Search results for: gene concordance factor confidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7621

Search results for: gene concordance factor confidence

1771 Temperature Distribution for Asphalt Concrete-Concrete Composite Pavement

Authors: Tetsya Sok, Seong Jae Hong, Young Kyu Kim, Seung Woo Lee

Abstract:

The temperature distribution for asphalt concrete (AC)-Concrete composite pavement is one of main influencing factor that affects to performance life of pavement. The temperature gradient in concrete slab underneath the AC layer results the critical curling stress and lead to causes de-bonding of AC-Concrete interface. These stresses, when enhanced by repetitive axial loadings, also contribute to the fatigue damage and eventual crack development within the slab. Moreover, the temperature change within concrete slab extremely causes the slab contracts and expands that significantly induces reflective cracking in AC layer. In this paper, the numerical prediction of pavement temperature was investigated using one-dimensional finite different method (FDM) in fully explicit scheme. The numerical predicted model provides a fundamental and clear understanding of heat energy balance including incoming and outgoing thermal energies in addition to dissipated heat in the system. By using the reliable meteorological data for daily air temperature, solar radiation, wind speech and variable pavement surface properties, the predicted pavement temperature profile was validated with the field measured data. Additionally, the effects of AC thickness and daily air temperature on the temperature profile in underlying concrete were also investigated. Based on obtained results, the numerical predicted temperature of AC-Concrete composite pavement using FDM provided a good accuracy compared to field measured data and thicker AC layer significantly insulates the temperature distribution in underlying concrete slab.

Keywords: asphalt concrete, finite different method (FDM), curling effect, heat transfer, solar radiation

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1770 Impact of Lobular Carcinoma in situ on Local Recurrence in Breast Cancer Treated with Breast Conservation Therapy: A Systematic Review and Meta-Analysis

Authors: Christopher G. Harris, Guy D. Eslick

Abstract:

Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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1769 Slope Stability Study at Jalan Tun Sardon and Sungai Batu, Pulau Pinang, Malaysia by Using 2-D Resistivity Method

Authors: Muhamad Iqbal Mubarak Faharul Azman, Azim Hilmy Mohd Yusof, Nur Azwin Ismail, Noer El Hidayah Ismail

Abstract:

Landslides and rock falls are the examples of environmental and engineering problems in Malaysia. There are various methods that can be applied for the environmental and engineering problems but geophysical methods are seldom applied as the main investigation technique. This paper aims to study the slope stability by using 2-D resistivity method at Jalan Tun Sardon and Sungai Batu, Pulau Pinang. These areas are considered as highly potential for unstable slope in Penang Island based on recent cases of rockfall and landslide reported especially during raining season. At both study areas, resistivity values greater than 5000 ohm-m are detected and considered as the fresh granite. The weathered granite is indicated by resistivity value of 750-1500 ohm-m with depth of < 14 meters at Sungai Batu area while at Jalan Tun Sardon area, the weathered granite with resistivity values of 750-2000 ohm-m is found at depth < 14 meter at distance 0-90 meter but at distance of 95-150 meter, the weathered granite is found at depth < 26 meter. Saturated zone is detected only at Sungai Batu with resistivity value <250 ohm-m at distance 100-120 meter. A fracture is detected at distance about 70 meter at Jalan Tun Sardon area. Unstable slope is expected to be affected by the weathered granite that dominates the subsurface of the study areas along with triggering factor such as heavy rainfall.

Keywords: 2-D resistivity, environmental issue, landslide, slope stability

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1768 Measuring Satisfaction with Life Construct Among Public and Private University Students During COVID-19 Pandemic in Sabah, Malaysia

Authors: Mohd Dahlan Abdul Malek, Muhamad Idris, Adi Fahrudin, Ida Shafinaz Mohamed Kamil, Husmiati Yusuf, Edeymend Reny Japil, Wan Anor Wan Sulaiman, Lailawati Madlan, Alfred Chan, Nurfarhana Adillah Aftar, Mahirah Masdin

Abstract:

This research intended to develop a valid and reliable instrument of the Satisfaction with Life Scale (SWLS) to measure satisfaction with life (SWL) constructs among public and private university students in Sabah, Malaysia, through the exploratory factor analysis (EFA) procedure. The pilot study obtained a sample of 108 students from public and private education institutions in Sabah, Malaysia, through an online survey using a self-administered questionnaire. The researchers performed the EFA procedure on SWL construct using IBM SPSS 25. The Bartletts' Test of Sphericity is highly significant (Sig. = .000). Furthermore, the sampling adequacy by Kaiser-Meyer-Olkin (KMO = 0.839) is excellent. Using the extraction method of Principal Component Analysis (PCA) with Varimax Rotation, a component of the SWL construct is extracted with an eigenvalue of 3.101. The variance explained for this component is 62.030%. The construct of SWL has Cronbach's alpha value of .817. The development scale and validation confirmed that the instrument is consistent and stable with both private and public college and university student samples. It adds a remarkable contribution to the measurement of SWLS, mainly in the context of higher education institution students. The EFA outcomes formed a configuration that extracts a component of SWL, which can be measured by the original five items established in this research. This research reveals that the SWL construct is applicable to this study.

Keywords: satisfaction, university students, measurement, scale development

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1767 Nutritional Status of Surgical and Orthopedic Patients: 3B Ward

Authors: Jitaree Tantiyasawatdikul, Bantita Jadnok, Sarunya Tijana

Abstract:

Background: Nutritional status is an important factor before, during, and after an operation. It can help wound healing. If the patients have good nutritional status before and after an operation, wound healing can occur more easily. It can strengthen the immune system leading to decreased infection, reduced length of stay, and reducing the cost to patients and caregivers. Therefore, screening to evaluate the nutritional status of patients in 3B becomes the database for further developing the treatment and also will lead to excellent service from the interdisciplinary team. Objective: To study the nutritional status of patients in surgical ward 3B at Surgical and Orthopedics Nursing Division, Srinagarind Hospital. Method: A descriptive study, to evaluate the nutritional status of 86 patients admitted in 3B between October 2014 and March 2015.The instruments used in this study consisted of two parts: 1) personal data, 2) Screening nutritional status. The data were analyzed by percentage and mean. Results: A sample population of 86 patients aged 22-81 years old, mean age 52.59years, 90.69% are married, female were 55.81%, regular diet 70.93%, patients with no problem oral cavity was 87.21%.The sample population had high incidence of CA 47.67% and secondly cardiovascular disease 36.05 %. Patients with high-risk nutrition was 12.79 % including 45.45% cardiovascular disease and 36.36% CA. Screening of nutritional status of high-risk nutrition was 39.36% severe triceps skinfold (TSF), severe mid-arm muscle circumference(MAMC) 9.09% and severe total lymphocyte 39.36%. Conclusion: The result of nutritional status screening of surgical ward 3B found 12.79% patients with high-risk nutrition including 45.45% with cardiovascular disease .There was no problem with oral cavity and eating.

Keywords: nutritional status, screening, surgical patients, 3B ward, Srinagarind Hospital

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1766 Embarrassment as a Trigger Factor of Code Switching From Arabic to English in Egypt: A Case Study in Sociolinguistic

Authors: Samar Mohamed Magdy Abdelrahim

Abstract:

This study is an attempt to investigate the phenomenon of code-switching that takes place between Arabic and English in social discourse among high, well-educated, and young people in Egypt. The study aims at digging deeper to extract the trigger factors of such occurrences, namely when people encounter embarrassing situations in their daily conversations. Nowadays, most young Egyptians tend to use English words in certain situations that might make them feel embarrassed. To disguise their feelings and soften the impact of these words in the context, they code-switch (CS) from Arabic into English. To obtain accurate results, the study utilized a quantitative analysis approach that combines personal observations and a questionnaire to examine the phenomenon appropriately. The questionnaire was designed to categorize different types of embarrassing topics to be evaluated by participants. These topics include certain parts of the human body, types of clothes, taboo words, and specific medical conditions. Many studies have examined the use of CS as a prestigious way of communicating and expressing solidarity between Arabic and English. Other studies have dealt with switches that take place in classrooms. However, not many studies have paid attention to this angle of CS, especially in Egypt. The results conclude that gender and the circumstances that surround the conversation are essential factors of CS since females tend to switch codes more than males in embarrassing situations. According to the study, CS serves the socio-pragmatic function in terms of helping young, well-educated bilinguals express themselves in a second language that would be distressing in the first.

Keywords: code-switching, embarrassment, Arabic, English

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1765 Defective Autophagy Disturbs Neural Migration and Network Activity in hiPSC-Derived Cockayne Syndrome B Disease Models

Authors: Julia Kapr, Andrea Rossi, Haribaskar Ramachandran, Marius Pollet, Ilka Egger, Selina Dangeleit, Katharina Koch, Jean Krutmann, Ellen Fritsche

Abstract:

It is widely acknowledged that animal models do not always represent human disease. Especially human brain development is difficult to model in animals due to a variety of structural and functional species-specificities. This causes significant discrepancies between predicted and apparent drug efficacies in clinical trials and their subsequent failure. Emerging alternatives based on 3D in vitro approaches, such as human brain spheres or organoids, may in the future reduce and ultimately replace animal models. Here, we present a human induced pluripotent stem cell (hiPSC)-based 3D neural in a vitro disease model for the Cockayne Syndrome B (CSB). CSB is a rare hereditary disease and is accompanied by severe neurologic defects, such as microcephaly, ataxia and intellectual disability, with currently no treatment options. Therefore, the aim of this study is to investigate the molecular and cellular defects found in neural hiPSC-derived CSB models. Understanding the underlying pathology of CSB enables the development of treatment options. The two CSB models used in this study comprise a patient-derived hiPSC line and its isogenic control as well as a CSB-deficient cell line based on a healthy hiPSC line (IMR90-4) background thereby excluding genetic background-related effects. Neurally induced and differentiated brain sphere cultures were characterized via RNA Sequencing, western blot (WB), immunocytochemistry (ICC) and multielectrode arrays (MEAs). CSB-deficiency leads to an altered gene expression of markers for autophagy, focal adhesion and neural network formation. Cell migration was significantly reduced and electrical activity was significantly increased in the disease cell lines. These data hint that the cellular pathologies is possibly underlying CSB. By induction of autophagy, the migration phenotype could be partially rescued, suggesting a crucial role of disturbed autophagy in defective neural migration of the disease lines. Altered autophagy may also lead to inefficient mitophagy. Accordingly, disease cell lines were shown to have a lower mitochondrial base activity and a higher susceptibility to mitochondrial stress induced by rotenone. Since mitochondria play an important role in neurotransmitter cycling, we suggest that defective mitochondria may lead to altered electrical activity in the disease cell lines. Failure to clear the defective mitochondria by mitophagy and thus missing initiation cues for new mitochondrial production could potentiate this problem. With our data, we aim at establishing a disease adverse outcome pathway (AOP), thereby adding to the in-depth understanding of this multi-faced disorder and subsequently contributing to alternative drug development.

Keywords: autophagy, disease modeling, in vitro, pluripotent stem cells

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1764 Quality of Life and Self-Assessed Health of Methadone – Maintained Opiate Addicts

Authors: Brajevic-gizdic Igna, Vuletic Gorka

Abstract:

Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking the Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment on OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients´ craving. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patient’s statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.

Keywords: abstinence, addicts, methadone, OST, quality of life

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1763 Effects of Folic Acid, Alone or in Combination with Other Nutrients on Homocysteine Level and Cognitive Function in Older People: A Systematic Review

Authors: Jiayan Gou, Kexin He, Xin Zhang, Fei Wang, Liuni Zou

Abstract:

Background: Homocysteine is a high-risk factor for cognitive decline, and folic acid supplementation can lower homocysteine levels. However, current clinical research results are inconsistent, and the effects of folic acid on homocysteine levels and cognitive function in older people are inconsistent. Objective: The objective of this study is to systematically evaluate the effects of folic acid alone or in combination with other nutrients on homocysteine levels and cognitive function in older adults. Methods: Systematic searches were conducted in five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, from inception to June 1, 2023. Randomized controlled trials were included investigating the effects of folic acid alone or in combination with other nutrients on cognitive function in older people. Results: 17 articles were included, with six focusing on the effects of folic acid alone and 11 examining folic acid in combination with other nutrients. The study included 3,100 individuals aged 60 to 83.2 years, with a relatively equal gender distribution (approximately 51.82% male). Conclusion: Folic acid alone or combined with other nutrients can effectively lower homocysteine level and improve cognitive function in patients with mild cognitive impairment. But for patients with Alzheimer's disease and dementia, the intervention only can reduce the homocysteine level, but the improvement in cognitive function is not significant. In healthy older people, high baseline homocysteine levels (>11.3 μmol/L) and good ω-3 fatty acid status (>590 μmol/L) can enhance the improvement effect of folic acid on cognitive function. This trial has been registered on PROSPERO as CRD42023433096.

Keywords: B-complex vitamins, cognitive function, folic acid, homocysteine

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1762 Effects of Channel Orientation on Heat Transfer in a Rotating Rectangular Channel with Jet Impingement Cooling and Film Coolant Extraction

Authors: Hua Li, Hongwu Deng

Abstract:

The turbine blade's leading edge is usually cooled by jet impingement cooling technology due to the heaviest heat load. For a rotating turbine blade, however, the channel orientation (β, the angle between the jet direction and the rotating plane) could play an important role in influencing the flow field and heat transfer. Therefore, in this work, the effects of channel orientation (from 90° to 180°) on heat transfer in a jet impingement cooling channel are experimentally investigated. Furthermore, the investigations are conducted under an isothermal boundary condition. Both the jet-to-target surface distance and jet-to-jet spacing are three times the jet hole diameter. The jet Reynolds number is 5,000, and the maximum jet rotation number reaches 0.24. The results show that the rotation-induced variations of heat transfer are different in each channel orientation. In the cases of 90°≤β≤135°, a vortex generated in the low-radius region of the supply channel changes the mass-flowrate distribution in each jet hole. Therefore, the heat transfer in the low-radius region decreases with the rotation number, whereas the heat transfer in the high-radius region increases, indicating that a larger temperature gradient in the radial direction could appear in the turbine blade's leading edge. When 135°<β≤180°; however, the heat transfer of the entire stagnant zone decreases with the rotation number. The rotation-induced jet deflection is the primary factor that weakens the heat transfer, and jets cannot reach the target surface at high rotation numbers. For the downstream regions, however, the heat transfer is enhanced by 50%-80% in every channel orientation because the dead zone is broken by the rotation-induced secondary flow in the impingement channel.

Keywords: heat transfer, jet impingement cooling, channel orientation, high rotation number, isothermal boundary

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1761 Development of Sports Nation on the Way of Health Management

Authors: Beatrix Faragó, Zsolt Szakály, Ágnes Kovácsné Tóth, Csaba Konczos, Norbert Kovács, Zsófia Pápai, Tamás Kertész

Abstract:

The future of the nation is the embodiment of a healthy society. A key segment of government policy is the development of health and a health-oriented environment. As a result, sport as an activator of health is an important area for development. In Hungary, sport is a strategic sector with the aim of developing a sports nation. The function of sport in the global society is multifaceted, which is manifested in both social and economic terms. The economic importance of sport is gaining ground in the world, with implications for Central and Eastern Europe. Smaller states, such as Hungary, cannot ignore the economic effects of exploiting the effects of sport. The relationship between physical activity and health is driven by the health economy towards the nation's economic factor. In our research, we analyzed sport as a national strategy sector and its impact on age groups. By presenting the current state of health behavior, we get an idea of the directions where development opportunities require even more intervention. The foundation of the health of a nation is the young age group, whose shaping of health will shape the future generation. Our research was attended by university students from the Faculty of Health and Sports Sciences who will be experts in the field of health in the future. The other group is the elderly, who are a growing social group due to demographic change and are a key segment of the labor market and consumer society. Our study presents the health behavior of the two age groups, their differences, and similarities. The survey also identifies gaps in the development of a health management strategy that national strategies should take into account.

Keywords: competitiveness, health behavior, health economy, health management, sports nation

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1760 Impacts of Opium Addiction on Patterns of Angiographic Findings in Patients with Coronary Artery Syndrome

Authors: Alireza Abdiardekani, Maryam Salimi, Shirin Sarejloo, Mehdi Bazrafshan, Amir Askarinejad, Amirhossein Salimi, Hanieh Bazrafshan, Salar Javanshir, Armin Attar, Shokoufeh Khanzadeh, Mohsen Esmaeili, Hamed Bazrafshan Drissi

Abstract:

Background: Opium, after tobacco, is the most abused substance in the Middle East. The effects of opium use on coronary artery disease are indeed unclear. This study aimed to assess the association between opium use and angiographic findings in patients with acute coronary syndrome (ACS) diagnosis at Al-Zahra Heart Hospital, Shiraz, Iran. Methods: In this case-control study, 170 patients admitted for coronary angiography were enrolled from 2019 to 2020. They were categorized into two groups based on their history: "non-opium" and "opium." SPSS (Version 26) was used to investigate the correlation between opioid addiction and the severity of coronary artery disease. Results: The results of our study reveal that the mean age of the participants was 61.63±9.07. This study indicated that 49 (28.82%) patients were female, and 121 (71.17%) were male. Our findings revealed that three-vessel disease was more frequent in non-opium (40; 47.05%) and opium (45; 52.94%) groups. There was a significant correlation between the severity of the second diagonal artery(D2) and right coronary artery(RCA) involvement and opium consumption. There was a strong positive correlation between the location of the vascular lesion in the left circumflex artery and opium consumption. Conclusion: Opium, as an independent risk factor for cardiovascular diseases, can have specific effects on angiographic findings in patients with coronary artery disease. Public health officials and politicians should arrange several programs to increase the general population’s consciousness about opioid use and its consequences.

Keywords: acute coronary syndrome, opium, coronary artery disease, angiography

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1759 Microbioreactor System for Cell Behavior Analysis Focused on Nerve Tissue Engineering

Authors: Yusser Olguín, Diego Benavente, Fernando Dorta, Nicole Orellana, Cristian Acevedo

Abstract:

One of the greatest challenges of tissue engineering is the generation of materials in which the highest possible number of conditions can be incorporated to stimulate the proliferation and differentiation of cells, which will be transformed together with the material into new functional tissue. In this sense, considering the properties of microfluidics and its relationship with cellular micro-environments, the possibility of controlling flow patterns and the ability to design diverse patterns in the chips, a microfluidic cell culture system can be established as a means for the evaluation of the effect of different parameters in a controlled and precise manner. Specifically in relation to the study and development of alternatives in peripheral nervous tissue engineering, it is necessary to consider different physical and chemical neurotrophic stimuli that promote cell growth and differentiation. Chemical stimuli include certain vitamins, glucocorticoids, gangliosides, and growth factors, while physical stimuli include topological stimuli, mechanical forces of the cellular environment and electrical stimulation. In this context, the present investigation shows the results of cell stimulation in a microbioreactor using electrical and chemical stimuli, where the differentiation of PC12 cells as a neuronal model is evidenced by neurite expression, dependent on the stimuli and their combination. The results were analysed with a multi-factor statistical approach, showing several relationships and dependencies between different parameters. Chip design, operating parameters and concentrations of neurotrophic chemical factors were found to be preponderant, based on the characteristics of the electrical stimuli.

Keywords: microfluidics, nerve tissue engineering, microbioreactor, electrical stimuli

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1758 Baseline Data from Specialist Obesity Clinic in a Large Tertiary Care Facility, Karachi, Pakistan

Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

Abstract:

Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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1757 Speciation, Preconcentration, and Determination of Iron(II) and (III) Using 1,10-Phenanthroline Immobilized on Alumina-Coated Magnetite Nanoparticles as a Solid Phase Extraction Sorbent in Pharmaceutical Products

Authors: Hossein Tavallali, Mohammad Ali Karimi, Gohar Deilamy-Rad

Abstract:

The proposed method for speciation, preconcentration and determination of Fe(II) and Fe(III) in pharmaceutical products was developed using of alumina-coated magnetite nanoparticles (Fe3O4/Al2O3 NPs) as solid phase extraction (SPE) sorbent in magnetic mixed hemimicell solid phase extraction (MMHSPE) technique followed by flame atomic absorption spectrometry analysis. The procedure is based on complexation of Fe(II) with 1, 10-phenanthroline (OP) as complexing reagent for Fe(II) that immobilized on the modified Fe3O4/Al2O3 NPs. The extraction and concentration process for pharmaceutical sample was carried out in a single step by mixing the extraction solvent, magnetic adsorbents under ultrasonic action. Then, the adsorbents were isolated from the complicated matrix easily with an external magnetic field. Fe(III) ions determined after facility reduced to Fe(II) by added a proper reduction agent to sample solutions. Compared with traditional methods, the MMHSPE method simplified the operation procedure and reduced the analysis time. Various influencing parameters on the speciation and preconcentration of trace iron, such as pH, sample volume, amount of sorbent, type and concentration of eluent, were studied. Under the optimized operating conditions, the preconcentration factor of the modified nano magnetite for Fe(II) 167 sample was obtained. The detection limits and linear range of this method for iron were 1.0 and 9.0 - 175 ng.mL−1, respectively. Also the relative standard deviation for five replicate determinations of 30.00 ng.mL-1 Fe2+ was 2.3%.

Keywords: Alumina-Coated magnetite nanoparticles, Magnetic Mixed Hemimicell Solid-Phase Extraction, Fe(ΙΙ) and Fe(ΙΙΙ), pharmaceutical sample

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1756 Reducing Waiting Time in Outpatient Services: Six Sigma and Technological Approach

Authors: Omkar More, Isha Saini, Gracy Mathai

Abstract:

To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of the tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. A detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂ 10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected by dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P < 0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film instability. On comparison of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing a risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight-threatening complications.

Keywords: footfall, nursing assessment, quality improvement, six sigma

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1755 Health Care using Queuing Theory

Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

Abstract:

The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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1754 Assessing the Impacts of Urbanization on Urban Precincts: A Case of Golconda Precinct, Hyderabad

Authors: Sai AKhila Budaraju

Abstract:

Heritage sites are an integral part of cities and carry a sense of identity to the cities/ towns, but the process of urbanization is a carrying potential threat for the loss of these heritage sites/monuments. Both Central and State Governments listed the historic Golconda fort as National Important Monument and the Heritage precinct with eight heritage-listed buildings and two historical sites respectively, for conservation and preservation, due to the presence of IT Corridor 6kms away accommodating more people in the precinct is under constant pressure. The heritage precinct possesses high property values, being a prime location connecting the IT corridor and CBD (central business district )areas. The primary objective of the study was to assess and identify the factors that are affecting the heritage precinct through Mapping and documentation, Identifying and assessing the factors through empirical analysis, Ordinal regression analysis and Hedonic Pricing Model. Ordinal regression analysis was used to identify the factors that contribute to the changes in the precinct due to urbanization. Hedonic Pricing Model was used to understand and establish a relation whether the presence of historical monuments is also a contributing factor to the property value and to what extent this influence can contribute. The above methods and field visit indicates the Physical, socio-economic factors and the neighborhood characteristics of the precinct contributing to the property values. The outturns and the potential elements derived from the analysis of the Development Control Rules were derived as recommendations to Integrate both Old and newly built environments.

Keywords: heritage planning, heritage conservation, hedonic pricing model, ordinal regression analysis

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1753 Stress as Risk Factor for Onset of Type-2 Diabetes Mellitus in Visakhapatnam Tribal Community of Andhra Pradesh, India

Authors: Vijaya Nirmala Pangi, K. V. Subhramanyam, C. Vijay Lakshmi

Abstract:

Background: The prevalence of Type 2 Diabetes Mellitus is increasing drastically at a vigorous rate all over the world population. Aim: The present study aims to determine the prevalence of type-2 diabetes mellitus in Paderu tribal area population of Visakhapatnam district, located in northeastern region of Andhra Pradesh. Methods: A random sampling method was followed in 1025 subjects including controls (n=25) and determined 75-g oral glucose tolerance test to assess the presence of type 2 diabetes mellitus. The effect of anthropometric factors like age, gender, literacy, socio economic status, and environmental risk factors such as body fat response, hypertension and psychophysical stress response were determined in the studied subjects. Results: 78 (7.8%) were diabetic. Type 2 Diabetes Mellitus was found to be comparable between the two genders. Prevalence of diabetes was observed to be high in illiterate, low economic status subjects. Body fat response was comparable between control and diabetic subjects. However hypertension, stress associated enzymes showed significant (p < 0.05) decrease in diabetic subjects compared to controls in both the genders. Conclusion: It appears that there is a rising pattern in the prevalence of diabetes mellitus in tribal area, Paderu, Andhra Pradesh, India compared to previous rural studies.

Keywords: anthropometric studies, hypertension, oral glucose tolerance test, stress enzymes, type-2 diabetes mellitus

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1752 Exploration of a Blockchain Assisted Framework for Through Baggage Interlining: Blocklining

Authors: Mary Rose Everan, Michael McCann, Gary Cullen

Abstract:

International travel journeys, by their nature, incorporate elements provided by multiple service providers such as airlines, rail carriers, airports, and ground handlers. Data needs to be stored by and exchanged between these parties in the process of managing the journey. The fragmented nature of this shared management of mutual clients is a limiting factor in the development of a seamless, hassle-free, end-to-end travel experience. Traditional interlining agreements attempt to facilitate many separate aspects of co-operation between service providers, typically between airlines and, to some extent, intermodal travel operators, including schedules, fares, ticketing, through check-in, and baggage handling. These arrangements rely on pre-agreement. The development of Virtual Interlining - that is, interlining facilitated by a third party (often but not always an airport) without formal pre-agreement by the airlines or rail carriers - demonstrates an underlying demand for a better quality end-to-end travel experience. Blockchain solutions are being explored in a number of industries and offer, at first sight, an immutable, single source of truth for this data, avoiding data conflicts and misinterpretation. Combined with Smart Contracts, they seemingly offer a more robust and dynamic platform for multi-stakeholder ventures, and even perhaps the ability to join and leave consortia dynamically. Applying blockchain to the intermodal interlining space – termed Blocklining in this paper - is complex and multi-faceted because of the many aspects of cooperation outlined above. To explore its potential, this paper concentrates on one particular dimension, that of through baggage interlining.

Keywords: aviation, baggage, blocklining, intermodal, interlining

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1751 First Formaldehyde Retrieval Using the Raw Data Obtained from Pandora in Seoul: Investigation of the Temporal Characteristics and Comparison with Ozone Monitoring Instrument Measurement

Authors: H. Lee, J. Park

Abstract:

In this present study, for the first time, we retrieved the Formaldehyde (HCHO) Vertical Column Density (HCHOVCD) using Pandora instruments in Seoul, a megacity in northeast Asia, for the period between 2012 and 2014 and investigated the temporal characteristics of HCHOVCD. HCHO Slant Column Density (HCHOSCD) was obtained using the Differential Optical Absorption Spectroscopy (DOAS) method. HCHOSCD was converted to HCHOVCD using geometric Air Mass Factor (AMFG) as Pandora is the direct-sun measurement. The HCHOVCDs is low at 12:00 Local Time (LT) and is high in the morning (10:00 LT) and late afternoon (16:00 LT) except for winter. The maximum (minimum) values of Pandora HCHOVCD are 2.68×1016 (1.63×10¹⁶), 3.19×10¹⁶ (2.23×10¹⁶), 2.00×10¹⁶ (1.26×10¹⁶), and 1.63×10¹⁶ (0.82×10¹⁶) molecules cm⁻² in spring, summer, autumn, and winter, respectively. In terms of seasonal variations, HCHOVCD was high in summer and low in winter which implies that photo-oxidation plays an important role in HCHO production in Seoul. In comparison with the Ozone Monitoring Instrument (OMI) measurements, the HCHOVCDs from the OMI are lower than those from Pandora. The correlation coefficient (R) between monthly HCHOVCDs values from Pandora and OMI is 0.61, with slop of 0.35. Furthermore, to understand HCHO mixing ratio within Planetary Boundary Layer (PBL) in Seoul, we converted Pandora HCHOVCDs to HCHO mixing ratio in the PBL using several meteorological input data from the Atmospheric InfraRed Sounder (AIRS). Seasonal HCHO mixing ratio in PBL converted from Pandora (OMI) HCHOVCDs are estimated to be 6.57 (5.17), 7.08 (6.68), 7.60 (4.70), and 5.00 (4.76) ppbv in spring, summer, autumn, and winter, respectively.

Keywords: formaldehyde, OMI, Pandora, remote sensing

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1750 The Effect of Endurance Training and Ginseng Consumption on VEGF and PDGF Plasma in Untrained Females

Authors: Barari Alireza, Seyed Hossein Alavi, Ghasemi Mohamad

Abstract:

Objectives: VEGF and PDGF play central role in the processes of angiogenesis and vascular changes in most body tissues. The aim of the present study to determine effect of endurance training with ginseng on VEGF and PDGF levels is untrained female. Methods: Statistic society of this study was untraining male students of Azad University of Sari Branch in year of 2012-2013. Forty young untrained female (age 21.3 ± 0.90 year, height162.08±8.07cm , body weight 65.45± 7.6 kg and body mass index [BMI] 23.23 ± 2.64 kg/m2) were randomly divided into four groups: control(C), endurance(E), ginseng (G), endurance and ginseng (EG). Participants in training groups performed endurance training for 6 weeks and three sessions per week with 60-80% HRmax. Subjects perform endurance training and consumed ginseng for six weeks. Blood samples from the subjects before and after the test was performed. One wey ANOVA were used to test for differences between group and pair T-test were used for differences within groups. In all cases, P<0.05 was considered to be statistically significant. Results: A higher and significant Vo2 max was found in E and EG groups, while no change in other groups. BMI and Fat% were significantly decreased in EG group. No significant difference was found between and within groups in VEGF level. A higher and significant PDGF was only in endurance group, while there was significant reduction observed in G and EG groups. One-way ANOVA for PDGF showed significant difference between groups. Conclusion: The finding of the current study indicated that ginseng likely could through reducing of angiogenesis factors Such as VEGF and PDGF and reduced activity of tumor necrosis factor and inhibited inflammatory process.

Keywords: endurance, ginseng, VEGF, PDGF, untrained female

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1749 The Healthcare Costs of BMI-Defined Obesity among Adults Who Have Undergone a Medical Procedure in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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1748 Development of a Self-Retractable Front Spoilers Suitable for Indian Road Conditions to Reduce Aerodynamic Drag

Authors: G. Sivaraj, K. M. Parammasivam, R. Veeramanikandan, S. Nithish

Abstract:

Reduction of ground clearance or (ride height) is a vital factor in minimizing aerodynamic drag force and improving vehicle performance. But in India, minimization of ground clearance is limited because of the road conditions. Due to this problem, reduction of aerodynamic drag and performance are not fully improved. In this view, this paper deals with the development of self-retractable front spoilers which are most suitable for Indian road conditions. These retractable spoilers are fitted in the front portion of the car and in speed below 60 km/hr these spoilers are in retracted positions. But, when the car crosses a speed above 60 km/hr, using electronic circuit the spoilers are activated. Thus, using this technique aerodynamic performance can be improved at a speed above 60 km/hr. Also, when the car speed is reduced below the 60 km/hr mark, the front spoiler are retracted which makes it as a normal car. This is because, in Indian roads, speed breakers are installed to cut off speed at particular places. Thus, in these circumstances there are chances of damaging front spoilers. Since, when the driver sees the speed breaker, he will automatically apply break to prevent damage, at this time using electronic circuit the front spoiler is retracted. However, accidentally when the driver fails to apply brakes there are chances for the front spoilers to get a hit. But as the front spoilers are made of Kevlar composite, it can withstand high impact loads and using a spring mechanism the spoilers are retracted immediately. By using CFD analysis and low-speed wind tunnel testing drag coefficient of the 1:10 scaled car model with and without self-retractable spoilers are calculated and validated. Also, using wind tunnel, proper working of self-retractable at car speed below and above 60 km/hr are validated.

Keywords: aerodynamic drag, CFD analysis, kevlar composite, self-retractable spoilers, wind tunnel

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1747 Causes and Impacts of Rework Costs in Construction Projects

Authors: Muhammad Ejaz1

Abstract:

Rework has been defined as: "The unnecessary effort of re-doing a process or activity that was incorrectly implemented the first time." A great threat to the construction industry is rework. By and large due attention has not been given to avoid the causes of reworks, resulting time and cost over runs, in civil engineering projects. Besides these direct consequences, there might also be indirect consequences, such as stress, de-motivation or loss of future clients. When delivered products do not meet the requirements or expectations, work often has to be redone. Rework occurs in various phases of the construction process or in various divisions of a company. Rework can occur on the construction site or in a management department due to for example bad materials management. Rework can also have internal or external origins. Changes in clients’ expectations are an example of an external factor that might lead to rework. Rework can cause many costs to be higher than calculated at the start of the project. Rework events can have many different origins and for this research they have been categorized into four categories; changes, errors, omissions, and damages. The research showed that the major source of reworks were non professional attitude from technical hands and ignorance of total quality management principals by stakeholders. It also revealed that sources of reworks have not major differences among project categories. The causes were further analyzed by interviewing employees. Based on existing literature an extensive list of rework causes was made and during the interviews the interviewees were asked to confirm or deny statements regarding rework causes. The causes that were most frequently confirmed can be grouped into the understanding categories. 56% (max) of the causes are change-related, 30% (max) is error-related and 18% (max) falls into another category. Therefore, by recognizing above mentioned factors, reworks can be reduced to a great extent.

Keywords: total quality management, construction industry, cost overruns, rework, material management, client’s expectations

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1746 Optimization of Springback Prediction in U-Channel Process Using Response Surface Methodology

Authors: Muhamad Sani Buang, Shahrul Azam Abdullah, Juri Saedon

Abstract:

There is not much effective guideline on development of design parameters selection on springback for advanced high strength steel sheet metal in U-channel process during cold forming process. This paper presents the development of predictive model for springback in U-channel process on advanced high strength steel sheet employing Response Surface Methodology (RSM). The experimental was performed on dual phase steel sheet, DP590 in U-channel forming process while design of experiment (DoE) approach was used to investigates the effects of four factors namely blank holder force (BHF), clearance (C) and punch travel (Tp) and rolling direction (R) were used as input parameters using two level values by applying Full Factorial design (24). From a statistical analysis of variant (ANOVA), result showed that blank holder force (BHF), clearance (C) and punch travel (Tp) displayed significant effect on springback of flange angle (β2) and wall opening angle (β1), while rolling direction (R) factor is insignificant. The significant parameters are optimized in order to reduce the springback behavior using Central Composite Design (CCD) in RSM and the optimum parameters were determined. A regression model for springback was developed. The effect of individual parameters and their response was also evaluated. The results obtained from optimum model are in agreement with the experimental values

Keywords: advance high strength steel, u-channel process, springback, design of experiment, optimization, response surface methodology (rsm)

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1745 Means of Securing Graves in the Egyptian Kingdom Era

Authors: Haitham Nabil Zaghlol Hasan

Abstract:

This research aims to study the means of securing graves in the Egyptian kingdom era, and revolves around many basic ideas used by the ancient Egyptian to protect his graves from thieves, which included architectural characteristics, which gave it importance only others. The most important of which was the choice of the place of the grave, which chose a kohl place in the desert to protect the graves, which is the valley of kings, and whether the choice of that place had an impact in protecting the grave or not, in addition to other elements followed in the architectural planning, which was in the valley of kings. The multiplicity of the tomb, the construction of the well chamber to deceive the thieves by the end of the graves suddenly, the construction of the wells of the tombs, which contained the burial chamber at the bottom of the main well and the effect of all these factors on the graves, and this shows the importance of the graves to the ancient Egyptian and his belief in resurrection and immortality. The Egyptian resorted to the elements of protection and was a religious worker by The protector gods and special texts to protect the deceased from any danger to protect the tomb. As for the human factor of securing the tomb through human guards (police) and security teams based on the guard and the words indicating the protection and the guard teams and the teams of the majai. The most important developments that arose on the cemetery from Tamit entrance, corridors, chambers, burial chamber and coffin, and the use of sand to close the well after from one cemetery to another and from time to time where it was built in the late period inside the temple campus to be under the attention of the priests and their protection, as the study dealt with an analytical study For the means of securing graves in the Egyptian kingdom period.

Keywords: Egypt, archaeology, civilization, Egyptian

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1744 Study on the Spatial Evolution Characteristics of Urban Agglomeration Integration in China: The Case of Chengdu-Chongqing Urban Agglomeration

Authors: Guoqin Ge, Minhui Huang, Yazhou Zhou

Abstract:

The growth of the Chengdu-Chongqing urban agglomeration has been designated as a national strategy in China. Analyzing its spatial evolution characteristics is crucial for devising relevant development strategies. This paper enhances the gravitational model by using temporal distance as a factor. It applies this improved model to assess the economic interconnection and concentration level of each geographical unit within the Chengdu-Chongqing urban agglomeration between 2011 and 2019. On this basis, this paper examines the spatial correlation characteristics of economic agglomeration intensity and urban-rural development equalization by employing spatial autocorrelation analysis. The study findings indicate that the spatial integration in the Chengdu-Chongqing urban agglomeration is currently in the "point-axis" development stage. The spatial organization structure is becoming more flattened, and there is a stronger economic connection between the core of the urban agglomeration and the peripheral areas. The integration of the Chengdu-Chongqing urban agglomeration is currently hindered by conflicting interests and institutional heterogeneity between Chengdu and Chongqing. Additionally, the connections between the relatively secondary spatial units are largely loose and weak. The strength and scale of economic ties and the level of urban-rural equilibrium among spatial units within the Chengdu-Chongqing urban agglomeration have increased, but regional imbalances have continued to widen, and such positive and negative changes have been characterized by the spatial and temporal synergistic evolution of the "core-periphery". Ultimately, this paper presents planning ideas for the future integration development of the Chengdu-Chongqing urban agglomeration, drawing from the findings.

Keywords: integration, planning strategy, space organization, space evolution, urban agglomeration

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1743 Engineering of Filtration Systems in Egyptian Cement Plants: Industrial Case Study

Authors: Mohamed. A. Saad

Abstract:

The paper represents a case study regarding the conversion of Electro-Static Precipitators (ESP`s) into Fabric Filters (FF). Seven cement production companies were established in Egypt during the period 1927 to 1980 and 6 new companies were established to cope with the increasing cement demand in 1980's. The cement production market shares in Egypt indicate that there are six multinational companies in the local market, they are interested in the environmental conditions improving and so decided to achieve emission reduction project. The experimental work in the present study is divided into two main parts: (I) Measuring Efficiency of Filter Fabrics with detailed description of a designed apparatus. The paper also reveals the factors that should be optimized in order to assist problem diagnosis, solving and increasing the life of bag filters. (II) Methods to mitigate dust emissions in Egyptian cement plants with a special focus on converting the Electrostatic Precipitators (ESP`s) into Fabric Filters (FF) using the same ESP casing, bottom hoppers, dust transportation system, and ESP ductwork. Only the fan system for the higher pressure drop with the fabric filter was replaced. The proper selection of bag material was a prime factor with regard to gas composition, temperature and particle size. Fiberglass with PTFE membrane coated bags was selected. This fabric is rated for a continuous temperature of 250 C and a surge temperature of 280C. The dust emission recorded was less than 20 mg/m3 from the production line fitted with fabric filters which is super compared with the ESP`s working lines stack.

Keywords: Engineering Electrostatic Precipitator, filtration, dust collectors, cement

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1742 Quality in Healthcare: An Autism-Friendly Hospital Emergency Waiting Room

Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

Abstract:

People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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