Search results for: hospital industry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7438

Search results for: hospital industry

2698 Test of Moisture Sensor Activation Speed

Authors: I. Parkova, A. Vališevskis, A. Viļumsone

Abstract:

Nocturnal enuresis or bed-wetting is intermittent incontinence during sleep of children after age 5 that may precipitate wide range of behavioural and developmental problems. One of the non-pharmacological treatment methods is the use of a bed-wetting alarm system. In order to improve comfort conditions of nocturnal enuresis alarm system, modular moisture sensor should be replaced by a textile sensor. In this study behaviour and moisture detection speed of woven and sewn sensors were compared by analysing change in electrical resistance after solution (salt water) was dripped on sensor samples. Material of samples has different structure and yarn location, which affects solution detection rate. Sensor system circuit was designed and two sensor tests were performed: system activation test and false alarm test to determine the sensitivity of the system and activation threshold. Sewn sensor had better result in system’s activation test – faster reaction, but woven sensor had better result in system’s false alarm test – it was less sensitive to perspiration simulation. After experiments it was found that the optimum switching threshold is 3V in case of 5V input voltage, which provides protection against false alarms, for example – during intensive sweating.

Keywords: conductive yarns, moisture textile sensor, industry, material

Procedia PDF Downloads 243
2697 Set-point Performance Evaluation of Robust ‎Back-Stepping Control Design for a Nonlinear ‎Electro-‎Hydraulic Servo System

Authors: Maria Ahmadnezhad, Seyedgharani Ghoreishi ‎

Abstract:

Electrohydraulic servo system have been used in industry in a wide ‎number of applications. Its ‎dynamics are highly nonlinear and also ‎have large extent of model uncertainties and external ‎disturbances. ‎In this thesis, a robust back-stepping control (RBSC) scheme is ‎proposed to overcome ‎the problem of disturbances and system ‎uncertainties effectively and to improve the set-point ‎performance ‎of EHS systems. In order to implement the proposed control ‎scheme, the system ‎uncertainties in EHS systems are considered as ‎total leakage coefficient and effective oil volume. In ‎addition, in ‎order to obtain the virtual controls for stabilizing system, the ‎update rule for the ‎system uncertainty term is induced by the ‎Lyapunov control function (LCF). To verify the ‎performance and ‎robustness of the proposed control system, computer simulation of ‎the ‎proposed control system using Matlab/Simulink Software is ‎executed. From the computer ‎simulation, it was found that the ‎RBSC system produces the desired set-point performance and ‎has ‎robustness to the disturbances and system uncertainties of ‎EHS systems.‎

Keywords: electro hydraulic servo system, back-stepping control, robust back-‎stepping control, Lyapunov redesign‎

Procedia PDF Downloads 992
2696 Women In Orthopedic Surgery, A Scoping Review

Authors: Katherine van Kampen, Reva Qiu, Patricia Farrugia

Abstract:

Orthopedic surgery has fallen behind when it comes to gender diversity despite medical school classes reaching gender parity. Studies have shown that orthopedic surgery would require 117 years to reach gender parity with the trainee population, the longest time than any other specialty, including neurosurgery, urology, and otolaryngology. The barriers that face women in orthopedic surgery have been well researched, with contributing factors being on-going stereotypes of the field, lack of women mentors, and gender roles outside of the hospital. Furthermore, women in orthopedic surgery face barriers to achieve promotion, publications, and leadership roles leading to a “leaky pipeline,” resulting in less and less women in key academic roles in the field. It is a complex topic with barriers and challenges faced in medical school, residency, and throughout employment. Our scoping review seeks to understand these challenges across a temporal timeline and to further characterize such barriers and the driving factors behind them. To this date, authors did not find a scoping review that seeks to look broadly at factors impacting the decreased amount of women entering orthopedics and the factors that cause women to hit a “glass ceiling”, the idea that women will not achieve the same success as men despite the same qualifications, upon entering the field. This scoping review is the first of its kind to attempt to summarize the large body of research focusing on women in orthopedic surgery from the preconceptions in medical school impacting their desire to pursue orthopedics all the way to employment, including challenges to academic success and financial success. Literature databases will be searched with the following key terms: women, gender inequity, workforce, orthopedics, and citations will be hand searched and collected. Articles included will discuss gender inequality within orthopedics with non-english, patient related articles excluded. Full-text review will seek to characterize the specific barriers faced by women across medical school, residency, and employment. Themes that are expected to be highlighted are workforce data, women in orthopedic leadership, medical student perspectives on the specialty, and gender bias and discrimination in the field.

Keywords: orthopedics, gender equity, workforce, women in surgery

Procedia PDF Downloads 85
2695 Towards Reliable Mobile Cloud Computing

Authors: Khaled Darwish, Islam El Madahh, Hoda Mohamed, Hadia El Hennawy

Abstract:

Cloud computing has been one of the fastest growing parts in IT industry mainly in the context of the future of the web where computing, communication, and storage services are main services provided for Internet users. Mobile Cloud Computing (MCC) is gaining stream which can be used to extend cloud computing functions, services and results to the world of future mobile applications and enables delivery of a large variety of cloud application to billions of smartphones and wearable devices. This paper describes reliability for MCC by determining the ability of a system or component to function correctly under stated conditions for a specified period of time to be able to deal with the estimation and management of high levels of lifetime engineering uncertainty and risks of failure. The assessment procedures consists of determine Mean Time between Failures (MTBF), Mean Time to Failure (MTTF), and availability percentages for main components in both cloud computing and MCC structures applied on single node OpenStack installation to analyze its performance with different settings governing the behavior of participants. Additionally, we presented several factors have a significant impact on rates of change overall cloud system reliability should be taken into account in order to deliver highly available cloud computing services for mobile consumers.

Keywords: cloud computing, mobile cloud computing, reliability, availability, OpenStack

Procedia PDF Downloads 391
2694 A Facile One Step Modification of Poly(dimethylsiloxane) via Smart Polymers for Biomicrofluidics

Authors: A. Aslihan Gokaltun, Martin L. Yarmush, Ayse Asatekin, O. Berk Usta

Abstract:

Poly(dimethylsiloxane) (PDMS) is one of the most widely used materials in the fabrication of microfluidic devices. It is easily patterned and can replicate features down to nanometers. Its flexibility, gas permeability that allows oxygenation, and low cost also drive its wide adoption. However, a major drawback of PDMS is its hydrophobicity and fast hydrophobic recovery after surface hydrophilization. This results in significant non-specific adsorption of proteins as well as small hydrophobic molecules such as therapeutic drugs limiting the utility of PDMS in biomedical microfluidic circuitry. While silicon, glass, and thermoplastics have been used, they come with problems of their own such as rigidity, high cost, and special tooling needs, which limit their use to a smaller user base. Many strategies to alleviate these common problems with PDMS are lack of general practical applicability, or have limited shelf lives in terms of the modifications they achieve. This restricts large scale implementation and adoption by industrial and research communities. Accordingly, we aim to tailor biocompatible PDMS surfaces by developing a simple and one step bulk modification approach with novel smart materials to reduce non-specific molecular adsorption and to stabilize long-term cell analysis with PDMS substrates. Smart polymers that blended with PDMS during device manufacture, spontaneously segregate to surfaces when in contact with aqueous solutions and create a < 1 nm layer that reduces non-specific adsorption of organic and biomolecules. Our methods are fully compatible with existing PDMS device manufacture protocols without any additional processing steps. We have demonstrated that our modified PDMS microfluidic system is effective at blocking the adsorption of proteins while retaining the viability of primary rat hepatocytes and preserving the biocompatibility, oxygen permeability, and transparency of the material. We expect this work will enable the development of fouling-resistant biomedical materials from microfluidics to hospital surfaces and tubing.

Keywords: cell culture, microfluidics, non-specific protein adsorption, PDMS, smart polymers

Procedia PDF Downloads 290
2693 Study of Relation between P53 and Mir-146a Rs2910164 Polymorphism in Cervical Lesion

Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

Abstract:

Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia(CIN)and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, p53, miR-146a, rs2910164, polymorphism

Procedia PDF Downloads 462
2692 Data Modeling and Calibration of In-Line Pultrusion and Laser Ablation Machine Processes

Authors: David F. Nettleton, Christian Wasiak, Jonas Dorissen, David Gillen, Alexandr Tretyak, Elodie Bugnicourt, Alejandro Rosales

Abstract:

In this work, preliminary results are given for the modeling and calibration of two inline processes, pultrusion, and laser ablation, using machine learning techniques. The end product of the processes is the core of a medical guidewire, manufactured to comply with a user specification of diameter and flexibility. An ensemble approach is followed which requires training several models. Two state of the art machine learning algorithms are benchmarked: Kernel Recursive Least Squares (KRLS) and Support Vector Regression (SVR). The final objective is to build a precise digital model of the pultrusion and laser ablation process in order to calibrate the resulting diameter and flexibility of a medical guidewire, which is the end product while taking into account the friction on the forming die. The result is an ensemble of models, whose output is within a strict required tolerance and which covers the required range of diameter and flexibility of the guidewire end product. The modeling and automatic calibration of complex in-line industrial processes is a key aspect of the Industry 4.0 movement for cyber-physical systems.

Keywords: calibration, data modeling, industrial processes, machine learning

Procedia PDF Downloads 284
2691 Application of Topical Imiquimod for Treatment Cervical Intraepithelial Neoplasia in Young Women: A Preliminary Result of a Pilot Study

Authors: Phill-Seung Jung, Dae-Yeon Kim

Abstract:

Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

Procedia PDF Downloads 248
2690 A Principal-Agent Model for Sharing Mechanism in Integrated Project Delivery Context

Authors: Shan Li, Qiuwen Ma

Abstract:

Integrated project delivery (IPD) is a project delivery method distinguished by a shared risk/rewards mechanism and multiparty agreement. IPD has drawn increasingly attention from construction industry because of its efficiency of solving adversarial problems and reliability to deliver high-performing buildings. However, some evidence showed that some project participants obtained less profit from IPD projects than the typical projects. They attributed it to the unfair IPD sharing mechanism, which resulted in additional time and cost of negotiation on the sharing fractions among project participants. The study is aimed to investigate the reward distribution by constructing a principal-agent model. Based on cooperative game theory, it is examined how to distribute the shared project rewards between client and non-client parties, and identify the sharing fractions among non-client parties. It is found that at least half of the project savings should be allocated to the non-client parties to motivate them to create more project value. Second, the client should raise his sharing fractions when the integration among project participants is efficient. In addition, the client should allocate higher sharing fractions to the non-client party who is more able. This study can help the IPD project participants make fair and motivated sharing mechanisms.

Keywords: cooperative game theory, IPD, principal agent model, sharing mechanism

Procedia PDF Downloads 285
2689 Investigation p53 and miR-146a rs2910164 Polymorphism in Cervical Lesion

Authors: Hossein Rassi, Marjan Moradi fard, Masoud Houshmand

Abstract:

Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human Papillomavirus (HPV) infection is the leading risk factor for Cervical Intraepithelial Neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33, and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, miR-146a rs2910164 polymorphism, p53 polymorphism, intraepithelial, neoplasia, HPV

Procedia PDF Downloads 394
2688 Wet Extraction of Lutein and Lipids from Microalga by Quantitative Determination of Polarity

Authors: Mengyue Gong, Xinyi Li, Amarjeet Bassi

Abstract:

Harvesting by-products while recovering biodiesel is considered a potentially valuable approach to increase the market feasibility of microalgae industry. Lutein is a possible by-product from microalgae that promotes eye health. The extraction efficiency and the expensive drying process of wet algae represent the major challenges for the utilization of microalgae biomass as a feedstock for lipids, proteins, and carotenoids. A wet extraction method was developed to extract lipids and lutein from microalga Chlorella vulgaris. To evaluate different solvent (mixtures) for the extraction, a quantitative analysis was established based on the polarity of solvents using Nile Red as the polarity (ETN) indicator. By the choice of binary solvent system then adding proper amount of water to achieve phase separation, lipids and lutein can be extracted simultaneously. Some other parameters for lipids and lutein production were also studied including saponification time, temperature, choice of alkali, and pre-treatment methods. The extraction efficiency with wet algae was compared with dried algae and shown better pigment recovery. The results indicated that the product pattern in each extracted phase was polarity dependent. Lutein and β-carotene were the main carotenoids extracted with ethanol while lipids come out with hexane.

Keywords: biodiesel, Chlorella vulgaris, extraction, lutein

Procedia PDF Downloads 337
2687 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study

Authors: Farah Naja, Mohamad Alameddine

Abstract:

Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

Procedia PDF Downloads 343
2686 Pain Intensity, Functional Disability and Physical Activity among Elderly Individuals with Chronic Mechanical Low Back Pain

Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

Abstract:

Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

Procedia PDF Downloads 309
2685 Unusual Presentation of Colorectal Cancer within Inguinal Hernia: A Systemic Review of Reported Cases

Authors: Sena Park

Abstract:

Background: The concurrent presentation with colorectal cancer in the inguinal hernia has been extremely rare. Due to its rarity, its presentation may lead to diagnostic and therapeutic dilemmas. We aim to review all the reported cases on colorectal cancer incarcerated in the inguinal hernia in the last 20 years, and discuss the operative approaches. Methods: We identified all case reports on colorectal cancer within inguinal hernia using PUBMED (2002-2022) and MEDLINE (2002-2022). The search strategy included the following keywords: colorectal cancer (title/abstract) AND inguinal hernia (title/abstract) OR incarceration (title/abstract). The search did not include letters, book chapters, systemic reviews, meta-analysis and editorials. Results: In the last 20 years, a total of 19 cases on colorectal cancer within the inguinal hernia were identified. The age of the patients ranged between 48 and 89. Majority of the patients were male (95%). Most commonly involved part of the large intestine was sigmoid colon (79%). Of all the cases, 79 percent of patients received open procedure and 21 percent had laparoscopic procedure. Discussion: Inguinal hernias are common with an incidence of approximately 1.7 percent. Colorectal cancer is the one of the leading causes of cancer-related mortality worldwide. However, their concurrent presentation has been extremely rare. In the last 20 years, 19 cases on concurrent presentation of colorectal cancer and inguinal hernia have been reported. Most patients who had open procedures had two incisions of groin incision and a midline laparotomy. There were 4 cases where the oncological resection was performed laparoscopically. The advantages of laparoscopic resection include reduced blood lost, reduced post-operative pain, reduced length of hospital stay and similar number of lymph nodes taken. From the review of the cases in the last 20 years, both open and laparoscopic approaches seemed to be safe and achieve adequate oncological resections. Conclusion: This is a brief overview of reported cases of colorectal cancer presenting with inguinal hernia concurrently. Due to its rarity, there are no current guidelines on operative approach in clinical practice. The experience in the last 20 years supports both open and laparoscopic approach.

Keywords: colorectal cancer, inguinal hernia, incarceration, operative approach

Procedia PDF Downloads 96
2684 Cauda Equina Syndrome: An Audit on Referral Adequacy and its Impact on Delay to Surgery

Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

Abstract:

PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

Procedia PDF Downloads 11
2683 The Economic Value of Mastitis Resistance in Dairy Cattle in Kenya

Authors: Caleb B. Sagwa, Tobias O. Okeno, Alexander K. Kahi

Abstract:

Dairy cattle production plays an important role in the Kenyan economy. However, high incidences of mastitis is a major setback to the productivity in this industry. The current dairy cattle breeding objective in Kenya does not include mastitis resistance, mainly because the economic value of mastitis resistance has not been determined. Therefore this study aimed at estimating the economic value of mastitis resistance in dairy cattle in Kenya. Initial input parameters were obtained from literature on dairy cattle production systems in the tropics. Selection index methodology was used to derive the economic value of mastitis resistance. Somatic cell count (SCC) was used an indicator trait for mastitis resistance. The economic value was estimated relative to milk yield (MY). Economic values were assigned to SCC in a selection index such that the overall gain in the breeding goal trait was maximized. The option of estimating the economic value for SCC by equating the response in the trait of interest to its index response was considered. The economic value of mastitis resistance was US $23.64 while maximum response to selection for MY was US $66.01. The findings of this study provide vital information that is a pre-requisite for the inclusion of mastitis resistance in the current dairy cattle breeding goal in Kenya.

Keywords: somatic cell count, milk quality, payment system, breeding goal

Procedia PDF Downloads 254
2682 Prevalence of Urinary Tract Infections and Risk Factors among Pregnant Women Attending Ante Natal Clinics in Government Primary Health Care Centres in Akure

Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

Abstract:

Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

Procedia PDF Downloads 133
2681 Cultivation And Production of Insects, Especially Mealworms (Mealworms) and Investigating Its Potential as Food for Animals and Even Humans

Authors: Marzieh Eshaghi Koupaei

Abstract:

By cultivating mealworm, we reduce greenhouse gases and avoid the use of transgenic products such as soybeans, and we provide food resources rich in protein, amino acids, minerals, etc. for humans and animals, and it has created employment and entrepreneurship. We serve the environment by producing oil from mealworm in the cosmetic industry, using its waste as organic fertilizer and its powder in bodybuilding, and by breaking down plastic by mealworm. The production and breeding of mealworm requires very little infrastructure and does not require much trouble, and requires very little food, and reproduces easily and quickly, and a mealworm production workshop is noiseless, odorless, and pollution-free And the costs are very low. It is possible to use third grade fruits and unsalable fruits of farmers to feed the mealworms, which is completely economical and cost-effective. Mealworms can break down plastic in their intestines and turn it into carbon dioxide. . This process was done in only 16 days, which is a very short time compared to several centuries for plastic to decompose. By producing mealworm, we have helped to preserve the environment and provided the source of protein needed by humans and animals. This industrial insect has the ability and value of commercialization and creates employment and helps the economy of the society.

Keywords: breeding, production of insects, mealworms, research, animal feed, human feed

Procedia PDF Downloads 46
2680 The Effect of Acute Rejection and Delayed Graft Function on Renal Transplant Fibrosis in Live Donor Renal Transplantation

Authors: Wisam Ismail, Sarah Hosgood, Michael Nicholson

Abstract:

The research hypothesis is that early post-transplant allograft fibrosis will be linked to donor factors and that acute rejection and/or delayed graft function in the recipient will be independent risk factors for the development of fibrosis. This research hypothesis is to explore whether acute rejection/delay graft function has an effect on the renal transplant fibrosis within the first year post live donor kidney transplant between 1998 and 2009. Methods: The study has been designed to identify five time points of the renal transplant biopsies [0 (pre-transplant), 1 month, 3 months, 6 months and 12 months] for 300 live donor renal transplant patients over 12 years period between March 1997 – August 2009. Paraffin fixed slides were collected from Leicester General Hospital and Leicester Royal Infirmary. These were routinely sectioned at a thickness of 4 Micro millimetres for standardization. Conclusions: Fibrosis at 1 month after the transplant was found significantly associated with baseline fibrosis (p<0.001) and HTN in the transplant recipient (p<0.001). Dialysis after the transplant showed a weak association with fibrosis at 1 month (p=0.07). The negative coefficient for HTN (-0.05) suggests a reduction in fibrosis in the absence of HTN. Fibrosis at 1 month was significantly associated with fibrosis at baseline (p 0.01 and 95%CI 0.11 to 0.67). Fibrosis at 3, 6 or 12 months was not found to be associated with fibrosis at baseline (p=0.70. 0.65 and 0.50 respectively). The amount of fibrosis at 1 month is significantly associated with graft survival (p=0.01 and 95%CI 0.02 to 0.14). Rejection and severity of rejection were not found to be associated with fibrosis at 1 month. The amount of fibrosis at 1 month was significantly associated with graft survival (p=0.02) after adjusting for baseline fibrosis (p=0.01). Both baseline fibrosis and graft survival were significant predictive factors. The amount of fibrosis at 1 month was not found to be significantly associated with rejection (p=0.64) after adjusting for baseline fibrosis (p=0.01). The amount of fibrosis at 1 month was not found to be significantly associated with rejection severity (p=0.29) after adjusting for baseline fibrosis (p=0.04). Fibrosis at baseline and HTN in the recipient were found to be predictive factors of fibrosis at 1 month. (p 0.02, p <0.001 respectively). Age of the donor, their relation to the patient, the pre-op Creatinine, artery, kidney weight and warm time were not found to be significantly associated with fibrosis at 1 month. In this complex model baseline fibrosis, HTN in the recipient and cold time were found to be predictive factors of fibrosis at 1 month (p=0.01,<0.001 and 0.03 respectively). Donor age was found to be a predictive factor of fibrosis at 6 months. The above analysis was repeated for 3, 6 and 12 months. No associations were detected between fibrosis and any of the explanatory variables with the exception of the donor age which was found to be a predictive factor of fibrosis at 6 months.

Keywords: fibrosis, transplant, renal, rejection

Procedia PDF Downloads 227
2679 A Study on Multidimensional Locus of Control and the Procrastinating Behavior in Employees

Authors: Richa Mishra, Sonia Munjal

Abstract:

In this increasingly hectic and competitive climate, employees are expected to manage the resources available to them to perform their work. However, many are wasting the most precious and scarce resource at their disposal, time, by procrastinating on tasks and thereby costing themselves and their organizations. As timely performance is a requirement of most jobs, procrastination is particularly problematic in the workplace. Evidence suggests that procrastination and poor performance go hand-in-hand, as procrastinators miss more deadlines than non-procrastinators and make more errors and work at a slower speed than non-procrastinators when performing timed tasks. This research is hence an effort to add a little in the sparse knowledge base. It is an effort to throw light on the relationship of Levenson’s multi dimensions of locus of control and also an effort to identify if it is one of the causes and of employees procrastination which have not been explored earlier. The study also explores the effect and relationship of multidimensional locus of control and various levels of stress on procrastination. The results of the research have ascertained that there is significant impact of LOC dimensions on the procrastinating behavior of the employees. One of the major findings to emerge from the current research that managers with powerful others as their LOC dimensions were least procrastinating, contradicts the previous research results that external procrastinate more than internals.

Keywords: Multidimensional Locus of Control, workplace procrastination, employee behaviour, manufacturing industry

Procedia PDF Downloads 234
2678 Analysis and Modeling of Vibratory Signals Based on LMD for Rolling Bearing Fault Diagnosis

Authors: Toufik Bensana, Slimane Mekhilef, Kamel Tadjine

Abstract:

The use of vibration analysis has been established as the most common and reliable method of analysis in the field of condition monitoring and diagnostics of rotating machinery. Rolling bearings cover a broad range of rotary machines and plays a crucial role in the modern manufacturing industry. Unfortunately, the vibration signals collected from a faulty bearing are generally non-stationary, nonlinear and with strong noise interference, so it is essential to obtain the fault features correctly. In this paper, a novel numerical analysis method based on local mean decomposition (LMD) is proposed. LMD decompose the signal into a series of product functions (PFs), each of which is the product of an envelope signal and a purely frequency modulated FM signal. The envelope of a PF is the instantaneous amplitude (IA) and the derivative of the unwrapped phase of a purely flat frequency demodulated (FM) signal is the IF. After that, the fault characteristic frequency of the roller bearing can be extracted by performing spectrum analysis to the instantaneous amplitude of PF component containing dominant fault information. the results show the effectiveness of the proposed technique in fault detection and diagnosis of rolling element bearing.

Keywords: fault diagnosis, local mean decomposition, rolling element bearing, vibration analysis

Procedia PDF Downloads 400
2677 Exergetic Analysis of Steam Turbine Power Plant Operated in Chemical Industry

Authors: F. Hafdhi, T. Khir, A. Ben Yahia, A. Ben Brahim

Abstract:

An Energetic and exergetic analysis is conducted on a Steam Turbine Power Plant of an existing Phosphoric Acid Factory. The heat recovery systems used in different parts of the plant are also considered in the analysis. Mass, thermal and exergy balances are established on the main compounds of the factory. A numerical code is established using EES software to perform the calculations required for the thermal and exergy plant analysis. The effects of the key operating parameters such as steam pressure and temperature, mass flow rate as well as seawater temperature, on the cycle performances are investigated. A maximum Exergy Loss Rate of about 72% is obtained for the melters, followed by the condensers, heat exchangers and the pumps. The heat exchangers used in the phosphoric acid unit present exergetic efficiencies around 33% while 60% to 72% are obtained for steam turbines and blower. For the explored ranges of HP steam temperature and pressure, the exergy efficiencies of steam turbine generators STGI and STGII increase of about 2.5% and 5.4% respectively. In the same way, optimum HP steam flow rate values, leading to the maximum exergy efficiencies are defined.

Keywords: steam turbine generator, energy efficiency, exergy efficiency, phosphoric acid plant

Procedia PDF Downloads 303
2676 Modelling Impacts of Global Financial Crises on Stock Volatility of Nigeria Banks

Authors: Maruf Ariyo Raheem, Patrick Oseloka Ezepue

Abstract:

This research aimed at determining most appropriate heteroskedastic model to predicting volatility of 10 major Nigerian banks: Access, United Bank for Africa (UBA), Guaranty Trust, Skye, Diamond, Fidelity, Sterling, Union, ETI and Zenith banks using daily closing stock prices of each of the banks from 2004 to 2014. The models employed include ARCH (1), GARCH (1, 1), EGARCH (1, 1) and TARCH (1, 1). The results show that all the banks returns are highly leptokurtic, significantly skewed and thus non-normal across the four periods except for Fidelity bank during financial crises; findings similar to those of other global markets. There is also strong evidence for the presence of heteroscedasticity, and that volatility persistence during crisis is higher than before the crisis across the 10 banks, with that of UBA taking the lead, about 11 times higher during the crisis. Findings further revealed that Asymmetric GARCH models became dominant especially during financial crises and post crises when the second reforms were introduced into the banking industry by the Central Bank of Nigeria (CBN). Generally, one could say that Nigerian banks returns are volatility persistent during and after the crises, and characterised by leverage effects of negative and positive shocks during these periods

Keywords: global financial crisis, leverage effect, persistence, volatility clustering

Procedia PDF Downloads 519
2675 Fiber-Reinforced Sandwich Structures Based on Selective Laser Sintering: A Technological View

Authors: T. Häfele, J. Kaspar, M. Vielhaber, W. Calles, J. Griebsch

Abstract:

The demand for an increasing diversification of the product spectrum associated with the current huge customization desire and subsequently the decreasing unit quantities of each production lot is gaining more and more importance within a great variety of industrial branches, e.g. automotive industry. Nevertheless, traditional product development and production processes (molding, extrusion) are already reaching their limits or fail to address these trends of a flexible and digitized production in view of a product variability up to lot size one. Thus, upcoming innovative production concepts like the additive manufacturing technology basically create new opportunities with regard to extensive potentials in product development (constructive optimization) and manufacturing (economic individualization), but mostly suffer from insufficient strength regarding structural components. Therefore, this contribution presents an innovative technological and procedural conception of a hybrid additive manufacturing process (fiber-reinforced sandwich structures based on selective laser sintering technology) to overcome these current structural weaknesses, and consequently support the design of complex lightweight components.

Keywords: additive manufacturing, fiber-reinforced plastics (FRP), hybrid design, lightweight design

Procedia PDF Downloads 292
2674 Sales-Based Dynamic Investment and Leverage Decisions: A Longitudinal Study

Authors: Rihab Belguith, Fathi Abid

Abstract:

The paper develops a system-based approach to investigate the dynamic adjustment of debt structure and investment policies of the Dow-Jones index. This approach enables the assessment of relations among sales, debt, and investment opportunities by considering the simultaneous effect of the market environmental change and future growth opportunities. We integrate the firm-specific sales variance to capture the industries' conditions in the model. Empirical results were obtained through a panel data set of firms with different sectors. The analysis support that environmental change does not affect equally the different industry since operating leverage differs among industries and so the sensitivity to sales variance. Including adjusted-specific variance, we find that there is no monotonic relation between leverage, sales, and investment. The firm may choose a low debt level in response to high sales variance but high leverage to attenuate the negative relation between sales variance and the current level of investment. We further find that while the overall effect of debt maturity on leverage is unaffected by the level of growth opportunities, the shorter the maturity of debt is, the smaller the direct effect of sales variance on investment.

Keywords: dynamic panel, investment, leverage decision, sales uncertainty

Procedia PDF Downloads 240
2673 Impact of Marketing towards Behavior Intention

Authors: Sathyamangalam Rangasamy Guru Prasath

Abstract:

Due to the increasing homogeneity in product offerings, the attendant services provided are emerging as a key differentiator in the mind of the consumers. Services marketing are a sub field of marketing which covers the marketing of both goods and services. Service marketing differs from product marketing due to the face that services are intangible and typically require personal interaction with the customer. Relationships are a key factor when it comes to the marketing of services. The role of interpersonal relationships distinguishes service and product marketing in strategic vision and organizational considerations. This paper explores some of the trends in service marketing as they relate to strategic vision, operational and organizational changes, and marketing tactics. The presence of the customer in the service facility means that capacity management becomes an important driver of the firm’s profitability service marketing is a process from the organization’s point of view, but an experience from the customer’s perspective. The quality of the experience is a function of the careful design of customer service processes, adoption of standardized procedures, rigorous management of service quality, high standards of training and automation. Services marketing helps to ensure that these processes are designed from the customer’s perspective. Services marketing includes customer loyalty, managing relationships, complaint handling, improving service quality and productivity of service operations, and how to become a service leader in your industry.

Keywords: customer perspective, product marketing, service marketing, rigorous management

Procedia PDF Downloads 363
2672 Embedding Sustainable Design Practices in Architecture Pedagogy: A Study on Ecological Conscious Building Design Techniques

Authors: Pooya Lotfabadi

Abstract:

As the global community struggles with pressing environmental challenges, the field of architecture finds itself at the forefront of sustainability issues. This study evaluates the effectiveness of "ecological conscious building design" courses in architecture education, promoting ecological awareness among future architects. Using the analytic hierarchy process (AHP) as a framework, the study assesses the course’s influence on students' knowledge, skills, and attitudes toward sustainable practices. Through analyzing student feedback, performance assessments, and course outcomes, the research highlights the advantages and limitations of integrating ecological building design into the curriculum. Furthermore, the alignment between the course content and the leadership in energy and environmental design (LEED) certification criteria is explored, evaluating its adequacy in preparing students for environmentally responsible architectural practices. This research offers critical insights for academia and the industry, offering guidance for refining pedagogical approaches, improving curriculum design, and fostering young architects committed to environmentally conscious practices. Ultimately, this study seeks to propel the field of architecture toward a more sustainable and ecologically responsible future.

Keywords: AHP, architectural education, ecological design, sustainability

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2671 Optimizing of the Micro EDM Parameters in Drilling of Titanium Ti-6Al-4V Alloy for Higher Machining Accuracy-Fuzzy Modelling

Authors: Ahmed A. D. Sarhan, Mum Wai Yip, M. Sayuti, Lim Siew Fen

Abstract:

Ti6Al4V alloy is highly used in the automotive and aerospace industry due to its good machining characteristics. Micro EDM drilling is commonly used to drill micro hole on extremely hard material with very high depth to diameter ratio. In this study, the parameters of micro-electrical discharge machining (EDM) in drilling of Ti6Al4V alloy is optimized for higher machining accuracy with less hole-dilation and hole taper ratio. The micro-EDM machining parameters includes, peak current and pulse on time. Fuzzy analysis was developed to evaluate the machining accuracy. The analysis shows that hole-dilation and hole-taper ratio are increased with the increasing of peak current and pulse on time. However, the surface quality deteriorates as the peak current and pulse on time increase. The combination that gives the optimum result for hole dilation is medium peak current and short pulse on time. Meanwhile, the optimum result for hole taper ratio is low peak current and short pulse on time.

Keywords: Micro EDM, Ti-6Al-4V alloy, fuzzy logic based analysis, optimization, machining accuracy

Procedia PDF Downloads 489
2670 A Rare Case of Synchronous Colon Adenocarcinoma

Authors: Mohamed Shafi Bin Mahboob Ali

Abstract:

Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.

Keywords: synchronous, colon, tumor, adenocarcinoma

Procedia PDF Downloads 102
2669 Effect of Building Construction Sizes on Project Delivery Methods in Nigeria

Authors: Nuruddeen Usman, Mohammad Sani

Abstract:

The performance of project delivery methods has been an issue of concern to various stakeholders in the construction industry. The contracting system of project delivery is the traditional system used in the delivery of most public projects in Nigeria. The direct labor system is used most times as an alternative to the traditional system. There were so many complain about the performance of contracting system and the suitability of direct labor as an alternative to the delivery of public projects. Therefore, this paper is aimed at investigating the effect of project size on the project delivery methods in the completed public buildings. Questionnaires were self-administered to managerial staff in the study area and analyzed using descriptive statistics. The findings reveals that contracting system was choosing for large size building construction project delivery with higher frequency (F) of 40 (76.9%) against direct labor with 12 (23.1%). While the small size project, the result revealed a frequency (F) of 26 (50%) for contracting system and direct labor system respectively. Base on the research findings, the contracting system, was recommended for all sizes of building construction project delivery while direct labor system can only use as an alternative for small size building construction projects delivery.

Keywords: construction size, contracting system, direct labour, effect

Procedia PDF Downloads 450