Search results for: history matching core flood simulator
Commenced in January 2007
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Paper Count: 5612

Search results for: history matching core flood simulator

302 An Integrated HCV Testing Model as a Method to Improve Identification and Linkage to Care in a Network of Community Health Centers in Philadelphia, PA

Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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301 Articulating the Colonial Relation, a Conversation between Afropessimism and Anti-Colonialism

Authors: Thomas Compton

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As Decolonialism becomes an important topic in Political Theory, the rupture between the colonized and the colonist relation has lost attention. Focusing on the anti-colonial activist Madhi Amel, we shall consider his attention to the permanence of the colonial relation and how it preempts Frank Wilderson’s formulation of (white) culturally necessary Anti-Black violence. Both projects draw attention away from empirical accounts of oppression, instead focusing on the structural relation which precipitates them. As Amel says that we should stop thinking of the ‘underdeveloped’ as beyond the colonial relation, Wilderson says we should stop think of the Black rights that have surpassed the role of the slave. However, Amel moves beyond his idol Althusser’s Structuralism toward a formulation of the colonial relation as source of domination. Our analysis will take a Lacanian turn in considering how this non-relation was formulated as a relation how this space of negativity became a ideological opportunity for Colonial domination. Wilderson’s work shall problematise this as we conclude with his criticisms of Structural accounts for the failure to consider how Black social death exists as more than necessity but a cite of white desire. Amel, a Lebanese activist and scholar (re)discovered by Hicham Safieddine, argues colonialism is more than the theft of land, but instead a privatization of collective property and form of investment which (re)produces the status of the capitalist in spaces ‘outside’ the market. Although Amel was a true Marxist-Leninsist, who exposited the economic determinacy of the Colonial Mode of Production, we are reading this account through Alenka Zupančič’s reformulation of the ‘invisible hand job of the market’. Amel points to the signifier ‘underdeveloped’ as buttressed on a pre-colonial epistemic break, as the Western investor (debt collector) sees the (post?) colony narcissistic image. However, the colony can never become site of class conflict, as the workers are not unified but existing between two countries. In industry, they are paid in Colonial subjectivisation, the promise of market (self)pleasure, at home, they are refugees. They are not, as Wilderson states, in the permanent social death of the slave, but they are less than the white worker. This is formulated as citizen (white), non-citizen (colonized), anti-citizen (Black/slave). Here we may also think of how indentured Indians were used as instruments of colonial violence. Wilderson’s aphorism “there is no analogy to anti-Black violence” lays bare his fundamental opposition between colonial and specifically anti-Black violence. It is not only that the debt collector, landowner, or other owners of production pleasures themselves as if their hand is invisible. The absolute negativity between colony and colonized provides a new frontier for desire, the development of a colonial mode of production. An invention inside the colonial structure that is generative of class substitution. We shall explore how Amel ignores the role of the slave but how Wilderson forecloses the history African anti-colonial.

Keywords: afropessimism, fanon, marxism, postcolonialism

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300 De-Pigmentary Effect of Ayurvedic Treatment on Hyper-Pigmentation of Skin Due to Chloroquine: A Case Report

Authors: Sunil Kumar, Rajesh Sharma

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Toxic epidermal necrolysis, pruritis, rashes, lichen planus like eruption, hyper pigmentation of skin are rare toxic effects of choloroquine used over a long time. Skin and mucus membrane hyper pigmentation is generally of a bluish black or grayish color and irreversible after discontinuation of the drug. According to Ayurveda, Dushivisha is the name given to any poisonous substance which is not fully endowed with the qualities of poison by nature (i.e. it acts as an impoverished or weak poison) and because of its mild potency, it remains in the body for many years causing various symptoms, one among them being discoloration of skin.The objective of this case report is to investigate the effect of Ayurvedic management of chloroquine induced hyper-pigmentation on the line of treatment of Dushivisha. Case Report: A 26-year-old female was suffering from hyper-pigmentation of the skin over the neck, forehead, temporo-mandibular joints, upper back and posterior aspect of both the arms since 8 years had history of taking Chloroquine came to Out Patient Department of National Institute of Ayurveda, Jaipur, India in Jan. 2015. The routine investigations (CBC, ESR, Eosinophil count) were within normal limits. Punch biopsy skin studied for histopathology under hematoxylin and eosin staining showed epidermis with hyper-pigmentation of the basal layer. In the papillary dermis as well as deep dermis there were scattered melanophages along with infiltration by mononuclear cells. There was no deposition of amyloid-like substances. These histopathological findings were suggestive of Chloroquine induced hyper-pigmentation. The case was treated on the line of treatment of Dushivisha and was given Vamana and Virechana (therapeutic emesis and purgation) every six months followed by Snehana karma (oleation therapy) with Panchatikta Ghrit and Swedana (sudation). Arogyavardhini Vati -1 g, Dushivishari Vati 500 mg, Mahamanjisthadi Quath 20 ml were given twelve hourly and Aragwadhadi Quath 25 ml at bed time orally. The patient started showing lightening of the pigments after six months and almost complete remission after 12 months of the treatment. Conclusion: This patient presented with the Dushivisha effect of Chloroquineandwas administered two relevant procedures from Panchakarma viz. Vamana and Virechana. Both Vamana and Virechanakarma here referred to Shodhana karma (purification procedures) eliminates accumulated toxins from the body. In this process, oleation dislodge the toxins from the tissues and sudation helps to bring them to the alimentary tract. The line of treatment did not target direct hypo pigmentary effects; rather aimed to eliminate the Dushivisha. This gave promising results in this condition.

Keywords: Ayurveda, chloroquine, Dushivisha, hyper-pigmentation

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299 Audit of Intraoperative Ventilation Strategy in Prolonged Abdominal Surgery

Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

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298 Land, History and Housing: Colonial Legacies and Land Tenure in Kuala Lumpur

Authors: Nur Fareza Mustapha

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Solutions to policy problems need to be curated to the local context, taking into account the trajectory of the local development path to ensure its efficacy. For Kuala Lumpur, rapid urbanization and migration into the city for the past few decades have increased the demand for housing to accommodate a growing urban population. As a critical factor affecting housing affordability, land supply constraints have been attributed to intensifying market pressures, which grew in tandem with the demands of urban development, along with existing institutional constraints in the governance of land. While demand-side pressures are inevitable given the fixed supply of land, supply-side constraints in regulations distort markets and if addressed inappropriately, may lead to mistargeted policy interventions. Given Malaysia’s historical development, regulatory barriers for land may originate from the British colonial period, when many aspects of the current laws governing tenure were introduced and formalized, and henceforth, became engrained in the system. This research undertakes a postcolonial institutional analysis approach to uncover the causal mechanism driving the evolution of land tenure systems in post-colonial Kuala Lumpur. It seeks to determine the sources of these shifts, focusing on the incentives and bargaining positions of actors during periods of institutional flux/change. It aims to construct a conceptual framework to further this understanding and to elucidate how this historical trajectory affects current access to urban land markets for housing. Archival analysis is used to outline and analyse the evolution of land tenure systems in Kuala Lumpur while stakeholder interviews are used to analyse its impact on the current urban land market, with a particular focus on the provision of and access to affordable housing in the city. Preliminary findings indicate that many aspects of the laws governing tenure that were introduced and formalized during the British colonial period have endured until the present day. Customary rules of tenure were displaced by rules following a European tradition, which found legitimacy through a misguided interpretation of local laws regarding the ownership of land. Colonial notions of race and its binary view of native vs. non-natives have also persisted in the construction and implementation of current legislation regarding land tenure. More concrete findings from this study will generate a more nuanced understanding of the regulatory land supply constraints in Kuala Lumpur, taking into account both the long and short term spatial and temporal processes that affect how these rules are created, implemented and enforced.

Keywords: colonial discourse, historical institutionalism, housing, land policy, post-colonial city

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297 Outputs from the Implementation of 'PHILOS' Programme: Emergency Health Response to Refugee Crisis, Greece, 2017

Authors: K. Mellou, G. Anastopoulos, T. Zakinthinos, C. Botsi, A. Terzidis

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‘PHILOS – Emergency health response to refugee crisis’ is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP). The programme is funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. With the EU Member States accepting, the last period, accelerating migration flows, Greece inevitably occupies a prominent position in the migratory map due to this geographical location. The main objectives of the programme are a) reinforcement of the capacity of the public health system and enhancement of the epidemiological surveillance in order to cover refugees/migrant population, b) provision of on-site primary health care and psychological support services, and c) strengthening of national health care system task-force. The basic methods for achieving the aforementioned goals are: a) implementation of syndromic surveillance system at camps and enhancement of public health response with the use of mobile medical units (Sub-action A), b) enhancement of health care services inside the camps via increasing human resources and implementing standard operating procedures (Sub-action B), and c) reinforcement of the national health care system (primary healthcare units, hospitals, and emergency care spots) of affected regions with personnel (Sub-action C). As a result, 58 health professionals were recruited under sub-action 2 and 10 mobile unit teams (one or two at each health region) were formed. The main actions taken so far by the mobile units are the evaluation, of syndromic surveillance, of living conditions at camps and medical services. Also, vaccination coverage of children population was assessed, and more than 600 catch-up vaccinations were performed by the end of June 2017. Mobile units supported transportation of refugees/migrants from camps to medical services reducing the load of the National Center for Emergency Care (more than 350 transportations performed). The total number of health professionals (MD, nurses, etc.) placed at camps was 104. Common practices were implemented in the recording and collection of psychological and medical history forms at the camps. Protocols regarding maternity care, gender based violence and handling of violent incidents were produced and distributed at personnel working at camps. Finally, 290 health care professionals were placed at primary healthcare units, public hospitals and the National Center for Emergency Care at affected regions. The program has, also, supported training activities inside the camps and resulted to better coordination of offered services on site.

Keywords: migrants, refugees, public health, syndromic surveillance, national health care system, primary care, emergency health response

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296 Interactive Virtual Patient Simulation Enhances Pharmacology Education and Clinical Practice

Authors: Lyndsee Baumann-Birkbeck, Sohil A. Khan, Shailendra Anoopkumar-Dukie, Gary D. Grant

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Technology-enhanced education tools are being rapidly integrated into health programs globally. These tools provide an interactive platform for students and can be used to deliver topics in various modes including games and simulations. Simulations are of particular interest to healthcare education, where they are employed to enhance clinical knowledge and help to bridge the gap between theory and practice. Simulations will often assess competencies for practical tasks, yet limited research examines the effects of simulation on student perceptions of their learning. The aim of this study was to determine the effects of an interactive virtual patient simulation for pharmacology education and clinical practice on student knowledge, skills and confidence. Ethics approval for the study was obtained from Griffith University Research Ethics Committee (PHM/11/14/HREC). The simulation was intended to replicate the pharmacy environment and patient interaction. The content was designed to enhance knowledge of proton-pump inhibitor pharmacology, role in therapeutics and safe supply to patients. The tool was deployed into a third-year clinical pharmacology and therapeutics course. A number of core practice areas were examined including the competency domains of questioning, counselling, referral and product provision. Baseline measures of student self-reported knowledge, skills and confidence were taken prior to the simulation using a specifically designed questionnaire. A more extensive questionnaire was deployed following the virtual patient simulation, which also included measures of student engagement with the activity. A quiz assessing student factual and conceptual knowledge of proton-pump inhibitor pharmacology and related counselling information was also included in both questionnaires. Sixty-one students (response rate >95%) from two cohorts (2014 and 2015) participated in the study. Chi-square analyses were performed and data analysed using Fishers exact test. Results demonstrate that student knowledge, skills and confidence within the competency domains of questioning, counselling, referral and product provision, show improvement following the implementation of the virtual patient simulation. Statistically significant (p<0.05) improvement occurred in ten of the possible twelve self-reported measurement areas. Greatest magnitude of improvement occurred in the area of counselling (student confidence p<0.0001). Student confidence in all domains (questioning, counselling, referral and product provision) showed a marked increase. Student performance in the quiz also improved, demonstrating a 10% improvement overall for pharmacology knowledge and clinical practice following the simulation. Overall, 85% of students reported the simulation to be engaging and 93% of students felt the virtual patient simulation enhanced learning. The data suggests that the interactive virtual patient simulation developed for clinical pharmacology and therapeutics education enhanced students knowledge, skill and confidence, with respect to the competency domains of questioning, counselling, referral and product provision. These self-reported measures appear to translate to learning outcomes, as demonstrated by the improved student performance in the quiz assessment item. Future research of education using virtual simulation should seek to incorporate modern quantitative measures of student learning and engagement, such as eye tracking.

Keywords: clinical simulation, education, pharmacology, simulation, virtual learning

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295 Ant and Spider Diversity in a Rural Landscape of the Vhembe Biosphere, South Africa

Authors: Evans V. Mauda, Stefan H. Foord, Thinandavha C. Munyai

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The greatest threat to biodiversity is a loss of habitat through landscape fragmentation and attrition. Land use changes are therefore among the most immediate drivers of species diversity. Urbanization and agriculture are the main drivers of habitat loss and transformation in the Savanna biomes of South Africa. Agricultural expansion and the intensification in particular, take place at the expense of biodiversity and will probably be the primary driver of biodiversity loss in this century. Arthropods show measurable behavioural responses to changing land mosaics at the smallest scale and heterogeneous environments are therefore predicted to support more complex and diverse biological assemblages. Ants are premier soil turners, channelers of energy and dominate insect fauna, while spiders are a mega-diverse group that can regulate other invertebrate populations. This study aims to quantify the response of these two taxa in a rural-urban mosaic of a rapidly developing communal area. The study took place in and around two villages in the north-eastern corner of South Africa. Two replicates for each of the dominant land use categories, viz. urban settlements, dryland cultivation and cattle rangelands, were set out in each of the villages and sampled during the dry and wet seasons for a total of 2 villages × 3 land use categories × 2 seasons = 24 assemblages. Local scale variables measured included vertical and horizontal habitat structure as well as structural and chemical composition of the soil. Ant richness was not affected by land use but local scale variables such as vertical vegetation structure (+) and leaf litter cover (+), although vegetation complexity at lower levels was negatively associated with ant richness. However, ant richness was largely shaped by regional and temporal processes invoking the importance of dispersal and historical processes. Spider species richness was mostly affected by land use and local conditions highlighting their landscape elements. Spider richness did not vary much between villages and across seasons and seems to be less dependent on context or history. There was a considerable amount of variation in spider richness that was not explained and this could be related to factors which were not measured in this study such as temperature and competition. For both ant and spider assemblages the constrained ordination explained 18 % of variation in these taxa. Three environmental variables (leaf litter cover, active carbon and rock cover) were important in explaining ant assemblage structure, while two (sand and leaf litter cover) were important for spider assemblage structure. This study highlights the importance of disturbance (land use activities) and leaf litter with the associated effects on ant and spider assemblages across the study area.

Keywords: ants, assemblages, biosphere, diversity, land use, spiders, urbanization

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294 Sculpted Forms and Sensitive Spaces: Walking through the Underground in Naples

Authors: Chiara Barone

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In Naples, the visible architecture is only what emerges from the underground. Caves and tunnels cross it in every direction, intertwining with each other. They are not natural caves but spaces built by removing what is superfluous in order to dig a form out of the material. Architects, as sculptors of space, do not determine the exterior, what surrounds the volume and in which the forms live, but an interior underground space, perceptive and sensitive, able to generate new emotions each time. It is an intracorporeal architecture linked to the body, not in its external relationships, but rather with what happens inside. The proposed aims to reflect on the design of underground spaces in the Neapolitan city. The idea is to intend the underground as a spectacular museum of the city, an opportunity to learn in situ the history of the place along an unpredictable itinerary that crosses the caves and, in certain points, emerges, escaping from the world of shadows. Starting form the analysis and the study of the many overlapping elements, the archaeological one, the geological layer and the contemporary city above, it is possible to develop realistic alternatives for underground itineraries. The objective is to define minor paths to ensure the continuity between the touristic flows and entire underground segments already investigated but now disconnected: open-air paths, which abyss in the earth, retracing historical and preserved fragments. The visitor, in this way, passes from real spaces to sensitive spaces, in which the imaginary replaces the real experience, running towards exciting and secret knowledge. To safeguard the complex framework of the historical-artistic values, it is essential to use a multidisciplinary methodology based on a global approach. Moreover, it is essential to refer to similar design projects for the archaeological underground, capable of guide action strategies, looking at similar conditions in other cities, where the project has led to an enhancement of the heritage in the city. The research limits the field of investigation, by choosing the historic center of Naples, applying bibliographic and theoretical research to a real place. First of all, it’s necessary to deepen the places’ knowledge understanding the potentialities of the project as a link between what is below and what is above. Starting from a scientific approach, in which theory and practice are constantly intertwined through the architectural project, the major contribution is to provide possible alternative configurations for the underground space and its relationship with the city above, understanding how the condition of transition, as passage between the below and the above becomes structuring in the design process. Starting from the consideration of the underground as both a real physical place and a sensitive place, which engages the memory, imagination, and sensitivity of a man, the research aims at identifying possible configurations and actions useful for future urban programs to make the underground a central part of the lived city, again.

Keywords: underground paths, invisible ruins, imaginary, sculpted forms, sensitive spaces, Naples

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293 Encounter, Dialogue and Presence in Doris Salcedo's Works

Authors: Wen-Shu Lai, Yi-Ting Wang

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The purpose of this paper is to discuss and clarify what are the essences of Colombian-born sculptor Doris Salcedo’s works. Under the frameworks of Buber’s dialogical philosophy of the “I-Thou relation” and Zurmuehlen’s philosophy of “Art as Presence” within the context of art praxis, Salcedo’s selected works are analyzed and interpreted. Salcedo’s sculptures and installations have expressed her concerns of the collective and personal memories within the context of Colombia’s violent, historical and political conflicts, especially the trauma inscribed onto her fellow people. Salcedo tried to rescue that memory though her work does not directly represent the violent incidents happened in Colombia. They are indirect portraits of the disappeared, the victims, and the lack of identity. What the viewers see is something in between vanishing and emergence, personal and collective. The work, the artist and the viewer are witnesses and also survivors of Columbia’s violent incidents. On the site, the work, the disappeared and the witness-survivors encounter each other, then mourning, memory and dialogue are unfolded, brought to present. Firstly, it is the power of encounter that allows the viewer-witness to recognize the effaced victims, repressive violence, and the profound mourning for the loss, then restore their existence through dialogues and bring them to present. In her sculptures and installations, the displacement of the fragments and the incoherent sites make these daily household objects become unfamiliar, arose feelings of uncanniness of the viewer. The feelings of alienation, confusion, displacement bring the viewer to here and now. The more one studies these objects and sites, the more hidden details begin to appear. And the more one looks at the details, the more absent memories or stories reveals themselves and becomes present. Salcedo’s work is about loss, displacement and alienation caused by violence. She expressed that words are no longer possible when one deals with violence. However, her installation translates the violence, memory, and loss of beloved ones into a place of dialogue, in which the visitors can immerse themselves in a twilight zone between knowing and not knowing, remembering and forgetting. The spaces are the sites or non-sites inhabited by the remains or traces of the victims, the wonders of the survivor-witnesses where they join together through encounter, remain present to others through genuine dialogue. In the moment, the past memory and the ongoing life merge, accept each other, and reconcile. Salcedo reconfigures the silent violence and repressive history in Colombia and transforms them into sites and installations. The victims, the viewer and the artist join together while contemplating and sharing the human situation of silent repression. In the moment of contemplating, a dialogue, spoken or not, occurs in the specific sites. People have become aware and present, and mutual understanding has achieved. This research concludes that encounter, presence and dialogue are the three essences embedded in Salcedo’s works.

Keywords: dialogue, Doris Salcedo, encounter, presence

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292 Information-Controlled Laryngeal Feature Variations in Korean Consonants

Authors: Ponghyung Lee

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This study seeks to investigate the variations occurring to Korean consonantal variations center around laryngeal features of the concerned sounds, to the exclusion of others. Our fundamental premise is that the weak contrast associated with concerned segments might be held accountable for the oscillation of the status quo of the concerned consonants. What is more, we assume that an array of notions as a measure of communicative efficiency of linguistic units would be significantly influential on triggering those variations. To this end, we have tried to compute the surprisal, entropic contribution, and relative contrastiveness associated with Korean obstruent consonants. What we found therein is that the Information-theoretic perspective is compelling enough to lend support our approach to a considerable extent. That is, the variant realizations, chronologically and stylistically, prove to be profoundly affected by a set of Information-theoretic factors enumerated above. When it comes to the biblical proper names, we use Georgetown University CQP Web-Bible corpora. From the 8 texts (4 from Old Testament and 4 from New Testament) among the total 64 texts, we extracted 199 samples. We address the issue of laryngeal feature variations associated with Korean obstruent consonants under the presumption that the variations stem from the weak contrast among the triad manifestations of laryngeal features. The variants emerge from diverse sources in chronological and stylistic senses: Christianity biblical texts, ordinary casual speech, the shift of loanword adaptation over time, and ideophones. For the purpose of discussing what they are really like from the perspective of Information Theory, it is necessary to closely look at the data. Among them, the massive changes occurring to loanword adaptation of proper nouns during the centennial history of Korean Christianity draw our special attention. We searched 199 types of initially capitalized words among 45,528-word tokens, which account for around 5% of total 901,701-word tokens (12,786-word types) from Georgetown University CQP Web-Bible corpora. We focus on the shift of the laryngeal features incorporated into word-initial consonants, which are available through the two distinct versions of Korean Bible: one came out in the 1960s for the Protestants, and the other was published in the 1990s for the Catholic Church. Of these proper names, we have closely traced the adaptation of plain obstruents, e. g. /b, d, g, s, ʤ/ in the sources. The results show that as much as 41% of the extracted proper names show variations; 37% in terms of aspiration, and 4% in terms of tensing. This study set out in an effort to shed light on the question: to what extent can we attribute the variations occurring to the laryngeal features associated with Korean obstruent consonants to the communicative aspects of linguistic activities? In this vein, the concerted effects of the triad, of surprisal, entropic contribution, and relative contrastiveness can be credited with the ups and downs in the feature specification, despite being contentiousness on the role of surprisal to some extent.

Keywords: entropic contribution, laryngeal feature variation, relative contrastiveness, surprisal

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291 Contentious Politics during a Period of Transition to Democracy from an Authoritarian Regime: The Spanish Cycle of Protest of November 1975-December 1978

Authors: Juan Sanmartín Bastida

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When a country experiences a period of transition from authoritarianism to democracy, involving an earlier process of political liberalization and a later process of democratization, a cycle of protest usually outbreaks, as there is a reciprocal influence between that kind of political change and the frequency and scale of social protest events. That is what happened in Spain during the first years of its transition to democracy from the Francoist authoritarian regime, roughly between November 1975 and December 1978. Thus, the object of this study is to show and explain how that cycle of protest started, developed, and finished in relation to such a political change, and offer specific information about the main features of all protest cycles: the social movements that arose during that period, the number of protest events by month, the forms of collective action that were utilized, the groups of challengers that engaged in contentious politics, the reaction of the authorities to the action and claims of those groups, etc. The study of this cycle of protest, using the primary sources and analytical tools that characterize the model of research of protest cycles, will make a contribution to the field of contentious politics and its phenomenon of cycles of contention, and more broadly to the political and social history of contemporary Spain. The cycle of protest and the process of political liberalization of the authoritarian regime began around the same time, but the first concluded long before the process of democratization was completed in 1982. The ascending phase of the cycle and therefore the process of liberalization started with the death of Francisco Franco and the proclamation of Juan Carlos I as King of Spain in November 1975; the peak of the cycle was around the first months of 1977; the descending phase started after the first general election of June 1977; and the level of protest stabilized in the last months of 1978, a year that finished with a referendum in which the Spanish people approved the current democratic constitution. It was then when we can consider that the cycle of protest came to an end. The primary sources are the news of protest events and social movements in the three main Spanish newspapers at the time, other written or audiovisual documents, and in-depth interviews; and the analytical tools are the political opportunities that encourage social protest, the available repertoire of contention, the organizations and networks that brought together people with the same claims and allowed them to engage in contentious politics, and the interpretative frames that justify, dignify and motivates their collective action. These are the main four factors that explain the beginning, development and ending of the cycle of protest, and therefore the accompanying social movements and events of collective action. Among those four factors, the political opportunities -their opening, exploitation, and closure-proved to be most decisive.

Keywords: contentious politics, cycles of protest, political opportunities, social movements, Spanish transition to democracy

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290 Comparison of Two Home Sleep Monitors Designed for Self-Use

Authors: Emily Wood, James K. Westphal, Itamar Lerner

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Background: Polysomnography (PSG) recordings are regularly used in research and clinical settings to study sleep and sleep-related disorders. Typical PSG studies are conducted in professional laboratories and performed by qualified researchers. However, the number of sleep labs worldwide is disproportionate to the increasing number of individuals with sleep disorders like sleep apnea and insomnia. Consequently, there is a growing need to supply cheaper yet reliable means to measure sleep, preferably autonomously by subjects in their own home. Over the last decade, a variety of devices for self-monitoring of sleep became available in the market; however, very few have been directly validated against PSG to demonstrate their ability to perform reliable automatic sleep scoring. Two popular mobile EEG-based systems that have published validation results, the DREEM 3 headband and the Z-Machine, have never been directly compared one to the other by independent researchers. The current study aimed to compare the performance of DREEM 3 and the Z-Machine to help investigators and clinicians decide which of these devices may be more suitable for their studies. Methods: 26 participants have completed the study for credit or monetary compensation. Exclusion criteria included any history of sleep, neurological or psychiatric disorders. Eligible participants arrived at the lab in the afternoon and received the two devices. They then spent two consecutive nights monitoring their sleep at home. Participants were also asked to keep a sleep log, indicating the time they fell asleep, woke up, and the number of awakenings occurring during the night. Data from both devices, including detailed sleep hypnograms in 30-second epochs (differentiating Wake, combined N1/N2, N3; and Rapid Eye Movement sleep), were extracted and aligned upon retrieval. For analysis, the number of awakenings each night was defined as four or more consecutive wake epochs between sleep onset and termination. Total sleep time (TST) and the number of awakenings were compared to subjects’ sleep logs to measure consistency with the subjective reports. In addition, the sleep scores from each device were compared epoch-by-epoch to calculate the agreement between the two devices using Cohen’s Kappa. All analysis was performed using Matlab 2021b and SPSS 27. Results/Conclusion: Subjects consistently reported longer times spent asleep than the time reported by each device (M= 448 minutes for sleep logs compared to M= 406 and M= 345 minutes for the DREEM and Z-Machine, respectively; both ps<0.05). Linear correlations between the sleep log and each device were higher for the DREEM than the Z-Machine for both TST and the number of awakenings, and, likewise, the mean absolute bias between the sleep logs and each device was higher for the Z-Machine for both TST (p<0.001) and awakenings (p<0.04). There was some indication that these effects were stronger for the second night compared to the first night. Epoch-by-epoch comparisons showed that the main discrepancies between the devices were for detecting N2 and REM sleep, while N3 had a high agreement. Overall, the DREEM headband seems superior for reliably scoring sleep at home.

Keywords: DREEM, EEG, seep monitoring, Z-machine

Procedia PDF Downloads 88
289 Authentic Connection between the Deity and the Individual Human Being Is Vital for Psychological, Biological, and Social Health

Authors: Sukran Karatas

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Authentic energy network interrelations between the Creator and the creations as well as from creations to creations are the most important points for the worlds of physics and metaphysic to unite together and work in harmony, both within human beings, on the other hand, have the ability to choose their own life style voluntarily. However, it includes the automated involuntary spirit, soul and body working systems together with the voluntary actions, which involve personal, cultural and universal, rational or irrational variable values. Therefore, it is necessary for human beings to know the methods of existing authentic energy network connections to be able to communicate correlate and accommodate the physical and metaphysical entities as a proper functioning unity; this is essential for complete human psychological, biological and social well-being. Authentic knowledge is necessary for human beings to verify the position of self within self and with others to regulate conscious and voluntary actions accordingly in order to prevent oppressions and frictions within self and between self and others. Unfortunately, the absence of genuine individual and universal basic knowledge about how to establish an authentic energy network connection within self, with the deity and the environment is the most problematic issue even in the twenty-first century. The second most problematic issue is how to maintain freedom, equality and justice among human beings during these strictly interwoven network connections, which naturally involve physical, metaphysical and behavioral actions of the self and the others. The third and probably the most complicated problem is the scientific identification and the authentication of the deity. This not only provides the whole power and control over the choosers to set their life orders but also to establish perfect physical and metaphysical links as fully coordinated functional energy network. This thus indicates that choosing an authentic deity is the key-point that influences automated, emotional, and behavioral actions altogether, which shapes human perception, personal actions, and life orders. Therefore, we will be considering the existing ‘four types of energy wave end boundary behaviors’, comprising, free end, fixed end boundary behaviors, as well as boundary behaviors from denser medium to less dense medium and from less dense medium to denser medium. Consequently, this article aims to demonstrate that the authentication and the choice of deity has an important effect on individual psychological, biological and social health. It is hoped that it will encourage new researches in the field of authentic energy network connections to establish the best position and the most correct interrelation connections with self and others without violating the authorized orders and the borders of one another to live happier and healthier lives together. In addition, the book ‘Deity and Freedom, Equality, Justice in History, Philosophy, Science’ has more detailed information for those interested in this subject.

Keywords: deity, energy network, power, freedom, equality, justice, happiness, sadness, hope, fear, psychology, biology, sociology

Procedia PDF Downloads 333
288 Blended Learning Instructional Approach to Teach Pharmaceutical Calculations

Authors: Sini George

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Active learning pedagogies are valued for their success in increasing 21st-century learners’ engagement, developing transferable skills like critical thinking or quantitative reasoning, and creating deeper and more lasting educational gains. 'Blended learning' is an active learning pedagogical approach in which direct instruction moves from the group learning space to the individual learning space, and the resulting group space is transformed into a dynamic, interactive learning environment where the educator guides students as they apply concepts and engage creatively in the subject matter. This project aimed to develop a blended learning instructional approach to teaching concepts around pharmaceutical calculations to year 1 pharmacy students. The wrong dose, strength or frequency of a medication accounts for almost a third of medication errors in the NHS therefore, progression to year 2 requires a 70% pass in this calculation test, in addition to the standard progression requirements. Many students were struggling to achieve this requirement in the past. It was also challenging to teach these concepts to students of a large class (> 130) with mixed mathematical abilities, especially within a traditional didactic lecture format. Therefore, short screencasts with voice-over of the lecturer were provided in advance of a total of four teaching sessions (two hours/session), incorporating core content of each session and talking through how they approached the calculations to model metacognition. Links to the screencasts were posted on the learning management. Viewership counts were used to determine that the students were indeed accessing and watching the screencasts on schedule. In the classroom, students had to apply the knowledge learned beforehand to a series of increasingly difficult set of questions. Students were then asked to create a question in group settings (two students/group) and to discuss the questions created by their peers in their groups to promote deep conceptual learning. Students were also given time for question-and-answer period to seek clarifications on the concepts covered. Student response to this instructional approach and their test grades were collected. After collecting and organizing the data, statistical analysis was carried out to calculate binomial statistics for the two data sets: the test grade for students who received blended learning instruction and the test grades for students who received instruction in a standard lecture format in class, to compare the effectiveness of each type of instruction. Student response and their performance data on the assessment indicate that the learning of content in the blended learning instructional approach led to higher levels of student engagement, satisfaction, and more substantial learning gains. The blended learning approach enabled each student to learn how to do calculations at their own pace freeing class time for interactive application of this knowledge. Although time-consuming for an instructor to implement, the findings of this research demonstrate that the blended learning instructional approach improves student academic outcomes and represents a valuable method to incorporate active learning methodologies while still maintaining broad content coverage. Satisfaction with this approach was high, and we are currently developing more pharmacy content for delivery in this format.

Keywords: active learning, blended learning, deep conceptual learning, instructional approach, metacognition, pharmaceutical calculations

Procedia PDF Downloads 154
287 To Access the Knowledge, Awareness and Factors Associated With Diabetes Mellitus in Buea, Cameroon

Authors: Franck kem Acho

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This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

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286 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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285 Implementation of Active Recovery at Immediate, 12 and 24 Hours Post-Training in Young Soccer Players

Authors: C. Villamizar, M. Serrato

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

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

Procedia PDF Downloads 147
284 Mineralized Nanoparticles as a Contrast Agent for Ultrasound and Magnetic Resonance Imaging

Authors: Jae Won Lee, Kyung Hyun Min, Hong Jae Lee, Sang Cheon Lee

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To date, imaging techniques have attracted much attention in medicine because the detection of diseases at an early stage provides greater opportunities for successful treatment. Consequently, over the past few decades, diverse imaging modalities including magnetic resonance (MR), positron emission tomography, computed tomography, and ultrasound (US) have been developed and applied widely in the field of clinical diagnosis. However, each of the above-mentioned imaging modalities possesses unique strengths and intrinsic weaknesses, which limit their abilities to provide accurate information. Therefore, multimodal imaging systems may be a solution that can provide improved diagnostic performance. Among the current medical imaging modalities, US is a widely available real-time imaging modality. It has many advantages including safety, low cost and easy access for patients. However, its low spatial resolution precludes accurate discrimination of diseased region such as cancer sites. In contrast, MR has no tissue-penetrating limit and can provide images possessing exquisite soft tissue contrast and high spatial resolution. However, it cannot offer real-time images and needs a comparatively long imaging time. The characteristics of these imaging modalities may be considered complementary, and the modalities have been frequently combined for the clinical diagnostic process. Biominerals such as calcium carbonate (CaCO3) and calcium phosphate (CaP) exhibit pH-dependent dissolution behavior. They demonstrate pH-controlled drug release due to the dissolution of minerals in acidic pH conditions. In particular, the application of this mineralization technique to a US contrast agent has been reported recently. The CaCO3 mineral reacts with acids and decomposes to generate calcium dioxide (CO2) gas in an acidic environment. These gas-generating mineralized nanoparticles generated CO2 bubbles in the acidic environment of the tumor, thereby allowing for strong echogenic US imaging of tumor tissues. On the basis of this previous work, it was hypothesized that the loading of MR contrast agents into the CaCO3 mineralized nanoparticles may be a novel strategy in designing a contrast agent for dual imaging. Herein, CaCO3 mineralized nanoparticles that were capable of generating CO2 bubbles to trigger the release of entrapped MR contrast agents in response to tumoral acidic pH were developed for the purposes of US and MR dual-modality imaging of tumors. Gd2O3 nanoparticles were selected as an MR contrast agent. A key strategy employed in this study was to prepare Gd2O3 nanoparticle-loaded mineralized nanoparticles (Gd2O3-MNPs) using block copolymer-templated CaCO3 mineralization in the presence of calcium cations (Ca2+), carbonate anions (CO32-) and positively charged Gd2O3 nanoparticles. The CaCO3 core was considered suitable because it may effectively shield Gd2O3 nanoparticles from water molecules in the blood (pH 7.4) before decomposing to generate CO2 gas, triggering the release of Gd2O3 nanoparticles in tumor tissues (pH 6.4~7.4). The kinetics of CaCO3 dissolution and CO2 generation from the Gd2O3-MNPs were examined as a function of pH and pH-dependent in vitro magnetic relaxation; additionally, the echogenic properties were estimated to demonstrate the potential of the particles for the tumor-specific US and MR imaging.

Keywords: calcium carbonate, mineralization, ultrasound imaging, magnetic resonance imaging

Procedia PDF Downloads 217
283 A Quantitative Analysis of Rural to Urban Migration in Morocco

Authors: Donald Wright

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The ultimate goal of this study is to reinvigorate the philosophical underpinnings the study of urbanization with scientific data with the goal of circumventing what seems an inevitable future clash between rural and urban populations. To that end urban infrastructure must be sustainable economically, politically and ecologically over the course of several generations as cities continue to grow with the incorporation of climate refugees. Our research will provide data concerning the projected increase in population over the coming two decades in Morocco, and the population will shift from rural areas to urban centers during that period of time. As a result, urban infrastructure will need to be adapted, developed or built to fit the demand of future internal migrations from rural to urban centers in Morocco. This paper will also examine how past experiences of internally displaced people give insight into the challenges faced by future migrants and, beyond the gathering of data, how people react to internal migration. This study employs four different sets of research tools. First, a large part of this study is archival, which involves compiling the relevant literature on the topic and its complex history. This step also includes gathering data bout migrations in Morocco from public data sources. Once the datasets are collected, the next part of the project involves populating the attribute fields and preprocessing the data to make it understandable and usable by machine learning algorithms. In tandem with the mathematical interpretation of data and projected migrations, this study benefits from a theoretical understanding of the critical apparatus existing around urban development of the 20th and 21st centuries that give us insight into past infrastructure development and the rationale behind it. Once the data is ready to be analyzed, different machine learning algorithms will be experimented (k-clustering, support vector regression, random forest analysis) and the results compared for visualization of the data. The final computational part of this study involves analyzing the data and determining what we can learn from it. This paper helps us to understand future trends of population movements within and between regions of North Africa, which will have an impact on various sectors such as urban development, food distribution and water purification, not to mention the creation of public policy in the countries of this region. One of the strengths of this project is the multi-pronged and cross-disciplinary methodology to the research question, which enables an interchange of knowledge and experiences to facilitate innovative solutions to this complex problem. Multiple and diverse intersecting viewpoints allow an exchange of methodological models that provide fresh and informed interpretations of otherwise objective data.

Keywords: climate change, machine learning, migration, Morocco, urban development

Procedia PDF Downloads 125
282 Inhibition of Mild Steel Corrosion in Hydrochloric Acid Medium Using an Aromatic Hydrazide Derivative

Authors: Preethi Kumari P., Shetty Prakasha, Rao Suma A.

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Mild steel has been widely employed as construction materials for pipe work in the oil and gas production such as down hole tubular, flow lines and transmission pipelines, in chemical and allied industries for handling acids, alkalis and salt solutions due to its excellent mechanical property and low cost. Acid solutions are widely used for removal of undesirable scale and rust in many industrial processes. Among the commercially available acids hydrochloric acid is widely used for pickling, cleaning, de-scaling and acidization of oil process. Mild steel exhibits poor corrosion resistance in presence of hydrochloric acid. The high reactivity of mild steel in presence of hydrochloric acid is due to the soluble nature of ferrous chloride formed and the cementite phase (Fe3C) normally present in the steel is also readily soluble in hydrochloric acid. Pitting attack is also reported to be a major form of corrosion in mild steel in the presence of high concentrations of acids and thereby causing the complete destruction of metal. Hydrogen from acid reacts with the metal surface and makes it brittle and causes cracks, which leads to pitting type of corrosion. The use of chemical inhibitor to minimize the rate of corrosion has been considered to be the first line of defense against corrosion. In spite of long history of corrosion inhibition, a highly efficient and durable inhibitor that can completely protect mild steel in aggressive environment is yet to be realized. It is clear from the literature review that there is ample scope for the development of new organic inhibitors, which can be conveniently synthesized from relatively cheap raw materials and provide good inhibition efficiency with least risk of environmental pollution. The aim of the present work is to evaluate the electrochemical parameters for the corrosion inhibition behavior of an aromatic hydrazide derivative, 4-hydroxy- N '-[(E)-1H-indole-2-ylmethylidene)] benzohydrazide (HIBH) on mild steel in 2M hydrochloric acid using Tafel polarization and electrochemical impedance spectroscopy (EIS) techniques at 30-60 °C. The results showed that inhibition efficiency increased with increase in inhibitor concentration and decreased marginally with increase in temperature. HIBH showed a maximum inhibition efficiency of 95 % at 8×10-4 M concentration at 30 °C. Polarization curves showed that HIBH act as a mixed-type inhibitor. The adsorption of HIBH on mild steel surface obeys the Langmuir adsorption isotherm. The adsorption process of HIBH at the mild steel/hydrochloric acid solution interface followed mixed adsorption with predominantly physisorption at lower temperature and chemisorption at higher temperature. Thermodynamic parameters for the adsorption process and kinetic parameters for the metal dissolution reaction were determined.

Keywords: electrochemical parameters, EIS, mild steel, tafel polarization

Procedia PDF Downloads 317
281 Livelihood Security and Mitigating Climate Changes in the Barind Tract of Bangladesh through Agroforestry Systems

Authors: Md Shafiqul Bari, Md Shafiqul Islam Sikdar

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This paper summarizes the current knowledge on Agroforestry practices in the Barind tract of Bangladesh. The part of greater Rajshahi, Dinajpur, Rangpur and Bogra district of Bangladesh is geographically identified as the Barind tract. The hard red soil of these areas is very significant in comparison to that of the other parts of the country. A typical dry climate with comparatively high temperature prevails in the Barind area. Scanty rainfall and excessive extraction of groundwater have created an alarming situation among the Barind people and others about irrigation to the rice field. In addition, the situation may cause an adverse impact on the people whose livelihood largely depends on agriculture. The groundwater table has been declined by at least 10 to 15 meters in some areas of the Barind tract during the last 20 years. Due to absent of forestland in the Barind tract, the soil organic carbon content can decrease more rapidly because of the higher rate of decomposition. The Barind soils are largely carbon depleted but can be brought back to carbon-carrying capacity by bringing under suitable Agroforestry systems. Agroforestry has tremendous potential for carbon sequestration not only in above C biomass but also root C biomass in deeper soil depths. Agroforestry systems habitually conserve soil organic carbon and maintain a great natural nutrient pool. Cultivation of trees with arable crops under Agroforestry systems help in improving soil organic carbon content and sequestration carbon, particularly in the highly degraded Barind lands. Agroforestry systems are a way of securing the growth of cash crops that may constitute an alternative source of income in moments of crisis. Besides being a source of fuel wood, a greater presence of trees in cropping system contributes to decreasing temperatures and to increasing rainfall, thus contrasting the negative environmental impact of climate changes. In order to fulfill the objectives of this study, two experiments were conducted. The first experiment was survey on the impact of existing agroforestry system on the livelihood security in the Barind tract of Bangladesh and the second one was the role of agroforestry system on the improvement of soil properties in a multilayered coconut orchard. Agroforestry systems have been generated a lot of employment opportunities in the Barind area. More crops mean involvement of more people in various activities like involvements in dairying, sericulture, apiculture and additional associated agro-based interventions. Successful adoption of Agroforestry practices in the Barind area has shown that the Agroforestry practitioners of this area were very sound positioned economically, and had added social status too. However, from the findings of the present study, it may be concluded that the majority rural farmers of the Barind tract of Bangladesh had a very good knowledge and medium extension contact related to agroforestry production system. It was also observed that 85 per cent farmers followed agroforestry production system and received benefits to a higher extent. Again, from the research study on orchard based mutistoried agroforestry cropping system, it was evident that there was an important effect of agroforestry cropping systems on the improvement of soil chemical properties. As a result, the agroforestry systems may be helpful to attain the development objectives and preserve the biosphere core.

Keywords: agroforestry systems, Barind tract, carbon sequestration, climate changes

Procedia PDF Downloads 183
280 Reviving the Past, Enhancing the Future: Preservation of Urban Heritage Connectivity as a Tool for Developing Liveability in Historical Cities in Jordan, Using as Salt City as a Case Study

Authors: Sahar Yousef, Chantelle Niblock, Gul Kacmaz

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Salt City, in the context of Jordan’s heritage landscape, is a significant case to explore when it comes to the interaction between tangible and intangible qualities of liveable cities. Most city centers, including Jerash, Salt, Irbid, and Amman, are historical locations. Six of these extraordinary sites were designated UNESCO World Heritage Sites. Jordan is widely acknowledged as a developing country characterized by swift urbanization and unrestrained expansion that exacerbate the challenges associated with the preservation of historic urban areas. The aim of this study is to conduct an examination and analysis of the existing condition of heritage connectivity within heritage city centers. This includes outdoor staircases, pedestrian pathways, footpaths, and other public spaces. Case study-style analysis of the urban core of As-Salt is the focus of this investigation. Salt City is widely acknowledged for its substantial tangible and intangible cultural heritage and has been designated as ‘The Place of Tolerance and Urban Hospitality’ by UNESCO since 2021. Liveability in urban heritage, particularly in historic city centers, incorporates several factors that affect our well-being; its enhancement is a critical issue in contemporary society. The dynamic interaction between humans and historical materials, which serves as a vehicle for the expression of their identity and historical narrative, constitutes preservation that transcends simple conservation. This form of engagement enables people to appreciate the diversity of their heritage recognising their previous and planned futures. Heritage preservation is inextricably linked to a larger physical and emotional context; therefore, it is difficult to examine it in isolation. Urban environments, including roads, structures, and other infrastructure, are undergoing unprecedented physical design and construction requirements. Concurrently, heritage reinforces a sense of affiliation with a particular location or space and unifies individuals with their ancestry, thereby defining their identity. However, a considerable body of research has focused on the conservation of heritage buildings in a fragmented manner without considering their integration within a holistic urban context. Insufficient attention is given to the significance of the physical and social roles played by the heritage staircases and baths that serve as connectors between these valued historical buildings. In doing so, the research uses a methodology that is based on consensus. Given that liveability is considered a complex matter with several dimensions. The discussion starts by making initial observations on the physical context and societal norms inside the urban center while simultaneously establishing the definitions of liveability and connectivity and examining the key criteria associated with these concepts. Then, identify the key elements that contribute to liveable connectivity within the framework of urban heritage in Jordanian city centers. Some of the outcomes that will be discussed in the presentation are: (1) There is not enough connectivity between heritage buildings as can be seen, for example, between buildings in Jada and Qala'. (2) Most of the outdoor spaces suffer from physical issues that hinder their use by the public, like in Salalem. (3) Existing activities in the city center are not well attended because of lack of communication between the organisers and the citizens.

Keywords: connectivity, Jordan, liveability, salt city, tangible and intangible heritage, urban heritage

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279 Construction Engineering and Cocoa Agriculture: A Synergistic Approach for Improved Livelihoods of Farmers

Authors: Felix Darko-Amoah, Daniel Acquah

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In contemporary ecosystems for developing countries like Ghana, the need to explore innovative solutions for sustainable livelihoods of farmers is more important than ever. With Ghana’s population growing steadily and the demand for food, fiber and shelter increasing, it is imperative that the construction industry and agriculture come together to address the challenges faced by farmers in the country. In order to enhance the livelihoods of cocoa farmers in Ghana, this paper provides an innovative strategy that aims to integrate the areas of civil engineering and cash crop agriculture. This study focuses on cocoa cultivation in poorer nations, where farmers confront a variety of difficulties include restricted access to financing, subpar infrastructure, and insufficient support services. We seek to improve farmers' access to financing, improve infrastructure, and provide support services that are essential to their success by combining the fields of building engineering and cocoa production. The findings of the study are beneficial to cocoa producers, community extension agents, and construction engineers. In order to accomplish our objectives, we conducted 307 of field investigations in particular cocoa growing communities in the Western Region of Ghana. Several studies have shown that there is a lack of adequate infrastructure and financing, leading to low yields, subpar beans, and low farmer profitability in developing nations like Ghana. Our goal is to give farmers access to better infrastructure, better financing, and support services that are crucial to their success through the fusion of construction engineering and cocoa production. Based on data gathered from the field investigations, the results show that the employment of appropriate technology and methods for developing structures, roads, and other infrastructure in rural regions is one of the essential components of this strategy. For instance, we find that using affordable, environmentally friendly materials like bamboo, rammed earth, and mud bricks can assist to cut expenditures while also protecting the environment. By applying simple relational techniques to the data gathered, the results also show that construction engineers are crucial in planning and building infrastructure that is appropriate for the local environment and circumstances and resilient to natural disasters like floods. Thus, the convergence of construction engineering and cash crop cultivation is another crucial component of the agriculture-construction interplay. For instance, farmers can receive financial assistance to buy essential inputs, such as seeds, fertilizer, and tools, as well as training in proper farming methods. Moreover, extension services can be offered to assist farmers in marketing their crops and enhancing their livelihoods and revenue. In conclusion, our analysis of responses from the 307 participants depicts that the combination of construction engineering and cash crop agriculture offers an innovative approach to improving farmers' livelihoods in cocoa farming communities in Ghana. In conclusion, by inculcating the findings of this study into core decision-making, policymakers can help farmers build sustainable and profitable livelihoods by addressing challenges such as limited access to financing, poor infrastructure, and inadequate support services.

Keywords: cocoa agriculture, construction engineering, farm buildings and equipment, improved livelihoods of farmers

Procedia PDF Downloads 72
278 Simultech - Innovative Country-Wide Ultrasound Training Center

Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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277 Belonging without Believing: Life Narratives of Six Social Generations of Members of the Apostolic Society

Authors: Frederique A. Demeijer

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This article addresses the religious beliefs of members of the Apostolic Society –a Dutch religious community wherein the oldest living members were raised with very different beliefs than those upheld today. Currently, the Apostolic Society is the largest liberal religious community of the Netherlands, consisting of roughly 15,000 members. It is characterized by its close-knit community life and the importance of its apostle: the spiritual leader who writes a weekly letter around which the Sunday morning service is centered. The society sees itself as ‘religious-humanistic’, inspired by its Judeo-Christian roots without being dogmatic. Only a century earlier, the beliefs of the religious community revolved more strongly around the Bible, the apostle is a link to Christ. Also, the community believed in the return of the Lord, resonating with the millenarian roots of community in 1830. Thus, the oldest living members have experienced fundamental changes in beliefs and rituals, yet remained members. This article reveals how members experience(d) their religious beliefs and feelings of belonging to the community, how these may or may not have changed over time, and what role the Apostolic Society played in their lives. The article presents a qualitative research approach based on two main pillars. First, life narrative interviews were conducted, to work inductively and allow different interview topics to emerge. Second, it uses generational theory, in three ways: 1) to select respondents; 2) to guide the interview methodology –by being sensitive to differences in socio-historical context and events experienced during formative years of interviewees of different social generations, and 3) to analyze and contextualize the qualitative interview data. The data were gathered from 27 respondents, belonging to six social generations. All interviews were recorded, transcribed, coded, and analyzed, using the Atlas.ti software program. First, the elder generations talk about growing up with the Apostolic Society being absolutely central in their daily and spiritual lives. They spent most of their time with fellow members and dedicated their free time to Apostolic activities. The central beliefs of the Apostolic Society were clear and strongly upheld, and they experienced strong belonging. Although they now see the set of central beliefs to be more individually interpretable and are relieved to not have to spend all that time to Apostolic activities anymore, they still regularly attend services and speak longingly of the past with its strong belief and belonging. Second, the younger generations speak of growing up in a non-dogmatic, religious-humanist set of beliefs, but still with a very strong belonging to the religious community. They now go irregularly to services, and talk about belonging, but not as strong as the elderly generations do. Third, across the generations, members spend more time outside of the Apostolic Society than within. The way they speak about their religious beliefs is fluid and differs as much within generations as between: for example, there is no central view on what God is. It seems the experience of members of the Apostolic Society across different generations can now be characterized as belonging without believing.

Keywords: generational theory, individual religious experiences, life narrative history interviews, qualitative research design

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276 Start with the Art: Early Results from a Study of Arts-Integrated Instruction for Young Children

Authors: Juliane Toce, Steven Holochwost

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A substantial and growing literature has demonstrated that arts education benefits young children’s socioemotional and cognitive development. Less is known about the capacity of arts-integrated instruction to yield benefits to similar domains, particularly among demographically and socioeconomically diverse groups of young children. However, the small literature on this topic suggests that arts-integrated instruction may foster young children’s socioemotional and cognitive development by presenting opportunities to 1) engage in instructional content in diverse ways, 2) experience and regulate strong emotions, 3) experience growth-oriented feedback, and 4) engage in collaborative work with peers. Start with the Art is a new program of arts-integrated instruction currently being implemented in four schools in a school district that serves students from a diverse range of backgrounds. The program employs a co-teaching model in which teaching artists and classroom teachers engage in collaborative lesson planning and instruction over the course of the academic year and is currently the focus of an impact study featuring a randomized-control design, as well as an implementation study, both of which are funded through an Educational Innovation and Research grant from the United States Department of Education. The paper will present the early results from the Start with the Art implementation study. These results will provide an overview of the extent to which the program was implemented in accordance with design, with a particular emphasis on the degree to which the four opportunities enumerated above (e.g., opportunities to engage in instructional content in diverse ways) were presented to students. There will be a review key factors that may influence the fidelity of implementation, including classroom teachers’ reception of the program and the extent to which extant conditions in the classroom (e.g., the overall level of classroom organization) may have impacted implementation fidelity. With the explicit purpose of creating a program that values and meets the needs of the teachers and students, Start with the Art incorporates the feedback from individuals participating in the intervention. Tracing its trajectory from inception to ongoing development and examining the adaptive changes made in response to teachers' transformative experiences in the post-pandemic classroom, Start with the Art continues to solicit input from experts in integrating artistic content into core curricula within educational settings catering to students from under-represented backgrounds in the arts. Leveraging the input from this rich consortium of experts has allowed for a comprehensive evaluation of the program’s implementation. The early findings derived from the implementation study emphasize the potential of arts-integrated instruction to incorporate restorative practices. Such practices serve as a crucial support system for both students and educators, providing avenues for children to express themselves, heal emotionally, and foster social development, while empowering teachers to create more empathetic, inclusive, and supportive learning environments. This all-encompassing analysis spotlights Start with the Art’s adaptability to any learning environment through the program’s effectiveness, resilience, and its capacity to transform - through art - the classroom experience within the ever-evolving landscape of education.

Keywords: arts-integration, social emotional learning, diverse learners, co-teaching, teaching artists, post-pandemic teaching

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275 Reliable and Error-Free Transmission through Multimode Polymer Optical Fibers in House Networks

Authors: Tariq Ahamad, Mohammed S. Al-Kahtani, Taisir Eldos

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Optical communications technology has made enormous and steady progress for several decades, providing the key resource in our increasingly information-driven society and economy. Much of this progress has been in finding innovative ways to increase the data carrying capacity of a single optical fiber. In this research article we have explored basic issues in terms of security and reliability for secure and reliable information transfer through the fiber infrastructure. Conspicuously, one potentially enormous source of improvement has however been left untapped in these systems: fibers can easily support hundreds of spatial modes, but today’s commercial systems (single-mode or multi-mode) make no attempt to use these as parallel channels for independent signals. Bandwidth, performance, reliability, cost efficiency, resiliency, redundancy, and security are some of the demands placed on telecommunications today. Since its initial development, fiber optic systems have had the advantage of most of these requirements over copper-based and wireless telecommunications solutions. The largest obstacle preventing most businesses from implementing fiber optic systems was cost. With the recent advancements in fiber optic technology and the ever-growing demand for more bandwidth, the cost of installing and maintaining fiber optic systems has been reduced dramatically. With so many advantages, including cost efficiency, there will continue to be an increase of fiber optic systems replacing copper-based communications. This will also lead to an increase in the expertise and the technology needed to tap into fiber optic networks by intruders. As ever before, all technologies have been subject to hacking and criminal manipulation, fiber optics is no exception. Researching fiber optic security vulnerabilities suggests that not everyone who is responsible for their networks security is aware of the different methods that intruders use to hack virtually undetected into fiber optic cables. With millions of miles of fiber optic cables stretching across the globe and carrying information including but certainly not limited to government, military, and personal information, such as, medical records, banking information, driving records, and credit card information; being aware of fiber optic security vulnerabilities is essential and critical. Many articles and research still suggest that fiber optics is expensive, impractical and hard to tap. Others argue that it is not only easily done, but also inexpensive. This paper will briefly discuss the history of fiber optics, explain the basics of fiber optic technologies and then discuss the vulnerabilities in fiber optic systems and how they can be better protected. Knowing the security risks and knowing the options available may save a company a lot embarrassment, time, and most importantly money.

Keywords: in-house networks, fiber optics, security risk, money

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274 Distribution System Modelling: A Holistic Approach for Harmonic Studies

Authors: Stanislav Babaev, Vladimir Cuk, Sjef Cobben, Jan Desmet

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The procedures for performing harmonic studies for medium-voltage distribution feeders have become relatively mature topics since the early 1980s. The efforts of various electric power engineers and researchers were mainly focused on handling large harmonic non-linear loads connected scarcely at several buses of medium-voltage feeders. In order to assess the impact of these loads on the voltage quality of the distribution system, specific modeling and simulation strategies were proposed. These methodologies could deliver a reasonable estimation accuracy given the requirements of least computational efforts and reduced complexity. To uphold these requirements, certain analysis assumptions have been made, which became de facto standards for establishing guidelines for harmonic analysis. Among others, typical assumptions include balanced conditions of the study and the negligible impact of impedance frequency characteristics of various power system components. In latter, skin and proximity effects are usually omitted, and resistance and reactance values are modeled based on the theoretical equations. Further, the simplifications of the modelling routine have led to the commonly accepted practice of neglecting phase angle diversity effects. This is mainly associated with developed load models, which only in a handful of cases are representing the complete harmonic behavior of a certain device as well as accounting on the harmonic interaction between grid harmonic voltages and harmonic currents. While these modelling practices were proven to be reasonably effective for medium-voltage levels, similar approaches have been adopted for low-voltage distribution systems. Given modern conditions and massive increase in usage of residential electronic devices, recent and ongoing boom of electric vehicles, and large-scale installing of distributed solar power, the harmonics in current low-voltage grids are characterized by high degree of variability and demonstrate sufficient diversity leading to a certain level of cancellation effects. It is obvious, that new modelling algorithms overcoming previously made assumptions have to be accepted. In this work, a simulation approach aimed to deal with some of the typical assumptions is proposed. A practical low-voltage feeder is modeled in PowerFactory. In order to demonstrate the importance of diversity effect and harmonic interaction, previously developed measurement-based models of photovoltaic inverter and battery charger are used as loads. The Python-based script aiming to supply varying voltage background distortion profile and the associated current harmonic response of loads is used as the core of unbalanced simulation. Furthermore, the impact of uncertainty of feeder frequency-impedance characteristics on total harmonic distortion levels is shown along with scenarios involving linear resistive loads, which further alter the impedance of the system. The comparative analysis demonstrates sufficient differences with cases when all the assumptions are in place, and results indicate that new modelling and simulation procedures need to be adopted for low-voltage distribution systems with high penetration of non-linear loads and renewable generation.

Keywords: electric power system, harmonic distortion, power quality, public low-voltage network, harmonic modelling

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273 Generation of Knowlege with Self-Learning Methods for Ophthalmic Data

Authors: Klaus Peter Scherer, Daniel Knöll, Constantin Rieder

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Problem and Purpose: Intelligent systems are available and helpful to support the human being decision process, especially when complex surgical eye interventions are necessary and must be performed. Normally, such a decision support system consists of a knowledge-based module, which is responsible for the real assistance power, given by an explanation and logical reasoning processes. The interview based acquisition and generation of the complex knowledge itself is very crucial, because there are different correlations between the complex parameters. So, in this project (semi)automated self-learning methods are researched and developed for an enhancement of the quality of such a decision support system. Methods: For ophthalmic data sets of real patients in a hospital, advanced data mining procedures seem to be very helpful. Especially subgroup analysis methods are developed, extended and used to analyze and find out the correlations and conditional dependencies between the structured patient data. After finding causal dependencies, a ranking must be performed for the generation of rule-based representations. For this, anonymous patient data are transformed into a special machine language format. The imported data are used as input for algorithms of conditioned probability methods to calculate the parameter distributions concerning a special given goal parameter. Results: In the field of knowledge discovery advanced methods and applications could be performed to produce operation and patient related correlations. So, new knowledge was generated by finding causal relations between the operational equipment, the medical instances and patient specific history by a dependency ranking process. After transformation in association rules logically based representations were available for the clinical experts to evaluate the new knowledge. The structured data sets take account of about 80 parameters as special characteristic features per patient. For different extended patient groups (100, 300, 500), as well one target value as well multi-target values were set for the subgroup analysis. So the newly generated hypotheses could be interpreted regarding the dependency or independency of patient number. Conclusions: The aim and the advantage of such a semi-automatically self-learning process are the extensions of the knowledge base by finding new parameter correlations. The discovered knowledge is transformed into association rules and serves as rule-based representation of the knowledge in the knowledge base. Even more, than one goal parameter of interest can be considered by the semi-automated learning process. With ranking procedures, the most strong premises and also conjunctive associated conditions can be found to conclude the interested goal parameter. So the knowledge, hidden in structured tables or lists can be extracted as rule-based representation. This is a real assistance power for the communication with the clinical experts.

Keywords: an expert system, knowledge-based support, ophthalmic decision support, self-learning methods

Procedia PDF Downloads 239