Search results for: Alexander David Natanson
542 Development of a Core Set of Clinical Indicators to Measure Quality of Care for Thyroid Cancer: A Modified-Delphi Approach
Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern
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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.Keywords: clinical registry, Delphi survey, quality indicators, quality of care
Procedia PDF Downloads 179541 Inclusive Education in Jordanian Double-Shift Schools: Attitudes of Teacher and Students
Authors: David Ross Cameron
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In an attempt to alleviate the educational planning problem, double-shift schools have been created throughout various regions in Jordan, namely communities closer to the Syrian border, where a large portion of the refugee population settled, allowing Jordanians to attend the morning-shift and Syrians to attend the afternoon-shift. Subsequently, overcrowded classrooms have added a significant amount of stress on school facilities and teacher capacities. Established national policies and the implementation of inclusive educational practices have been jeopardized. In particular, teachers’ and student’s attitudes of the importance of inclusive education provisions in the classroom have deteriorated. To have a more comprehensive understanding of the current situation and possible plan for intervention, a focus study was carried out at a double-shift Jordanian/Syrian girls’ public school in Irbid, Jordan. Interviews and surveys of 29 students with physical, learning, emotional and behavioral disabilities, 33 students without any special needs and nine teachers were included with a mixed-method social research approach to highlight the current attitudes that students and teachers held and factors that contributed to shaping their inclinations and beliefs of inclusive education.Keywords: capacity building, development, double-shift, Irbid, inclusive education, Jordan, pedagogy, planning, policy, refugee, special education, special needs, vulnerable population
Procedia PDF Downloads 255540 Third Eye: A Hybrid Portrayal of Visuospatial Attention through Eye Tracking Research and Modular Arithmetic
Authors: Shareefa Abdullah Al-Maqtari, Ruzaika Omar Basaree, Rafeah Legino
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A pictorial representation of hybrid forms in science-art collaboration has become a crucial issue in the course of exploring a new painting technique development. This is straight related to the reception of an invisible-recognition phenomenology. In hybrid pictorial representation of invisible-recognition phenomenology, the challenging issue is how to depict the pictorial features of indescribable objects from its mental source, modality and transparency. This paper proposes the hybrid technique of painting Demonstrate, Resemble, and Synthesize (DRS) through a combination of the hybrid aspect-recognition representation of understanding picture, demonstrative mod, the number theory, pattern in the modular arithmetic system, and the coherence theory of visual attention in the dynamic scenes representation. Multi-methods digital gaze data analyses, pattern-modular table operation design, and rotation parameter were used for the visualization. In the scientific processes, Eye-trackingvideo-sections based was conducted using Tobii T60 remote eye tracking hardware and TobiiStudioTM analysis software to collect and analyze the eye movements of ten participants when watching the video clip, Alexander Paulikevitch’s performance’s ‘Tajwal’. Results: we found that correlation of fixation count in section one was positively and moderately correlated with section two Person’s (r=.10, p < .05, 2-tailed) as well as in fixation duration Person’s (r=.10, p < .05, 2-tailed). However, a paired-samples t-test indicates that scores were significantly higher for the section one (M = 2.2, SD = .6) than for the section two (M = 1.93, SD = .6) t(9) = 2.44, p < .05, d = 0.87. In the visual process, the exported data of gaze number N was resembled the hybrid forms of visuospatial attention using the table-mod-analyses operation. The explored hybrid guideline was simply applicable, and it could be as alternative approach to the sustainability of contemporary visual arts.Keywords: science-art collaboration, hybrid forms, pictorial representation, visuospatial attention, modular arithmetic
Procedia PDF Downloads 364539 Exploring Factors Influencing Orthopedic Patients' Willingness to Recommend a Hospital: Insights from a Cross-Sectional Survey
Authors: Merav Ben Natan, David Maman, Milana Avramov, Galina Shamilov, Yaron Berkovich
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Introduction: Patient satisfaction and the willingness to recommend a hospital are vital for improving healthcare quality. This study examines orthopedic patients to identify factors influencing their willingness to recommend the hospital. Aim: This study to explore the demographic and clinical variables affecting orthopedic patients' willingness to recommend the hospital and to understand the role of patient satisfaction in this context. Methods: A cross-sectional survey was conducted with 200 orthopedic patients hospitalized between July and December 2023 in north-central Israel. Data were analyzed to assess the impact of various factors on the willingness to recommend the hospital. Results: Age was positively associated with the willingness to recommend (OR=2.44), while the length of stay in the Emergency Department negatively impacted this willingness (OR=0.58). Satisfaction with hospital care had a positive effect on willingness to recommend (OR=1.96). Gender, comorbidities, and total hospital stay length did not significantly influence willingness to recommend. Conclusions: Satisfaction with hospital care and the length of Emergency Department stays are crucial factors affecting orthopedic patients' willingness to recommend the hospital. This underscores the need for strategies to improve patient experiences and address delays in the Emergency Department. The findings offer valuable insights for healthcare providers and policymakers.Keywords: orthopedic patients, patient satisfaction, willingness to recommend, hospital recommendation
Procedia PDF Downloads 30538 The Effect of Mindfulness on Eating Enjoyment and Behavior in Preschool and Elementary Children: A Field Experiment across Four Schools
Authors: Phan Hong, David Lishner, Matthew Hanson
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Sixty-five children across four school research sites participated in the present experiment, which was designed to examine whether mindfulness promotes eating enjoyment and diverse eating behaviors in preschool- and early elementary-age children. Children, ages 3-9 years old, were randomly assigned to a 4-week mindfulness intervention condition or a 4-week exposure, control condition. Each week for four days, children received one of four different foods (celery, cauliflower, kidney beans, or garbanzo beans). Children either received instructions to mindfully engage with the food or were given the food and allowed to eat without mindfulness prompts from the researchers. Following the eating exercise, they recorded the amount eaten and rated their enjoyment level. Across all sessions, researchers modeled eating behaviors for the children by eating all the offered food. Results suggested that a brief mindfulness intervention promoted more diverse eating behaviors and more overall food consumption of typically not preferred and unfamiliar foods (celery, cauliflower, and garbanzo beans), compared with an exposure, control condition in preschool children and elementary-age children. However, food enjoyment ratings did not significantly differ between the two conditions for any of the foods. Implications of the finding for addressing eating behavior of young children are considered.Keywords: children, control trial, eating behavior, eating enjoyment, mindfulness, schools
Procedia PDF Downloads 227537 High-Resolution Surface Temperature Changes for Portugal Under CMIP6 Future Climate Scenarios
Authors: David Carvalho
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Future changes in the mean, maximum and minimum temperature in continental Portugal were investigated using high-resolution future climate projections based on the latest IPCC AR6 CMIP6 climate scenarios. The results show that the mean, maximum and minimum temperatures are projected to increase substantially in all of continental Portugal, particularly in the south-central inland regions. For the near-term future (2046-2065 period), SSP3-7.0 is the future climate scenario that projects higher increases of around 1 ºC, 1.5 ºC and 2 ºC for the daily mean, maximum and minimum temperatures, respectively. For the long-term future (2081-2100 period), the projected warming is higher, particularly under the SSP5-8.5 future climate scenario with projected warmings of 3 ºC, 3.5 ºC and 2.5 ºC for the daily mean, maximum and minimum temperatures, respectively. Occurrences of hot days (mean temperature above 30 ºC), very hot days (maximum temperature above 40 ºC) and tropical nights (minimum temperature above 20 ºC) are all projected to increase up to 35-40, 12-15 and 50 more days per year, respectively, mainly in the interior areas of Portugal. Oppositely, the occurrence of frost days is projected to decrease in practically all mountainous areas in Portugal. These results show a clear tendency of a significant increase in the surface temperatures and frequency of occurrence of extreme temperature episodes in continental Portugal, which can have severe impacts on the population, environment, economy and vital human activities such as agriculture.Keywords: climate change, global warming, CMIP6, Portugal
Procedia PDF Downloads 32536 Filmic and Verbal Metafphors
Authors: Manana Rusieshvili, Rusudan Dolidze
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This paper aims at 1) investigating the ways in which a traditional, monomodal written verbal metaphor can be transposed as a monomodal non-verbal (visual) or multimodal (aural and -visual) filmic metaphor ; 2) exploring similarities and differences in the process of encoding and decoding of monomodal and multimodal metaphors. The empiric data, on which the research is based, embrace three sources: the novel by Harry Gray ‘The Hoods’, the script of the film ‘Once Upon a Time in America’ (English version by David Mills) and the resultant film by Sergio Leone. In order to achieve the above mentioned goals, the research focuses on the following issues: 1) identification of verbal and non-verbal monomodal and multimodal metaphors in the above-mentioned sources and 2) investigation of the ways and modes the specific written monomodal metaphors appearing in the novel and the script are enacted in the film and become visual, aural or visual-aural filmic metaphors ; 3) study of the factors which play an important role in contributing to the encoding and decoding of the filmic metaphor. The collection and analysis of the data were carried out in two stages: firstly, the relevant data, i.e. the monomodal metaphors from the novel, the script and the film were identified and collected. In the second, final stage the metaphors taken from all of the three sources were analysed, compared and two types of phenomena were selected for discussion: (1) the monomodal written metaphors found in the novel and/or in the script which become monomodal visual/aural metaphors in the film; (2) the monomodal written metaphors found in the novel and/or in the script which become multimodal, filmic (visual-aural) metaphors in the film.Keywords: encoding, decoding, filmic metaphor, multimodality
Procedia PDF Downloads 526535 Competition as an Appropriate Instructional Practice in the Physical Education Environment: Reflective Experiences
Authors: David Barney, Francis Pleban, Muna Muday
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The purpose of this study was to explore gender differences of former physical education students related to reflective experiences of competition in physical education learning environment. In the school environment, students are positioned in competitive situations, including in the physical education context. Therefore it is important to prepare future physical educators to address the role of competition in physical education. Participants for this study were 304 college-aged students and young adults (M = 1.53, SD = .500), from a private university and local community located in the western United States. When comparing gender, significant differences (p < .05) were reported for four (questions 5, 7, 12, and 14) of the nine scaling questions. Follow-up quantitative findings reported that males (41%) more than females (27%) witnessed fights in physical education environment during competitive games. Qualitative findings reported fighting were along the lines of verbal confrontation. Female participants tended to experience being excluded from games, when compared to male participants. Both male and female participants (total population; 95%, males; 98%; and females 92%) were in favor of including competition in physical education for students. Findings suggest that physical education teachers and physical education teacher education programs have a responsibility to develop gender neutral learning experiences that help students better appreciate the role competition plays, both in and out of the physical education classroom.Keywords: competition, physical education, physical education teacher education, gender
Procedia PDF Downloads 497534 Synthesis, Antibacterial Activities, and Synergistic Effects of Novel Juglone and Naphthazarin Derivatives Against Clinical Methicillin-Resistant Staphylococcus aureus Strains
Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre
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New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination
Procedia PDF Downloads 126533 Criminalizing the Transmission of HIV-Lessons for South Africa
Authors: Desiree David
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South Africa has one of the highest rates of HIV infection in the world, with a sizable percentage of the population living with HIV. A substantial number of new infections occur as a result of sexual activity. South African courts have awarded civil claims for damages as a result of the transmission of HIV as a result of non-disclosure by the HIV-positive sexual partner, and more recently, the criminal courts have also convicted and sentenced individuals accused of infecting others as a result of sexual activity. This paper will analyse some case law from South African court cases that have dealt with criminal convictions for the transmission of HIV, and the potential for more widespread prosecutions of these cases. It will also address the desirability of this trend in light of the social public health system, as well as human rights concerns surrounding this highly contentious issue. This will be done by considering some applicable provisions of the Bill of Rights such as the right to privacy and equality, as espoused in the Constitution of the Republic of South Africa. The paper further addresses the experience of other jurisdictions such as Canada, Singapore, Lesotho and Uganda, by analyzing case law, and consider the pitfalls of criminalizing a wide spectrum of sexual conduct that could result in the transmission of HIV. The paper concludes with a proposal that the issue of criminalizing the transmission of HIV cannot be addressed by the criminal justice system alone, as to do so could result in harsh consequences for those living with HIV. As such individuals may be burdened with additional responsibilities that could potentially impact on the rights of the individual. This may ultimately result in injustice for those living with HIV.Keywords: criminalization, HIV, human rights, South Africa
Procedia PDF Downloads 342532 Implementation of a Lattice Boltzmann Method for Pulsatile Flow with Moment Based Boundary Condition
Authors: Zainab A. Bu Sinnah, David I. Graham
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The Lattice Boltzmann Method has been developed and used to simulate both steady and unsteady fluid flow problems such as turbulent flows, multiphase flow and flows in the vascular system. As an example, the study of blood flow and its properties can give a greater understanding of atherosclerosis and the flow parameters which influence this phenomenon. The blood flow in the vascular system is driven by a pulsating pressure gradient which is produced by the heart. As a very simple model of this, we simulate plane channel flow under periodic forcing. This pulsatile flow is essentially the standard Poiseuille flow except that the flow is driven by the periodic forcing term. Moment boundary conditions, where various moments of the particle distribution function are specified, are applied at solid walls. We used a second-order single relaxation time model and investigated grid convergence using two distinct approaches. In the first approach, we fixed both Reynolds and Womersley numbers and varied relaxation time with grid size. In the second approach, we fixed the Womersley number and relaxation time. The expected second-order convergence was obtained for the second approach. For the first approach, however, the numerical method converged, but not necessarily to the appropriate analytical result. An explanation is given for these observations.Keywords: Lattice Boltzmann method, single relaxation time, pulsatile flow, moment based boundary condition
Procedia PDF Downloads 231531 Energy Efficient Construction and the Seismic Resistance of Passive Houses
Authors: Vojko Kilar, Boris Azinović, David Koren
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Recently, an increasing trend of passive and low-energy buildings transferring form non earthquake-prone to earthquake-prone regions has thrown out the question about the seismic safety of such buildings. The paper describes the most commonly used thermal insulating materials and the special details, which could be critical from the point of view of earthquake resistance. The most critical appeared to be the cases of buildings founded on the RC foundation slab lying on a thermal insulation (TI) layer made of extruded polystyrene (XPS). It was pointed out that in such cases the seismic response of such buildings might differ to response of their fixed based counterparts. The main parameters that need special designers’ attention are: the building’s lateral top displacement, the ductility demand of the superstructure, the foundation friction coefficient demand, the maximum compressive stress in the TI layer and the percentage of the uplifted foundation. The analyses have shown that the potentially negative influences of inserting the TI under the foundation slab could be expected only for slender high-rise buildings subjected to severe earthquakes. Oppositely it was demonstrated for the foundation friction coefficient demand which could exceed the capacity value yet in the case of low-rise buildings subjected to moderate earthquakes. Some suggestions to prevent the horizontal shifts are also given.Keywords: earthquake response, extruded polystyrene (XPS), low-energy buildings, foundations on thermal insulation layer
Procedia PDF Downloads 252530 The Lead Poisoning of Beethoven and Handel
Authors: Michael Stevens
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David Hunter, a musicologist, has suggested that both Beethoven and Handel had chronic lead poisoning from the wine that they drank. These two eminent musical composers had some striking similarities. Beethoven had alcohol dependency and preferred wine, to which lead had been added to improve the taste. Handel was obese due to an eating disorder that included drinking tainted wine after large meals. They both had paresthesia of their extremities that they interpreted as rheumatism. This is a common sensory symptom from chronic lead poisoning. Their differences are marked in that Beethoven was profoundly deaf by the end of his life, whereas Handel had remarkably good hearing. Handel had paresis of three fingers of his right hand, whereas Beethoven lacked any motor symptoms. Beethoven reported recurrent abdominal pain suggestive of lead colic, whereas it can only be inferred that this symptom was present in Handel. Lead poisoning is likely in Handel because his paralysis was consistent with radial nerve involvement in the dominant hand. In addition, it was cured by hot baths, which have been shown to reduce total body lead content by exchanging with iron and calcium ions in water. Although lead produces predominantly motor symptoms in classic or subacute lead poisoning, and sensory symptoms in chronic lead poisoning, lead poisoning causes a variety of symptoms that depending on duration and level of exposure, are extremely variable from person to person. It therefore seems likely that Handel had lead poisoning, but extremely likely that Beethoven did because of the confirmatory finding of high levels of lead deep in his skull bone, which is a good measure of total body burden.Keywords: beethoven, handel, lead, poisoning
Procedia PDF Downloads 95529 Efficiency of Membrane Distillation to Produce Fresh Water
Authors: Sabri Mrayed, David Maccioni, Greg Leslie
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Seawater desalination has been accepted as one of the most effective solutions to the growing problem of a diminishing clean drinking water supply. Currently, two desalination technologies dominate the market – the thermally driven multi-stage flash distillation (MSF) and the membrane based reverse osmosis (RO). However, in recent years membrane distillation (MD) has emerged as a potential alternative to the established means of desalination. This research project intended to determine the viability of MD as an alternative process to MSF and RO for seawater desalination. Specifically the project involves conducting a thermodynamic analysis of the process based on the second law of thermodynamics to determine the efficiency of the MD. Data was obtained from experiments carried out on a laboratory rig. In order to determine exergy values required for the exergy analysis, two separate models were built in Engineering Equation Solver – the ’Minimum Separation Work Model’ and the ‘Stream Exergy Model’. The efficiency of MD process was found to be 17.3 %, and the energy consumption was determined to be 4.5 kWh to produce one cubic meter of fresh water. The results indicate MD has potential as a technique for seawater desalination compared to RO and MSF. However, it was shown that this was only the case if an alternate energy source such as green or waste energy was available to provide the thermal energy input to the process. If the process was required to power itself, it was shown to be highly inefficient and in no way thermodynamically viable as a commercial desalination process.Keywords: desalination, exergy, membrane distillation, second law efficiency
Procedia PDF Downloads 363528 Unpacking Tourist Experience: A Case Study of Chinese Tourists Visiting the UK
Authors: Guanhao Tong, Li Li, Ben David
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This study aims to provide an explanatory account of how the leisure tourist experience emerges from tourists and their surroundings through a critical realist lens. This was achieved by applying Archer’s realist social theory as the underlying theoretical ground to unpack the interplays between the external (tourism system or structure) and the internal (tourists or agency). This theory argues that social phenomena can be analyzed in three domains - structure, agency, and culture (SAC), and along three phases – structure conditioning, sociocultural interactions, and structure elaboration. From the realist perspective, the world is an open system; events and discourses are irreducible to present individuals and collectivities. Therefore, identifying the processes or mechanisms is key to help researchers understand how social reality is brought about. Based on the contextual nature of the tourist experience, the research focuses on Chinese tourists (from mainland China) to London as a destination and British culture conveyed through the concept of the destination image. This study uses an intensive approach based on Archer’s M/M approach to discover the mechanisms/processes of the emergence of the tourist experience. Individual interviews were conducted to reveal the underlying causes of lived experiences of the tourists. Secondary data was also collected to understand how British destinations are portrayed to Chinese tourists.Keywords: Chinese tourists, destination image, M/M approach, realist social theory, social mechanisms, tourist experience
Procedia PDF Downloads 72527 Abandoning 'One-Time' Optional Information Literacy Workshops for Year 1 Medical Students and Gearing towards an 'Embedded Librarianship' Approach
Authors: R. L. David, E. C. P. Tan, M. A. Ferenczi
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This study aimed to investigate the effect of a 'one-time' optional Information Literacy (IL) workshop to enhance Year 1 medical students' literature search, writing, and citation management skills as directed by a customized five-year IL framework developed for LKC Medicine students. At the end of the IL workshop, the overall rated 'somewhat difficult' when finding, citing, and using information from sources. The study method is experimental using a standardized IL test to study the cohort effect of a 'one-time' optional IL workshop on Year 1 students; experimental group in comparison to Year 2 students; control group. Test scores from both groups were compared and analyzed using mean scores and one-way analysis of variance (ANOVA). Unexpectedly, there were no statistically significant differences between group means as determined by One-Way ANOVA (F₁,₁₉₃ = 3.37, p = 0.068, ηp² = 0.017). Challenges and shortfalls posed by 'one-time' interventions raised a rich discussion to adopt an 'embedded librarianship' approach, which shifts the medial librarians' role into the curriculum and uses Team Based Learning to teach IL skills to medical students. The customized five-year IL framework developed for LKC Medicine students becomes a useful librarian-faculty model for embedding and bringing IL into the classroom.Keywords: information literacy, 'one-time' interventions, medical students, standardized tests, embedded librarianship, curriculum, medical librarians
Procedia PDF Downloads 113526 Health Care Waste Management Practices in Liberia: An Investigative Case Study
Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina
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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia
Procedia PDF Downloads 345525 Microfluidic Chambers with Fluid Walls for Cell Biology
Authors: Cristian Soitu, Alexander Feuerborn, Cyril Deroy, Alfonso Castrejon-Pita, Peter R. Cook, Edmond J. Walsh
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Microfluidics now stands as an academically mature technology after a quarter of a century research activities have delivered a vast array of proof of concepts for many biological workflows. However, translation to industry remains poor, with only a handful of notable exceptions – e.g. digital PCR, DNA sequencing – mainly because of biocompatibility issues, limited range of readouts supported or complex operation required. This technology exploits the domination of interfacial forces over gravitational ones at the microscale, replacing solid walls with fluid ones as building blocks for cell micro-environments. By employing only materials used by biologists for decades, the system is shown to be biocompatible, and easy to manufacture and operate. The method consists in displacing a continuous fluid layer into a pattern of isolated chambers overlaid with an immiscible liquid to prevent evaporation. The resulting fluid arrangements can be arrays of micro-chambers with rectangular footprint, which use the maximum surface area available, or structures with irregular patterns. Pliant, self-healing fluid walls confine volumes as small as 1 nl. Such fluidic structures can be reconfigured during the assays, giving the platform an unprecedented level of flexibility. Common workflows in cell biology are demonstrated – e.g. cell growth and retrieval, cloning, cryopreservation, fixation and immunolabeling, CRISPR-Cas9 gene editing, and proof-of-concept drug tests. This fluid-shaping technology is shown to have potential for high-throughput cell- and organism-based assays. The ability to make and reconfigure on-demand microfluidic circuits on standard Petri dishes should find many applications in biology, and yield more relevant phenotypic and genotypic responses when compared to standard microfluidic assays.Keywords: fluid walls, micro-chambers, reconfigurable, freestyle
Procedia PDF Downloads 193524 Automatic Early Breast Cancer Segmentation Enhancement by Image Analysis and Hough Transform
Authors: David Jurado, Carlos Ávila
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Detection of early signs of breast cancer development is crucial to quickly diagnose the disease and to define adequate treatment to increase the survival probability of the patient. Computer Aided Detection systems (CADs), along with modern data techniques such as Machine Learning (ML) and Neural Networks (NN), have shown an overall improvement in digital mammography cancer diagnosis, reducing the false positive and false negative rates becoming important tools for the diagnostic evaluations performed by specialized radiologists. However, ML and NN-based algorithms rely on datasets that might bring issues to the segmentation tasks. In the present work, an automatic segmentation and detection algorithm is described. This algorithm uses image processing techniques along with the Hough transform to automatically identify microcalcifications that are highly correlated with breast cancer development in the early stages. Along with image processing, automatic segmentation of high-contrast objects is done using edge extraction and circle Hough transform. This provides the geometrical features needed for an automatic mask design which extracts statistical features of the regions of interest. The results shown in this study prove the potential of this tool for further diagnostics and classification of mammographic images due to the low sensitivity to noisy images and low contrast mammographies.Keywords: breast cancer, segmentation, X-ray imaging, hough transform, image analysis
Procedia PDF Downloads 83523 Board Composition and Performance of Listed Deposit Money Banks in Nigeria
Authors: Mary David, Denis Basila
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This study assessed the Impact of Board Composition on the Performance of Listed Deposit Money Banks in Nigeria. A sample of ten (10) deposit money banks formed the sample of this study. Board size, gender diversity, and board independence were used as the independent variables, and firm size as a control variable, whiles the bank performance was proxy with Tobin’s Q (TQ) as the dependent variable. Secondary data was collected from secondary source through the annual report and account of the banks and was analyzed through the support of STATA 14 versions. Descriptive statistics, correlation matrix, and OLS multiple regression model were adopted for the study. Breusch and pagan lagrangian multiplier test for random effect was conducted. The findings of the study reveal that board size has positive and significant impact on Tobin’s Q, gender diversity has positive and significant impact on Tobin’s Q, while board independent had a negative and nonsignificant influence on the Tobin’s Q, Similarly, firm size was found to have a negative and nonsignificant impact on Tobin’s Q of the study banks. This study recommended that policy makers, stakeholders, and corporate managers of deposit money banks of Nigeria and related industries are encouraged to adopt board sizes and gender diversity that impact positively on bank performance.Keywords: board composition, performance, deposit money banks, nigeria
Procedia PDF Downloads 73522 The Significance of Intellectual Capital and Strategic Orientations on Innovation Capability in Malaysian ICTSMEs
Authors: Juliana Osman, David Gilbert, Caroline Tan
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Innovation capability is recognized as a critical factor that contributes to promoting firm growth and wealth creation. While studies on innovation are in abundance, few empirical studies have been undertaken to examine the relationships of intellectual capital with innovation capability, and research investigating the combinations of strategic orientation dimensions is limited and virtually nothing in regard to the Malaysian context. This research investigates the impact of intellectual capital and three strategic orientations on the innovation capability and firm performance of Malaysian ICT SMEs. Data was collected from 213 firms relating to intellectual capital and the three strategic orientations; market orientation, learning orientation and technology orientation. Using partial least squares structural equation modelling (PLS-SEM) to analyse the data, results indicate that while market orientation has a direct negative relationship to firm performance, it is positively related to performance through the mediating effect of innovation capability. Learning orientation and technology orientation are mediated by innovation capability, while intellectual capital was found to be partially mediated by innovation capability. Findings indicate that firm performance is positively and significantly related to innovation capability and that market orientation, learning orientation, technology orientation and intellectual capital are all significant and positively related to innovation capability. The developed model indicates that Malaysian ICT SMEs would perform better with greater emphasis on developing innovation capability through enhancement of intellectual capital and the strategic orientations measured in this study.Keywords: innovation capability, intellectual capital, strategic orientations, PLS-SEM
Procedia PDF Downloads 472521 A Contemporary Gender Predominance: A Honduran Textile Manufacturing Diagnose
Authors: Jesús David Argueta Moreno, Taria Ruiz, Cesar Ortega
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This qualitative investigation represents the first stage of the human capital engineering analysis, along the small and medium textile manufacturing companies, located on the city of Tegucigalpa, Honduras where the symptoms of the local manufacturing industry´s describe a severe gender displacement phenomenon. The evaluation of this phenomena, intends to trigger the Honduran small and medium technology manufactures into a collective performance, analysis through the development of a sectorial diagnose and the creation of a manufacturers guide, personalized. In accordance to the Honduran textile manufacturing needs, in order to strengthen their personnel capacities and thereby smoothen the gender equilibrium on this particular sector. It is worth mentioning, that on the last decade, the female gender has gathered positive statistics upon Central American job market´s, were the local business landscape describes a significant displacement of the Honduran female operators over the male gender workers that has significantly diminished their employment predominance. On the other hand, this study aims to evaluate the main features that impact on the job market local gender supplanting. On the other hand, this document aims to holistically describe the Honduran manufacturing context, as well as the current textile operator qualifications, in order to infer over the most proper human resources enforcement approaches/techniques on the industry.Keywords: gender predominance, manufacturing, higher education institutions, emerging trends
Procedia PDF Downloads 430520 Traumatic Brachiocephalic Artery Pseudoaneurysm
Authors: Sally Shepherd, Jessica Wong, David Read
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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma
Procedia PDF Downloads 230519 A Simulation-Based Method for Evaluation of Energy System Cooperation between Pulp and Paper Mills and a District Heating System: A Case Study
Authors: Alexander Hedlund, Anna-Karin Stengard, Olof Björkqvist
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A step towards reducing greenhouse gases and energy consumption is to collaborate with the energy system between several industries. This work is based on a case study on integration of pulp and paper mills with a district heating system in Sundsvall, Sweden. Present research shows that it is possible to make a significant reduction in the electricity demand in the mechanical pulping process. However, the profitability of the efficiency measures could be an issue, as the excess steam recovered from the refiners decreases with the electricity consumption. A consequence will be that the fuel demand for steam production will increase. If the fuel price is similar to the electricity price it would reduce the profit of such a project. If the paper mill can be integrated with a district heating system, it is possible to upgrade excess heat from a nearby kraft pulp mill to process steam via the district heating system in order to avoid the additional fuel need. The concept is investigated by using a simulation model describing both the mass and energy balance as well as the operating margin. Three scenarios were analyzed: reference, electricity reduction and energy substitution. The simulation show that the total input to the system is lowest in the Energy substitution scenario. Additionally, in the Energy substitution scenario the steam from the incineration boiler covers not only the steam shortage but also a part of the steam produced using the biofuel boiler, the cooling tower connected to the incineration boiler is no longer needed and the excess heat can cover the whole district heating load during the whole year. The study shows a substantial economic advantage if all stakeholders act together as one system. However, costs and benefits are unequally shared between the actors. This means that there is a need for new business models in order to share the system costs and benefits.Keywords: energy system, cooperation, simulation method, excess heat, district heating
Procedia PDF Downloads 226518 Assessing the Risk of Condensation and Moisture Accumulation in Solid Walls: Comparing Different Internal Wall Insulation Options
Authors: David Glew, Felix Thomas, Matthew Brooke-Peat
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Improving the thermal performance of homes is seen as an essential step in achieving climate change, fuel security, fuel poverty targets. One of the most effective thermal retrofits is to insulate solid walls. However, it has been observed that applying insulation to the internal face of solid walls reduces the surface temperature of the inner wall leaf, which may introduce condensation risk and may interrupt seasonal moisture accumulation and dissipation. This research quantifies the extent to which the risk of condensation and moisture accumulation in the wall increases (which can increase the risk of timber rot) following the installation of six different types of internal wall insulation. In so doing, it compares how risk is affected by both the thermal resistance, thickness, and breathability of the insulation. Thermal bridging, surface temperatures, condensation risk, and moisture accumulation are evaluated using hygrothermal simulation software before and after the thermal upgrades. The research finds that installing internal wall insulation will always introduce some risk of condensation and moisture. However, it identifies that risks were present prior to insulation and that breathable materials and insulation with lower resistance have lower risks than alternative insulation options. The implications of this may be that building standards that encourage the enhanced thermal performance of solid walls may be introducing moisture risks into homes.Keywords: condensation risk, hygrothermal simulation, internal wall insulation, thermal bridging
Procedia PDF Downloads 161517 Cognitive Fusion and Obstacles to Valued Living: Beyond Pain-Specific Events in Chronic Pain
Authors: Sergio A. Carvalho, Jose Pinto-Gouveia, David Gillanders, Paula Castilho
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The role of psychological processes has long been recognized as crucial factors in depressive symptoms in chronic pain (CP). Although some studies have explored the negative impact of being entangled with internal experiences (e.g., thoughts, emotions, physical sensations) – cognitive fusion, it is not extensively explored 1) whether these are pain-related or rather general difficult experiences, and 2) how they relate to experiencing obstacles in committing to valued actions. The current study followed a cross-sectional design in a sample of 231 participants with CP, in which a mediational model was tested through path analyses in AMOS software. The model presented a very good model fit (Χ²/DF = 1.161; CFI = .999; TLI = .996; RMSEA = .026, PCLOSE = .550.), and results showed that pain intensity was not directly related to depressive symptoms (β = .055; p = .239) but was mediated by cognitive fusion with both general and pain-related internal experiences (β = .181, 95%CI [.097; .271]; p = .015). Additionally, results showed that only general cognitive fusion (but not pain-specific fusion) was associated with experiencing obstacles to living a meaningful life, which mediated its impact on depressive symptoms (β = .197, 95%CI [.102; .307]; p = .001). Overall, this study adds on current literature by suggesting that psychological interventions to pain management should not be focused only on management of pain-related experiences, but also on developing more effective ways of relating to overall internal experiences.Keywords: cognitive fusion, chronic pain, depressive symptoms, valued living
Procedia PDF Downloads 226516 The Functional Roles of Right Dorsolateral Prefrontal Cortex and Ventromedial Prefrontal Cortex in Risk-Taking Behavior
Authors: Aline M. Dantas, Alexander T. Sack, Elisabeth Bruggen, Peiran Jiao, Teresa Schuhmann
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Risk-taking behavior has been associated with the activity of specific prefrontal regions of the brain, namely the right dorsolateral prefrontal cortex (DLPFC) and the ventromedial prefrontal cortex (VMPFC). While the deactivation of the rDLPFC has been shown to lead to increased risk-taking behavior, the functional relationship between VMPFC activity and risk-taking behavior is yet to be clarified. Correlational evidence suggests that the VMPFC is involved in valuation processes that involve risky choices, but evidence on the functional relationship is lacking. Therefore, this study uses brain stimulation to investigate the role of the VMPFC during risk-taking behavior and replicate the current findings regarding the role of the rDLPFC in this same phenomenon. We used continuous theta-burst stimulation (cTBS) to inhibit either the VMPFC or DLPFC during the execution of the computerized Maastricht Gambling Task (MGT) in a within-subject design with 30 participants. We analyzed the effects of such stimulation on risk-taking behavior, participants’ choices of probabilities and average values, and response time. We hypothesized that, compared to sham stimulation, VMPFC inhibition leads to a reduction in risk-taking behavior by reducing the appeal to higher-value options and, consequently, the attractiveness of riskier options. Right DLPFC (rDLPFC) inhibition, on the other hand, should lead to an increase in risk-taking due to a reduction in cognitive control, confirming existent findings. Stimulation of both the rDLPFC and the VMPFC led to an increase in risk-taking behavior and an increase in the average value chosen after both rDLPFC and VMPFC stimulation compared to sham. No significant effect on chosen probabilities was found. A significant increase in response time was observed exclusively after rDLPFC stimulation. Our results indicate that inhibiting DLPFC and VMPFC separately leads to similar effects, increasing both risk-taking behavior and average value choices, which is likely due to the strong anatomical and functional interconnection of the VMPFC and rDLPFC.Keywords: decision-making, risk-taking behavior, brain stimulation, TMS
Procedia PDF Downloads 106515 Integral Form Solutions of the Linearized Navier-Stokes Equations without Deviatoric Stress Tensor Term in the Forward Modeling for FWI
Authors: Anyeres N. Atehortua Jimenez, J. David Lambraño, Juan Carlos Muñoz
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Navier-Stokes equations (NSE), which describe the dynamics of a fluid, have an important application on modeling waves used for data inversion techniques as full waveform inversion (FWI). In this work a linearized version of NSE and its variables, neglecting deviatoric terms of stress tensor, is presented. In order to get a theoretical modeling of pressure p(x,t) and wave velocity profile c(x,t), a wave equation of visco-acoustic medium (VAE) is written. A change of variables p(x,t)=q(x,t)h(ρ), is made on the equation for the VAE leading to a well known Klein-Gordon equation (KGE) describing waves propagating in variable density medium (ρ) with dispersive term α^2(x). KGE is reduced to a Poisson equation and solved by proposing a specific function for α^2(x) accounting for the energy dissipation and dispersion. Finally, an integral form solution is derived for p(x,t), c(x,t) and kinematics variables like particle velocity v(x,t), displacement u(x,t) and bulk modulus function k_b(x,t). Further, it is compared this visco-acoustic formulation with another form broadly used in the geophysics; it is argued that this formalism is more general and, given its integral form, it may offer several advantages from the modern parallel computing point of view. Applications to minimize the errors in modeling for FWI applied to oils resources in geophysics are discussed.Keywords: Navier-Stokes equations, modeling, visco-acoustic, inversion FWI
Procedia PDF Downloads 520514 Assessment of Groundwater Quality around a Cement Factory in Ewekoro, Ogun State, Southwest Nigeria
Authors: A. O. David, A. A. Akaho, M. A. Abah, J. O. Ogunjimi
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This study focuses on the growing concerns about the quality of groundwater found around cement factories, which have caused several health issues for residents located within two (2) kilometer radius. The qualities of groundwater were determined by an investigative study that involved the determination of some heavy metals and physicochemical properties in drinking water samples. Eight (8) samples of groundwater were collected from the eight sampling sites. The samples were analysed for the following parameters; iron, copper, manganese, zinc, lead, color, dissolved solids, electrical conductivity, pH, dissolved oxygen (DO), biological oxygen demand (BOD), chemical oxygen demand (COD), temperature, turbidity and total hardness using standard methods. The test results showed the variation of the investigated parameters in the samples as follows: temperature 26-31oC, pH 5.9-7.2, electrical conductivity (EC) 0.37 – 0.78 µS/cm, total hardness 181.8 – 333.0 mg/l, turbidity 0.00-0.05 FTU, colour 5-10 TCU, dissolved oxygen 4.31-5.01 mg/l, BOD 0.2-1.0 mg/l, COD 2.0 -4.0 mg/l, Cu 0.04 – 0.09 mg/l, Fe 0.006-0.122 mg/l, Zn 0.016-0.306 mg/l, Mn 0.01-0.05 mg/l and Pb < 0.001 mg/l. The World Health Organization's standard for drinking water quality guidelines was exceeded in several of the analyzed parameters' amounts in the drinking water samples from the study area. The dissolved oxygen was found to exceed 5.0 mg/l, which is the WHO permissible limit; also, Limestone was found to exceed the WHO maximum limit of 170 mg/l. All the above results confirmed the high pollution of the groundwater sources, and hence, they are not suitable for consumption without any prior treatment.Keywords: groundwater, quality, heavy metals, parameters
Procedia PDF Downloads 64513 Re-Os Application to Petroleum System: Implications from the Geochronology and Oil-Source Correlation of Duvernay Petroleum System, Western Canadian Sedimentary Basin
Authors: Junjie Liu, David Selby, Mark Obermajer, Andy Mort
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The inaugural application of Re-Os dating, which is based on the beta decay of 187Re to 187Os with a long half-life of 41.577 ± 0.12 Byr and initially used for sulphide minerals and organic rich rocks, to petroleum systems was performed on bitumen of the Polaris Mississippi Valley Type Pb-Zn deposit, Canada. To further our understanding of the Re-Os system and its application to petroleum systems, here we present a study on Duvernay Petroleum System, Western Canadian Sedimentary Basin. The Late Devonian Duvernay Formation organic-rich shales are the only source of the petroleum system. The Duvernay shales reached maturation only during the Laramide Orogeny (80 – 35 Ma) and the generated oil migrated short distances into the interfingering Leduc reefs and overlying Nisku carbonates with no or little secondary alteration post oil-generation. Although very low in Re and Os, the asphaltenes of Duvernay-sourced Leduc and Nisku oils define a Laramide Re-Os age. In addition, the initial Os isotope compositions of the oil samples are similar to that of the Os isotope composition of the Duvernay Formation at the time of oil generation, but are very different to other oil-prone intervals of the basin, showing the ability of the Os isotope composition as an inorganic oil-source correlation tool. In summary, the ability of the Re-Os geochronometer to record the timing of oil generation and trace the source of an oil is confirmed in the Re-Os study of Duvernay Petroleum System.Keywords: Duvernay petroleum system, oil generation, oil-source correlation, Re-Os
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