Search results for: patient safety incidents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6373

Search results for: patient safety incidents

643 Polyvinyl Alcohol Incorporated with Hibiscus Extract Microcapsules as Combined Active and Intelligent Composite Film for Meat Preservation

Authors: Ahmed F. Ghanem, Marwa I. Wahba, Asmaa N. El-Dein, Mohamed A. EL-Raey, Ghada E.A. Awad

Abstract:

Numerous attempts are being performed in order to formulate suitable packaging materials for meat products. However, to the best of our knowledge, the incorporation of free hibiscus extract or its microcapsules in the pure polyvinyl alcohol (PVA) matrix as packaging materials for meats is seldom reported. Therefore, this study aims at protection of the aqueous crude extract of hibiscus flowers utilizing spry drying encapsulation technique. Fourier transform infrared (FTIR), scanning electron microscope (SEM), and zetasizer results confirmed the successful formation of assembled capsules via strong interactions, spherical rough microparticles, and ~ 235 nm of particle size, respectively. Also, the obtained microcapsules enjoy high thermal stability, unlike the free extract. Then, the obtained spray-dried particles were incorporated into the casting solution of the pure PVA film with a concentration 10 wt. %. The segregated free-standing composite films were investigated, compared to the neat matrix, with several characterization techniques such as FTIR, SEM, thermal gravimetric analysis (TGA), mechanical tester, contact angle, water vapor permeability, and oxygen transmission. The results demonstrated variations in the physicochemical properties of the PVA film after the inclusion of the free and the extract microcapsules. Moreover, biological studies emphasized the biocidal potential of the hybrid films against microorganisms contaminating the meat. Specifically, the microcapsules imparted not only antimicrobial but also antioxidant activities to PVA. Application of the prepared films on the real meat samples displayed low bacterial growth with a slight increase in the pH over the storage time up to 10 days at 4 oC which further proved the meat safety. Moreover, the colors of the films did not significantly changed except after 21 days indicating the spoilage of the meat samples. No doubt, the dual-functional of prepared composite films pave the way towards combined active/smart food packaging applications. This would play a vital role in the food hygiene, including also quality control and assurance.

Keywords: PVA, hibiscus, extraction, encapsulation, active packaging, smart and intelligent packaging, meat spoilage

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642 Recommendations to Improve Classification of Grade Crossings in Urban Areas of Mexico

Authors: Javier Alfonso Bonilla-Chávez, Angélica Lozano

Abstract:

In North America, more than 2,000 people annually die in accidents related to railroad tracks. In 2020, collisions at grade crossings were the main cause of deaths related to railway accidents in Mexico. Railway networks have constant interaction with motor transport users, cyclists, and pedestrians, mainly in grade crossings, where is the greatest vulnerability and risk of accidents. Usually, accidents at grade crossings are directly related to risky behavior and non-compliance with regulations by motorists, cyclists, and pedestrians, especially in developing countries. Around the world, countries classify these crossings in different ways. In Mexico, according to their dangerousness (high, medium, or low), types A, B and C have been established, recommending for each one different type of auditive and visual signaling and gates, as well as horizontal and vertical signaling. This classification is based in a weighting, but regrettably, it is not explained how the weight values were obtained. A review of the variables and the current approach for the grade crossing classification is required, since it is inadequate for some crossings. In contrast, North America (USA and Canada) and European countries consider a broader classification so that attention to each crossing is addressed more precisely and equipment costs are adjusted. Lack of a proper classification, could lead to cost overruns in the equipment and a deficient operation. To exemplify the lack of a good classification, six crossings are studied, three located in the rural area of Mexico and three in Mexico City. These cases show the need of: improving the current regulations, improving the existing infrastructure, and implementing technological systems, including informative signals with nomenclature of the involved crossing and direct telephone line for reporting emergencies. This implementation is unaffordable for most municipal governments. Also, an inventory of the most dangerous grade crossings in urban and rural areas must be obtained. Then, an approach for improving the classification of grade crossings is suggested. This approach must be based on criteria design, characteristics of adjacent roads or intersections which can influence traffic flow through the crossing, accidents related to motorized and non-motorized vehicles, land use and land management, type of area, and services and economic activities in the zone where the grade crossings is located. An expanded classification of grade crossing in Mexico could reduce accidents and improve the efficiency of the railroad.

Keywords: accidents, grade crossing, railroad, traffic safety

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641 Analyzing the Impact of Bariatric Surgery in Obesity Associated Chronic Kidney Disease: A 2-Year Observational Study

Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

Abstract:

Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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640 Characterization of Mycoplasma Pneumoniae Causing Exacerbation of Asthma: A Prototypical Finding from Sri Lanka

Authors: Lakmini Wijesooriya, Vicki Chalker, Jessica Day, Priyantha Perera, N. P. Sunil-Chandra

Abstract:

M. pneumoniae has been identified as an etiology for exacerbation of asthma (EQA), although viruses play a major role in EOA. M. pneumoniae infection is treated empirically with macrolides, and its antibiotic sensitivity is not detected routinely. Characterization of the organism by genotyping and determination of macrolide resistance is important epidemiologically as it guides the empiric antibiotic treatment. To date, there is no such characterization of M. pneumoniae performed in Sri Lanka. The present study describes the characterization of M. pneumoniae detected from a child with EOA following a screening of 100 children with EOA. Of the hundred children with EOA, M. pneumoniae was identified only in one child by Real-Time polymerase chain reaction (PCR) test for identifying the community-acquired respiratory distress syndrome (CARDS) toxin nucleotide sequences. The M. pneumoniae identified from this patient underwent detection of macrolide resistance via conventional PCR, amplifying and sequencing the region of the 23S rDNA gene that contains single nucleotide polymorphisms that confer resistance. Genotyping of the isolate was performed via nested Multilocus Sequence Typing (MLST) in which eight (8) housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, and adk) were amplified via nested PCR followed by gene sequencing and analysis. As per MLST analysis, the M. pneumoniae was identified as sequence type 14 (ST14), and no mutations that confer resistance were detected. Resistance to macrolides in M. pneumoniae is an increasing problem globally. Establishing surveillance systems is the key to informing local prescriptions. In the absence of local surveillance data, antibiotics are started empirically. If the relevant microbiological samples are not obtained before antibiotic therapy, as in most occasions in children, the course of antibiotic is completed without a microbiological diagnosis. This happens more frequently in therapy for M. pneumoniae which is treated with a macrolide in most patients. Hence, it is important to understand the macrolide sensitivity of M. pneumoniae in the setting. The M. pneumoniae detected in the present study was macrolide sensitive. Further studies are needed to examine a larger dataset in Sri Lanka to determine macrolide resistance levels to inform the use of macrolides in children with EOA. The MLST type varies in different geographical settings, and it also provides a clue to the existence of macrolide resistance. The present study enhances the database of the global distribution of different genotypes of M. pneumoniae as this is the first such characterization performed with the increased number of samples to determine macrolide resistance level in Sri Lanka. M. pneumoniae detected from a child with exacerbation of asthma in Sri Lanka was characterized as ST14 by MLST and no mutations that confer resistance were detected.

Keywords: mycoplasma pneumoniae, Sri Lanka, characterization, macrolide resistance

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639 Additional Pathological Findings Using MRI on Patients with First Time Traumatic Lateral Patella Dislocation: A Study of 150 Patients

Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

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Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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638 Dimensionality Control of Li Transport by MOFs Based Quasi-Solid to Solid Electrolyte

Authors: Manuel Salado, Mikel Rincón, Arkaitz Fidalgo, Roberto Fernandez, Senentxu Lanceros-Méndez

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Lithium-ion batteries (LIBs) are a promising technology for energy storage, but they suffer from safety concerns due to the use of flammable organic solvents in their liquid electrolytes. Solid-state electrolytes (SSEs) offer a potential solution to this problem, but they have their own limitations, such as poor ionic conductivity and high interfacial resistance. The aim of this research was to develop a new type of SSE based on metal-organic frameworks (MOFs) and ionic liquids (ILs). MOFs are porous materials with high surface area and tunable electronic properties, making them ideal for use in SSEs. ILs are liquid electrolytes that are non-flammable and have high ionic conductivity. A series of MOFs were synthesized, and their electrochemical properties were evaluated. The MOFs were then infiltrated with ILs to form a quasi-solid gel and solid xerogel SSEs. The ionic conductivity, interfacial resistance, and electrochemical performance of the SSEs were characterized. The results showed that the MOF-IL SSEs had significantly higher ionic conductivity and lower interfacial resistance than conventional SSEs. The SSEs also exhibited excellent electrochemical performance, with high discharge capacity and long cycle life. The development of MOF-IL SSEs represents a significant advance in the field of solid-state electrolytes. The high ionic conductivity and low interfacial resistance of the SSEs make them promising candidates for use in next-generation LIBs. The data for this research was collected using a variety of methods, including X-ray diffraction, scanning electron microscopy, and electrochemical impedance spectroscopy. The data was analyzed using a variety of statistical and computational methods, including principal component analysis, density functional theory, and molecular dynamics simulations. The main question addressed by this research was whether MOF-IL SSEs could be developed that have high ionic conductivity, low interfacial resistance, and excellent electrochemical performance. The results of this research demonstrate that MOF-IL SSEs are a promising new type of solid-state electrolyte for use in LIBs. The SSEs have high ionic conductivity, low interfacial resistance, and excellent electrochemical performance. These properties make them promising candidates for use in next-generation LIBs that are safer and have higher energy densities.

Keywords: energy storage, solid-electrolyte, ionic liquid, metal-organic-framework, electrochemistry, organic inorganic plastic crystal

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637 Medication Side Effects: Implications on the Mental Health and Adherence Behaviour of Patients with Hypertension

Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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636 Integration of the Electro-Activation Technology for Soy Meal Valorization

Authors: Natela Gerliani, Mohammed Aider

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Nowadays, the interest of using sustainable technologies for protein extraction from underutilized oilseeds is growing. Currently, a major disposal problem for the oil industry is by-products of plant food processing such as soybean meal. That is why valorization of soybean meal is important for the oil industry since it contains high-quality proteins and other valuable components. Generally, soybean meal is used in livestock and poultry feed but is rarely used in human feed. Though chemical composition of this meal compensate nutritional deficiency and can be used to balance protein in human food. Regarding the efficiency of soybean meal valorization, extraction is a key process for obtaining enriched protein ingredient, which can be incorporated into the food matrix. However, most of the food components such as proteins extracted from oilseeds by-products imply the utilization of organic and inorganic chemicals (e.g. acids, bases, TCA-acetone) having a significant environmental impact. In a context of sustainable production, the use of an electro-activation technology seems to be a good alternative. Indeed, the electro-activation technology requires only water, food grade salt and electricity as main materials. Moreover, this innovative technology helps to avoid special equipment and trainings for workers safety as well as transport and storage of hazardous materials. Electro-activation is a technology based on applied electrochemistry for the generation of acidic and alkaline solutions on the basis of the oxidation-reduction reactions that occur at the vicinity electrode/solution interfaces. It is an eco-friendly process that can be used to replace the conventional acidic and alkaline extraction. In this research, the electro-activation technology for protein extraction from soybean meal was carried out in the electro-activation reactor. This reactor consists of three compartments separated by cation and anion exchange membranes that allow creating non-contacting acidic and basic solutions. Different current intensities (150 mA, 300 mA and 450 mA) and treatment durations (10 min, 30 min and 50 min) were tested. The results showed that the extracts obtained by the electro-activation method have good quality in comparison to conventional extracts. For instance, extractability obtained with electro-activation method was 55% whereas with the conventional method it was only 36%. Moreover, a maximum protein quantity of 48 % in the extract was obtained with the electro-activation technology comparing to the maximum amount of protein obtained by conventional extraction of 41 %. Hence, the environmentally sustainable electro-activation technology seems to be a promising type of protein extraction that can replace conventional extraction technology.

Keywords: by-products, eco-friendly technology, electro-activation, soybean meal

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635 Retrospective Demographic Analysis of Patients Lost to Follow-Up from Antiretroviral Therapy in Mulanje Mission Hospital, Malawi

Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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634 A Comparative Study on the Use of Learning Resources in Learning Biochemistry by MBBS Students at Ras Al Khaimah Medical and Health Sciences University, UAE

Authors: B. K. Manjunatha Goud, Aruna Chanu Oinam

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The undergraduate medical curriculum is oriented towards training the students to undertake the responsibilities of a physician. During the training period, adequate emphasis is placed on inculcating logical and scientific habits of thought; clarity of expression and independence of judgment; and ability to collect and analyze information and to correlate them. At Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Biochemistry a basic medical science subject is taught in the 1st year of 5 years medical course with vertical interdisciplinary interaction with all subjects, which needs to be taught and learned adequately by the students to be related to clinical case or clinical problem in medicine and future diagnostics so that they can practice confidently and skillfully in the community. Based on these facts study was done to know the extent of usage of library resources by the students and the impact of study materials on their preparation for examination. It was a comparative cross sectional study included 100 and 80 1st and 2nd-year students who had successfully completed Biochemistry course. The purpose of the study was explained to all students [participants]. Information was collected on a pre-designed, pre-tested and self-administered questionnaire. The questionnaire was validated by the senior faculties and pre tested on students who were not involved in the study. The study results showed that 80.30% and 93.15% of 1st and 2nd year students have the clear idea of course outline given in course handout or study guide. We also found a statistically significant number of students agreed that they were benefited from the practical session and writing notes in the class hour. A high percentage of students [50% and 62.02%] disagreed that that reading only the handouts is enough for their examination as compared to other students. The study also showed that only 35% and 41% of students visited the library on daily basis for the learning process, around 65% of students were using lecture notes and text books as a tool for learning and to understand the subject and 45% and 53% of students used the library resources (recommended text books) compared to online sources before the examinations. The results presented here show that students perceived that e-learning resources like power point presentations along with text book reading using SQ4R technique had made a positive impact on various aspects of their learning in Biochemistry. The use of library by students has overall positive impact on learning process especially in medical field enhances the outcome, and medical students are better equipped to treat the patient. But it’s also true that use of library use has been in decline which will impact the knowledge aspects and outcome. In conclusion, a student has to be taught how to use the library as learning tool apart from lecture handouts.

Keywords: medical education, learning resources, study guide, biochemistry

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633 Antibacterial and Anti-Biofilm Activity of Vaccinium meridionale S. Pomace Extract Against Staphylococcus aureus, Escherichia coli and Salmonella Enterica

Authors: Carlos Y. Soto, Camila A. Lota, G. Astrid Garzón

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Bacterial biofilms cause an ongoing problem for food safety. They are formed when microorganisms aggregate to form a community that attaches to solid surfaces. Biofilms increase the resistance of pathogens to cleaning, disinfection and antibacterial products. This resistance gives rise to problems for human health, industry, and agriculture. At present, plant extracts rich in polyphenolics are being investigated as natural alternatives to degrade bacterial biofilms. The pomace of the tropical Berry Vaccinium meridionale S. contains high amounts of phenolic compounds. Therefore, in the current study, the antimicrobial and antibiofilm effects of extracts from the pomace of Vaccinium meridionale S. were tested on three foodborne pathogens: Enterohaemorrhagic Escherichia coli O157:H7 (ATCC®700728TM), Staphylococcus aureus subsp. aureus (ATCC® 6538TM), and Salmonella enterica serovar Enteritidis (ATCC® 13076TM). Microwave-assisted extraction was used to extract polyphenols with aqueous methanol (80% v/v) at a solid to solvent ratio of 1:10 (w/v) for 20 min. The magnetic stirring was set at 400 rpm, and the microwave power was adjusted to 400 W. The antimicrobial effect of the extract was assessed by determining the half maximal inhibitory concentration (IC50) against the three food poisoning pathogens at concentrations ranging from 50 to 2,850 μg gallic acid equivalents (GAE)/mL of the extract. Biofilm inhibition was assessed using a crystal violet assay applying the same range of concentration. Three replications of the experiments were carried out, and all analyses were run in triplicate. IC50 values were determined using the GraphPad Prism8® program. Significant differences (P<0.05) among means were identified using one-factor analysis of variance (ANOVA) and the post-hoc least significant difference (LSD) test using the Statgraphics plus program, version 2.1.There was significant difference among the mean IC50 values for the tested bacteria. The IC50 for S. aureus was 48 ± 9 μg GAE/mL, followed by 123 ± 49 μg GAE/mL for Salmonella and 376 ± 32 μg GAE/mL for E. coli. The percent inhibition of the extract on biofilm formation was significantly higher for S. aureus (85.8  0.3), followed by E. coli (74.5  1.0) and Salmonella (53.6  9.7). These findings suggest that polyphenolic extracts obtained from the pomace of V. meridionale S. might be used as natural antimicrobial and anti-biofilm natural agents, effective against S. aureus, E. coli and Salmonella enterica.

Keywords: antibiofilm, antimicrobial, E. coli, S. aureus, salmonella, IC50, pomace, V. meridionale

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632 Detecting Elderly Abuse in US Nursing Homes Using Machine Learning and Text Analytics

Authors: Minh Huynh, Aaron Heuser, Luke Patterson, Chris Zhang, Mason Miller, Daniel Wang, Sandeep Shetty, Mike Trinh, Abigail Miller, Adaeze Enekwechi, Tenille Daniels, Lu Huynh

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Machine learning and text analytics have been used to analyze child abuse, cyberbullying, domestic abuse and domestic violence, and hate speech. However, to the authors’ knowledge, no research to date has used these methods to study elder abuse in nursing homes or skilled nursing facilities from field inspection reports. We used machine learning and text analytics methods to analyze 356,000 inspection reports, which have been extracted from CMS Form-2567 field inspections of US nursing homes and skilled nursing facilities between 2016 and 2021. Our algorithm detected occurrences of the various types of abuse, including physical abuse, psychological abuse, verbal abuse, sexual abuse, and passive and active neglect. For example, to detect physical abuse, our algorithms search for combinations or phrases and words suggesting willful infliction of damage (hitting, pinching or burning, tethering, tying), or consciously ignoring an emergency. To detect occurrences of elder neglect, our algorithm looks for combinations or phrases and words suggesting both passive neglect (neglecting vital needs, allowing malnutrition and dehydration, allowing decubiti, deprivation of information, limitation of freedom, negligence toward safety precautions) and active neglect (intimidation and name-calling, tying the victim up to prevent falls without consent, consciously ignoring an emergency, not calling a physician in spite of indication, stopping important treatments, failure to provide essential care, deprivation of nourishment, leaving a person alone for an inappropriate amount of time, excessive demands in a situation of care). We further compare the prevalence of abuse before and after Covid-19 related restrictions on nursing home visits. We also identified the facilities with the most number of cases of abuse with no abuse facilities within a 25-mile radius as most likely candidates for additional inspections. We also built an interactive display to visualize the location of these facilities.

Keywords: machine learning, text analytics, elder abuse, elder neglect, nursing home abuse

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631 Application of Natural Dyes on Polyester and Polyester-Cellulosic Blended Fabrics

Authors: Deepali Rastogi, Akanksha Rastogi

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Comfort and safety are two essential factors in a newborn’s clothing. Natural dyes are considered safe for infant clothes because they are non-toxic and have medicinal properties. Natural dyes are sensitive to pH and may show changes in hue under different pH conditions. Infant garments face treatments different than adult clothing, for instance, exposure to infant’s saliva, milk, and urine. The present study was designed to study the suitability of natural dyes for infant clothes. Cotton fabric was dyed using fifteen natural dyes and two mordants, alum, and ferrous sulphate. The dyed samples were assessed for colour fastness to washing, rubbing, perspiration and light. In addition, fastness to milk, saliva, and urine was also tested. Simulated solutions of saliva and urine were prepared for the study. For milk, one of the commercial formulations for infants was taken and used as per the directions. A wide gamut of colours was obtained after dyeing the cotton with different natural dyes and mordants. The colour strength of all the dyed samples was determined in terms of K/S values. Most of the ferrous sulphate mordanted dyes gave higher K/S values than alum mordanted samples. The wash fastness of dyed cotton fabrics ranged from 3/4 -5. Perspiration fastness test for the samples was done in both acidic and alkaline mediums. The ratings ranged from 3-5, with most of the dyes falling in the range of 4-5. The rubbing fastness of the dyed samples was tested in dry and wet conditions. The results showed excellent rub fastness ranging between 4-5. Light fastness was found to be good to moderate. The main food for infants is milk, and this becomes one of the main agents to spot infants' garments. All dyes showed excellent fastness properties against milk with a grey scale rating of 4-5. Fastness against saliva is recommended by various eco-labels, standards, and organizations for fabrics of infants or babies. The fastness of most of the dyes was found to be satisfactory against saliva. Infant garments get frequently soiled with urine. Most of the natural dyes on cotton fabric had good to excellent fastness to simulated urine. The grey scale ratings ranged from 3/4 – 5. Thus, it can be concluded that most of the natural dyes can be successfully used for infant wear and accessories and are fast to various liquids to which infant wear are exposed. Therefore, we can surround little ones with beautiful hues from nature's garden and clothe them in natural fibres dyed with natural dyes.

Keywords: fastness properties, infant wear, mordants, natural dyes

Procedia PDF Downloads 135
630 Compression-Extrusion Test to Assess Texture of Thickened Liquids for Dysphagia

Authors: Jesus Salmeron, Carmen De Vega, Maria Soledad Vicente, Mireia Olabarria, Olaia Martinez

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Dysphagia or difficulty in swallowing affects mostly elder people: 56-78% of the institutionalized and 44% of the hospitalized. Liquid food thickening is a necessary measure in this situation because it reduces the risk of penetration-aspiration. Until now, and as proposed by the American Dietetic Association in 2002, possible consistencies have been categorized in three groups attending to their viscosity: nectar (50-350 mPa•s), honey (350-1750 mPa•s) and pudding (>1750 mPa•s). The adequate viscosity level should be identified for every patient, according to her/his impairment. Nevertheless, a systematic review on dysphagia diet performed recently indicated that there is no evidence to suggest that there is any transition of clinical relevance between the three levels proposed. It was also stated that other physical properties of the bolus (slipperiness, density or cohesiveness, among others) could influence swallowing in affected patients and could contribute to the amount of remaining residue. Texture parameters need to be evaluated as possible alternative to viscosity. The aim of this study was to evaluate the instrumental extrusion-compression test as a possible tool to characterize changes along time in water thickened with various products and in the three theoretical consistencies. Six commercial thickeners were used: NM® (NM), Multi-thick® (M), Nutilis Powder® (Nut), Resource® (R), Thick&Easy® (TE) and Vegenat® (V). All of them with a modified starch base. Only one of them, Nut, also had a 6,4% of gum (guar, tara and xanthan). They were prepared as indicated in the instructions of each product and dispensing the correspondent amount for nectar, honey and pudding consistencies in 300 mL of tap water at 18ºC-20ºC. The mixture was stirred for about 30 s. Once it was homogeneously spread, it was dispensed in 30 mL plastic glasses; always to the same height. Each of these glasses was used as a measuring point. Viscosity was measured using a rotational viscometer (ST-2001, Selecta, Barcelona). Extrusion-compression test was performed using a TA.XT2i texture analyzer (Stable Micro Systems, UK) with a 25 mm diameter cylindrical probe (SMSP/25). Penetration distance was set at 10 mm and a speed of 3 mm/s. Measurements were made at 1, 5, 10, 20, 30, 40, 50 and 60 minutes from the moment samples were mixed. From the force (g)–time (s) curves obtained in the instrumental assays, maximum force peak (F) was chosen a reference parameter. Viscosity (mPa•s) and F (g) showed to be highly correlated and had similar development along time, following time-dependent quadratic models. It was possible to predict viscosity using F as an independent variable, as they were linearly correlated. In conclusion, compression-extrusion test could be an alternative and a useful tool to assess physical characteristics of thickened liquids.

Keywords: compression-extrusion test, dysphagia, texture analyzer, thickener

Procedia PDF Downloads 361
629 Hawaii, Colorado, and Netherlands: A Comparative Analysis of the Respective Space Sectors

Authors: Mclee Kerolle

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For more than 50 years, the state of Hawaii has had the beginnings of a burgeoning commercial aerospace presence statewide. While Hawaii provides the aerospace industry with unique assets concerning geographic location, lack of range safety issues and other factors critical to aerospace development, Hawaii’s strategy and commitment for aerospace have been unclear. For this reason, this paper presents a comparative analysis of Hawaii’s space sector with two of the world’s leading space sectors, Colorado and the Netherlands, in order to provide a strategic plan that establishes a firm position going forward to support Hawaii’s aerospace development statewide. This plan will include financial and other economic incentives legislatively supported by the State to help grow and diversify Hawaii’s aerospace sector. The first part of this paper will examine the business model adopted by the Colorado Space Coalition (CSC), a group of industry stakeholders working to make Colorado a center of excellence for aerospace, as blueprint for growth in Hawaii’s space sector. The second section of this paper will examine the business model adopted by the Netherlands Space Business Incubation Centre (NSBIC), a European Space Agency (ESA) affiliated program that offers business support for entrepreneurs to turn space-connected business ideas into commercial companies. This will serve as blueprint to incentivize space businesses to launch and develop in Hawaii. The third section of this paper will analyze the current policies both CSC, and NSBIC implores to promote industry expansion and legislative advocacy. The final section takes the findings from both space sectors and applies their most adaptable features to a Hawaii specific space business model that takes into consideration the unique advantage and disadvantages found in developing Hawaii’s space sector. The findings of this analysis will show that the development of a strategic plan based on a comparative analysis that creates high technology jobs and new pathways for a trained workforce in the space sector, as well as elicit state support and direction, will achieve the goal of establishing Hawaii as a center of space excellence. This analysis will also serve as a signal to the federal, private sector and international community that Hawaii is indeed serious about developing its’ aerospace industry. Ultimately this analysis and subsequent aerospace development plan will serve as a blueprint for the benefit of all space-faring nations seeking to develop their space sectors.

Keywords: Colorado, Hawaii, Netherlands, space policy

Procedia PDF Downloads 163
628 Human Factors as the Main Reason of the Accident in Scaffold Use Assessment

Authors: Krzysztof J. Czarnocki, E. Czarnocka, K. Szaniawska

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Main goal of the research project is Scaffold Use Risk Assessment Model (SURAM) formulation, developed for the assessment of risk levels as a various construction process stages with various work trades. Finally, in 2016, the project received financing by the National Center for Research and development according to PBS3/A2/19/2015–Research Grant. The presented data, calculations and analyzes discussed in this paper were created as a result of the completion on the first and second phase of the PBS3/A2/19/2015 project. Method: One of the arms of the research project is the assessment of worker visual concentration on the sight zones as well as risky visual point inadequate observation. In this part of research, the mobile eye-tracker was used to monitor the worker observation zones. SMI Eye Tracking Glasses is a tool, which allows us to analyze in real time and place where our eyesight is concentrated on and consequently build the map of worker's eyesight concentration during a shift. While the project is still running, currently 64 construction sites have been examined, and more than 600 workers took part in the experiment including monitoring of typical parameters of the work regimen, workload, microclimate, sound vibration, etc. Full equipment can also be useful in more advanced analyses. Because of that technology we have verified not only main focus of workers eyes during work on or next to scaffolding, but we have also examined which changes in the surrounding environment during their shift influenced their concentration. In the result of this study it has been proven that only up to 45.75% of the shift time, workers’ eye concentration was on one of three work-related areas. Workers seem to be distracted by noisy vehicles or people nearby. In opposite to our initial assumptions and other authors’ findings, we observed that the reflective parts of the scaffoldings were not more recognized by workers in their direct workplaces. We have noticed that the red curbs were the only well recognized part on a very few scaffoldings. Surprisingly on numbers of samples, we have not recognized any significant number of concentrations on those curbs. Conclusion: We have found the eye-tracking method useful for the construction of the SURAM model in the risk perception and worker’s behavior sub-modules. We also have found that the initial worker's stress and work visual conditions seem to be more predictive for assessment of the risky developing situation or an accident than other parameters relating to a work environment.

Keywords: accident assessment model, eye tracking, occupational safety, scaffolding

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627 Assessing the Effectiveness of Warehousing Facility Management: The Case of Mantrac Ghana Limited

Authors: Kuhorfah Emmanuel Mawuli

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Generally, for firms to enhance their operational efficiency of logistics, it is imperative to assess the logistics function. The cost of logistics conventionally represents a key consideration in the pricing decisions of firms, which suggests that cost efficiency in logistics can go a long way to improve margins. Warehousing, which is a key part of logistics operations, has the prospect of influencing operational efficiency in logistics management as well as customer value, but this potential has often not been recognized. It has been found that there is a paucity of research that evaluates the efficiency of warehouses. Indeed, limited research has been conducted to examine potential barriers to effective warehousing management. Due to this paucity of research, there is limited knowledge on how to address the obstacles associated with warehousing management. In order for warehousing management to become profitable, there is the need to integrate, balance, and manage the economic inputs and outputs of the entire warehouse operations, something that many firms tend to ignore. Management of warehousing is not solely related to storage functions. Instead, effective warehousing management requires such practices as maximum possible mechanization and automation of operations, optimal use of space and capacity of storage facilities, organization through "continuous flow" of goods, a planned system of storage operations, and safety of goods. For example, there is an important need for space utilization of the warehouse surface as it is a good way to evaluate the storing operation and pick items per hour. In the setting of Mantrac Ghana, not much knowledge regarding the management of the warehouses exists. The researcher has personally observed many gaps in the management of the warehouse facilities in the case organization Mantrac Ghana. It is important, therefore, to assess the warehouse facility management of the case company with the objective of identifying weaknesses for improvement. The study employs an in-depth qualitative research approach using interviews as a mode of data collection. Respondents in the study mainly comprised warehouse facility managers in the studied company. A total of 10 participants were selected for the study using a purposive sampling strategy. Results emanating from the study demonstrate limited warehousing effectiveness in the case company. Findings further reveal that the major barriers to effective warehousing facility management comprise poor layout, poor picking optimization, labour costs, and inaccurate orders; policy implications of the study findings are finally outlined.

Keywords: assessing, warehousing, facility, management

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626 Development of a Novel Clinical Screening Tool, Using the BSGE Pain Questionnaire, Clinical Examination and Ultrasound to Predict the Severity of Endometriosis Prior to Laparoscopic Surgery

Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

Procedia PDF Downloads 348
625 Establishing a Sustainable Construction Industry: Review of Barriers That Inhibit Adoption of Lean Construction in Lesotho

Authors: Tsepiso Mofolo, Luna Bergh

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The Lesotho construction industry fails to embrace environmental practices, which has then lead to excessive consumption of resources, land degradation, air and water pollution, loss of habitats, and high energy usage. The industry is highly inefficient, and this undermines its capability to yield the optimum contribution to social, economic and environmental developments. Sustainable construction is, therefore, imperative to ensure the cultivation of benefits from all these intrinsic themes of sustainable development. The development of a sustainable construction industry requires a holistic approach that takes into consideration the interaction between Lean Construction principles, socio-economic and environmental policies, technological advancement and the principles of construction or project management. Sustainable construction is a cutting-edge phenomenon, forming a component of a subjectively defined concept called sustainable development. Sustainable development can be defined in terms of attitudes and judgments to assist in ensuring long-term environmental, social and economic growth in society. The key concept of sustainable construction is Lean Construction. Lean Construction emanates from the principles of the Toyota Production System (TPS), namely the application and adaptation of the fundamental concepts and principles that focus on waste reduction, the increase in value to the customer, and continuous improvement. The focus is on the reduction of socio-economic waste, and protestation of environmental degradation by reducing carbon dioxide emission footprint. Lean principles require a fundamental change in the behaviour and attitudes of the parties involved in order to overcome barriers to cooperation. Prevalent barriers to adoption of Lean Construction in Lesotho are mainly structural - such as unavailability of financing, corruption, operational inefficiency or wastage, lack of skills and training and inefficient construction legislation and political interferences. The consequential effects of these problems trigger down to quality, cost and time of the project - which then result in an escalation of operational costs due to the cost of rework or material wastage. Factor and correlation analysis of these barriers indicate that they are highly correlated, which then poses a detrimental potential to the country’s welfare, environment and construction safety. It is, therefore, critical for Lesotho’s construction industry to develop a robust governance through bureaucracy reforms and stringent law enforcement.

Keywords: construction industry, sustainable development, sustainable construction industry, lean construction, barriers to sustainable construction

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624 Finite Element Modelling of Mechanical Connector in Steel Helical Piles

Authors: Ramon Omar Rosales-Espinoza

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Pile-to-pile mechanical connections are used if the depth of the soil layers with sufficient bearing strength exceeds the original (“leading”) pile length, with the additional pile segment being termed “extension” pile. Mechanical connectors permit a safe transmission of forces from leading to extension pile while meeting strength and serviceability requirements. Common types of connectors consist of an assembly of sleeve-type external couplers, bolts, pins, and other mechanical interlock devices that ensure the transmission of compressive, tensile, torsional and bending stresses between leading and extension pile segments. While welded connections allow for a relatively simple structural design, mechanical connections are advantageous over welded connections because they lead to shorter installation times and significant cost reductions since specialized workmanship and inspection activities are not required. However, common practices followed to design mechanical connectors neglect important aspects of the assembly response, such as stress concentration around pin/bolt holes, torsional stresses from the installation process, and interaction between the forces at the installation (torsion), service (compression/tension-bending), and removal stages (torsion). This translates into potentially unsatisfactory designs in terms of the ultimate and service limit states, exhibiting either reduced strength or excessive deformations. In this study, the experimental response under compressive forces of a type of mechanical connector is presented, in terms of strength, deformation and failure modes. The tests revealed that the type of connector used can safely transmit forces from pile to pile. Using the results from the compressive tests, an analysis model was developed using the finite element (FE) method to study the interaction of forces under installation and service stages of a typical mechanical connector. The response of the analysis model is used to identify potential areas for design optimization, including size, gap between leading and extension piles, number of pin/bolts, hole sizes, and material properties. The results show the design of mechanical connectors should take into account the interaction of forces present at every stage of their life cycle, and that the torsional stresses occurring during installation are critical for the safety of the assembly.

Keywords: piles, FEA, steel, mechanical connector

Procedia PDF Downloads 260
623 Development of Coastal Inundation–Inland and River Flow Interface Module Based on 2D Hydrodynamic Model

Authors: Eun-Taek Sin, Hyun-Ju Jang, Chang Geun Song, Yong-Sik Han

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Due to the climate change, the coastal urban area repeatedly suffers from the loss of property and life by flooding. There are three main causes of inland submergence. First, when heavy rain with high intensity occurs, the water quantity in inland cannot be drained into rivers by increase in impervious surface of the land development and defect of the pump, storm sewer. Second, river inundation occurs then water surface level surpasses the top of levee. Finally, Coastal inundation occurs due to rising sea water. However, previous studies ignored the complex mechanism of flooding, and showed discrepancy and inadequacy due to linear summation of each analysis result. In this study, inland flooding and river inundation were analyzed together by HDM-2D model. Petrov-Galerkin stabilizing method and flux-blocking algorithm were applied to simulate the inland flooding. In addition, sink/source terms with exponentially growth rate attribute were added to the shallow water equations to include the inland flooding analysis module. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. To consider the coastal surge, another module was developed by adding seawater to the existing Inland Flooding-River Inundation binding module for comprehensive flooding analysis. Based on the combined modules, the Coastal Inundation – Inland & River Flow Interface was simulated by inputting the flow rate and depth data in artificial flume. Accordingly, it was able to analyze the flood patterns of coastal cities over time. This study is expected to help identify the complex causes of flooding in coastal areas where complex flooding occurs, and assist in analyzing damage to coastal cities. Acknowledgements—This research was supported by a grant ‘Development of the Evaluation Technology for Complex Causes of Inundation Vulnerability and the Response Plans in Coastal Urban Areas for Adaptation to Climate Change’ [MPSS-NH-2015-77] from the Natural Hazard Mitigation Research Group, Ministry of Public Safety and Security of Korea.

Keywords: flooding analysis, river inundation, inland flooding, 2D hydrodynamic model

Procedia PDF Downloads 357
622 Enhancing VR Exposure Therapy for the Treatment of Phobias with the Use of Photorealistic VR Environments and Stimuli, and the Use of Tactile Feedback Suits and Responsive Systems

Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

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Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

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621 Optimization for Autonomous Robotic Construction by Visual Guidance through Machine Learning

Authors: Yangzhi Li

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Network transfer of information and performance customization is now a viable method of digital industrial production in the era of Industry 4.0. Robot platforms and network platforms have grown more important in digital design and construction. The pressing need for novel building techniques is driven by the growing labor scarcity problem and increased awareness of construction safety. Robotic approaches in construction research are regarded as an extension of operational and production tools. Several technological theories related to robot autonomous recognition, which include high-performance computing, physical system modeling, extensive sensor coordination, and dataset deep learning, have not been explored using intelligent construction. Relevant transdisciplinary theory and practice research still has specific gaps. Optimizing high-performance computing and autonomous recognition visual guidance technologies improves the robot's grasp of the scene and capacity for autonomous operation. Intelligent vision guidance technology for industrial robots has a serious issue with camera calibration, and the use of intelligent visual guiding and identification technologies for industrial robots in industrial production has strict accuracy requirements. It can be considered that visual recognition systems have challenges with precision issues. In such a situation, it will directly impact the effectiveness and standard of industrial production, necessitating a strengthening of the visual guiding study on positioning precision in recognition technology. To best facilitate the handling of complicated components, an approach for the visual recognition of parts utilizing machine learning algorithms is proposed. This study will identify the position of target components by detecting the information at the boundary and corner of a dense point cloud and determining the aspect ratio in accordance with the guidelines for the modularization of building components. To collect and use components, operational processing systems assign them to the same coordinate system based on their locations and postures. The RGB image's inclination detection and the depth image's verification will be used to determine the component's present posture. Finally, a virtual environment model for the robot's obstacle-avoidance route will be constructed using the point cloud information.

Keywords: robotic construction, robotic assembly, visual guidance, machine learning

Procedia PDF Downloads 81
620 Estimation of Morbidity Level of Industrial Labour Conditions at Zestafoni Ferroalloy Plant

Authors: M. Turmanauli, T. Todua, O. Gvaberidze, R. Javakhadze, N. Chkhaidze, N. Khatiashvili

Abstract:

Background: Mining process has the significant influence on human health and quality of life. In recent years the events in Georgia were reflected on the industry working process, especially minimal requirements of labor safety, hygiene standards of workplace and the regime of work and rest are not observed. This situation is often caused by the lack of responsibility, awareness, and knowledge both of workers and employers. The control of working conditions and its protection has been worsened in many of industries. Materials and Methods: For evaluation of the current situation the prospective epidemiological study by face to face interview method was conducted at Georgian “Manganese Zestafoni Ferroalloy Plant” in 2011-2013. 65.7% of employees (1428 bulletin) were surveyed and the incidence rates of temporary disability days were studied. Results: The average length of a temporary disability single accident was studied taking into consideration as sex groups as well as the whole cohort. According to the classes of harmfulness the following results were received: Class 2.0-10.3%; 3.1-12.4%; 3.2-35.1%; 3.3-12.1%; 3.4-17.6%; 4.0-12.5%. Among the employees 47.5% and 83.1% were tobacco and alcohol consumers respectively. According to the age groups and years of work on the base of previous experience ≥50 ages and ≥21 years of work data prevalence respectively. The obtained data revealed increased morbidity rate according to age and years of work. It was found that the bone and articulate system and connective tissue diseases, aggravation of chronic respiratory diseases, ischemic heart diseases, hypertension and cerebral blood discirculation were the leading among the other diseases. High prevalence of morbidity observed in the workplace with not satisfactory labor conditions from the hygienic point of view. Conclusion: According to received data the causes of morbidity are the followings: unsafety labor conditions; incomplete of preventive medical examinations (preliminary and periodic); lack of access to appropriate health care services; derangement of gathering, recording, and analysis of morbidity data. This epidemiological study was conducted at the JSC “Manganese Ferro Alloy Plant” according to State program “ Prevention of Occupational Diseases” (Program code is 35 03 02 05).

Keywords: occupational health, mining process, morbidity level, cerebral blood discirculation

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619 Tiebout and Crime: How Crime Affect the Income Tax Capacity

Authors: Nik Smits, Stijn Goeminne

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Despite the extensive literature on the relation between crime and migration, not much is known about how crime affects the tax capacity of local communities. This paper empirically investigates whether the Flemish local income tax base yield is sensitive to changes in the local crime level. The underlying assumptions are threefold. In a Tiebout world, rational voters holding the local government accountable for the safety of its citizens, move out when the local level of security gets too much alienated from what they want it to be (first assumption). If migration is due to crime, then the more wealthy citizens are expected to move first (second assumption). Looking for a place elsewhere implies transaction costs, which the more wealthy citizens are more likely to be able to pay. As a consequence, the average income per capita and so the income distribution will be affected, which in turn, will influence the local income tax base yield (third assumption). The decreasing average income per capita, if not compensated by increasing earnings by the citizens that are staying or by the new citizens entering the locality, must result in a decreasing local income tax base yield. In the absence of a higher level governments’ compensation, decreasing local tax revenues could prove to be disastrous for a crime-ridden municipality. When communities do not succeed in forcing back the number of offences, this can be the onset of a cumulative process of urban deterioration. A spatial panel data model containing several proxies for the local level of crime in 306 Flemish municipalities covering the period 2000-2014 is used to test the relation between crime and the local income tax base yield. In addition to this direct relation, the underlying assumptions are investigated as well. Preliminary results show a modest, but positive relation between local violent crime rates and the efflux of citizens, persistent up until a 2 year lag. This positive effect is dampened by possible increasing crime rates in neighboring municipalities. The change in violent crimes -and to a lesser extent- thefts and extortions reduce the influx of citizens with a one year lag. Again this effect is diminished by external effects from neighboring municipalities, meaning that increasing crime rates in neighboring municipalities (especially violent crimes) have a positive effect on the local influx of citizens. Crime also has a depressing effect on the average income per capita within a municipality, whereas increasing crime rates in neighboring municipalities increase it. Notwithstanding the previous results, crime does not seem to significantly affect the local tax base yield. The results suggest that the depressing effect of crime on the income basis has to be compensated by a limited, but a wealthier influx of new citizens.

Keywords: crime, local taxes, migration, Tiebout mobility

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618 CyberSteer: Cyber-Human Approach for Safely Shaping Autonomous Robotic Behavior to Comply with Human Intention

Authors: Vinicius G. Goecks, Gregory M. Gremillion, William D. Nothwang

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Modern approaches to train intelligent agents rely on prolonged training sessions, high amounts of input data, and multiple interactions with the environment. This restricts the application of these learning algorithms in robotics and real-world applications, in which there is low tolerance to inadequate actions, interactions are expensive, and real-time processing and action are required. This paper addresses this issue introducing CyberSteer, a novel approach to efficiently design intrinsic reward functions based on human intention to guide deep reinforcement learning agents with no environment-dependent rewards. CyberSteer uses non-expert human operators for initial demonstration of a given task or desired behavior. The trajectories collected are used to train a behavior cloning deep neural network that asynchronously runs in the background and suggests actions to the deep reinforcement learning module. An intrinsic reward is computed based on the similarity between actions suggested and taken by the deep reinforcement learning algorithm commanding the agent. This intrinsic reward can also be reshaped through additional human demonstration or critique. This approach removes the need for environment-dependent or hand-engineered rewards while still being able to safely shape the behavior of autonomous robotic agents, in this case, based on human intention. CyberSteer is tested in a high-fidelity unmanned aerial vehicle simulation environment, the Microsoft AirSim. The simulated aerial robot performs collision avoidance through a clustered forest environment using forward-looking depth sensing and roll, pitch, and yaw references angle commands to the flight controller. This approach shows that the behavior of robotic systems can be shaped in a reduced amount of time when guided by a non-expert human, who is only aware of the high-level goals of the task. Decreasing the amount of training time required and increasing safety during training maneuvers will allow for faster deployment of intelligent robotic agents in dynamic real-world applications.

Keywords: human-robot interaction, intelligent robots, robot learning, semisupervised learning, unmanned aerial vehicles

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617 Challenges & Barriers for Neuro Rehabilitation in Developing Countries

Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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616 Patterns of Private Transfers in the Philippines: An Analysis of Who Gives and Receives More

Authors: Rutcher M. Lacaza, Stephen Jun V. Villejo

Abstract:

This paper investigated the patterns of private transfers in the Philippines using the Family Income Expenditure Survey (FIES) 2009, conducted by the Philippine government’s National Statistics Office (NSO) every three years. The paper performed bivariate analysis on net transfers, using the identified determinants for a household to be either a net receiver or a net giver. The household characteristics considered are the following: age, sex, marital status, employment status and educational attainment of the household head, and also size, location, pre-transfer income and the number of employed members of the household. The variables net receiver and net giver are determined by computing the net transfer, subtracting total gifts from total receipts. The receipts are defined as the sum of cash received from abroad, cash received from domestic sources, total gifts received and inheritance. While gifts are defined as the sum of contributions and donations to church and other religious institutions, contributions and donations to other institutions, gifts and contributions to others, and gifts and assistance to private individuals outside the family. Both in kind and in cash transfers are considered in the analysis. It also performed a multiple regression analysis on transfers received and income including other household characteristics to examine the motives for giving transfers – whether altruism or exchanged. It also used the binary logistic regression to estimate the probability of being a net receiver or net giver given the household characteristics. The study revealed that receiving tends to be universal – both the non-poor and the poor benefit although the poor receive substantially less than the non-poor. Regardless of whether households are net receivers or net givers, households in the upper deciles generally give and receive more than those in the lower deciles. It also appears that private transfers may just flow within economic groups. Big amounts of transfers are, therefore, directed to the non-poor and the small amounts go to the poor. This was also supported by the increasing function of gross transfers received and the income of households – the poor receiving less and the non-poor receiving more. This is contrary to the theory that private transfers can help equalize the distribution of income. This suggested that private transfers in the Philippines are not altruistically motivated but exchanged. However, bilateral data on transfers received or given is needed to test this theory directly. The results showed that transfers are much needed by the poor and it is important to understand the nature of private transfers, to ensure that government transfer programs are properly designed and targeted so as to prevent the duplication of private safety nets already present among the non-poor.

Keywords: private transfers, net receiver, net giver, altruism, exchanged.

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615 Recognising the Importance of Smoking Cessation Support in Substance Misuse Patients

Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

Abstract:

Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

Procedia PDF Downloads 139
614 Comparative Study of Urban Structure between an Island-Type and a General-Type City

Authors: Tomoya Oshiro, Hiroko Ono

Abstract:

Japan's aging population is increasing due to the decrease in birthrate. It causes various problems like the decrease in the gross domestic product of the country. The reason is why the local government of Japan has been on the way to a sustainable city recently. Then it is essential to get control of an urban structure to make the compact city successful. There are many kinds of paper about the compact city; however, the paper about a compact city of the island-type city is less. The purpose of this study is to clarify difference of urban structure between an island-type and a general city type. The method which has conducted in this research has two steps. First of all, by using evaluation indexes in the handbook, we evaluated the urban structures among each same -population-class cities from 50,000 to 100,000 people. Next, to clear the difference about the urban structure and feature between island-type and general-type cities compare the radar chart which is composed with each evaluation indexes of urban structure. Moreover, in order to clarify the relationship between evaluation indexes and the place of residence by using GIS software to show up population density on the map. As a result of this research, the management of local government and the local economy in evaluation indexes are indicated to be negative point in comparison of island-type cities with general cities. However, evaluation indexes of safety/security and low-carbon/energy are proved to be positive point. The research to find the difference features of the island-type of urban structure proves that the management of local government or the local economy is negative point in these island-type cities. In addition, the public transportation coverage in Miyako Island, Sado Island, and Amakusa Island show low value compare with other islands and average value. Relationship between evaluation indexes of an urban structure and the place of residence prove that the place of residence is related to public transportation coverage. If the place of residence is spread out, the public transportation coverage will be decreased. The results of this research reveal that the finances in island-type cities are negative point compare to general cities. This problem is caused by declining population. In addition, the place of residence is related to the public transportation coverage. Even though, it needs a much money to increase the public transportation coverage. It is possibly to cause other problems furthermore the aspect of finance is influenced by that as well. The conclusion in this research suggests that it is important for creating the compact city in island-type cities that we first need to address solving the problems about the management of local government and the local economy.

Keywords: sustainable city, comparative analysis, geographic information system, urban structure

Procedia PDF Downloads 146