Search results for: exponentially weighted moving average (EWMA)

Authors: L. J. de Jager

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In the South African English school curriculum, one of the aims is to achieve communicative competence, the knowledge of using language competently and appropriately in a speech community. Communicatively competent speakers should not only produce grammatically correct sentences but also produce contextually appropriate sentences for various purposes and in different situations. As most speakers of English are non-native speakers, achieving communicative competence remains a complex challenge. Moreover, the changing needs of society necessitate not merely language proficiency, but also technological proficiency. One of the burning issues in the South African educational landscape is the replacement of the standardised literacy model by the pedagogy of multiliteracies that incorporate, by default, the exploration of technological text forms that are part of learners’ everyday lives. It foresees learners as decoders, encoders, and manufacturers of their own futures by exploiting technological possibilities to constantly create and recreate meaning. As such, 21st century learners will feel comfortable working with multimodal texts that are intrinsically part of their lives and by doing so, become authors of their own learning experiences while teachers may become agents supporting learners to discover their capacity to acquire new digital skills for the century of multiliteracies. The aim is transformed practice where learners use their skills, ideas, and knowledge in new contexts. This paper reports on a research project on the integration of technology for language learning, based on the technological pedagogical content knowledge framework, conceptually founded in the theory of multiliteracies, and which aims to achieve communicative competence. The qualitative study uses the community of inquiry framework to answer the research question: How does the integration of technology transform language teaching of preservice teachers? Pre-service teachers in the Postgraduate Certificate of Education Programme with English as methodology were purposively selected to source and evaluate apps for teaching and learning English. The participants collaborated online in a dedicated Blackboard module, using discussion threads to sift through applicable apps and develop interactive lessons using the Apps. The selected apps were entered on to a predesigned Qualtrics form. Data from the online discussions, focus group interviews, and reflective journals were thematically and inductively analysed to determine the participants’ perceptions and experiences when integrating technology in lesson design and the extent to which communicative competence was achieved when using these apps. Findings indicate transformed practice among participants and research team members alike with a better than average technology acceptance and integration. Participants found value in online collaboration to develop and improve their own teaching practice by experiencing directly the benefits of integrating e-learning into the teaching of languages. It could not, however, be clearly determined whether communicative competence was improved. The findings of the project may potentially inform future e-learning activities, thus supporting student learning and development in follow-up cycles of the project.

Keywords: apps, communicative competence, English teaching, technology integration, technological pedagogical content knowledge

Procedia PDF Downloads 168

Authors: Márcia Afonso, Cristina Fael, Marisa Dinis-Almeida

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Population growth in cities has led to an increase in the infrastructures construction, including buildings and roadways. This aspect leads directly to the soils waterproofing. In turn, changes in precipitation patterns are developing into higher and more frequent intensities. Thus, these two conjugated aspects decrease the rainwater infiltration into soils and increase the volume of surface runoff. The practice of green and sustainable urban solutions has encouraged research in these areas. The porous asphalt pavement, as a green infrastructure, is part of practical solutions set to address urban challenges related to land use and adaptation to climate change. In this field, permeable pavements with porous asphalt mixtures (PA) have several advantages in terms of reducing the runoff generated by the floods. The porous structure of these pavements, compared to a conventional asphalt pavement, allows the rainwater infiltration in the subsoil, and consequently, the water quality improvement. This green infrastructure solution can be applied in cities, particularly in streets or parking lots to mitigate the floods effects. Over the years, the pores of these pavements can be filled by sediment, reducing their function in the rainwater infiltration. Thus, double layer porous asphalt (DLPA) was developed to mitigate the clogging effect and facilitate the water infiltration into the lower layers. This study intends to deepen the knowledge of the performance of DLPA when subjected to clogging. The experimental methodology consisted on four evaluation phases of the DLPA infiltration capacity submitted to three precipitation events (100, 200 and 300 mm/h) in each phase. The evaluation first phase determined the behavior after DLPA construction. In phases two and three, two 500 g/m² clogging cycles were performed, totaling a 1000 g/m² final simulation. Sand with gradation accented in fine particles was used as clogging material. In the last phase, the DLPA was subjected to simple sweeping and vacuuming maintenance. A precipitation simulator, type sprinkler, capable of simulating the real precipitation was developed for this purpose. The main conclusions show that the DLPA has the capacity to drain the water, even after two clogging cycles. The infiltration results of flows lead to an efficient performance of the DPLA in the surface runoff attenuation, since this was not observed in any of the evaluation phases, even at intensities of 200 and 300 mm/h, simulating intense precipitation events. The infiltration capacity under clogging conditions decreased about 7% on average in the three intensities relative to the initial performance that is after construction. However, this was restored when subjected to simple maintenance, recovering the DLPA hydraulic functionality. In summary, the study proved the efficacy of using a DLPA when it retains thicker surface sediments and limits the fine sediments entry to the remaining layers. At the same time, it is guaranteed the rainwater infiltration and the surface runoff reduction and is therefore a viable solution to put into practice in permeable pavements.

Keywords: clogging, double layer porous asphalt, infiltration capacity, rainfall intensity

Procedia PDF Downloads 492

Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

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College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

Procedia PDF Downloads 453

Authors: Merve Begum Terzi, Orhan Arikan, Adnan Abaci, Mustafa Candemir

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Acute myocardial infarction is a major cause of death in the world. Therefore, its fast and reliable diagnosis is a major clinical need. ECG is the most important diagnostic methodology which is used to make decisions about the management of the cardiovascular diseases. In patients with acute myocardial ischemia, temporary chest pains together with changes in ST segment and T wave of ECG occur shortly before the start of myocardial infarction. In this study, a technique which detects changes in ST/T sections of ECG is developed for the early diagnosis of acute myocardial ischemia. For this purpose, a database of real ECG recordings that contains a set of records from 75 patients presenting symptoms of chest pain who underwent elective percutaneous coronary intervention (PCI) is constituted. 12-lead ECG’s of the patients were recorded before and during the PCI procedure. Two ECG epochs, which are the pre-inflation ECG which is acquired before any catheter insertion and the occlusion ECG which is acquired during balloon inflation, are analyzed for each patient. By using pre-inflation and occlusion recordings, ECG features that are critical in the detection of acute myocardial ischemia are identified and the most discriminative features for the detection of acute myocardial ischemia are extracted. A classification technique based on support vector machine (SVM) approach operating with linear and radial basis function (RBF) kernels to detect ischemic events by using ST-T derived joint features from non-ischemic and ischemic states of the patients is developed. The dataset is randomly divided into training and testing sets and the training set is used to optimize SVM hyperparameters by using grid-search method and 10fold cross-validation. SVMs are designed specifically for each patient by tuning the kernel parameters in order to obtain the optimal classification performance results. As a result of implementing the developed classification technique to real ECG recordings, it is shown that the proposed technique provides highly reliable detections of the anomalies in ECG signals. Furthermore, to develop a detection technique that can be used in the absence of ECG recording obtained during healthy stage, the detection of acute myocardial ischemia based on ECG recordings of the patients obtained during ischemia is also investigated. For this purpose, a Gaussian mixture model (GMM) is used to represent the joint pdf of the most discriminating ECG features of myocardial ischemia. Then, a Neyman-Pearson type of approach is developed to provide detection of outliers that would correspond to acute myocardial ischemia. Neyman – Pearson decision strategy is used by computing the average log likelihood values of ECG segments and comparing them with a range of different threshold values. For different discrimination threshold values and number of ECG segments, probability of detection and probability of false alarm values are computed, and the corresponding ROC curves are obtained. The results indicate that increasing number of ECG segments provide higher performance for GMM based classification. Moreover, the comparison between the performances of SVM and GMM based classification showed that SVM provides higher classification performance results over ECG recordings of considerable number of patients.

Keywords: ECG classification, Gaussian mixture model, Neyman–Pearson approach, support vector machine

Procedia PDF Downloads 162

Authors: Sunitha Sampathi, Pankaj Kumar Tiriya, Sonia Gera, Sravanthi Reddy Pailla, V. Likhitha, A. J. Maruthi

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Surgical site infections (SSIs) are the most common nosocomial infections localized at the incision site. With an estimated 27 million surgical procedures each year in USA, approximately 2-5% rate of SSIs are predicted to occur annually. SSIs are treated with antibiotic medication. Current trend suggest that the direct drug delivery from the suture to the scared tissue can improve patient comfort and wound recovery. For that reason coating the surface of the medical device such as suture and catguts with broad spectrum antibiotics can prevent the formation of bactierial colonies with out comprimising the mechanical properties of the sutures.Hence, the present study was aimed to develop and evaluate a surgical suture coated with an antibiotic Ciprofloxacin hydrochloride loaded on gold nanoparticles. Gold nanoparticles were synthesized by chemical reduction method and conjugated with ciprofloxacin using Polyvinylpyrolidone as stabilizer and gold as carrier. Ciprofloxacin conjugated gold nanoparticles were coated over an absorbable surgical suture made of Polyglactan using sodium alginate as an immobilising agent by slurry dipping technique. The average particle size and Polydispersity Index of drug conjugated gold NPs were found to be 129±2.35 nm and 0.243±0.36 respectively. Gold nanoparticles are characterized by UV-Vis absorption spectroscopy, Fourier Transform Infrared Spectroscopy (FT-IR), Scanning electron microscopy and Transmission electron microscopy. FT-IR revealed that there is no chemical interaction between drug and polymer. Antimicrobial activity for coated sutures was evaluated by disc diffusion method on culture plates of both gram negative (E-coli) and gram positive bacteria (Staphylococcus aureus) and results found to be satisfactory. In vivo studies for coated sutures was performed on Swiss albino mice and histological evaluation of intestinal wound healing parameters such as wound edges in mucosa, muscularis, presence of necrosis, exudates, granulation tissue, granulocytes, macrophages, restoration, and repair of mucosal epithelium and muscularis propria on day 7 after surgery were studied. The control animal group, sutured with plain suture (uncoated suture) showed signs of restoration and repair, but presence of necrosis, heamorraghic infiltration and granulation tissue was still noticed. Whereas the animal group treated with ciprofloxacin and ciprofloxacin gold nanoparticle coated sutures has shown promising decrease in terms of haemorraghic infiltration, granulation tissue, necrosis and better repaired muscularis layers on comparision with plain coated sutures indicating faster rate of repair and less chance of sepsis. Hence coating of sutures with broad spectrum antibiotics can be an alternate technique to reduce SSIs.

Keywords: ciprofloxacin hydrochloride, gold nanoparticles, surgical site infections, sutures

Procedia PDF Downloads 256

Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

Procedia PDF Downloads 145

Authors: Abdou Elhendy

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Numerous study have shown the efficacy of the percutaneous intervention (PCI) and coronary stenting in improving left ventricular function and relieving exertional angina. Furthermore, PCI remains the main line of therapy in acute myocardial infarction. Improvement of procedural techniques and new devices have resulted in an increased number of PCI in those with difficult and extensive lesions, multivessel disease as well as total occlusion. Immediate and late outcome may be compromised by acute thrombosis or the development of fibro-intimal hyperplasia. In addition, progression of coronary artery disease proximal or distal to the stent as well as in non-stented arteries is not uncommon. As a result, complications can occur, such as acute myocardial infarction, worsened heart failure or recurrence of angina. In a stent, restenosis can occur without symptoms or with atypical complaints rendering the clinical diagnosis difficult. Routine invasive angiography is not appropriate as a follow up tool due to associated risk and cost and the limited functional assessment. Exercise and pharmacologic stress testing are increasingly used to evaluate the myocardial function, perfusion and adequacy of revascularization. Information obtained by these techniques provide important clues regarding presence and severity of compromise in myocardial blood flow. Stress echocardiography can be performed in conjunction with exercise or dobutamine infusion. The diagnostic accuracy has been moderate, but the results provide excellent prognostic stratification. Adding myocardial contrast agents can improve imaging quality and allows assessment of both function and perfusion. Stress radionuclide myocardial perfusion imaging is an alternative to evaluate these patients. The extent and severity of wall motion and perfusion abnormalities observed during exercise or pharmacologic stress are predictors of survival and risk of cardiac events. According to current guidelines, stress echocardiography and radionuclide imaging are considered to have appropriate indication among patients after PCI who have cardiac symptoms and those who underwent incomplete revascularization. Stress testing is not recommended in asymptomatic patients, particularly early after revascularization, Coronary CT angiography is increasingly used and provides high sensitive for the diagnosis of coronary artery stenosis. Average sensitivity and specificity for the diagnosis of in stent stenosis in pooled data are 79% and 81%, respectively. Limitations include blooming artifacts and low feasibility in patients with small stents or thick struts. Anatomical and functional cardiac imaging modalities are corner stone for the assessment of patients after PCI and provide salient diagnostic and prognostic information. Current imaging techniques cans serve as gate keeper for coronary angiography, thus limiting the risk of invasive procedures to those who are likely to benefit from subsequent revascularization. The determination of which modality to apply requires careful identification of merits and limitation of each technique as well as the unique characteristic of each individual patient.

Keywords: coronary artery disease, stress testing, cardiac imaging, restenosis

Procedia PDF Downloads 168

Authors: Domagoj Nakic, Drazen Vouk, Nina Stirmer, Mario Siljeg, Ana Baricevic

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Wastewater treatment processes generate significant quantities of sewage sludge that need to be adequately treated and disposed. In many EU countries, the problem of adequate disposal of sewage sludge has not been solved, nor is determined by the unique rules, instructions or guidelines. Disposal of sewage sludge is important not only in terms of satisfying the regulations, but the aspect of choosing the optimal wastewater and sludge treatment technology. Among the solutions that seem reasonable, recycling of sewage sludge and its byproducts reaches the top recommendation. Within the framework of sustainable development, recycling of sludge almost completely closes the cycle of wastewater treatment in which only negligible amounts of waste that requires landfilling are being generated. In many EU countries, significant amounts of sewage sludge are incinerated, resulting in a new byproduct in the form of ash. Sewage sludge ash is three to five times less in volume compared to stabilized and dehydrated sludge, but it also requires further management. The combustion process also destroys hazardous organic components in the sludge and minimizes unpleasant odors. The basic objective of the presented research is to explore the possibilities of recycling of the sewage sludge ash as a supplementary cementitious material. This is because of the main oxides present in the sewage sludge ash (SiO2, Al2O3 and Cao, which is similar to cement), so it can be considered as latent hydraulic and pozzolanic material. Physical and chemical characteristics of ashes, generated by sludge collected from different wastewater treatment plants, and incinerated in laboratory conditions at different temperatures, are investigated since it is a prerequisite of its subsequent recycling and the eventual use in other industries. Research was carried out by replacing up to 20% of cement by mass in cement mortar mixes with different obtained ashes and examining characteristics of created mixes in fresh and hardened condition. The mixtures with the highest ash content (20%) showed an average drop in workability of about 15% which is attributed to the increased water requirements when ash was used. Although some mixes containing added ash showed compressive and flexural strengths equivalent to those of reference mixes, generally slight decrease in strength was observed. However, it is important to point out that the compressive strengths always remained above 85% compared to the reference mix, while flexural strengths remained above 75%. Ecological impact of innovative construction products containing sewage sludge ash was determined by analyzing leaching concentrations of heavy metals. Results demonstrate that sewage sludge ash can satisfy technical and environmental criteria for use in cementitious materials which represents a new recycling application for an increasingly important waste material that is normally landfilled. Particular emphasis is placed on linking the composition of generated ashes depending on its origin and applied treatment processes (stage of wastewater treatment, sludge treatment technology, incineration temperature) with the characteristics of the final products. Acknowledgement: This work has been fully supported by Croatian Science Foundation under the project '7927 - Reuse of sewage sludge in concrete industry – from infrastructure to innovative construction products'.

Keywords: cement mortar, recycling, sewage sludge ash, sludge disposal

Procedia PDF Downloads 247

Authors: Alice Carter, Lucy Dumbell, Lorna Cameron, Victoria Lewis

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The Olympic discipline of eventing is the triathlon of equestrian sport, consisting of dressage, cross-country and show jumping. Falls on the cross-country are common and can be serious even causing death to rider. Research identifies an increased risk of a fall with an increasing number of obstacles and for jumping efforts later in the course suggesting fatigue maybe a contributing factor. Advice based on anecdotal evidence suggests riders undertake strength and conditioning programs to improve their ‘core’, thus improving their ability to maintain and control their riding position. There is little empirical evidence to support this advice. Therefore, the aim of this study is to investigate truck muscle fatigue and cognitive function during a simulated jumping test. Eight adult riders participated in a riding test on a Racewood Event simulator for 10 minutes, over a continuous jumping programme. The SEMG activity of six trunk muscles were bilaterally measured at every minute, and normalised root mean squares (RMS) and median frequencies (MDF) were computed from the EMG power spectra. Visual analogue scales (VAS) measuring Fatigue and Pain levels and Cognitive Function ‘tapping’ tests were performed before and after the riding test. Average MDF values for all muscles differed significantly between each sampled minute (p = 0.017), however a consistent decrease from Minute 1 and Minute 9 was not found, suggesting the trunk muscles fatigued and then recovered as other muscle groups important in maintaining the riding position during dynamic movement compensated. Differences between the MDF and RMS of different muscles were highly significant (H=213.01, DF=5, p < 0.001), supporting previous anecdotal evidence that different trunk muscles carry out different roles of posture maintenance during riding. RMS values were not significantly different between the sampled minutes or between riders, suggesting the riding test produced a consistent and repeatable effect on the trunk muscles. MDF values differed significantly between riders (H=50.8, DF = 5, p < 0.001), suggesting individuals may experience localised muscular fatigue of the same test differently, and that other parameters of physical fitness should be investigated to provide conclusions. Lumbar muscles were shown to be important in maintaining the position, therefore physical training program should focus on these areas. No significant differences were found between pre- and post-riding test VAS Pain and Fatigue scores or cognitive function test scores, suggesting the riding test was not significantly fatiguing for participants. However, a near significant correlation was found between time of riding test and VAS Pain score (p = 0.06), suggesting somatic pain may be a limiting factor to performance. No other correlations were found between the factors of participant riding test time, VAS Pain and Fatigue, however a larger sample needs to be tested to improve statistical analysis. The findings suggest the simulator riding test was not sufficient to provoke fatigue in the riders, however foundations for future studies have been laid to enable methodologies in realistic eventing settings.

Keywords: eventing, fatigue, horse-rider, surface EMG, trunk muscles

Procedia PDF Downloads 191

Authors: Vaisnavy Govindasamy, Saba Ishrat

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Introduction: The Dexamethasone Intravitreal Implant 0.7 mg (OzurdexTM, Allergan®) is a biodegradable corticosteroid implant approved by the FDA for managing diabetic macular edema (DMO), macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and posterior segment non-infectious uveitis. This implant can release dexamethasone over a six-month period, exhibiting peak effectiveness between 60 and 90 days post-administration. The intravitreal injection should be performed under sterile conditions. At James Cook University Hospital (JCUH), Ozurdex injections are currently administered in the Vitreo-Retinal (VR) theatre. This study aimed to evaluate the feasibility and potential advantages of establishing a dedicated clinic for Ozurdex administration separate from the VR theatre setting. Method: Retrospectively, data of all Ozurdex injections administered between October 2021 to October 2022 was collected from operating theatre registers at JCUH. Data pertaining to the indications for Ozurdex; waiting times from referral date to date of injection; duration of theatre time consumed; and post-injection complications were collected from electronic notes. The resources needed to establish a dedicated Ozurdex clinic were evaluated. Over a six-month period from October 2023 to March 2024, we gathered data on utilization of theatre 28. Results: A total of 135 Ozurdex injections were administered. Among the indications, uveitis represented 47.3% of cases, DMO with 23.6% and RVO with 22.9%. Remaining cases lacked sufficient data. Each Ozurdex injection procedure consumed 15 minutes in the VR theatre list. Complications arose in 5% of injections, totaling 7 cases. These included glaucoma, ocular hypertension, subconjunctival haemorrhage and implant migration. Waiting times averaged 6 weeks from date for referral to procedure date. We also found that, on an average theatre 28 was offered but remained unused for 4 days, totalling eight sessions in a month. Analysis: Establishing a sperate Ozurdex clinic would improve the quality of patient care in following ways: 1.Decrease injection waiting times (currently averaging 6 weeks), leading to better visual outcomes. 2.Free up approximately three hours of theatre time in Vitreo-Retina theatres each month, allowing for 3-4 additional surgeries. Reduce waiting times for critical retinal surgeries and enhance visual outcomes. 3.Provide additional training opportunities for trainees and retina fellows, improving their skills. 4.Optimize the use of empty theatre slots (theatre 28) currently experiencing underutilization of resources. Conclusion: These findings support the implementation of a separate clinic for administering Ozurdex injections at JCUH. It is evident that introducing a dedicated clinic will enhance operational efficiency, optimise resource utilsation, and improve overall quality of care for patients undergoing this treatment.

Keywords: opthalmology, ozurdex, efficiency, complication

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Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

Procedia PDF Downloads 140

Authors: Renu Satish Nair

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Indian higher education system is the third largest in the world next to United States and China. India is experiencing a rapid growth in higher education in terms of student enrollment as well as establishment of new universities, colleges and institutes of national importance. Presently about 22 million students are being enrolled in higher education and more than 46 thousand institutions’ are functioning as centers of higher education. Indian government plays a 'command and control' role in higher education. The main governing body is University Grants Commission, which enforces its standards, advises the government, and helps coordinate between the centre and the state. Accreditation of higher learning is over seen by 12 autonomous institutions established by the University Grants Commission. The present paper is an effort to analyze the strength, weakness, opportunities and threat (SWOT Analysis) of Indian Higher education system. The higher education in India is progressing ahead by virtue of its strength which is being recognized at global level. Several institutions of India, such as Indian Institutes of Technology (IITs), Indian Institutes of Management (IIMs) and National Institutes of Technology (NITs) have been globally acclaimed for their standard of education. Three Indian universities were listed in the Times Higher Education list of the world’s top 200 universities i.e. Indian Institutes of Technology, Indian Institute of Management and Jawahar Lal Nehru University in 2005 and 2006. Six Indian Institutes of Technology and the Birla Institute of Technology and Science - Pilani were listed among the top 20 science and technology schools in Asia by the Asia Week. The school of Business situated in Hyderabad was ranked number 12 in Globe MBA ranking by the Financial Times of London in 2010 while the All India Institute of Medical Sciences has been recognized as a global leader in medical research and treatment. But at the same time, because of vast expansion, the system bears several weaknesses. The Indian higher education system in many parts of the country is in the state of disrepair. In almost half the districts in the country higher education enrollment are very low. Almost two third of total universities and 90% of colleges are rated below average on quality parameters. This can be attributed to the under prepared faculty, unwieldy governance and other obstacles to innovation and improvement that could prohibit India from meeting its national education goals. The opportunities in Indian higher education system are widely ranged. The national institutions are training their products to compete at global level and make them capable to grab opportunities worldwide. The state universities and colleges with their limited resources are giving the products that are capable enough to secure career opportunities and hold responsible positions in various government and private sectors with in the country. This is further creating opportunities for the weaker section of the society to join the main stream. There are several factors which can be defined as threats to Indian higher education system. It is a matter of great concern and needs proper attention. Some important factors are -Conservative society, particularly for women education; -Lack of transparency, -Taking higher education as a means of business

Keywords: Indian higher education system, SWOT analysis, university grants commission, Indian institutes of technology

Procedia PDF Downloads 898

Authors: Aditya Purohit, Neha Bansal

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Unplanned urbanization and multidirectional sprawl of the cities have resulted in increased motorization and deteriorating transport conditions like traffic congestion, longer commuting, pollution, increased carbon footprint, and above all increased fatalities. In order to overcome these problems, various practices have been adopted including– promoting and implementing mass transport; traffic junction channelization; smart transport etc. However, these methods are found to be primarily focusing on vehicular mobility rather than people accessibility. With this research gap, this paper tries to resolve the mobility issues for Ahmedabad city in India, which being the economic capital Gujarat state has a huge commuter and visitor inflow. This research aims to resolve the traffic congestion and urban mobility issues focusing on Gujarat State Regional Transport Corporation (GSRTC) for the city of Ahmadabad by analyzing the existing operations and network structure of GSRTC followed by finding possibilities of integrating it with other modes of urban transport. The network restructuring (NR) methodology is used with appropriate variations, based on commuter demand and growth pattern of the city. To do these ‘scenarios’ based on priority issues (using 12 parameters) and their best possible solution, are established after route network analysis for 2700 population sample of 20 traffic junctions/nodes across the city. Approximately 5% sample (of passenger inflow) at each node is considered using random stratified sampling technique two scenarios are – Scenario 1: Resolving mobility issues by use of Special Purpose Vehicle (SPV) in joint venture to GSRTC and Private Operators for establishing feeder service, which shall provide a transfer service for passenger for movement from inner city area to identified peripheral terminals; and Scenario 2: Augmenting existing mass transport services such as BRTS and AMTS for using them as feeder service to the identified peripheral terminals. Each of these has now been analyzed for the best suitability/feasibility in network restructuring. A desire-line diagram is constructed using this analysis which indicated that on an average 62% of designated GSRTC routes are overlapping with mass transportation service routes of BRTS and AMTS in the city. This has resulted in duplication of bus services causing traffic congestion especially in the Central Bus Station (CBS). Terminating GSRTC services on the periphery of the city is found to be the best restructuring network proposal. This limits the GSRTC buses at city fringe area and prevents them from entering into the city core areas. These end-terminals of GSRTC are integrated with BRTS and AMTS services which help in segregating intra-state and inter-state bus services. The research concludes that absence of integrated multimodal transport network resulted in complexity of transport access to the commuters. As a further scope of research comparing and understanding of value of access time in total travel time and its implication on generalized cost on trip and how it varies city wise may be taken up.

Keywords: mass transportation, multi-modal integration, network restructuring, travel behavior, urban transport

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Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur

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Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.

Keywords: tuberculosis, tumor, curettage, bone

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Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha

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The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.

Keywords: exercises, balance, seniors 65+, health, mental and social balance

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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Authors: Zamira Sattinova, Tassybek Bekenov

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The article is devoted to modeling the technology of hot casting of beryllium oxide ceramics. The stages of ultrasonic activation of beryllium oxide slurry in the plant vessel to improve the rheological property, hot casting in the moulding cavity with cooling and solidification of the casting are described. Thermoplastic slurry (hereinafter referred to as slurry) shows the rheology of a non-Newtonian fluid with yield and plastic viscosity. Cooling-solidification of the slurry in the forming cavity occurs in the liquid, taking into account crystallization and solid state. In this work is the method of calculation of hot casting of the slurry using the method of effective molecular viscosity of viscoplastic fluid. It is shown that the slurry near the cooled wall is in a state of crystallization and plasticity, and the rest may still be in the liquid phase. Nonuniform distribution of temperature, density and concentration of kinetically free binder takes place along the cavity section. This leads to compensation of shrinkage by the influx of slurry from the liquid into the crystallization zones and plasticity of the castings. In the plasticity zone, the shrinkage determined by the concentration of kinetically free binder is compensated under the action of the pressure gradient. The solidification mechanism, as well as the mechanical behavior of the casting mass during casting, the rheological and thermophysical properties of the thermoplastic BeO slurry due to ultrasound exposure have not been well studied. Nevertheless, experimental data allow us to conclude that the effect of ultrasonic vibrations on the slurry mass leads to it: a change in structure, an increase in technological properties, a decrease in heterogeneity and a change in rheological properties. In the course of experiments, the effect of ultrasonic treatment and its duration on the change in viscosity and ultimate shear stress of the slurry depending on temperature (55-75℃) and the mass fraction of the binder (10 - 11.7%) have been studied. At the same time, changes in these properties before and after ultrasound exposure have been analyzed, as well as the nature of the flow in the system under study. The experience of operating the unit with ultrasonic impact has shown that at the same time, the casting capacity of the slurry increases by an average of 15%, and the viscosity decreases by more than half. Experimental study of physicochemical properties and phase change with simultaneous consideration of all factors affecting the quality of products in the process of continuous casting is labor-intensive. Therefore, an effective way to control the physical processes occurring in the formation of articles with predetermined properties and shapes is to simulate the process and determine its basic characteristics. The results of the calculations show the whole stage of hot casting of beryllium oxide slurry, taking into account the change in its state of aggregation. Ultrasonic treatment improves rheological properties and increases the fluidity of the slurry in the forming cavity. Calculations show the influence of velocity, temperature factors and structural data of the cavity on the cooling-solidification process of the casting. In the calculations, conditions for molding with shrinkage of the slurry by hot casting have been found, which makes it possible to obtain a solidifying product with a uniform beryllium oxide structure at the outlet of the cavity.

Keywords: hot casting, thermoplastic slurry molding, shrinkage, beryllium oxide

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Authors: Rizwana Tabassum

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Introductive Statement: Delay in budget releases is often cited as one of the biggest bottlenecks to smooth and efficient service delivery. While budget release from the ministry of finance to the line ministries has been expedited by simplifying the procedure, budget distribution within the line ministries remains one of the major causes of slow budget utilization. While the budget preparation is a bottom-up process where all DDOs submit their proposals to their controlling officers (such as Upazila Civil Surgeon sends it to Director General Health), who consolidate the budget proposals in iBAS++ budget preparation module, the approved budget is not disaggregated by all DDOs. Instead, it is left to the discretion of the controlling officers to distribute the approved budget to their sub-ordinate offices over the course of the year. Though there are some need-based criteria/formulae to distribute the approved budget among DDOs in some sectors, there is little evidence that these criteria are actually used. This means that majority of the DDOs don’t know their yearly allocations upfront to enable yearly planning of activities and expenditures. This delays the implementation of critical activities and the payment to the suppliers of goods and services and sometimes leads to undocumented arrears to suppliers for essential goods/services. In addition, social sector budgets are fragmented because of the vertical programs and externally financed interventions that pose several management challenges at the level of the budget holders and frontline service providers. Slow procurement processes further delay the provision of necessary goods and services. For example, it takes an average of 15–18 months for drugs to reach the Upazila Health Complex and below, while it should not take more than 9 months in procuring and distributing these. Aim of the Study: This paper aims to investigate the budget distribution practices of an emerging economy, Bangladesh. The paper identifies challenges of timely distribution and ways to deal with problems as well. Methodology: The study draws conclusions on the basis of document analysis which is a branch of the qualitative research method. Major Findings: Upon approval of the National Budget, the Ministry of Finance is required to distribute the budget to budget holders at the department level; however, budget is distributed to drawing and disbursing officers much later. Conclusions: Timely and predictable budget releases assist completion of development schemes on time and on budget, with sufficient recurrent resources for effective operation. ADP implementation is usually very low at the beginning of the fiscal year and expedited dramatically during the last few months, leading to inefficient use of resources. The timely budget release will resolve this issue and deliver economic benefits faster, better, and more reliably. This will also give the project directors/DDOs the freedom to think and plan the budget execution in a predictable manner, thereby ensuring value for money by reducing time overrun and expediting the completion of capital investments, and improving infrastructure utilization through timely payment of recurrent costs.

Keywords: budget distribution, challenges, digitization, emerging economy, service delivery

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Authors: Nihad Chakri, Btissam El Amrani, Faouzi Berrada, Halima Jounaid, Fouad Amraoui

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Public baths or hammams play an essential role in the Moroccan urban and peri-urban fabric, constituting part of the cultural heritage. Urbanization in Morocco has led to a significant increase in the number of these traditional hammams: between 6,000 and 15,000 units (to be updated) operate with a traditional heating system. Numerous studies on energy consumption indicate that a hammam consumes between 60 and 120m3 of water and one to two tons of wood per day. On average, one ton of wood costs 650 Moroccan dirhams (approximately 60 Euros), resulting in a daily fuel cost of around 1300 Moroccan dirhams (about 120 Euros). These high consumptions result in significant environmental nuisances generated by: Wastewater: in the case of hammams located on the outskirts of Casablanca, such as our study area, the Municipality of Dar Bouazza, most of these waters are directly discharged into the receiving environment without prior treatment because they are not connected to the sanitation network. Emissions of black smoke and ashes produced by the often incomplete combustion of wood. Reducing the liquid and gas emissions generated by these hammams thus poses an environmental and sustainable development challenge that needs to be addressed. In this context, we initiated the Eco-hammam project with the objective of implementing innovative and locally adapted solutions to limit the negative impacts of hammams on the environment and reduce water and wood energy consumption. This involves treating and reusing wastewater through a compact system with heat recovery and using alternative energy sources to increase and enhance the energy efficiency of these traditional hammams. To achieve this, on-site surveys of hammams in the Dar Bouazza Municipality and the application of statistical approaches to the results of the physico-chemical and bacteriological characterization of incoming and outgoing water from these units were conducted. This allowed us to establish an environmental diagnosis of these entities. In conclusion, the analysis of well water used by Dar Bouazza's hammams revealed the presence of certain parameters that could be hazardous to public health, such as total germs, total coliforms, sulfite-reducing spores, chromium, nickel, and nitrates. Therefore, this work primarily focuses on prospecting upstream of our study area to verify if other sources of pollution influence the quality of well water.

Keywords: public baths, hammams, cultural heritage, urbanization, water consumption, wood consumption, environmental nuisances, wastewater, environmental challenge, sustainable development, Eco-hammam project, innovative solutions, local adaptation, negative impacts, water conservation, wastewater treatment, heat recovery, alternative energy sources, on-site surveys, Dar Bouazza Municipality, statistical approaches, physico-chemical characterization, bacteriological characterization, environmental diagnosis, well water analysis, public health, pollution sources, well water quality

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Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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Authors: Frank Adusah-Poku, John Bosco Dramani, Prince Boakye Frimpong

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Climate change is considered a principal threat to human existence and livelihood. The persistence and intensity of droughts and floods in recent years have adversely affected food production systems and value chains, making it impossible to end global hunger by 2030. Thus, this study aims to examine the effect of climate change on food consumption for both farm and non-farm households in Ghana. An important focus of the analysis is to investigate how climate change affects alternative dimensions of food security, examine the extent to which these effects vary across heterogeneous groups, and explore the channels through which climate change affects food consumption. Finally, we conducted a pilot study to understand the significance of farm and non-farm diversification measures in reducing the harmful impact of climate change on farm households. The approach of this article is to use two secondary and one primary datasets. The first secondary dataset is the Ghana Socioeconomic Panel Survey (GSPS). The GSPS is a household panel dataset collected during the period 2009 to 2019. The second dataset is monthly district rainfall and temperature gridded data from the Ghana Meteorological Agency. This data was matched to the GSPS dataset at the district level. Finally, the primary data was obtained from a survey of farm and non-farm adaptation practices used by farmers in three regions in Northern Ghana. The study employed the household fixed effects model to estimate the effect of climate change (measured by temperature and rainfall) on food consumption in Ghana. Again, it used the spatial and temporal variation in temperature and rainfall across the districts in Ghana to estimate the household-level model. Evidence of potential mechanisms through which climate change affects food consumption was explored using two steps. First, the potential mechanism variables were regressed on temperature, rainfall, and the control variables. In the second and final step, the potential mechanism variables were included as extra covariates in the first model. The results revealed that extreme average temperature and drought had caused a decrease in food consumption as well as reduced the intake of important food nutrients such as carbohydrates, protein and vitamins. The results further indicated that low rainfall increased food insecurity among households with no education compared with those with primary and secondary education. Again, non-farm activity and silos have been revealed as the transmission pathways through which the effect of climate change on farm households can be moderated. Finally, the results indicated over 90% of the small-holder farmers interviewed had no farm diversification adaptation strategies for climate change, and a little over 50% of the farmers owned unskilled or manual non-farm economic ventures. This makes it very difficult for the majority of the farmers to withstand climate-related shocks. These findings suggest that achieving the Sustainable Development Goal of Zero Hunger by 2030 needs an integrated approach, such as reducing the over-reliance on rainfed agriculture, educating farmers, and implementing non-farm interventions to improve food consumption in Ghana.

Keywords: climate change, food consumption, Ghana, non-farm activity

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Authors: Eric Bang

Abstract:

Interactions between receptors and ligands are crucial for many essential biological processes, including neurotransmission and metabolism. Ligand-receptor analyses that examine cell behavior and interactions often utilize cell type-specific RNA expressions from single-cell RNA sequencing (scRNA-seq) data. Using CellPhoneDB, a public repository consisting of ligands, receptors, and ligand-receptor interactions, the cell-cell interactions were explored in a specific scRNA-seq dataset from kidney tissue and portrayed the results with dot plots and heat maps. Depending on the type of cell, each ligand-receptor pair was aligned with the interacting cell type and calculated the positori probabilities of these associations, with corresponding P values reflecting average expression values between the triads and their significance. Using single-cell data (sample kidney cell references), genes in the dataset were cross-referenced with ones in the existing CellPhoneDB dataset. For example, a gene such as Pleiotrophin (PTN) present in the single-cell data also needed to be present in the CellPhoneDB dataset. Using the single-cell transcriptomics data via slide-seq and reference data, the CellPhoneDB program defines cell types and plots them in different formats, with the two main ones being dot plots and heat map plots. The dot plot displays derived measures of the cell to cell interaction scores and p values. For the dot plot, each row shows a ligand-receptor pair, and each column shows the two interacting cell types. CellPhoneDB defines interactions and interaction levels from the gene expression level, so since the p-value is on a -log10 scale, the larger dots represent more significant interactions. By performing an interaction analysis, a significant interaction was discovered for myeloid and T-cell ligand-receptor pairs, including those between Secreted Phosphoprotein 1 (SPP1) and Fibronectin 1 (FN1), which is consistent with previous findings. It was proposed that an effective protocol would involve a filtration step where cell types would be filtered out, depending on which ligand-receptor pair is activated in that part of the tissue, as well as the incorporation of the CellPhoneDB data in a streamlined workflow pipeline. The filtration step would be in the form of a Python script that expedites the manual process necessary for dataset filtration. Being in Python allows it to be integrated with the CellPhoneDB dataset for future workflow analysis. The manual process involves filtering cell types based on what ligand/receptor pair is activated in kidney cells. One limitation of this would be the fact that some pairings are activated in multiple cells at a time, so the manual manipulation of the data is reflected prior to analysis. Using the filtration script, accurate sorting is incorporated into the CellPhoneDB database rather than waiting until the output is produced and then subsequently applying spatial data. It was envisioned that this would reveal wherein the cell various ligands and receptors are interacting with different cell types, allowing for easier identification of which cells are being impacted and why, for the purpose of disease treatment. The hope is this new computational method utilizing spatially explicit ligand-receptor association data can be used to uncover previously unknown specific interactions within kidney tissue.

Keywords: bioinformatics, Ligands, kidney tissue, receptors, spatial transcriptome

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Authors: Rami Hashish, Manon Limousis-Gayda, Caitlin H. McCleery

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Introduction: A leading cause of emergency room visits among youth (in the United States), is sports-related traumatic brain injuries. Mild traumatic brain injuries (mTBIs), also called concussions, are caused by linear and/or angular acceleration experienced at the head and represent an increasing societal burden. Due to the developing nature of the brain in youth, there is a great risk for long-term neuropsychological deficiencies following a concussion. Accordingly, the purpose of this paper is to investigate incidence rates of concussion across gender for the five most common youth sports in the United States. These include basketball, track and field, soccer, baseball (boys), softball (girls), football (boys), and volleyball (girls). Methods: A PubMed search was performed for four search themes combined. The first theme identified the outcomes (concussion, brain injuries, mild traumatic brain injury, etc.). The second theme identified the sport (American football, soccer, basketball, softball, volleyball, track, and field, etc.). The third theme identified the population (adolescence, children, youth, boys, girls). The last theme identified the study design (prevalence, frequency, incidence, prospective). Ultimately, 473 studies were surveyed, with 15 fulfilling the criteria: prospective study presenting original data and incidence of concussion in the relevant youth sport. The following data were extracted from the selected studies: population age, total study population, total athletic exposures (AE) and incidence rate per 1000 athletic exposures (IR/1000). Two One-Way ANOVA and a Tukey’s post hoc test were conducted using SPSS. Results: From the 15 selected studies, statistical analysis revealed the incidence of concussion per 1000 AEs across the considered sports ranged from 0.014 (girl’s track and field) to 0.780 (boy’s football). Average IR/1000 across all sports was 0.483 and 0.268 for boys and girls, respectively; this difference in IR was found to be statistically significant (p=0.013). Tukey’s post hoc test showed that football had significantly higher IR/1000 than boys’ basketball (p=0.022), soccer (p=0.033) and track and field (p=0.026). No statistical difference was found for concussion incidence between girls’ sports. Removal of football was found to lower the IR/1000 for boys without a statistical difference (p=0.101) compared to girls. Discussion: Football was the only sport showing a statistically significant difference in concussion incidence rate relative to other sports (within gender). Males were overall more likely to be concussed than females when football was included (1.8x), whereas concussion was more likely for females when football was excluded. While the significantly higher rate of concussion in football is not surprising because of the nature and rules of the sport, it is concerning that research has shown higher incidence of concussion in practices than games. Interestingly, findings indicate that girls’ sports are more concussive overall when football is removed. This appears to counter the common notion that boys’ sports are more physically taxing and dangerous. Future research should focus on understanding the concussive mechanisms of injury in each sport to enable effective rule changes.

Keywords: gender, football, soccer, traumatic brain injury

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Authors: Puzanova Zhanna Vasilyevna, Larina Tatiana Igorevna, Tertyshnikova Anastasia Gennadyevna

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In this day and age, extremism in various forms of its manifestation is a real threat to the world community, the national security of a state and its territorial integrity, as well as to the constitutional rights and freedoms of citizens. Extremism, as it is known, in general terms described as a commitment to extreme views and actions, radically denying the existing social norms and rules. Supporters of extremism in the ideological and political struggles often adopt methods and means of psychological warfare, appeal not to reason and logical arguments, but to emotions and instincts of the people, to prejudices, biases, and a variety of mythological designs. They are dissatisfied with the established order and aim at increasing this dissatisfaction among the masses. Youth extremism holds a specific place among the existing forms and types of extremism. In this context in 2015, we conducted a survey among Moscow college and high school students. The aim of this study was to determine how great or small is the difference in understanding and attitudes towards extremism manifestations, inclination and readiness to take part in extremist activities and what causes this predisposition, if it exists. We performed multivariate analysis and found the Russian college and high school students' opinion about the extremism and terrorism situation in our country and also their cognition on these topics. Among other things, we showed, that the level of aggressiveness of young people were not above the average for the whole population. The survey was conducted using the questionnaire method. The sample included college and high school students in Moscow (642 and 382, respectively) by method of random selection. The questionnaire was developed by specialists of RUDN University Sociological Laboratory and included both original questions (projective questions, the technique of incomplete sentences), and the standard test Dayhoff S. to determine the level of internal aggressiveness. It is also used as an experiment, the technique of study option using of FACS and SPAFF to determine the psychotypes and determination of non-verbal manifestations of emotions. The study confirmed the hypothesis that in respondents’ opinion, the level of aggression is higher today than a few years ago. Differences were found in the understanding of and respect for such social phenomena as extremism, terrorism, and their danger and appeal for the two age groups of young people. Theory of psychotypes, SPAFF (specific affect cording system) and FACS (facial action cording system) are considered as additional techniques for the diagnosis of a tendency to extreme views. Thus, it is established that diagnostics of acceptance of extreme views among young people is possible thanks to simultaneous use of knowledge from the different fields of socio-humanistic sciences. The results of the research can be used in a comparative context with other countries and as a starting point for further research in the field, taking into account its extreme relevance.

Keywords: extremism, youth extremism, diagnostics of extremist manifestations, forecast of behavior, sociological polls, theory of psychotypes, FACS, SPAFF

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Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

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Authors: Tatsiana Ihnatovich, Darya Nizheharodava, Mikalai Halabarodzka, Tatsiana Savitskaya, Marina Zafranskaya

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Liver fibrosis is a complex of histological changes resulting from chronic liver disease accompanied by an excessive production and deposition of extracellular matrix components in the hepatic parenchyma. Liver fibrosis is a serious medical and social problem. Hepatic stellate cells (HSCs) make a significant contribution to the extracellular matrix deposition due to liver injury. Mesenchymal stem cells (MSCs) have a pronounced anti-inflammatory, regenerative and immunomodulatory effect; they are able to differentiate into hepatocytes and induce apoptosis of activated HSCs that opens the prospect of their use for preventing the excessive fibro-formation and the development of liver cirrhosis. The aim of the study is to evaluate the effect of MSCs therapy on the expression of fibrogenesis markers genes in liver tissue and HSCs cultures of rats with experimental liver cirrhosis (ELC). Materials and methods: ELC was induced by the common bile duct ligation (CBDL) in female Wistar rats (n = 19) with an average body weight of 250 (220 ÷ 270) g. Animals from the control group (n = 10) were sham-operated. On the 56th day after the CBDL, the rats of the experimental (n = 12) and the control (n = 5) groups received intraportal MSCs in concentration of 1×106 cells/animal (previously obtained from rat’s bone marrow) or saline, respectively. The animals were taken out of the experiment on the 21st day. HSCs were isolated by sequential liver perfusion in situ with following disaggregation, enzymatic treatment and centrifugation of cell suspension on a two-stage density gradient. The expression of collagen type I (Col1a1) and type III (Col3a1), matrix metalloproteinase type 2 (MMP2) and type 9 (MMP9), tissue inhibitor of matrix metalloproteinases type 1 (TIMP1), transforming growth factor β type 1 (TGFβ1) and type 3 (TGFβ3) was determined by real-time polymerase chain reaction. Statistical analysis was performed using Statistica 10.0. Results: In ELC rats compared to sham-operated animals, a significant increase of all studied markers expression was observed. The administration of MSCs led to a significant decrease of all detectable markers in the experimental group compared to rats without cell therapy. In ELC rats, an increased MMP9/TIMP1 ratio after cell therapy was also detected. The infusion of MSCs in the sham-operated animals did not lead to any changes. In the HSCs from ELC animals, the expression of Col1a1 and Col3a1 exceeded the similar parameters of the control group (p <0.05) and statistically decreased after the MSCs administration. The correlation between Col3a1 (Rs = 0.51, p <0.05), TGFβ1 (Rs = 0.6, p <0.01), and TGFβ3 (Rs = 0.75, p <0.001) expression in HSCs cultures and liver tissue has been found. Conclusion: Intraportal administration of MSCs to rats with ELC leads to a decreased Col1a1 and Col3a1, MMP2 and MMP9, TIMP1, TGFβ1 and TGFβ3 expression. The correlation between the expression of Col3a1, TGFβ1 and TGFβ3 in liver tissue and in HSCs cultures indicates the involvement of activated HSCs in the fibrogenesis that allows considering HSCs to be the main cell therapy target in ELC.

Keywords: cell therapy, experimental liver cirrhosis, hepatic stellate cells, mesenchymal stem cells

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Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde

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Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.

Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity

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Authors: Ramiz M. Shubbar, Dong In Lee, Hatem A. Gzar, Arthur S. Rood

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Air pollution is one of the biggest environmental problems in Baghdad, Iraq. The Daura refinery located nearest the center of Baghdad, represents the largest industrial area, which transmits enormous amounts of pollutants, therefore study the gaseous pollutants and particulate matter are very important to the environment and the health of the workers in refinery and the people whom leaving in areas around the refinery. Actually, some studies investigated the studied area before, but it depended on the basic Gaussian equation in a simple computer programs, however, that kind of work at that time is very useful and important, but during the last two decades new largest production units were added to the Daura refinery such as, PU_3 (Power unit_3 (Boiler 11&12)), CDU_1 (Crude Distillation unit_70000 barrel_1), and CDU_2 (Crude Distillation unit_70000 barrel_2). Therefore, it is necessary to use new advanced model to study air pollution at the region for the new current years, and calculation the monthly emission rate of pollutants through actual amounts of fuel which consumed in production unit, this may be lead to accurate concentration values of pollutants and the behavior of dispersion or transport in study area. In this study to the best of author’s knowledge CALPUFF model was used and examined for first time in Iraq. CALPUFF is an advanced non-steady-state meteorological and air quality modeling system, was applied to investigate the pollutants concentration of SO2, NO2, CO, and PM1-10μm, at areas adjacent to Daura refinery which located in the center of Baghdad in Iraq. The CALPUFF modeling system includes three main components: CALMET is a diagnostic 3-dimensional meteorological model, CALPUFF (an air quality dispersion model), CALPOST is a post processing package, and an extensive set of preprocessing programs produced to interface the model to standard routinely available meteorological and geophysical datasets. The targets of this work are modeling and simulation the four pollutants (SO2, NO2, CO, and PM1-10μm) which emitted from Daura refinery within one year. Emission rates of these pollutants were calculated for twelve units includes thirty plants, and 35 stacks by using monthly average of the fuel amount consumption at this production units. Assess the performance of CALPUFF model in this study and detect if it is appropriate and get out predictions of good accuracy compared with available pollutants observation. CALPUFF model was investigated at three stability classes (stable, neutral, and unstable) to indicate the dispersion of the pollutants within deferent meteorological conditions. The simulation of the CALPUFF model showed the deferent kind of dispersion of these pollutants in this region depends on the stability conditions and the environment of the study area, monthly, and annual averages of pollutants were applied to view the dispersion of pollutants in the contour maps. High values of pollutants were noticed in this area, therefore this study recommends to more investigate and analyze of the pollutants, reducing the emission rate of pollutants by using modern techniques and natural gas, increasing the stack height of units, and increasing the exit gas velocity from stacks.

Keywords: CALPUFF, daura refinery, Iraq, pollutants

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