Search results for: evaluation criteria

Authors: Eva L. Suarez, Daniel E. Meeroff, Yan Yong

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The U.S. Federal Emergency Management Agency (FEMA) developed flood maps based on experts’ experience and estimates of the probability of flooding. Current flood-risk models evaluate flood risk with regional and subjective measures without impact from torrential rain and nuisance flooding at the neighborhood level. Nuisance flooding occurs in small areas in the community, where a few streets or blocks are routinely impacted. This type of flooding event occurs when torrential rainstorm combined with high tide and sea level rise temporarily exceeds a given threshold. In South Florida, this threshold is 1.7 ft above Mean Higher High Water (MHHW). The National Weather Service defines torrential rain as rain deposition at a rate greater than 0.3-inches per hour or three inches in a single day. Data from the Florida Climate Center, 1970 to 2020, shows 371 events with more than 3-inches of rain in a day in 612 months. The purpose of this research is to develop a data-driven method to determine comprehensive analytical damage-avoidance criteria that account for nuisance flood events at the single-family home level. The method developed uses the Failure Mode and Effect Analysis (FMEA) method from the American Society of Quality (ASQ) to estimate the Damage Avoidance (DA) preparation for a 1-day 100-year storm. The Consequence of Nuisance Flooding (CoNF) is estimated from community mitigation efforts to prevent nuisance flooding damage. The Probability of Nuisance Flooding (PoNF) is derived from the frequency and duration of torrential rainfall causing delays and community disruptions to daily transportation, human illnesses, and property damage. Urbanization and population changes are related to the U.S. Census Bureau's annual population estimates. Data collected by the United States Department of Agriculture (USDA) Natural Resources Conservation Service’s National Resources Inventory (NRI) and locally by the South Florida Water Management District (SFWMD) track the development and land use/land cover changes with time. The intent is to include temporal trends in population density growth and the impact on land development. Results from this investigation provide the risk of nuisance flooding as a function of CoNF and PoNF for coastal areas of South Florida. The data-based criterion provides awareness to local municipalities on their flood-risk assessment and gives insight into flood management actions and watershed development.

Keywords: flood risk, nuisance flooding, urban flooding, FMEA

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Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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Authors: Charly Julien Nyobe, Eric Jacquelin, Denis Brizard, Alexy Mercier

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The performance of road side safety barriers depends largely on the dynamic interactions between post and soil. These interactions play a key role in the response of barriers to crash testing. In the literature, soil-post interaction is modeled in crash test simulations using three approaches. Many researchers have initially used the finite element approach, in which the post is embedded in a continuum soil modelled by solid finite elements. This method represents a more comprehensive and detailed approach, employing a mesh-based continuum to model the soil’s behavior and its interaction with the post. Although this method takes all soil properties into account, it is nevertheless very costly in terms of simulation time. In the second approach, all the points of the post located at a predefined depth are fixed. Although this approach reduces CPU computing time, it overestimates soil-post stiffness. The third approach involves modeling the post as a beam supported by a set of nonlinear springs in the horizontal directions. For support in the vertical direction, the posts were constrained at a node at ground level. This approach is less costly, but the literature does not provide a simple procedure to determine the constitutive law of the springs The aim of this study is to propose a simple and low-cost procedure to obtain the constitutive law of nonlinear springs that model the soil-post interaction. To achieve this objective, we will first present a procedure to obtain the constitutive law of nonlinear springs thanks to the simulation of a soil compression test. The test consists in compressing the soil contained in the tank by a rigid solid, up to a vertical displacement of 200 mm. The resultant force exerted by the ground on the rigid solid and its vertical displacement are extracted and, a force-displacement curve was determined. The proposed procedure for replacing the soil with springs must be tested against a reference model. The reference model consists of a wooden post embedded into the ground and impacted with an impactor. Two simplified models with springs are studied. In the first model, called Kh-Kv model, the springs are attached to the post in the horizontal and vertical directions. The second Kh model is the one described in the literature. The two simplified models are compared with the reference model according to several criteria: the displacement of a node located at the top of the post in vertical and horizontal directions; displacement of the post's center of rotation and impactor velocity. The results given by both simplified models are very close to the reference model results. It is noticeable that the Kh-Kv model is slightly better than the Kh model. Further, the former model is more interesting than the latter as it involves less arbitrary conditions. The simplified models also reduce the simulation time by a factor 4. The Kh-Kv model can therefore be used as a reliable tool to represent the soil-post interaction in a future research and development of road safety barriers.

Keywords: crash tests, nonlinear springs, soil-post interaction modeling, constitutive law

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Authors: Meva Apaydin, Fatih Apaydin

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Role of education in the development of society is great. Teaching and training started with the beginning of the history and different methods and techniques which have been applied as the time passed and changed everything with the aim of raising the level of learning. In addition to the traditional teaching methods, technology has been used in recent years. With the beginning of the use of internet in education, some problems which could not be soluted till that time has been dealt and it is inferred that it is possible to educate the learners by using contemporary methods as well as traditional methods. As an advantage of technological developments, distance education is a system which paves the way for the students to be educated individually wherever and whenever they like without the needs of physical school environment. Distance education has become prevalent because of the physical inadequacies in education institutions, as a result; disadvantageous circumstances such as social complexities, individual differences and especially geographical distance disappear. What’s more, the high-speed of the feedbacks between teachers and learners, improvement in student motivation because there is no limitation of time, low-cost, the objective measuring and evaluation are on foreground. In spite of the fact that there is teaching beneficences in distance education, there are also limitations. Some of the most important problems are that : Some problems which are highly possible to come across may not be solved in time, lack of eye-contact between the teacher and the learner, so trust-worthy feedback cannot be got or the problems stemming from the inadequate technological background are merely some of them. Courses are conducted via distance education in many departments of the universities in our country. In recent years, giving lectures such as Turkish Language, English, and History in the first grades of the academic departments in the universities is an application which is constantly becoming prevalent. In this study, the application of Turkish Language course via distance education system by analyzing advantages and disadvantages of the distance education system which is based on internet.

Keywords: distance education, Turkish language, motivation, benefits

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Authors: Pramod Jagtap, Kisan Jadhav, Neha Dand

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Risperidone (RISP) is an antipsychotic agent and has low water solubility and nontargeted delivery results in numerous side effects. Hence, an attempt was made to develop SLNs hydrogel for intranasal delivery of RISP to achieve maximum bioavailability and reduction of side effects. RISP loaded SLNs composed of 1.65% (w/v) lipid mass were produced by high shear homogenization (HSH) coupled ultrasound (US) method using glyceryl monostearate (GMS) or Imwitor 900K (solid lipid). The particles were loaded with 0.2% (w/v) of the RISP & surface-tailored with a 2.02% (w/v) non-ionic surfactant Tween® 80. Optimization was done using 32 factorial design using Design Expert® software. The prepared SLNs dispersion incorporated into Polycarbophil AA1 hydrogel (0.5% w/v). The final gel formulation was evaluated for entrapment efficiency, particle size, rheological properties, X ray diffraction, in vitro diffusion, ex vivo permeation using sheep nasal mucosa and histopathological studies for nasocilliary toxicity. The entrapment efficiency of optimized SLNs was found to be 76 ± 2 %, polydispersity index <0.3., particle size 278 ± 5 nm. This optimized batch was incorporated into hydrogel. The pH was found to be 6.4 ± 0.14. The rheological behaviour of hydrogel formulation revealed no thixotropic behaviour. In histopathology study, there was no nasocilliary toxicity observed in nasal mucosa after ex vivo permeation. X-ray diffraction data shows drug was in amorphous form. Ex vivo permeation study shows controlled release profile of drug.

Keywords: ex vivo, particle size, risperidone, solid lipid nanoparticles

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Authors: Haley Gershon

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The transition from using fossil fuel-based building material to formulating eco-friendly and biobased building materials plays a key role in sustainable building. The growing demand on a global level for biobased materials in the building and construction industries heightens the importance of carbon-14 testing, an analytical method used to determine the percentage of biobased content that comprises a material’s ingredients. This presentation will focus on the use of carbon-14 analysis within the building materials sector. Carbon-14, also known as radiocarbon, is a weakly radioactive isotope present in all living organisms. Any fossil material older than 50,000 years will not contain any carbon-14 content. The radiocarbon method is thus used to determine the amount of carbon-14 content present in a given sample. Carbon-14 testing is performed according to ASTM D6866, a standard test method developed specifically for biobased content determination of material in solid, liquid, or gaseous form, which requires radiocarbon dating. Samples are combusted and converted into a solid graphite form and then pressed onto a metal disc and mounted onto a wheel of an accelerator mass spectrometer (AMS) machine for the analysis. The AMS instrument is used in order to count the amount of carbon-14 present. By submitting samples for carbon-14 analysis, manufacturers of building materials can confirm the biobased content of ingredients used. Biobased testing through carbon-14 analysis reports results as percent biobased content, indicating the percentage of ingredients coming from biomass sourced carbon versus fossil carbon. The analysis is performed according to standardized methods such as ASTM D6866, ISO 16620, and EN 16640. Products 100% sourced from plants, animals, or microbiological material are therefore 100% biobased, while products sourced only from fossil fuel material are 0% biobased. Any result in between 0% and 100% biobased indicates that there is a mixture of both biomass-derived and fossil fuel-derived sources. Furthermore, biobased testing for building materials allows manufacturers to submit eligible material for certification and eco-label programs such as the United States Department of Agriculture (USDA) BioPreferred Program. This program includes a voluntary labeling initiative for biobased products, in which companies may apply to receive and display the USDA Certified Biobased Product label, stating third-party verification and displaying a product’s percentage of biobased content. The USDA program includes a specific category for Building Materials. In order to qualify for the biobased certification under this product category, examples of product criteria that must be met include minimum 62% biobased content for wall coverings, minimum 25% biobased content for lumber, and a minimum 91% biobased content for floor coverings (non-carpet). As a result, consumers can easily identify plant-based products in the marketplace.

Keywords: carbon-14 testing, biobased, biobased content, radiocarbon dating, accelerator mass spectrometry, AMS, materials

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Authors: Thi Huong Vu, Vijay Jayasena, Zhongxiang Fang, Gary Dykes

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Carob kibble has recently received attention due to the presence of high level of polyphenol antioxidants. The capacity of microorganisms to improve antioxidant activities and total phenolics in carob kibble was investigated in the study. Two types of microorganisms including lactic acid bacteria Lactobacillus plantarum (L. plantarum) and yeast Saccharomyces cerevisiae (S. cerevisiae) were used in single and in their combination as starters. The total phenolic content was determined by the Folin–Ciocalteu method. Antioxidant activities were assessed scavenging capacity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS). The study found that S. cerevisiae alone considerably improved 55% total phenolics content at 15 h, while L. plantarum caused in a loss of 20% through the process. Antioxidant capacity of the yeast-fermented samples significantly increased by 43 % and 10 % in ABTS and DPPH assays, respectively. However, reduction of 13 % and 32 % inhibition were recorded in the carob treated with L. plantarum. In the combination of S. cerevisiae and L. plantarum (1:1), both total phenolic content and antioxidant activity of carob kibble were a similar trend as these of S. cerevisiae single, but a lower improvement. The antioxidant power of the extracts was linearly correlated to their total phenolic contents (R=0.75). The results suggested that S. cerevisiae alone was the better for enhancement of both total phenolic content and antioxidant activity in carob kibble using submerged fermentation. The efficiency of fermentation reached the highest at 15h. Thus submerged fermentation with S. cerevisiae offers a tool with simple and cost effective to further increase the bioactive potential of carob kibble, which is in use for food, cosmetic and pharmaceutical industries.

Keywords: antioxidant activity, carob kibble, lactobacillus plantarum, saccharomyces cerevisiae, total phenolics

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: R. Hosny, Mahmoud F. Mubarak, Heba M. Salem, Asmaa A. Abdelrahman

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Oilfield scaling is a major problem in the oil and gas industry. Scale issues cost the industry millions of dollars in damage and lost production every year. One of the main causes of global production decline is scale. In this study, solid scale inhibitors based on silver tungstate loaded KIT-6 were synthesized and evaluated in both static and scale inhibition modeling. The silver tungstate loaded KIT-6 catalysts were synthesized via a simple impregnated method using 3D mesoporous KIT-6 as support. The synthesized materials were characterized using wide and low XRD, N2 adsorption–desorption analysis, TGA analysis, and FTIR, SEM, and XPS analysis. The scale inhibition efficiency of the synthesized materials was evaluated using a static scale inhibition test. The results of this study demonstrate the potential application of silver tungstate-loaded KIT-6 solid scale inhibitors for the oil and gas industry. The results of this study will contribute to the development of new and innovative solid scale inhibitors based on silver tungstate-loaded KIT-6. The inhibition efficiency of the scale inhibitor increases, and calcite scale inhibitor decreases with increasing pH (2 to8), it proposes that the scale inhibitor was more effective under alkaline conditions. An inhibition efficiency of 99% on calcium carbonate can be achieved at the optimal dosage of 7.5 ppm at 55oC, indicating that the scale inhibitor exhibits a relatively good inhibition performance on calcium carbonate. The use of these materials can potentially lead to more efficient and cost-effective solutions for scaling inhibition in various industrial processes.

Keywords: produced water treatment, solid scale inhibitors, calcite, silver tungestate, 3 D mesoporous KIT-6, oilfield scales, adsorption

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Authors: Kamal KC, Zhendong Yin, Dasen Li, Zhilu Wu

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Intra-plant disease classification based on leaf images is a challenging computer vision task due to similarities in texture, color, and shape of leaves with a slight variation of leaf spot; and external environmental changes such as lighting and background noises. Deep convolutional neural network (DCNN) has proven to be an effective tool for binary classification. In this paper, two methods for binary classification of diseased plant leaves using DCNN are presented; model created from scratch and transfer learning. Our main contribution is a thorough evaluation of 4 networks created from scratch and transfer learning of 5 pre-trained models. Training and testing of these models were performed on a plant leaf images dataset belonging to 16 distinct classes, containing a total of 22,265 images from 8 different plants, consisting of a pair of healthy and diseased leaves. We introduce a deep CNN model, Optimized MobileNet. This model with depthwise separable CNN as a building block attained an average test accuracy of 99.77%. We also present a fine-tuning method by introducing the concept of a convolutional block, which is a collection of different deep neural layers. Fine-tuned models proved to be efficient in terms of accuracy and computational cost. Fine-tuned MobileNet achieved an average test accuracy of 99.89% on 8 pairs of [healthy, diseased] leaf ImageSet.

Keywords: deep convolution neural network, depthwise separable convolution, fine-grained classification, MobileNet, plant disease, transfer learning

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Authors: Witthaya Mekhum, Waleerak Sittisom

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This research investigated the effect on occupational health safety and environment at work from metal handicraft using Rattanakosin local wisdom focusing on pollution, accidents, and injuries from work. The sample group in this study included 48 metal handicraft workers in 5 communities by using questionnaires and interview to collect data. The evaluation form TISI 18001 was used to analyze job safety analysis (JSA). The results showed that risk at work reduced after applying the developed model. Banbu Community produces alloy bowl rubbed with stone. The high risk process is melting and hitting process. Before the application, the work risk was 82.71%. After the application of the developed model, the work risk was reduced to 50.61%. Banbart Community produces monk’s food bowl. The high risk process is blow pipe welding. Before the application, the work risk was 93.59%. After the application of the developed model, the work risk was reduced to 48.14%. Bannoen Community produces circle gong. The high risk process is milling process. Before the application, the work risk was 85.18%. After the application of the developed model, the work risk was reduced to 46.91%. Teethong Community produces gold leaf. The high risk process is hitting and spreading process. Before the application, the work risk was 86.42%. After the application of the developed model, the work risk was reduced to 64.19%. Ban Changthong Community produces gold ornament. The high risk process is gold melting process. Before the application, the work risk was 67.90%. After the application of the developed model, the work risk was reduced to 37.03%. It can be concluded that with the application of the developed model, the work risk of 5 communities was reduced in the 3 main groups: (1) Work illness reduced by 16.77%; (2) Pollution from work reduced by 10.31%; (3) Accidents and injuries from work reduced by 15.62%.

Keywords: occupational health, safety, local wisdom, Rattanakosin

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Authors: Dinoo Kirthinanda, Sujani Wijeratne

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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Isaiah Phillip Smith, Sam Erevbenagie Usadolo, Pamela Theresa Tancsik

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This paper is part of ongoing doctoral research that examines the role of Theatre for Development (TfD) in addressing climate change in the Mosuthu community in Reservoir Hills, Durban, South Africa. The context of the research underscores the pressing challenges facing South Africa, including drought, water shortages, deterioration of land, and civil unrest that require innovative approaches to the mitigation of climate change. TfD, described as a dialogical form of theatre that allows communities to express and contribute to development, emerges as a strategic medium for engaging communities in the process. The research problem focused on the unexamined potential of TfD in promoting community involvement and critical awareness of climate change. The study objectives included assessing the community's understanding of climate change, exploring TfD's potential as a participatory tool, examining its role in community mobilization, and developing recommendations for its effective implementation. A review of relevant literature and preliminary investigations in the research community indicates that TfD is an effective medium for promoting societal transformation and engaging marginalized communities. Through culturally resonant narratives, TfD can instill a deeper understanding of environmental challenges, fostering empathy and motivating behavioural changes. By integrating community voices and cultural elements, TfD serves as a powerful catalyst for promoting climate change awareness and inspiring collective action within the South African context. This research contributes to the global discourse on innovative approaches to climate change awareness and action.

Keywords: TfD, climate change, community involvement, societal transformation, culture

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Authors: Muogbo Chukwudi Peter, Gbabo Agidi

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Influence of different turmeric rhizome sizes and machine operational speed on the field capacity and efficiency of a developed prototype tractor-drawn turmeric planter was studied. This was done with a view to ascertaining how the field capacity and field efficiency were affected by the turmeric rhizome lengths and tractor operational speed. The turmeric rhizome planter consists of trapezoidal hopper, grooved cylindrical metering devise, rectangular frame, ground wheels made of mild steel, furrow opener, chain/sprocket drive system, three linkage point seed delivery tube and press wheel. The experiment was randomized in a factorial design of three levels of rhizome lengths (30, 45 and 60 mm) and operational speeds of 8, 10, and 12 kmh-1. About 3 kg cleaned turmeric rhizomes were introduced into each hopper of the planter and were planted 30 m2 of experimental plot. During the field evaluation of the planter, the effective field capacity, field efficiency, missing index, multiple index and percentage rhizome bruise were evaluated. 30.08% was recorded for maximum percentage bruise on the rhizome. The mean effective field capacity ranged between 0.63 – 0.96hah-1 at operational speeds of 8 and 12kmh-1 respectively and 45 mm rhizome length. The result also shows that the mean efficiency was obtained to be 65.8%. The percentage rhizome bruise decreases with increase in operational speed. The highest and lowest percentage turmeric rhizome miss index of 35% were recorded for turmeric rhizome length of 30 mm at a speed of 10 kmhr-1 and 8 kmhr-1, respectively. The potential implications of the experimental result is to determine the optimal machine process conditions for higher field capacity and gross reduction in mechanical injury (bruise) of planted turmeric rhizomes.

Keywords: rhizome sizes, operational speed, field capacity. field efficiency, turmeric rhizome, planter

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Authors: Damayanti Sen

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The Fair and Equitable Treatment standard has emerged as a core tenet of a formulated legal structure aimed at encouraging investment through the granting of a secure and stable environment for the investor in the Host State. As an absolute, non-contingent standard, it constitutes an independent and reliable system for the protection of the investor and is frequently invoked and applied in investor-state dispute settlement under bilateral and multilateral investment treaties. Thus far, the standard has been examined principally as a measure for determining the responsibility of host countries towards investors and investments. The conduct of investor in applying the Fair and Equitable Treatment Standard is relatively unexplored. Such an assessment may be necessary in light of the development of new defenses to demands of host governments to confine the application of the standard in order to ensure a proper balance between the protection of investors and the inherent right of a State to regulate economic conduct within its borders. This paper explores the implications of including considerations of investor conduct in the determination of whether an act of the host country’s administrative and/or judicial authorities has breached the fair and equitable treatment principle. The need for such defenses are of special concern for governments of developing countries, whose limited resources can affect their ability to provide an effective evaluation of the nature of the proposed investment, and, subsequently, to ensure that the expected benefits are realized. On the basis of conceptual analysis, and emerging international judicial and arbitral case law, this paper suggests that investor duties such as, the avoidance of unconscionable conduct, the reasonable assessment of investment risk in the host country, and a duty to operate an investment reasonably are leading to a new limit upon the fair and equitable treatment standard- one that can be succinctly captured in the phrase “Caveat Investor”.

Keywords: BITs, FET Standard, investor behavior, arbitral case law

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Authors: Zakir Hossain, Md. Saddam Hossain

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A nutritionally balanced diet and selection of appropriate species are important criteria in aquaculture. The present study was conducted to evaluate the effects of polyunsaturated fatty acids (PUFAs) and beta glucan containing diet on growth performance, feed utilization, maturation, immunity, early embryonic and larval development of endangered Pabdah catfish, Ompok pabda. In this study, squid extracted lipids and mushroom powder were used as the source of PUFAs and beta glucan, respectively, and formulated two isonitrogenous diets such as basal or control (CON) diet and treated (PBG) diet with maintaining 30% protein levels. During the study period, similar physicochemical conditions of water such as temperature, pH, and dissolved oxygen (DO) were 26.5±2 °C, 7.4±0.2, and 6.7±0.5 ppm, respectively in each cistern. The results showed that final mean body weight, final mean length gain, food conversion ratio (FCR), specific growth rate (SGR), food conversion efficiency (%), hepatosomatic index (HSI), kidney index (KI), and viscerosomatic index (VSI) were significantly (P<0.01 and P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet. The length-weight relationship and relative condition factor (K) of O. pabda were significantly (P<0.05) affected by the PBG diet. The gonadosomatic index (GSI), sperm viability, blood serum calcium ion concentrations (Ca²⁺), and vitellogenin level were significantly (P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet; which was used to the indication of fish maturation. During the spawning season, lipid granules and normal morphological structure were observed in the treated fish liver, whereas fewer lipid granules of liver were observed in the control group. Based on the immunity and stress resistance-related parameters such as hematological indices, antioxidant activity, lysozyme level, respiratory burst activity, blood reactive oxygen species (ROS), complement activity (ACH50 assay), specific IgM, brain AChE, plasma PGOT, and PGPT enzyme activity were significantly (P<0.01 and P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet. The fecundity, fertilization rate (92.23±2.69%), hatching rate (87.43±2.17 %) and survival (76.62±0.82%) of offspring were significantly higher (P˂0.05) in the PBG diet than in the control. Consequently, early embryonic and larval development was better in PBG treated group than in the control. Therefore, the present study showed that the polyunsaturated fatty acids (PUFAs) and beta glucan enriched experimental diet were more effective and achieved better growth, feed utilization, maturation, immunity, and spawning performances of O. pabda.

Keywords: polyunsaturated fatty acids, beta glucan, maturity, immunity, catfish

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Authors: Erin Micali, Katerina Tolstikova, Cheryl Maykel, Elizabeth Harwood

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Female ASD is seldomly studied separately from males. Further, females with ASD are disproportionately underrepresented in the research at a rate of 3:1 (male to female). As such, much of the current understanding about female rigid repetitive behaviors (RRBs) stems from research’s understanding of male RRBs. This can be detrimental to understanding female ASD because this understanding of female RRBs largely discounts female camouflaging and the possibility that females present their autistic symptoms differently. Current literature suggests that females with ASD engage in fewer RRBs than males with ASD and when females do engage in RRBs, they are likely to engage in more subtle, less overt obsessions and repetitive behaviors than males. Method: The current study utilized a mixed methods research design to identify the type and frequency of RRBs that females with ASD engaged in by using a cross-sectional design. The researcher recruited only females to be part of the present study with the criteria they be at least age six and not have co-occurring cognitive impairment. Results: The researcher collected previous testing data (Autism Diagnostic Interview-Revised (ADI-R), Child or Adolescent/Adult Sensory Profile-2, Autism/ Empathy Quotient, Yale Brown Obsessive Compulsive Checklist, Rigid Repetitive Behavior Checklist (evaluator created list), and demographic questionnaire) from 25 total participants. The participants ages ranged from six to 52. The participants were 96% Caucasion and 4% Latin American. Qualitative analysis found the current participant pool engaged in six RRB themes including repetitive behaviors, socially restrictive behaviors, repetitive speech, difficulty with transition, obsessive behaviors, and restricted interests. The current dataset engaged in socially restrictive behaviors and restrictive interests most frequently. Within the main themes 40 subthemes were isolated, defined, and analyzed. Further, preliminary quantitative analysis was run to determine if age impacted camouflaging behaviors and overall presentation of RRBs. Within this dataset this was not founded. Further qualitative data will be run to determine if this dataset engaged in more overt or subtle RRBs to confirm or rebuff previous research. The researcher intends to run SPSS analysis to determine if there was statistical difference between each RRB theme and overall presentation. Secondly, each participant will be analyzed for presentation of RRB, age, and previous diagnoses. Conclusion: The present study aimed to assist in diagnostic clarity. This was achieved by collecting data from a female only participant pool across the lifespan. Current data aided in clarity of the type of RRBs engage in. A limited sample size was a barrier in this study.

Keywords: autism spectrum disorder, camouflaging, rigid repetitive behaviors, gender disparity

Procedia PDF Downloads 143

Authors: John Tarus, Zhendong Niu, Bakhti Khadidja

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In recent years, e-learning recommender systems has attracted great attention as a solution towards addressing the problem of information overload in e-learning environments and providing relevant recommendations to online learners. E-learning recommenders continue to play an increasing educational role in aiding learners to find appropriate learning materials to support the achievement of their learning goals. Although general recommender systems have recorded significant success in solving the problem of information overload in e-commerce domains and providing accurate recommendations, e-learning recommender systems on the other hand still face some issues arising from differences in learner characteristics such as learning style, skill level and study level. Conventional recommendation techniques such as collaborative filtering and content-based deal with only two types of entities namely users and items with their ratings. These conventional recommender systems do not take into account the learner characteristics in their recommendation process. Therefore, conventional recommendation techniques cannot make accurate and personalized recommendations in e-learning environment. In this paper, we propose a recommendation technique combining collaborative filtering and ontology to recommend personalized learning materials to online learners. Ontology is used to incorporate the learner characteristics into the recommendation process alongside the ratings while collaborate filtering predicts ratings and generate recommendations. Furthermore, ontological knowledge is used by the recommender system at the initial stages in the absence of ratings to alleviate the cold-start problem. Evaluation results show that our proposed recommendation technique outperforms collaborative filtering on its own in terms of personalization and recommendation accuracy.

Keywords: collaborative filtering, e-learning, ontology, recommender system

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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Authors: Akudo Ejelonu, Sarah Willig, J. Anthony Sauder, Heather Murphy, Frances Shofer

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Background: The high prevalence of diarrheal diseases in the village of Tzununá, Guatemala is linked to lack of sanitation facilities and handwashing practices. Diarrheal diseases are preventable and improved access to latrines, hygiene education and clean water may improve sanitation by reducing the spread of disease. Objective: Between May 2015-January 2017, the University of Pennsylvania Chapter of Engineers Without Border (PennEWB) and local partners designed an intervention to reduce diarrheal disease by building pour flush latrines in 50 individual households and providing education on the importance of handwashing practice. Design/Methods: Through convenient sampling, we surveyed 45 households to evaluate the community’s knowledge of diarrheal disease, handwashing practices, and maintenance of the latrines. Results: 92% of the study participants experienced decrease of new cases of diarrheal disease after receiving a latrine. Only 11% washed their hands after defecating in the latrine. There was gap in understanding the health outcome of latrine sanitation and handwashing education. The respondents did not connect the reduction of diarrheal disease with latrine use and maintenance. Instead, they associated their motivation for latrine use with aesthetics, proximity to their home, ease and comfort, and reduction of shame. We recommend that PennEWB adopt UNICEF or WHO education on hand washing practice. Conclusion: Social interaction and social pressure drove the household use of latrines. The latrines are being valued and cleaned. The education that the residents received did not target norms and behaviors. Latrines could be used to create a new social norm that supports behavioral change.

Keywords: diarrheal disease, latrine, open defecation, water, sanitation and hygiene

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Authors: P. Acosta-Santamaría, A. Ibatá-Soto, A. López-Vásquez

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Organic compounds in wastewaters coming from textile and pharmaceutical industry generated multiple harmful effects on the environment and the human health. One of them is the methyl orange (MeO), an azoic dye considered to be a recalcitrant compound. The heterogeneous photocatalysis emerges as an alternative for treating this type of hazardous compounds, through the generation of OH radicals using radiation and a semiconductor oxide. According to the author’s knowledge, catalysts such as TiO₂ doped with metals show high efficiency in degrading MeO; however, this presents economic limitations on industrial scale. Black sand can be considered as a naturally doped catalyst because in its structure is common to find compounds such as titanium, iron and aluminum oxides, also elements such as zircon, cadmium, manganese, etc. This study reports the photocatalytic activity of the mineral black sand used as semiconductor in the discoloration of MeO by oxidation and reduction photocatalytic techniques. For this, magnetic composites from the mineral were prepared (RM, M1, M2 and NM) and their activity were tested through MeO discoloration while TiO₂ was used as reference. For the fractions, chemical, morphological and structural characterizations were performed using Scanning Electron Microscopy with Energy Dispersive X-Ray (SEM-EDX), X-Ray Diffraction (XRD) and X-Ray Fluorescence (XRF) analysis. M2 fraction showed higher MeO discoloration (93%) in oxidation conditions at pH 2 and it could be due to the presence of ferric oxides. However, the best result to reduction process was using M1 fraction (20%) at pH 2, which contains a higher titanium percentage. In the first process, hydrogen peroxide (H₂O₂) was used as electron donor agent. According to the results, black sand mineral can be used as natural semiconductor in photocatalytic process. It could be considered as a photocatalyst precursor in such processes, due to its low cost and easy access.

Keywords: black sand mineral, methyl orange, oxidation, photocatalysis, reduction

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Authors: Yujie Chen , Zhen Li

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In the context of planning transformation, how to promote public participation in the formulation and implementation of collaborative planning has been the focused issue of discussion. However, existing studies have often been case-specific or focused on a specific design field, leaving the role of participatory social media (PSM) in urban collaborative planning generally questioned. A systematic database search was conducted in December 2019. Articles and projects were eligible if they reported a quantitative empirical study applying participatory social media in the collaborative planning process (a prospective, retrospective, experimental, longitudinal research, or collective actions in planning practices). Twenty studies and seven projects were included in the review. Findings showed that social media are generally applied in public spatial behavior, transportation behavior, and community planning fields, with new technologies and new datasets. PSM has provided a new platform for participatory design, decision analysis, and collaborative negotiation most widely used in participatory design. Findings extracted several existing forms of PSM. PSM mainly act as three roles: the language of decision-making for communication, study mode for spatial evaluation, and decision agenda for interactive decision support. Three optimization content of PSM were recognized, including improving participatory scale, improvement of the grass-root organization, and promotion of politics. However, basically, participants only could provide information and comment through PSM in the future collaborative planning process, therefore the issues of low data response rate, poor spatial data quality, and participation sustainability issues worth more attention and solutions.

Keywords: participatory social media, collaborative planning, planning workshop, application mode

Procedia PDF Downloads 133

Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

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Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

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Authors: Amani Abdallah, Isam Shahrour

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The quality of drinking water is a major concern of public health. The control of this quality is generally performed in the laboratory, which requires a long time. This type of control is not adapted for accidental pollution from sudden events, which can have serious consequences on population health. Therefore, it is of major interest to develop real-time innovative solutions for the detection of accidental contamination in drinking water systems This paper presents researches conducted within the SunRise Demonstrator for ‘Smart and Sustainable Cities’ with a particular focus on the supervision of the water quality. This work aims at (i) implementing a smart water system in a large water network (Campus of the University Lille1) including innovative equipment for real-time detection of abnormal events, such as those related to the contamination of drinking water and (ii) develop a numerical modeling of the contamination diffusion in the water distribution system. The first step included verification of the water quality sensors and their effectiveness on a network prototype of 50m length. This part included the evaluation of the efficiency of these sensors in the detection both bacterial and chemical contamination events in drinking water distribution systems. An on-line optical sensor integral with a laboratory-scale distribution system (LDS) was shown to respond rapidly to changes in refractive index induced by injected loads of chemical (cadmium, mercury) and biological contaminations (Escherichia coli). All injected substances were detected by the sensor; the magnitude of the response depends on the type of contaminant introduced and it is proportional to the injected substance concentration.

Keywords: distribution system, drinking water, refraction index, sensor, real-time

Procedia PDF Downloads 354

Authors: Domenico M. Mongelli, Michele De Carli, Laura Carnieletto, Filippo Busato

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Europe's dependence on imported fossil fuels has been particularly highlighted by the Russian invasion of Ukraine. Limiting this dependency with a massive replacement of fossil fuel boilers with heat pumps for building heating is the goal of this work. Therefore, with the aim of diversifying energy sources and evaluating the potential use of heat pump technologies for residential buildings with a view to decarbonization, the quantitative reduction in the consumption of fossil fuels was investigated in all regions of Europe through the use of heat pumps. First, a general overview of energy consumption in buildings in Europe has been assessed. The consumption of buildings has been addressed to the different uses (heating, cooling, DHW, etc.) as well as the different sources (natural gas, oil, biomass, etc.). The analysis has been done in order to provide a baseline at the European level on the current consumptions and future consumptions, with a particular interest in the future increase of cooling. A database was therefore created on the distribution of residential energy consumption linked to air conditioning among the various energy carriers (electricity, waste heat, gas, solid fossil fuels, liquid fossil fuels, and renewable sources) for each region in Europe. Subsequently, the energy profiles of various European cities representative of the different climates are analyzed in order to evaluate, in each European climatic region, which energy coverage can be provided by heat pumps in replacement of natural gas and solid and liquid fossil fuels for air conditioning of the buildings, also carrying out the environmental and economic assessments for this energy transition operation. This work aims to make an innovative contribution to the evaluation of the potential for introducing heat pump technology for decarbonization in the air conditioning of buildings in all climates of the different European regions.

Keywords: heat pumps, heating, decarbonization, energy policies

Procedia PDF Downloads 129

Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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Authors: Saut Samuel Simamora

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PURPOSE: Nucleus drop is one of the most feared and severe complications of modern cataract surgery. The lens material may drop through iatrogenic breaks of the posterior capsule. The incidence of the nucleus as the complication of phacoemulsification increases concomitant to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary intraocular lens (IOL) implantation is the choice of management procedure. This case report aims to present the outcome of PPV for the treatment dropped nucleus after cataract surgery METHODS: A 65 year old female patient came to Vitreoretina department with chief complaints blurry vision in her left eye after phacoemulsification one month before. Ophthalmological examination revealed visual acuity of the right eye (VA RE) was 6/15, and the left eye (VA LE) was hand movement. The intraocular pressure (IOP) on the right eye was 18 mmHg, and on the left eye was 59 mmHg. On her left eye, there were aphakic, dropped lens nucleus and secondary glaucoma.RESULTS: The patient got antiglaucoma agent until her IOP was decreased. She underwent pars plana vitrectomy to remove dropped nucleus and iris fixated IOL. One week post operative evaluation revealed VA LE was 6/7.5 and iris fixated IOL in proper position. CONCLUSIONS: Nucleus drop generally occurs in phacoemulsification cataract surgery techniques. Retained lens nucleus or fragments in the vitreous may cause severe intraocular inflammation leading to secondary glaucoma. The proper and good management for retained lens fragments in nucleus drop give excellent outcome to patient.

Keywords: secondary glaucoma, complication of phacoemulsification, nucleus drop, pars plana vitrectomy

Procedia PDF Downloads 79

Authors: R. Barros, J. Azevedo, P. Padrão, M. Gregório, I. Pádua, C. Almeida, C. Rodrigues, P. Fontes, A. Coelho

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Recent evidence shows a positive association between nutritional literacy and healthy eating. Traditional nutrition education strategies for childhood obesity prevention have shown weak effect. The Nutriscience project aims to create and evaluate an innovative and multidisciplinary strategy for promoting effective and accessible nutritional information to children, their families, and educators. Nutriscience is a one-year prospective follow-up evaluation study including pre-school children (3-5 y), who attend national schools’ network (29). The project is structured around a web-based intervention, using an on-line interactive platform, and focus on increasing fruit and vegetable consumption, and reducing sugar and salt intake. The platform acts as a social network where educational materials, games, and nutritional challenges are proposed in a gamification approach that promotes family and community social ties. A nutrition Massive Online Open Course is developed for educators, and a national healthy culinary contest will be promoted on TV channel. A parental self-reported questionnaire assessing sociodemographic and nutritional literacy (knowledge, attitudes, skills) is administered (baseline and end of the intervention). We expect that results on nutritional literacy from the presented strategy intervention will give us important information about the best practices for health intervention with kindergarten families. This intervention program using a digital interactive platform could be an educational tool easily adapted and disseminated for childhood obesity prevention.

Keywords: childhood obesity, educational tool, nutritional literacy, web-based intervention

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