Search results for: approach to patient

Authors: M. Volpini, D. Alves, A. Horta, M. Borges, P. Reis

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The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.

Keywords: additive manufacture, new designs, orthoses, finite elements

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Authors: Preeti Verma, P. Chellapandi, N.C. Santhi Srinivas, Vakil Singh

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Modified 9Cr-1Mo steel is widely used for structural components like heat exchangers, pressure vessels and steam generator in the nuclear reactors. It is also found to be a candidate material for future metallic fuel sodium cooled fast breeder reactor because of its high thermal conductivity, lower thermal expansion coefficient, micro structural stability, high irradiation void swelling resistance and higher resistance to stress corrosion cracking in water-steam systems compared to austenitic stainless steels. The components of steam generators that operate at elevated temperatures are often subjected to repeated thermal stresses as a result of temperature gradients which occur on heating and cooling during start-ups and shutdowns or during variations in operating conditions of a reactor. These transient thermal stresses give rise to LCF damage. In the present investigation strain controlled low cycle fatigue tests were conducted at room temperature and 300 °C in normalized and tempered condition using total strain amplitudes in the range from ±0.25% to ±0.5% at strain rate of 10-2 s-1. Cyclic Stress response at high strain amplitudes (±0.31% to ±0.5%) showed initial softening followed by hardening upto a few cycles and subsequent softening till failure. The extent of softening increased with increase in strain amplitude and temperature. Depends on the strain amplitude of the test the stress strain hysteresis loops displayed Masing behaviour at higher strain amplitudes and non-Masing at lower strain amplitudes at both the temperatures. It is quite opposite to the usual Masing and Non-Masing behaviour reported earlier for different materials. Low cycle fatigue damage was evaluated in terms of plastic strain and plastic strain energy approach at room temperature and 300 °C. It was observed that the plastic strain energy approach was found to be more closely matches with the experimental fatigue lives particularly, at 300 °C where dynamic strain aging was observed.

Keywords: Modified 9Cr-mo steel, low cycle fatigue, Masing behavior, cyclic softening

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Authors: Abderrahim Siam, Ramdane Maamri, Zaidi Sahnoun

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The development of adaptive user interfaces (UI) presents for a long time an important research area in which researcher attempt to call upon the full resources and skills of several disciplines. The adaptive UI community holds a thorough knowledge regarding the adaptation of UIs with users and with contexts of use. Several solutions, models, formalisms, techniques, and mechanisms were proposed to develop adaptive UI. In this paper, we propose an approach based on the fuzzy set theory for modeling the concept of the appropriateness of different solutions of UI adaptation with different situations for which interactive systems have to adapt their UIs.

Keywords: adaptive user interfaces, adaptation solution’s appropriateness, fuzzy sets

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Authors: Mannika Garg, N. Srinivas Murthy, Sunish Nair

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TeamIndus is only Indian team participated in the Google Lunar X Prize (GLXP). GLXP is an incentive prize space competition which is organized by the XPrize Foundation and sponsored by Google. The main objective of the mission is to soft land a rover on the moon surface, travel minimum displacement of 500 meters and transmit HD and NRT videos and images to the Earth. Team Indus is designing a Lunar Lander which carries Rover with it and deliver onto the surface of the moon with a soft landing. For lander to survive throughout the mission, energy is required to operate all attitude control sensors, actuators, heaters and other necessary components. Photovoltaic solar array systems are the most common and primary source of power generation for any spacecraft. The scope of this paper is to provide a system-level approach for designing the solar array systems of the lander to generate required power to accomplish the mission. For this mission, the direction of design effort is to higher efficiency, high reliability and high specific power. Towards this approach, highly efficient multi-junction cells have been considered. The design is influenced by other constraints also like; mission profile, chosen spacecraft attitude, overall lander configuration, cost effectiveness and sizing requirements. This paper also addresses the various solar array design challenges such as operating temperature, shadowing, radiation environment and mission life and strategy of supporting required power levels (peak and average). The challenge to generate sufficient power at the time of surface touchdown, due to low sun elevation (El) and azimuth (Az) angle which depends on Lunar landing site, has also been showcased in this paper. To achieve this goal, energy balance analysis has been carried out to study the impact of the above-mentioned factors and to meet the requirements and has been discussed in this paper.

Keywords: energy balance analysis, multi junction solar cells, photovoltaic, reliability, spacecraft attitude

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Authors: P. Mambanga, T. G. Tshitangano, H. Akinsola

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Background: Unintended pregnancies constitute a most serious public health challenge to women to an extent that they sometimes end in illegal abortions resulting in adverse consequences. However, the introduction of emergency contraception has served as the last chance for women to avoid unintended pregnancies, though, in countries like Zimbabwe the cause for underutilisation of emergency contraception has been hardly investigated. Purpose: The main purpose of this study was to assess the knowledge, attitude and practice of female students regarding emergency contraception among in preventing unintended pregnancy. Methodology: A quantitative approach using descriptive cross-sectional survey design was conducted among 319 stratified random sampled female university students of Midland State University, Zimbabwe. Self-administered close-ended questionnaire was used to collect the data. To ensure validity, the development of the instrument was guided by a wide range of literature and the inputs of experts. The instrument was retested for reliability and the responses will be comparing using Cronbach’s alpha which yielded high reliability alpha (α) value of 0.84. Data was coded and entered into a computer using Microsoft Excel 2010 and analysed using Statistical Package for Social Scientists (SPSS) version 22.0. Descriptive statistics were used to analyse data in the form of cross tabulation and the results were presented in table, graphs and pie charts. Results: The results indicated that apart from all sources of information about EC, mass media has shown to be the most famous. Although female students knows about EC, the knowledge about effective level and correct use of EC poor. The attitudes of female students at MSU are unfavourable for EC as they gave reasons like EC promotes promiscuity and it can pose risk. The practice of EC at MSU is low with only 47% of respondents said they have once use EC. Conclusion and recommendation: The study concluded the lack of actual knowledge about EC which has directly influenced attitudes and practices. The study concluded that there MSU female students has fair knowledge about EC which has resulted in negative and attitudes towards EC with few EC practices. The study, therefore, recommends the adoption and use of Health Belief Model approach in promoting the young to use EC to prevent unwanted pregnancies.

Keywords: emergency contraception, knowledge, attitude, practice, female students

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Authors: Marcelo Hayashi, João Lima, Bruno Chieregatti, Ernani Volpe

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The adjoint method has been used as a successful tool to obtain sensitivity gradients in aerodynamic design and optimisation for many years. This work presents an alternative approach to the continuous adjoint formulation that enables one to compute gradients of a given measure of merit with respect to control parameters other than those pertaining to geometry. The procedure is then applied to the steady 2–D compressible Euler and incompressible Navier–Stokes flow equations. Finally, the results are compared with sensitivities obtained by finite differences and theoretical values for validation.

Keywords: adjoint method, aerodynamics, sensitivity theory, non-geometric sensitivities

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Authors: H. Assaedi, F. U. A. Shaikh, I. M. Low

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This paper presents the effects of mixing procedures on mechanical properties of flyash-based geopolymer matrices containing nanosilica (NS) at 0.5%, 1.0%, 2.0%, and 3.0% by wt.. Comparison is made with conventional mechanical dry-mixing of NS with flyash and wet-mixing of NS in alkaline solutions. Physical and mechanical properties are investigated using X-Ray Diffraction (XRD) and Scanning Electron Microscope (SEM). Results show that generally the addition of NS particles enhanced the microstructure and improved flexural and compressive strengths of geopolymer nanocomposites. However, samples prepared using dry-mixing approach demonstrate better physical and mechanical properties than wet-mixing of NS.

Keywords: geopolymer, nano-silica, dry mixing, wet mixing, physical properties, mechanical properties

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Authors: Satoshi Furukawa, Satomu Morita, Lisa Wingenfeld, Katsuji Nishi, Masahito Hitosugi

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We studied the expression of hypoxia-related antigens (e.g., cold-inducible antigens and apoptotic antigens) in the myocardium and the cerebellumthat were obtained from individuals after death by carbon monoxide or hypothermia. The immunohistochemistry results revealed that expression of cold-inducible RNA binding protein (CIRBP) and RNA-binding protein 3 (RBM3) may be associated with hpyothermic and the hypoxic conditions. The expression of CIRBP and RBM3 in the myocardium was different from their expression in the cerebellum, especially in the Purkinje cells. The results indicate that agonal duration influences antigen expression. In the hypothermic condition, the myocardium uses more ATP since the force of the excitation-contraction coupling of the myocardium increases by more than 400% when the experimental temperature is reduced from 35°C to 25°C. The results obtained in this study indicate that physicians should pay attention to the myocardium when cooling the patient’s body to protect the brain.

Keywords: carbon monoxide death, cerebellum, CIRBP, hypothermic death, myocardium, RBM3

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Authors: Andy Ho

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Breast cancer is a common cancer in Australia. Early diagnosis is crucial for improving patient outcomes, as later-stage detection correlates with poorer prognoses. While multiparametric MRI offers superior sensitivity in detecting invasive and high-grade breast cancers compared to conventional mammography, its extended scan duration and high costs limit widespread application. As a result, full protocol MRI screening is typically reserved for patients at elevated risk. Recent advancements in imaging technology have facilitated the development of Abbreviated MRI protocols, which dramatically reduce scan times (<10 minutes compared to >30 minutes for full protocol). The potential for Abbreviated MRI to offer a more time- and cost-efficient alternative has implications for improving patient accessibility, reducing appointment durations, and enhancing compliance—especially relevant for individuals requiring regular annual screening over several decades. The purpose of this study is to assess the diagnostic efficacy of Abbreviated MRI for breast cancer screening among high-risk patients at the Royal Prince Alfred Hospital (RPA). This study aims to determine the sensitivity, specificity, and inter-reader variability of Abbreviated MRI protocols when interpreted by subspecialty-trained Breast Radiologists. A systematic review of the RPA’s electronic Picture Archive and Communication System identified high-risk patients, defined by Australian ‘Medicare Benefits Schedule’ criteria, who underwent Breast MRI from 2021 to 2022. Eligible participants included asymptomatic patients under 50 years old and referred by the High-Risk Clinic due to a high-risk genetic profile or relevant familial history. The MRIs were anonymized, randomized, and interpreted by four Breast Radiologists, each independently completing standardized proforma evaluations. Radiological findings were compared against histopathology as the gold standard or follow-up imaging if biopsies were unavailable. Statistical metrics, including sensitivity, specificity, and inter-reader variability, were assessed. The Fleiss-Kappa analysis demonstrated a fair inter-reader agreement (kappa = 0.25; 95% CI: 0.19–0.32; p < 0.0001). The sensitivity for detecting malignancies was 0.72, with a specificity of 0.92. For benign lesions, sensitivity and specificity were 0.844 and 0.73, respectively. These findings underline the potential of Abbreviated MRI as a reliable screening tool for malignancies with significant specificity, though reduced sensitivity highlights the importance of robust radiologist training and consistent evaluation standards. Abbreviated MRI protocols exhibit promise as a viable screening option for high-risk patients, combining reduced scan times and acceptable diagnostic accuracy. Further work to refine interpretation practices and optimize training is essential to maximize the protocol’s utility in routine clinical screening and facilitate broader accessibility.

Keywords: abbreviated, breast, cancer, MRI

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Authors: Safak Isik, Ozalp Vayvay

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Strategic partnerships with suppliers play a vital role for the long-term value-based supply chain. This strategic collaboration keeps still being one of the top priority of many business organizations in order to create more additional value; benefiting mainly from supplier’s specialization, capacity and innovative power, securing supply and better managing costs and quality. However, many organizations encounter difficulties in initiating, developing and managing those partnerships and many attempts result in failures. One of the reasons for such failure is the incompatibility of members of this partnership or in other words wrong supplier selection which emphasize the significance of the selection process since it is the beginning stage. An effective selection process of strategic suppliers is critical to the success of the partnership. Although there are several research studies to select the suppliers in literature, only a few of them is related to strategic supplier selection for long-term partnership. The purpose of this study is to propose a conceptual model for the selection of strategic partnership suppliers. A two-stage approach has been used in proposed model incorporating first segmentation and second selection. In the first stage; considering the fact that not all suppliers are strategically equal and instead of a long list of potential suppliers, Kraljic’s purchasing portfolio matrix can be used for segmentation. This supplier segmentation is the process of categorizing suppliers based on a defined set of criteria in order to identify types of suppliers and determine potential suppliers for strategic partnership. In the second stage, from a pool of potential suppliers defined at first phase, a comprehensive evaluation and selection can be performed to finally define strategic suppliers considering various tangible and intangible criteria. Since a long-term relationship with strategic suppliers is anticipated, criteria should consider both current and future status of the supplier. Based on an extensive literature review; strategical, operational and organizational criteria have been determined and elaborated. The result of the selection can also be used to determine suppliers who are not ready for a partnership but to be developed for strategic partnership. Since the model is based on multiple criteria for both stages, it provides a framework for further utilization of Multi-Criteria Decision Making (MCDM) techniques. The model may also be applied to a wide range of industries and involve managerial features in business organizations.

Keywords: Kraljic’s matrix, purchasing portfolio, strategic supplier selection, supplier collaboration, supplier partnership, supplier segmentation

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Authors: Rajwanlop Kumpoopong, Sukit Yindeesuk, Pornchai Silarom

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Modeling cracks in concrete is complicated by its strain-softening behavior which requires the use of sophisticated energy criteria of fracture mechanics to assure stable and convergent solutions in the finite-element (FE) analysis particularly for relatively large structures. However, for small-scale structures such as beams and slabs, a simpler approach relies on retaining some shear stiffness in the cracking plane has been adopted in literature to model the strain-softening behavior of concrete under monotonically increased loading. According to the shear retaining approach, each element is assumed to be an isotropic material prior to cracking of concrete. Once an element is cracked, the isotropic element is replaced with an orthotropic element in which the new orthotropic stiffness matrix is formulated with respect to the crack orientation. The shear transfer factor of 0.5 is used in parallel to the crack plane. The shear retaining approach is adopted in this research to model cracks in RC bridge deck with some modifications to take into account the effect of repetitive moving truck wheel loads as they cause fatigue cracking of concrete. First modification is the introduction of fatigue tests of concrete and reinforcing steel and the Palmgren-Miner linear criterion of cumulative damage in the conventional FE analysis. For a certain loading, the number of cycles to failure of each concrete or RC element can be calculated from the fatigue or S-N curves of concrete and reinforcing steel. The elements with the minimum number of cycles to failure are the failed elements. For the elements that do not fail, the damage is accumulated according to Palmgren-Miner linear criterion of cumulative damage. The stiffness of the failed element is modified and the procedure is repeated until the deck slab fails. The total number of load cycles to failure of the deck slab can then be obtained from which the S-N curve of the deck slab can be simulated. Second modification is the modification in shear transfer factor. Moving loading causes continuous rubbing of crack interfaces which greatly reduces shear transfer mechanism. It is therefore conservatively assumed in this study that the analysis is conducted with shear transfer factor of zero for the case of moving loading. A customized FE program has been developed using the MATLAB software to accomodate such modifications. The developed procedure has been validated with the fatigue test of the 1/6.6-scale AASHTO bridge deck under the applications of both fixed-point repetitive loading and moving loading presented in the literature. Results are in good agreement both experimental vs. simulated S-N curves and observed vs. simulated crack patterns. Significant contribution of the developed procedure is a series of S-N relations which can now be simulated at any desired levels of cracking in addition to the experimentally derived S-N relation at the failure of the deck slab. This permits the systematic investigation of crack propagation or deterioration of RC bridge deck which is appeared to be useful information for highway agencies to prolong the life of their bridge decks.

Keywords: bridge deck, cracking, deterioration, fatigue, finite-element, moving truck, reinforced concrete

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Authors: Martin Goubej, Tomas Popule, Alois Krejci

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This paper deals with experimental identification of mechanical systems with nonlinear friction characteristics. Dynamic LuGre friction model is adopted and a systematic approach to parameter identification of both linear and nonlinear subsystems is given. The identification procedure consists of three subsequent experiments which deal with the individual parts of plant dynamics. The proposed method is experimentally verified on an industrial-grade robotic manipulator. Model fidelity is compared with the results achieved with a static friction model.

Keywords: mechanical friction, LuGre model, friction identification, motion control

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Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

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Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

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Authors: Timothy Wale Olaosebikan

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The adverse effect of the Covid-19 outbreak and lock-downs on the world economy has coursed a major disrupt in mostly all sectors. The educational sector is not exempted from this disruption as it is one of the most affected sectors in the world. Similarly, most developing countries are still struggling to adopt/ adapt with the 21st-century advancement of technology, which includes e-learning/ e-education. Furthermore, one is left to wonder of the possibility of these countries surviving this disruption on their various educational systems that may no longer be business as usual after the Covid Pandemic era. This study evaluates the e-learning process of educational systems, especially in developing countries. The collection of data for the study was effected through the use of questionnaires with sampling drawn by stratified random sampling. The data was analyzed using descriptive and inferential statistics. The findings of the study show that about 30% of developing countries have fully adopted the e-learning system, about 45% of these countries are still struggling to upgrade while about 25% of these countries are yet to adopt the e-learning system of education. The study concludes that the sudden closure of educational institutions around the world during the Covid Pandemic period should facilitate a teaching pedagogy of e-learning and virtual delivery of courses and programmes in these developing countries. If this approach can be fully adopted, schools might have to grapple with the initial teething problems, given the sudden transition just in order to preserve the welfare of students. While progress should be made to transit as the case may be, lectures and seminars can be delivered through the web conferencing site-zoom. Interestingly, this can be done on a mobile phone. The demands of this approach would equally allow lecturers to make major changes to their work habits, uploading their teaching materials online, and get to grips with what online lecturing entails. Consequently, the study recommends that leaders of developing countries, regulatory authorities, and heads of educational institutions must adopt e-learning into their educational system. Also, e-learning should be adopted into the educational curriculum of students, especially from elementary school up to tertiary level. Total compliance to the e-learning system must be ensured on the part of both the institutions, stake holders, lecturers, tutors, and students. Finally, collaborations with developed countries and effective funding for e-learning integration must form the heart of their cardinal mission.

Keywords: Covid pandemic, developing countries, educational system, e-learning

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Authors: Vincent Liu

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Machine learning algorithms (ML) can achieve high accuracy in predicting outcomes compared to classical models. Metaheuristic, nature-inspired algorithms can enhance traditional ML algorithms by optimizing them such as by performing feature selection. We compare ten ML algorithms to predict 30-day hospital readmission rates for diabetes patients in the US using a dataset from UCI Machine Learning Repository with feature selection performed by Greywolf nature-inspired algorithm. The baseline accuracy for the initial random forest model was 65%. After performing feature engineering, SMOTE for class balancing, and Greywolf optimization, the machine learning algorithms showed better metrics, including F1 scores, accuracy, and confusion matrix with improvements ranging in 10%-30%, and a best model of XGBoost with an accuracy of 95%. Applying machine learning this way can improve patient outcomes as unnecessary rehospitalizations can be prevented by focusing on patients that are at a higher risk of readmission.

Keywords: diabetes, machine learning, 30-day readmission, metaheuristic

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Authors: Ran Etgar

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The process of rounding off measurements in continuous variables is commonly encountered. Although it usually has minor effects, sometimes it can lead to poor outcomes in statistical process control using X ̅-chart. The traditional control limits can cause incorrect conclusions if applied carelessly. This study looks into the limitations of classical control limits, particularly the impact of asymmetry. An approach to determining the distribution function of the measured parameter (Y ̅) is presented, resulting in a more precise method to establish the upper and lower control limits. The proposed method, while slightly more complex than Shewhart's original idea, is still user-friendly and accurate and only requires the use of two straightforward tables.

Keywords: inaccurate measurement, SPC, statistical process control, rounded-off, control chart

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Authors: Jungyeol Hong, Dongjoo Park

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The primary purpose of this study is to develop a methodological framework to predict daily subway ridership at a station-level and to examine the association between subway ridership and bus demand incorporating commercial business facility in the vicinity of each subway station. The socio-economic characteristics, land-use, and built environment as factors may have an impact on subway ridership. However, it should be considered not only the endogenous relationship between bus and subway demand but also the characteristics of commercial business within a subway station’s sphere of influence, and integrated transit network topology. Regarding a statistical approach to estimate subway ridership at a station level, therefore it should be considered endogeneity and heteroscedastic issues which might have in the subway ridership prediction model. This study focused on both discovering the impacts of bus demand, commercial business characteristics, and network topology on subway ridership and developing more precise subway ridership estimation accounting for its statistical bias. The spatial scope of the study covers entire Seoul city in South Korea and includes 243 stations with the temporal scope set at twenty-four hours with one-hour interval time panels each. The data for subway and bus ridership was collected Seoul Smart Card data from 2015 and 2016. Three-Stage Least Square(3SLS) approach was applied to develop daily subway ridership model as capturing the endogeneity and heteroscedasticity between bus and subway demand. Independent variables incorporating in the modeling process were commercial business characteristics, social-economic characteristics, safety index, transit facility attributes, and dummies for seasons and time zone. As a result, it was found that bus ridership and subway ridership were endogenous each other and they had a significantly positive sign of coefficients which means one transit mode could increase another transportation mode’s ridership. In other words, two transit modes of subway and bus have a mutual relationship instead of the competitive relationship. The commercial business characteristics are the most critical dimension among the independent variables. The variables of commercial business facility rate in the paper containing six types; medical, educational, recreational, financial, food service, and shopping. From the model result, a higher rate in medical, financial buildings, shopping, and food service facility lead to increment of subway ridership at a station, while recreational and educational facility shows lower subway ridership. The complex network theory was applied for estimating integrated network topology measures that cover the entire Seoul transit network system, and a framework for seeking an impact on subway ridership. The centrality measures were found to be significant and showed a positive sign indicating higher centrality led to more subway ridership at a station level. The results of model accuracy tests by out of samples provided that 3SLS model has less mean square error rather than OLS and showed the methodological approach for the 3SLS model was plausible to estimate more accurate subway ridership. Acknowledgement: This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science and ICT (2017R1C1B2010175).

Keywords: subway ridership, bus ridership, commercial business characteristic, endogeneity, network topology

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Authors: Kathleen Joy Hingan, Jessiraye Luienne Catubigan, Carlo Mercado, Janisse RañEses

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In this research, the researchers wanted to explore how specialists and resident doctors in the fields of surgery, and obstetrics and gynecology handle their medical errors. They are interested in understanding the factors that contributed to the disclosure of medical error, the feelings after the occurrence of an error, and the way they coped with it given the power relations in place. The researchers conducted semi-structured interviews, transcribed the recordings, and analyzed the transcripts using thematic analysis. They found that doctors disclosed to their superiors and co-residents to cope with and to learn from the errors. In terms of disclosure to patients, the participants told them about the adverse event, but not about the error because of fear for themselves, their colleagues, their institution, and their patient. Doctors also performed compensatory actions to make up for the error and the nondisclosure of its occurrence. These actions functioned as a form of damage control too. Resident doctors and specialists receive different sanctions because of the power structures in the system.

Keywords: coping, disclosure, doctors, interviews, medical errors, thematic analysis

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Authors: Cecília M. Antão, Paulo Jorge Nogueira

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Breast cancer (BC) is the first cause of cancer mortality among Portuguese women. This retrospective observational study aimed at identifying comorbidities associated with BC female patients admitted to Portuguese public hospitals (2010-2018), investigating the effect of comorbidities on BC mortality rate, and building a predictive model using logistic regression. Results showed that the BC mortality in Portugal decreased in this period and reached 4.37% in 2018. Adjusted odds ratio indicated that secondary malignant neoplasms of liver, of bone and bone marrow, congestive heart failure, and diabetes were associated with an increased chance of dying from breast cancer. Although the Lisbon district (the most populated area) accounted for the largest percentage of BC patients, the logistic regression model showed that, besides patient’s age, being resident in Bragança, Castelo Branco, or Porto districts was directly associated with an increase of the mortality rate.

Keywords: breast cancer, comorbidities, logistic regression, adjusted odds ratio

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Authors: Olurankinse Felix

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Local governments in Ondo State Nigeria are the third tier of government saddled with the responsibility of providing governance and economic services at the grassroots. To be able to do this, the Constitution of the Federal Republic of Nigeria provided that a proportion of Federation Account be allocated to them in addition to their internally generated revenue. From the allocation and other incidental sources of revenue, the local governments are expected to provide basic infrastructures and other social amenities to better the lots of the rural dwellers. Nevertheless, local governments’ performances in terms of provision of social amenities are without questioning and quite not encouraging. Assessing the performance of local governments in this period of dearth and scarcity of resources is highly indispensable more so that the activities of local governments’ staff are bedeviled and characterized with fraud, corruption and mismanagement. Considering the direct impact of the consequences of their action on the living standard of the rural dwellers therefore calls for the need to evaluate their level of performances using capital budgeting approach. The paper being a time series study adopts the survey design. Data were obtained through secondary source mainly from the Annual financial statements and publication of approved budgets estimates covering the period of study (2008-2012). The use of ratio analysis was employed in analyzing the comparative level of performances of the local governments under study. The result of the study shows that less than 30% of the local governments were able to harness the budgetary allocation to provide amenities to the beneficiaries while majority of the local governments were involved in unethical conduct ranging from theft of fund, corruption, diversion of funds and extra-budgetary activities. Also, there is poor internally generated revenue to complement the statutory allocation and besides, the monthly withholding of larger portions of local government share by the state in the name of joint account were also seen as contributory factors. The study recommends the need for transparency and accountability in public fund management through the oversight function of the state house of assembly. Also local government should be made to be autonomous and independent of the state by jettisoning the idea of joint account.

Keywords: performance, transparency and accountability, capital budgeting, joint account, local government autonomy

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Authors: Rabab A. El Wahsh, Hatem M. Marey, Maha Yousif, Asmaa M. Ibrahim

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Background: OSA and COPD are associated with microvascular changes. Retinal microvasculature can be directly and non-invasively examined. Aim: to evaluate retinal vascular tortuosity in patients with COPD, OSA, and overlap syndrome. Subjects and method: Sixty subjects were included; 15 OSA patients, 15 COPD patients, 15 COPD-OSA overlap patients, and 15 matched controls. They underwent digital retinal photography, polysomnography, arterial blood gases, spirometry, ESS, and stop-bang questionnaires. Results: Tortuosity of most retinal vessels was higher in all patient groups compared to the control group; tortuosity was more marked in overlap syndrome. There was a negative correlation between tortuosity of retinal vessels and PO2, O2 saturation, and minimum O2 desaturation, and a positive correlation with PCO2, AHI, O2 desaturation index, BMI and smoking index. Conclusion: Retinal vascular tortuosity occurs in OSA, COPD and overlap syndrome. Retinal vascular tortuosity is correlated with arterial blood gases parameters, polysomnographic findings, smoking index and BMI.

Keywords: OSA, COPD, overlap syndrome, retinal vascular tortuosity

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Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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Authors: Georges Jabbour

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Background and aims: This two-year follow-up study explores the long-term sustainability of physical activity (PA) levels in young people with type 1 diabetes, focusing on the relationship between PA, hypoglycemia, and behavioral scores. The literature highlights the importance of PA and its health benefits, as well as the barriers to engaging in PA practices. Studies have shown that individuals with high levels of vigorous physical activity have higher fear of hypoglycemia (FOH) scores and more hypoglycemia episodes. Considering that hypoglycemia episodes are a major barrier to physical activity, and many studies reported a negative association between PA and high FOH scores, it cannot be guaranteed that those experiencing hypoglycemia over a long period will remain active. Building on that, the present work assesses whether high PA levels, despite elevated hypoglycemia risk, can be maintained over time. The study tracks PA levels at one and two years, correlating them with hypoglycemia instances and Fear of Hypoglycemia (FOH) scores. Materials and methods: A self-administered questionnaire was completed by 61 youth with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores and HbA1C levels were collected. All assessments were realized at baseline (visit 0: V0), one year (V1) and two years later (V2). For the purpose of the present work, we explore the relationships between PA levels, hypoglycemia episodes, and FOH scores at each time point. We used multiple linear regression to model the mean outcomes for each exposure of interest. Results: Findings indicate no changes in total moderate to vigorous PA (MVPA) and VPA levels among visits, and HbA1c (%) was negatively correlated with the total amount of VPA per day in minutes (β= -0.44; p=0.01, β= -0.37; p=0.04, and β= -0.66; p=0.01 for V0, V1, and V2, respectively). Our linear regression model reported a significant negative correlation between VPA and FOH across the visits (β=-0.59, p=0.01; β= -0.44, p=0.01; and β= -0.34, p=0.03 for V0, V1, and V2, respectively), and HbA1c (%) was influenced by both the number of hypoglycemic episodes and FOH score at V2 (β=0.48; p=0.02 and β=0.38; p=0.03, respectively). Conclusion: The sustainability of PA levels and HbA1c (%) in young individuals with type 1 diabetes is influenced by various factors, including fear of hypoglycemia. Understanding these complex interactions is essential for developing effective interventions to promote sustained PA levels in this population. Our results underline the necessity of a multi-strategic approach to promoting active lifestyles among diabetic youths. This approach should synergize PA enhancement with vigilant glucose monitoring and effective FOH management.

Keywords: physical activity, hypoglycemia, fear of hypoglycemia, youth

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Authors: George Eduful, Kingsford J. A. Atanga

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Copper clad steel wire (CCS) is primarily used for grounding applications to reduce the high incidence of copper ground conductor theft in electrical installations. The cross sectional area of the CCS is selected by relating the diameter equivalence to a copper conductor. The main difficulty is how to use a simple analytical relation to determine the right conductivity of CCS for a particular application. The use of Eddy-Current instrument for measuring conductivity is known but in most cases, the instrument is not readily available. The paper presents a simplified approach on how to size and determine CCS conductivity for a given application.

Keywords: copper clad steel wire, conductivity, grounding, skin effect

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Authors: Mohammad Alhajeri

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This paper reports a computational fluid dynamics (CFD) investigation of cylindrical filter. Silicon carbide cylindrical filter elements have proven to be an effective mean of removing particulates to levels exceeding the new source performance standard. The CFD code is used here to understand the deposition process and the factors that affect the particles distribution over the filter element surface. Different approach cross flow velocity to filter face velocity ratios and different face velocities (ranging from 2 to 5 cm/s) are used in this study. Particles in the diameter range 1 to 100 microns are tracked through the domain. The radius of convergence (or the critical trajectory) is compared and plotted as a function of many parameters.

Keywords: filtration, CFD, CCF, hot gas filtration

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Authors: Chengcao Sun, Shujun Li, Dejia Li

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Sulforaphane (SFN) possesses powerful chemo-preventive effects and plays a crucial role on oxidative stress and inflammatory. In our recent study, SFN treatment could relieve muscular dystrophy in mdx mice by activating Nrf2 (NF-E2 related factor 2). Moreover, our findings indicated that SFN-activated Nrf2 alleviated muscle inflammation in dystrophin-deficient mdx mice through suppressing NF-κB signaling pathway. Collectively, SFN-induced Nrf2 molecular pathway might be a promising approach for treatment of the patients with Duchenne muscular dystrophy.

Keywords: sulforaphane, Duchenne muscular dystrophy, Nrf2, inflammation, fibrosis, oxidative stress

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Authors: Riffi Mohammed Amine

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A cloud is made up of small particles of liquid water or ice suspended in the atmosphere, which generally do not reach the ground. Various methods are used to classify clouds. This article focuses specifically on a technique known as particle swarm optimization (PSO), an AI approach inspired by the collective behaviors of animals living in groups, such as schools of fish and flocks of birds, and a method used to solve complex classification and optimization problems with approximate solutions. The proposed technique was evaluated using a series of second-generation METOSAT images taken by the MSG satellite. The acquired results indicate that the proposed method gave acceptable results.

Keywords: remote sensing, particle swarm optimization, clouds, meteorological image

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Authors: Yena Lee, Vassilis M. Charitopoulos, Karthik Thyagarajan, Ian Morris, Jose M. Pinto, Lazaros G. Papageorgiou

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With globalisation, the need to have better coordination of production and distribution decisions has become increasingly important for industrial gas companies in order to remain competitive in the marketplace. In this work, we investigate a problem that integrates production, inventory, and routing decisions in a liquid oxygen supply chain. The oxygen supply chain consists of production facilities, external third-party suppliers, and multiple customers, including hospitals and industrial customers. The product produced by the plants or sourced from the competitors, i.e., third-party suppliers, is distributed by a fleet of heterogenous vehicles to satisfy customer demands. The objective is to minimise the total operating cost involving production, third-party, and transportation costs. The key decisions for production include production and inventory levels and product amount from third-party suppliers. In contrast, the distribution decisions involve customer allocation, delivery timing, delivery amount, and vehicle routing. The optimisation of the coordinated production, inventory, and routing decisions is a challenging problem, especially when dealing with large-size problems. Thus, we present a two-stage procedure to solve the integrated problem efficiently. First, the problem is formulated as a mixed-integer linear programming (MILP) model by simplifying the routing component. The solution from the first-stage MILP model yields the optimal customer allocation, production and inventory levels, and delivery timing and amount. Then, we fix the previous decisions and solve a detailed routing. In the second stage, we propose a column generation scheme to address the computational complexity of the resulting detailed routing problem. A case study considering a real-life oxygen supply chain in the UK is presented to illustrate the capability of the proposed models and solution method. Furthermore, a comparison of the solutions from the proposed approach with the corresponding solutions provided by existing metaheuristic techniques (e.g., guided local search and tabu search algorithms) is presented to evaluate the efficiency.

Keywords: production planning, inventory routing, column generation, mixed-integer linear programming

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Authors: S. Alireza Mirghasemi, Elly Trepman, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Shervin Rashidinia

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Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by atraumatic extremity pain with unknown of etiology. Symptom onset may include sudden or gradual swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is made with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis often is delayed because of the low prevalence and nonspecific signs in the foot and ankle. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery.

Keywords: transient osteoporosis, bone marrow edema syndrome, iloprost, bisphosphonates

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Authors: M. Gulam Kibria, Shourav Ahmed, Kais Zaman

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In system analysis, the information on the uncertain input variables cause uncertainty in the system responses. Different probabilistic approaches for uncertainty representation and propagation in such cases exist in the literature. Different uncertainty representation approaches result in different outputs. Some of the approaches might result in a better estimation of system response than the other approaches. The NASA Langley Multidisciplinary Uncertainty Quantification Challenge (MUQC) has posed challenges about uncertainty quantification. Subproblem A, the uncertainty characterization subproblem, of the challenge posed is addressed in this study. In this subproblem, the challenge is to gather knowledge about unknown model inputs which have inherent aleatory and epistemic uncertainties in them with responses (output) of the given computational model. We use two different methodologies to approach the problem. In the first methodology we use sampling-based uncertainty propagation with first order error analysis. In the other approach we place emphasis on the use of Percentile-Based Optimization (PBO). The NASA Langley MUQC’s subproblem A is developed in such a way that both aleatory and epistemic uncertainties need to be managed. The challenge problem classifies each uncertain parameter as belonging to one the following three types: (i) An aleatory uncertainty modeled as a random variable. It has a fixed functional form and known coefficients. This uncertainty cannot be reduced. (ii) An epistemic uncertainty modeled as a fixed but poorly known physical quantity that lies within a given interval. This uncertainty is reducible. (iii) A parameter might be aleatory but sufficient data might not be available to adequately model it as a single random variable. For example, the parameters of a normal variable, e.g., the mean and standard deviation, might not be precisely known but could be assumed to lie within some intervals. It results in a distributional p-box having the physical parameter with an aleatory uncertainty, but the parameters prescribing its mathematical model are subjected to epistemic uncertainties. Each of the parameters of the random variable is an unknown element of a known interval. This uncertainty is reducible. From the study, it is observed that due to practical limitations or computational expense, the sampling is not exhaustive in sampling-based methodology. That is why the sampling-based methodology has high probability of underestimating the output bounds. Therefore, an optimization-based strategy to convert uncertainty described by interval data into a probabilistic framework is necessary. This is achieved in this study by using PBO.

Keywords: aleatory uncertainty, epistemic uncertainty, first order error analysis, uncertainty quantification, percentile-based optimization

Procedia PDF Downloads 240