of sections for maintenance. It is more important to repair a section with poor functional conditions which includes uncomfortable ride etc. or poor structural conditions i.e. sections those are in danger of becoming structurally unsound. It would seem therefore that any rational priority setting approach must consider the relative importance of functional and structural condition of the section. The maintenance priority index and pavement performance models tend to focus mainly on the pavement condition, traffic criteria etc. There is a need to develop the model which is suitably used with respect to limited budget provisions for maintenance of pavement. Linear programming is one of the most popular and widely used quantitative techniques. A linear programming model provides an efficient method for determining an optimal decision chosen from a large number of possible decisions. The optimum decision is one that meets a specified objective of management, subject to various constraints and restrictions. The objective is mainly minimization of maintenance cost of roads in industrial area. In order to determine the objective function for analysis of distress model it is necessary to fix the realistic data into a formulation. Each type of repair is to be quantified in a number of stretches by considering 1000 m as one stretch. A stretch considered under study is having 3750 m length. The quantity has to be put into an objective function for maximizing the number of repairs in a stretch related to quantity. The distress observed in this stretch are potholes, surface cracks, rutting and ravelling. The distress data is measured manually by observing each distress level on a stretch of 1000 m. The maintenance and rehabilitation measured that are followed currently are based on subjective judgments. Hence, there is a need to adopt a scientific approach in order to effectively use the limited resources. It is also necessary to determine the pavement performance and deterioration prediction relationship with more accurate and economic benefits of road networks with respect to vehicle operating cost. The infrastructure of road network should have best results expected from available funds. In this paper objective function for distress model is determined by linear programming and deterioration model considering overloading is discussed.

Keywords: budget, maintenance, deterioration, priority

Procedia PDF Downloads 203

Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

Procedia PDF Downloads 444

Authors: Delphine Ribes Lemay, Valentine Bernasconi, André Andrade, Lara DéFayes, Mathieu Salzmann, FréDéRic Kaplan, Nicolas Henchoz

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Digitization and preservation of large heritage induce high maintenance costs to keep up with the technical standards and ensure sustainable access. Creating impactful usage is instrumental to justify the resources for long-term preservation. The Museum für Gestaltung of Zurich holds one of the biggest poster collections of the world from which 52’000 were digitised. In the process of building a digital installation to valorize the collection, one objective was to develop an algorithm capable of predicting the next poster to show according to the ones already displayed. The work presented here describes the steps to build an algorithm able to automatically create sequences of posters reflecting associations performed by curator and professional designers. The exposed challenge finds similarities with the domain of song playlist algorithms. Recently, artificial intelligence techniques and more specifically, deep-learning algorithms have been used to facilitate their generations. Promising results were found thanks to Recurrent Neural Networks (RNN) trained on manually generated playlist and paired with clusters of extracted features from songs. We used the same principles to create the proposed algorithm but applied to a challenging medium, posters. First, a convolutional autoencoder was trained to extract features of the posters. The 52’000 digital posters were used as a training set. Poster features were then clustered. Next, an RNN learned to predict the next cluster according to the previous ones. RNN training set was composed of poster sequences extracted from a collection of books from the Gestaltung Museum of Zurich dedicated to displaying posters. Finally, within the predicted cluster, the poster with the best proximity compared to the previous poster is selected. The mean square distance between features of posters was used to compute the proximity. To validate the predictive model, we compared sequences of 15 posters produced by our model to randomly and manually generated sequences. Manual sequences were created by a professional graphic designer. We asked 21 participants working as professional graphic designers to sort the sequences from the one with the strongest graphic line to the one with the weakest and to motivate their answer with a short description. The sequences produced by the designer were ranked first 60%, second 25% and third 15% of the time. The sequences produced by our predictive model were ranked first 25%, second 45% and third 30% of the time. The sequences produced randomly were ranked first 15%, second 29%, and third 55% of the time. Compared to designer sequences, and as reported by participants, model and random sequences lacked thematic continuity. According to the results, the proposed model is able to generate better poster sequencing compared to random sampling. Eventually, our algorithm is sometimes able to outperform a professional designer. As a next step, the proposed algorithm should include a possibility to create sequences according to a selected theme. To conclude, this work shows the potentiality of artificial intelligence techniques to learn from existing content and provide a tool to curate large sets of data, with a permanent renewal of the presented content.

Keywords: Artificial Intelligence, Digital Humanities, serendipity, design research

Procedia PDF Downloads 177

Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

Procedia PDF Downloads 177

Authors: C. Villamizar, M. Serrato

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In the pursuit of athletic performance, the role of physical training which is determined by a number of charges or taxes on physiological stress and musculoskeletal systems of the human body generated by the intensity and duration is fundamental. Given the physical demands of these activities both training and competitive must take into account the optimal relationship with a straining process recovery post favoring the process of overcompensation which aims to facilitate the return and rising energy potential and protein synthesis also of different tissues. Allowing muscle function returns to baseline or pre-exercise states. If this recovery process is not performed or is not allowed in a proper way, will result in an increased state of fatigue. Active recovery, is one of the strategies implemented in the sport for a return to pre-exercise physiological states. However, there are some adverse assumptions regarding the negative effects, as is the possibility of increasing the degradation of muscle glycogen and thus delaying the synthesis thereof. For them, it is necessary to investigate what would be the effects generated application made at different times after the effort. The aim of this study was to determine the effects of active recovery post effort made at three different times: immediately, at 12 and 24 hours on biochemical markers creatine kinase in youth soccer player’s categories. A randomized controlled trial with allocation to three groups was performed: A. active recovery immediately after the effort; B. active recovery performed at 12 hours after the effort; C. active recovery made at 24 hours after the effort. This study included 27 subjects belonging to a Colombian soccer team of the second division. Vital signs, weight, height, BMI, the percentage of muscle mass, fat mass percentage, personal medical history, and family were valued. The velocity, explosive force and Creatin Kinase (CK) in blood were tested before and after interventions. SAFT 90 protocol (Soccer Field specific Aerobic Test) was applied to participants for generating fatigue. CK samples were taken one hour before the application of the fatigue test, one hour after the fatigue protocol and 48 of the initial CK sample. Mean age was 18.5 ± 1.1 years old. Improvements in jumping and speed recovery the 3 groups (p < 0.05), but no statistically significant differences between groups was observed after recuperation. In all participants, there was a significant increment of CK when applied SAFT 90 in all the groups (median 103.1-111.1). The CK measurement after 48 hours reflects a recovery in all groups, however the group C, a decline below baseline levels of -55.5 (-96.3 /-20.4) which is a significant find. Other research has shown that CK does not return quickly to their baseline, but our study shows that active recovery favors the clearance of CK and also to perform recovery 24 hours after the effort generates higher clearance of this biomarker.

Keywords: active recuperation, creatine phosphokinase, post training, young soccer players

Procedia PDF Downloads 158

Authors: Juan S. Mantilla, Peter Thomson

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Seismic events may result in discomfort on occupants of the buildings, structural damage or even buildings collapse. Traditional design aims to reduce dynamic response of structures by increasing stiffness, thus increasing the construction costs and the design forces. Structural control systems arise as an alternative to reduce these dynamic responses. A commonly used control systems in buildings are the passive friction dampers, which adds energy dissipation through damping mechanisms induced by sliding friction between their surfaces. Passive friction dampers are usually implemented on the diagonal of braced buildings, but such devices have the disadvantage that are optimal for a range of sliding force and out of that range its efficiency decreases. The above implies that each passive friction damper is designed, built and commercialized for a specific sliding/clamping force, in which the damper shift from a locked state to a slip state, where dissipates energy through friction. The risk of having a variation in the efficiency of the device according to the sliding force is that the dynamic properties of the building can change as result of many factor, even damage caused by a seismic event. In this case the expected forces in the building can change and thus considerably reduce the efficiency of the damper (that is designed for a specific sliding force). It is also evident than when a seismic event occurs the forces in each floor varies in the time what means that the damper's efficiency is not the best at all times. Semi-Active Friction devices adapt its sliding force trying to maintain its motion in the slipping phase as much as possible, because of this, the effectiveness of the device depends on the control strategy used. This paper deals with the development and performance evaluation of a low cost Semiactive Variable Friction Damper (SAVFD) in reduced scale to reduce vibrations of structures subject to earthquakes. The SAVFD consist in a (1) hydraulic brake adapted to (2) a servomotor which is controlled with an (3) Arduino board and acquires accelerations or displacement from (4) sensors in the immediately upper and lower floors and a (5) power supply that can be a pair of common batteries. A test structure, based on a Benchmark structure for structural control, was design and constructed. The SAVFD and the structure are experimentally characterized. A numerical model of the structure and the SAVFD is developed based on the dynamic characterization. Decentralized control algorithms were modeled and later tested experimentally using shaking table test using earthquake and frequency chirp signals. The controlled structure with the SAVFD achieved reductions greater than 80% in relative displacements and accelerations in comparison to the uncontrolled structure.

Keywords: earthquake response, friction damper, semiactive control, shaking table

Procedia PDF Downloads 376

Authors: Vladimir Messerle, Alfred Mosse, Alexandr Ustimenko, Oleg Lavrichshev

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Hygiene and sanitary study of typical medical-biological waste made in Kazakhstan, Russia, Belarus and other countries show that their risk to the environment is much higher than that of most chemical wastes. For example, toxicity of solid waste (SW) containing cytotoxic drugs and antibiotics is comparable to toxicity of radioactive waste of high and medium level activity. This report presents the results of the thermodynamic analysis of thermal processing of SW and experiments at the developed plasma unit for SW processing. Thermodynamic calculations showed that the maximum yield of the synthesis gas at plasma gasification of SW in air and steam mediums is achieved at a temperature of 1600K. At the air plasma gasification of SW high-calorific synthesis gas with a concentration of 82.4% (СO – 31.7%, H2 – 50.7%) can be obtained, and at the steam plasma gasification – with a concentration of 94.5% (СO – 33.6%, H2 – 60.9%). Specific heat of combustion of the synthesis gas produced by air gasification amounts to 14267 kJ/kg, while by steam gasification - 19414 kJ/kg. At the optimal temperature (1600 K), the specific power consumption for air gasification of SW constitutes 1.92 kWh/kg, while for steam gasification - 2.44 kWh/kg. Experimental study was carried out in a plasma reactor. This is device of periodic action. The arc plasma torch of 70 kW electric power is used for SW processing. Consumption of SW was 30 kg/h. Flow of plasma-forming air was 12 kg/h. Under the influence of air plasma flame weight average temperature in the chamber reaches 1800 K. Gaseous products are taken out of the reactor into the flue gas cooling unit, and the condensed products accumulate in the slag formation zone. The cooled gaseous products enter the gas purification unit, after which via gas sampling system is supplied to the analyzer. Ventilation system provides a negative pressure in the reactor up to 10 mm of water column. Condensed products of SW processing are removed from the reactor after its stopping. By the results of experiments on SW plasma gasification the reactor operating conditions were determined, the exhaust gas analysis was performed and the residual carbon content in the slag was determined. Gas analysis showed the following composition of the gas at the exit of gas purification unit, (vol.%): СO – 26.5, H2 – 44.6, N2–28.9. The total concentration of the syngas was 71.1%, which agreed well with the thermodynamic calculations. The discrepancy between experiment and calculation by the yield of the target syngas did not exceed 16%. Specific power consumption for SW gasification in the plasma reactor according to the results of experiments amounted to 2.25 kWh/kg of working substance. No harmful impurities were found in both gas and condensed products of SW plasma gasification. Comparison of experimental results and calculations showed good agreement. Acknowledgement—This work was supported by Ministry of Education and Science of the Republic of Kazakhstan and Ministry of Education and Science of the Russian Federation (Agreement on grant No. 14.607.21.0118, project RFMEF160715X0118).

Keywords: coal, efficiency, ignition, numerical modeling, plasma-fuel system, plasma generator

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Authors: Piotr Romaniuk, Krzysztof Kaczmarek, Adam Szromek

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Background: A number of approaches to assess the performance of health system have been proposed so far. Nonetheless, they lack a consensus regarding the key components of assessment procedure and criteria of evaluation. The WHO and OECD have developed methods of assessing health system to counteract the underlying issues, but they are not free of controversies and did not manage to produce a commonly accepted consensus. The aim of the study: On the basis of WHO and OECD approaches we decided to develop own methodology to assess the performance of health systems in Central and Eastern European countries. We have applied the method to compare the effects of health systems reforms in 20 countries of the region, in order to evaluate the dynamic of changes in terms of health system outcomes.Methods: Data was collected from a 25-year time period after the fall of communism, subsetted into different post-reform stages. Datasets collected from individual countries underwent one-, two- or multi-dimensional statistical analyses, and the Synthetic Measure of health system Outcomes (SMO) was calculated, on the basis of the method of zeroed unitarization. A map of dynamics of changes over time across the region was constructed. Results: When making a comparative analysis of the tested group in terms of the average SMO value throughout the analyzed period, we noticed some differences, although the gaps between individual countries were small. The countries with the highest SMO were the Czech Republic, Estonia, Poland, Hungary and Slovenia, while the lowest was in Ukraine, Russia, Moldova, Georgia, Albania, and Armenia. Countries differ in terms of the range of SMO value changes throughout the analyzed period. The dynamics of change is high in the case of Estonia and Latvia, moderate in the case of Poland, Hungary, Czech Republic, Croatia, Russia and Moldova, and small when it comes to Belarus, Ukraine, Macedonia, Lithuania, and Georgia. This information reveals fluctuation dynamics of the measured value in time, yet it does not necessarily mean that in such a dynamic range an improvement appears in a given country. In reality, some of the countries moved from on the scale with different effects. Albania decreased the level of health system outcomes while Armenia and Georgia made progress, but lost distance to leaders in the region. On the other hand, Latvia and Estonia showed the most dynamic progress in improving the outcomes. Conclusions: Countries that have decided to implement comprehensive health reform have achieved a positive result in terms of further improvements in health system efficiency levels. Besides, a higher level of efficiency during the initial transition period generally positively determined the subsequent value of the efficiency index value, but not the dynamics of change. The paths of health system outcomes improvement are highly diverse between different countries. The instrument we propose constitutes a useful tool to evaluate the effectiveness of reform processes in post-communist countries, but more studies are needed to identify factors that may determine results obtained by individual countries, as well as to eliminate the limitations of methodology we applied.

Keywords: health system outcomes, health reforms, health system assessment, health system evaluation

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Authors: Kristina Horvat Blazinovic

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In the context of a work of art, one can talk about the idea-concept-term-intention expressed by the artist by using various forms of repetition (external, material, visible repetition). Such repetitions of elements (images in space or moving visual and sound images in time) suggest a "covert", "latent" ("dressed") repetition – i.e., "hidden", "latent" term-intention-idea. Repeating in this way reveals a "deeper truth" that the viewer needs to decode and which is hidden "under" the technical manifestation of the multiplied images. It is not only images, sounds, and screens that are repeated - something else is repeated through them as well, even if, in some cases, the very idea of repetition is repeated. This paper examines serial images and single-channel or multi-channel artwork in the field of video/film art and video installations, which in a way implies the concept of repetition and multiplication. Moving or static images and screens (as multi-screens) are repeated in time and space. The categories of the real and the symbolic partly refer to the Lacan registers of reality, i.e., the Imaginary - Symbolic – Real trinity that represents the orders within which human subjectivity is established. Authors such as Bruce Nauman, VALIE EXPORT, Ragnar Kjartansson, Wolf Vostell, Shirin Neshat, Paul Sharits, Harun Farocki, Dalibor Martinis, Andy Warhol, Douglas Gordon, Bill Viola, Frank Gillette, and Ira Schneider, and Marina Abramovic problematize, in different ways, the concept and procedures of multiplication - repetition, but not in the sense of "copying" and "repetition" of reality or the original, but of repeated repetitions of the simulacrum. Referential works of art are often connected by the theme of the traumatic. Repetitions of images and situations are a response to the traumatic (experience) - repetition itself is a symptom of trauma. On the other hand, repeating and multiplying traumatic images results in a new traumatic effect or cancels it. Reflections on repetition as a temporal and spatial phenomenon are in line with the chapters that link philosophical considerations of space and time and experience temporality with their manifestation in works of art. The observations about time and the relation of perception and memory are according to Henry Bergson and his conception of duration (durée) as "quality of quantity." The video works intended to be displayed as a video loop, express the idea of infinite duration ("pure time," according to Bergson). The Loop wants to be always present - to fixate in time. Wholeness is unrecognizable because the intention is to make the effect infinitely cyclic. Reflections on time and space end with considerations about the occurrence and effects of time and space intervals as places and moments "between" – the points of connection and separation, of continuity and stopping - by reference to the "interval theory" of Soviet filmmaker DzigaVertov. The scale of opportunities that can be explored in interval mode is wide. Intervals represent the perception of time and space in the form of pauses, interruptions, breaks (e.g., emotional, dramatic, or rhythmic) denote emptiness or silence, distance, proximity, interstitial space, or a gap between various states.

Keywords: video installation, performance, repetition, multi-screen, real and symbolic, loop, video art, interval, video time

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Authors: Keda Li, Hong Hu

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Auxetic materials, as an emerging artificial designed metamaterial has attracted growing attention due to their promising negative Poisson’s ratio behaviors and tunable properties. The conventional auxetic lattice structures for which the deformation process is governed by a bending-dominated mechanism have faced the limitation of poor mechanical performance for many potential engineering applications. Recently, both load-bearing and energy absorption capabilities have become a crucial consideration in auxetic structure design. This study reports the finite element analysis of a class of hexagonal double-arrowhead auxetic structures with enhanced stiffness and energy absorption performance. The structure design was developed by extending the traditional double-arrowhead honeycomb to a hexagon frame, the stretching-dominated deformation mechanism was determined according to Maxwell’s stability criterion. The finite element (FE) models of 2D lattice structures established with stainless steel material were analyzed in ABAQUS/Standard for predicting in-plane structural deformation mechanism, failure process, and compressive elastic properties. Based on the computational simulation, the parametric analysis was studied to investigate the effect of the structural parameters on Poisson’s ratio and mechanical properties. The geometrical optimization was then implemented to achieve the optimal Poisson’s ratio for the maximum specific energy absorption. In addition, the optimized 2D lattice structure was correspondingly converted into a 3D geometry configuration by using the orthogonally splicing method. The numerical results of 2D and 3D structures under compressive quasi-static loading conditions were compared separately with the traditional double-arrowhead re-entrant honeycomb in terms of specific Young's moduli, Poisson's ratios, and specified energy absorption. As a result, the energy absorption capability and stiffness are significantly reinforced with a wide range of Poisson’s ratio compared to traditional double-arrowhead re-entrant honeycomb. The auxetic behaviors, energy absorption capability, and yield strength of the proposed structure are adjustable with different combinations of joint angle, struts thickness, and the length-width ratio of the representative unit cell. The numerical prediction in this study suggests the proposed concept of hexagonal double-arrowhead structure could be a suitable candidate for the energy absorption applications with a constant request of load-bearing capacity. For future research, experimental analysis is required for the validation of the numerical simulation.

Keywords: auxetic, energy absorption capacity, finite element analysis, negative Poisson's ratio, re-entrant hexagonal honeycomb

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Authors: Muteb Alotaibi, Graham Clarke, Nick Malleson

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The Hajj religious festival at Mina in Saudi Arabia has always presented the opportunity for injuries or deaths. For example, in 1990, a stampede killed 1426 pilgrims, whilst in 1997, 343 people were killed and 1500 injured due to a fire fuelled by high winds sweeping through the tent city in Mina.Many more minor incidents have occurred since then. It is predicted that 5 million pilgrims will soon perform the ritual at Mina (which is, in effect, a temporary city built each year in the desert), which might lead in the future to severe congestion and accidents unless the research is conducted on actions that contribute positively to improving the management of the crowd and facilitating the flow of pilgrims safely and securely. To help prevent further disasters, it is important to first plan better, more accessible locations for emergency services across Mina to ensure a good service for pilgrims. In this paper, we first use a Location Allocation Model (LAM) within a network GIS to examine the optimal locations for key services in the temporary city of Mina. This has been undertaken in relation to the location and movement of the pilgrims during the six day religious festival. The results of various what-if scenarios have been compared against the current location of services. A major argument is that planners should be flexible and locate facilities at different locations throughout the day and night. The use of location-allocation models in this type of comparative static mode has rarely been operationalised in the literature. Second, we model pilgrim movements and behaviours along with the most crowded parts of the network. This has been modelled using an agent-based model. This model allows planners to understand the key bottlenecks in the network and at what usage levels the paths become critically congested. Thus the paper has important implications and recommendations for future disaster planning strategies. This will enable planners to see at what stage in the movements of pilgrims problems occur in terms of potential crushes and trampling incidents. The main application of this research was only customised for pedestrians as the concentration only for pedestrians who move to Jamarat via foot. Further, the network in the middle of Mina was only dedicated for pedestrians for safety, so no Buses, trains and private cars were allowed in this area to prevent the congestion within this network. Initially, this research focus on Mina city as ‘temporary city’ and also about service provision in temporary cities, which is not highlighted in literature so far. Further, it is the first study which use the dynamic demand to optimise the services in the case of day and night time. Moreover, it is the first study which link the location allocation model for optimising services with ABM to find out whether or not the service location is located in the proper location in which it’s not affecting on crowd movement in mainstream flow where some pilgrims need to have health services.

Keywords: ABM, crowd management, hajj, temporary city

Procedia PDF Downloads 117