Search results for: multiple detection

Authors: Elham Falatoonitoosi, Vikki Schaffer, Don Kerr

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Over-development for tourism and its consequences on residents’ well-being turn into a critical issue in tourism destinations. Learning about undesirable impacts of tourism has led many people to seek more sustainable and responsible tourism. The main objective of this research is to understand how and to what extent sustainable tourism development enhances locals’ well-being regarding stakeholder perception. The research was conducted in a coastal-hinterland tourism region through two sequential phases. At the first phase, a unique set of 19 sustainable tourism indicators resulted from a triplex model was used to examine the sustainability effects on the main factors of residents’ well-being including equity and living condition, life satisfaction, health condition, and education quality. The triplex model including i) systematic literature search, ii) convergent interviewing, and iii) DEMATEL aimed to develop sustainability indicators, specify them for a particular destination, and identify the dominant sustainability issues acting as key predictors in sustainable development. At the second phase, a hierarchical multiple regression was used to examine the relationship between sustainable development and local residents’ well-being. A number of 167 participants from five different groups of stakeholders perceived the importance level of each sustainability indicators regarding well-being factors on 5-point Likert scale. Results from the first phase indicated that sustainability training, government support, tourism sociocultural effects, tourism revenue, and climate change are the top dominant sustainability issues in the regional sustainable development. Results from the second phase showed that sustainable development considerably improves the overall residents’ well-being and has positive relationships with all well-being factors except life satisfaction. It explains that it was difficult for stakeholders to recognize a link between sustainable development and their overall life satisfaction and happiness. Among well-being’s factors, health condition was influenced the most by sustainability indicators that indicate stakeholders believed sustainability development can promote public health, health sector performance, quality of drinking water, and sanitation. For the future research, it is highly recommended to analysis the effects of sustainable tourism development on the other features of a tourism destination’s well-being including residents sociocultural empowerment, local economic growth, and attractiveness of the destination.

Keywords: residents' well-being, stakeholder perception, sustainability indicators, sustainable tourism

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Authors: Allyson Dale, Max Hlywa

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The Canadian public expects the highest moral standards from Canadian Armed Forces (CAF) members and Department of National Defence (DND) employees. The Chief, Professional Conduct and Culture (CPCC) stood up in April 2021 with the mission of ensuring that the defence culture and members’ conduct are aligned with the ethical principles and values that the organization aspires towards. The Defence Ethics Program (DEP), which stood up in 1997, is a values-based ethics program for individuals and organizations within the DND/CAF and now falls under CPCC. The DEP is divided into five key functional areas, including policy, communications, collaboration, training and education, and advice and guidance. The main focus of the DEP is to foster an ethical culture within defence so that members and organizations perform to the highest ethical standards. The measurement of organizational ethics is often complex and challenging. In order to monitor whether the DEP is achieving its intended outcomes, a performance measurement framework (PMF) was developed using the Director General Military Personnel Research and Analysis (DGMPRA) PMF development process. This evidence-based process is based on subject-matter expertise from the defence team. The goal of this presentation is to describe each stage of the DGMPRA PMF development process and to present and discuss the products of the DEP PMF (e.g., logic model). Specifically, first, a strategic framework was developed to provide a high-level overview of the strategic objectives, mission, and vision of the DEP. Next, Key Performance Questions were created based on the objectives in the strategic framework. A logic model detailing the activities, outputs (what is produced by the program activities), and intended outcomes of the program were developed to demonstrate how the program works. Finally, Key Performance Indicators were developed based on both the intended outcomes in the logic model and the Key Performance Questions in order to monitor program effectiveness. The Key Performance Indicators measure aspects of organizational ethics such as ethical conduct and decision-making, DEP collaborations, and knowledge and awareness of the Defence Ethics Code while leveraging ethics-related items from multiple DGMPRA surveys where appropriate.

Keywords: defence ethics, ethical culture, organizational performance, performance measurement framework

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Authors: Marjila Burhanzoi, Kenta Onohara, Tomoaki Ikegami

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Faults in photovoltaic (PV) modules should be detected to the greatest extent as early as possible. For that conventional fault detection methods such as electrical characterization, visual inspection, infrared (IR) imaging, ultraviolet fluorescence and electroluminescence (EL) imaging are used, but they either fail to detect the location or category of fault, or they require expensive equipment and are not convenient for onsite application. Hence, these methods are not convenient to use for monitoring small-scale PV systems. Therefore, low cost and efficient inspection techniques with the ability of onsite application are indispensable for PV modules. In this study in order to establish efficient inspection technique, correlation between faults and magnetic flux density on the surface is of crystalline PV modules are investigated. Magnetic flux on the surface of normal and faulted PV modules is measured under the short circuit and illuminated conditions using two different sensor devices. One device is made of small integrated sensors namely 9-axis motion tracking sensor with a 3-axis electronic compass embedded, an IR temperature sensor, an optical laser position sensor and a microcontroller. This device measures the X, Y and Z components of the magnetic flux density (Bx, By and Bz) few mm above the surface of a PV module and outputs the data as line graphs in LabVIEW program. The second device is made of a laser optical sensor and two magnetic line sensor modules consisting 16 pieces of magnetic sensors. This device scans the magnetic field on the surface of PV module and outputs the data as a 3D surface plot of the magnetic flux intensity in a LabVIEW program. A PC equipped with LabVIEW software is used for data acquisition and analysis for both devices. To show the effectiveness of this method, measured results are compared to those of a normal reference module and their EL images. Through the experiments it was confirmed that the magnetic field in the faulted areas have different profiles which can be clearly identified in the measured plots. Measurement results showed a perfect correlation with the EL images and using position sensors it identified the exact location of faults. This method was applied on different modules and various faults were detected using it. The proposed method owns the ability of on-site measurement and real-time diagnosis. Since simple sensors are used to make the device, it is low cost and convenient to be sued by small-scale or residential PV system owners.

Keywords: fault diagnosis, fault location, integrated sensors, PV modules

Procedia PDF Downloads 224

Authors: Elyas Palantei, Dewiani, Farid Armin, Ardiansyah

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High precision of printed microwave sensor utilized for sensing and monitoring the potential breast cancer existed in women breast tissue was optimally computed. The single element of UWB printed sensor that successfully modeled through several numerical optimizations was multiple fabricated and incorporated with woman bra to form the spherical sensors array. One sample of UWB microwave sensor obtained through the numerical computation and optimization was chosen to be fabricated. In overall, the spherical sensors array consists of twelve stair patch structures, and each element was individually measured to characterize its electrical properties, especially the return loss parameter. The comparison of S11 profiles of all UWB sensor elements is discussed. The constructed UWB sensor is well verified using HFSS programming, CST programming, and experimental measurement. Numerically, both HFSS and CST confirmed the potential operation bandwidth of UWB sensor is more or less 4.5 GHz. However, the measured bandwidth provided is about 1.2 GHz due to the technical difficulties existed during the manufacturing step. The configuration of UWB microwave sensing and monitoring system implemented consists of 12 element UWB printed sensors, vector network analyzer (VNA) to perform as the transceiver and signal processing part, the PC Desktop/Laptop acting as the image processing and displaying unit. In practice, all the reflected power collected from whole surface of artificial breast model are grouped into several numbers of pixel color classes positioned on the corresponding row and column (pixel number). The total number of power pixels applied in 2D-imaging process was specified to 100 pixels (or the power distribution pixels dimension 10x10). This was determined by considering the total area of breast phantom of average Asian women breast size and synchronizing with the single UWB sensor physical dimension. The interesting microwave imaging results were plotted and together with some technical problems arisen on developing the breast sensing and monitoring system are examined in the paper.

Keywords: UWB sensor, UWB microwave imaging, spherical array, breast cancer monitoring, 2D-medical imaging

Procedia PDF Downloads 194

Authors: Farhaz Amyn Rajabali, Collins Odour

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Mathematics has been there for over 4000 years and has been one of the very first educational topics explored by human civilization. Throughout the years, it has become a complex study and has derived so many other subjects. With advancements in ICT, most of the computation in mathematics is done using powerful computers. In many different countries, the children in primary and secondary schools face difficulties in learning mathematics, and this has many reasons behind it, one being the students don’t engage much with the mathematical concepts hence failing to understand them deeply. The objective of this system is to help the students understand this mathematical concept interactively, which in return will encourage the love for learning and increase thorough understanding of many concepts. Research was conducted among a group of samples and about 50% of respondents replied that they had never used an augmented reality application before. This means that the chances for this system to be accepted in the market are high due to its innovative idea. Around 60% of people did recommend the use of this system to learn mathematics. The study also showed several challenges in an educational system, including but not limited to lack of resources which was chosen by 30% of respondents, the challenge to read from textbooks (34.6%) and how hard it is to visualize concepts (46.2%). The survey question asked what benefits the users see using augmented reality to learn mathematics. The responses that were picked the most were increased student engagement and using real-world examples to understand concepts, both being 65.4% and followed by easy access to learning material at 61.5%, and increased knowledge retention at 50%. This shows that there are plenty of issues with an education system that can be addressed by software applications; now that the newer generation is so enthusiastic about electronic devices, it can actually be used to deliver good knowledge and skills to the upcoming students and mitigate most of the challenges faced currently. The study concludes that the implementation of the system is a best practice for the educational system especially leveraging a new technology that has the ability to attract the attention of many young students and use it to deliver information. It will also give rise to awareness of new technology and on multiple ways it can be implemented. Addressing the educational sector in developing countries using information technology is an imperative task since these kids studying now is the future of the country and will use what they learn and understand during their childhood will help them to make decisions about their lives in the future which will not only affect them personally but also affect the whole society in general.

Keywords: AR, mathematics, system development, augmented reality

Procedia PDF Downloads 83

Authors: Fazıl Gökgöz, Fahrettin Filiz

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Load forecasting has become crucial in recent years and become popular in forecasting area. Many different power forecasting models have been tried out for this purpose. Electricity load forecasting is necessary for energy policies, healthy and reliable grid systems. Effective power forecasting of renewable energy load leads the decision makers to minimize the costs of electric utilities and power plants. Forecasting tools are required that can be used to predict how much renewable energy can be utilized. The purpose of this study is to explore the effectiveness of LSTM-based neural networks for estimating renewable energy loads. In this study, we present models for predicting renewable energy loads based on deep neural networks, especially the Long Term Memory (LSTM) algorithms. Deep learning allows multiple layers of models to learn representation of data. LSTM algorithms are able to store information for long periods of time. Deep learning models have recently been used to forecast the renewable energy sources such as predicting wind and solar energy power. Historical load and weather information represent the most important variables for the inputs within the power forecasting models. The dataset contained power consumption measurements are gathered between January 2016 and December 2017 with one-hour resolution. Models use publicly available data from the Turkish Renewable Energy Resources Support Mechanism. Forecasting studies have been carried out with these data via deep neural networks approach including LSTM technique for Turkish electricity markets. 432 different models are created by changing layers cell count and dropout. The adaptive moment estimation (ADAM) algorithm is used for training as a gradient-based optimizer instead of SGD (stochastic gradient). ADAM performed better than SGD in terms of faster convergence and lower error rates. Models performance is compared according to MAE (Mean Absolute Error) and MSE (Mean Squared Error). Best five MAE results out of 432 tested models are 0.66, 0.74, 0.85 and 1.09. The forecasting performance of the proposed LSTM models gives successful results compared to literature searches.

Keywords: deep learning, long short term memory, energy, renewable energy load forecasting

Procedia PDF Downloads 266

Authors: Hussam Ashwi, Magbool Oraiby, Ali Muyidi, Hamad Al-Oufi, Mohammed Al-Oufi, Adel Al-Juhani, Salman Al-Zemaa, Saeed Al-Shahrani, Amal Abuallah, Wedad Sherwani, Mohammed Alattas, Ibraheem Attafi

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Ethanol must be accurately identified and quantified to establish their use and contribution in criminal cases and forensic medicine. In some situations, it may be necessary to reanalyze an old specimen; therefore, it is essential to comprehend the effect of storage conditions and how long the result of a reanalyzed specimen can be reliable and reproducible. Additionally, ethanol can be produced via multiple in vivo and in vitro processes, particularly in diabetic patients, and the results can be affected by storage conditions and time. In order to distinguish between in vivo and in vitro alcohol generation in diabetes patient urine samples, various factors should be considered. This study identifies and quantifies ethanol and EtG in diabetic patients' urine samples stored in two different settings over time. Ethanol levels were determined using gas chromatography-headspace (GC-HS), and ethyl glucuronide (EtG) levels were determined using the immunoassay (RANDOX) technique. Ten urine specimens were collected and placed in a standard container. Each specimen was separated into two containers. The specimens were divided into two groups: those kept at room temperature (25 °C) and those kept cold (2-8 °C). Ethanol and EtG levels were determined serially over a two-week period. Initial results showed that none of the specimens tested positive for ethanol or EtG. At room temperature (15-25 °C), 7 and 14 days after the sample was taken, the average concentration of ethanol increased from 1.7 mg/dL to 2 mg/dL, and the average concentration of EtG increased from 108 ng/mL to 186 ng/mL. At 2–8 °C, the average ethanol concentration was 0.4 and 0.5 mg/dL, and the average EtG concentration was 138 and 124 ng/mL seven and fourteen days after the sample was collected, respectively. When ethanol and EtG levels were determined 14 days post collection, they were considerably lower than when stored at room temperature. A considerable increase in EtG concentrations (14-day range 0–186 ng/mL) is produced during room-temperature storage, although negative initial results for all specimens. Because EtG might be produced after a sampling collection, it is not a reliable indicator of recent alcohol consumption. Given the possibility of misleading EtG results due to in vitro EtG production in the urine of diabetic patients.

Keywords: ethyl glucuronide, ethanol, forensic toxicology, diabetic

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Authors: Rajeshwari Balasubramanian, Margit Van Wessel, Nandini Deo

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The participation of women in local bodies witnessed a rise after the implementation of 73rd and 74th Amendments to the Indian Constitution which created quotas for women representatives. However, even when participation increased, it did not translate into meaningful contributions by women in local bodies. This led some civil society organisations (CSOs) to begin working with women panchayat representatives in various states to build their capacity for political participation. The focus of this paper is to study capacity building training by CSOs in Jharkhand. The paper maps how the training helps women elected representatives to negotiate their autonomy at multiple levels. The paper describes the capacity building program conducted by an international feminist organisation along with its seven local partners in Jharkhand. The central question that the study asks is: How does capacity building training by CSOs in Jharkhand impact the autonomy of elected women representatives? It uses a qualitative research methodology based on empirical data gathered through field visits in four districts of Jharkhand (Chatra, Hazaribagh, East Singhbum and Ranchi) where the program was implemented for three years. The study found that women elected representatives had to develop strategies to negotiate their choice to move out of their homes and attend the training conducted by CSOs. The ability to participate in the training programs itself was a significant achievement of personal autonomy for many women. The training provided them a platform to voice their opinion and appreciate their own value as panchayat leaders. This realization allowed them to negotiate their presence and a space for themselves in Gram panchayats. A Foucauldian approach to analyze capacity building workshops might lead us to see them as systems in which CSOs impose a form of governmentality on rural elected representatives. Instead, what we see here is a much more complex negotiation of agency in which the CSO creates spaces and practices that allow women to achieve their own forms of autonomy. The study concludes that the impact of the training on the autonomy of these women is based on their everyday negotiations of time, space and mobility. Autonomy for these elected women representatives is also contextual and relative, as they seem to realize it during the training process. The training allows the women to not only negotiate their participation in panchayats but also challenge everyday practices that are rooted in patriarchy.

Keywords: autonomy, feminist organization, local bodies, political participation

Procedia PDF Downloads 149

Authors: Johannes Mertl

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Our surrounding air contains various particles. Besides typical representatives of inorganic dust, such as soot and ash, also particles originating from animals, microorganisms or plants are floating through the air, so-called bioaerosols. The group of bioaerosols consists of a broad spectrum of particles of different size, including fungi, bacteria, viruses, spores, or tree, flower and grass pollen that are of high relevance for allergy sufferers. In dependence of the environmental climate and the actual season, these allergenic particles can be found in enormous numbers in the air and are inhaled by humans via the respiration tract, with a potential for inflammatory diseases of the airways, such as asthma or allergic rhinitis. As a consequence air filter systems of ventilation and air conditioning devices are required to meet very high standards to prevent, or at least lower the number of allergens and airborne germs entering the indoor air. Still, filter systems are merely classified for their separation rates using well-defined mineral test dust, while no appropriate sufficiently standardized test methods for bioaerosols exist. However, determined separation rates for mineral test particles of a certain size cannot simply be transferred to bioaerosols, as separation efficiency of particularly fine and respirable particles (< 10 microns) is dependent not only on their shape and particle diameter, but also defined by their density and physicochemical properties. For this reason, the OFI developed a test method, which directly enables a testing of filters and filter media for their separation rates on bioaerosols, as well as a classification of filters. Besides allergens from an intact or fractured tree or grass pollen, allergenic proteins bound to particulates, as well as allergenic fungal spores (e.g. Cladosporium cladosporioides), or bacteria can be used to classify filters regarding their separation rates. Allergens passing through the filter can then be detected by highly sensitive immunological assays (ELISA) or in the case of fungal spores by microbiological methods, which allow for the detection of even one single spore passing the filter. The test procedure, which is carried out in laboratory scale, was furthermore validated regarding its sufficiency to cover real life situations by upscaling using air conditioning devices showing great conformity in terms of separation rates. Additionally, a clinical study with allergy sufferers was performed to verify analytical results. Several different air conditioning filters from the car industry have been tested, showing significant differences in their separation rates.

Keywords: airborne germs, allergens, classification of filters, fine dust

Procedia PDF Downloads 253

Authors: Kirstin Griffin

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During a period of increased anxiety and stress, communication became the essential tool to help the public stay informed and feel prepared during the Covid-19 pandemic. However, certain groups of patients were not feeling as reassured. The news and media blasted the message that patients with diabetes were “high-risk" in regards to contracting the Covid-19 infection. Routine clinics were being cancelled, GP practices were closing their doors, and patients with type 1 diabetes were understandably scared. The influx of calls to diabetes specialists nurses from concerned patients highlighted the need for better and more specialised information. An Application specifically for patients with type 1 diabetes was created to deliver this information, and it proved to be the essential communication tool that was desperately needed. The Application for patients with type 1 diabetes aimed to deliver specialist information to patients in regards to their diagnosis, management, and ongoing follow-up commitments. The Application gives practical advice on multiple areas of diabetes management, including sick-day rules and diabetic emergencies, as well as up-to-date information on technology, including setting up Libre devices and downloading glucose meters to facilitate attending virtual clinics. Delivery of this information in an easy-to-understand and comprehensive way is intended to improve patient engagement with diabetes services and ultimately empower patients in the control of their own disease. The application also offers a messaging service to allow the diabetes team to send out alerts to patient groups on specific issues, such as changes to clinics, or respond to recent news updates regarding Covid-19. The App was launched in NHS Fife in June 2020 and has amassed 800 active users so far. There is growing engagement with the App since its launch, with over 1000 user interactions in the last month alone. Feedback shows that 100% of users like the App and have found it useful in the management of their diabetes. The App has proven to be an essential tool in communication with one of the most vulnerable groups during the Covid-19 pandemic, and its ongoing development will continue to increase patient engagement and improve glycaemic control for patients with type 1 diabetes. The future of chronic disease management should involve digital solutions such as apps to further empower patients in their healthcare.

Keywords: diabetes, endocrinology, digital healthcare, medical apps

Procedia PDF Downloads 87

Authors: Amin Karimi, Lele Zhang, Mark Fackrell

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Rural-to-urban population migrations are a global phenomenon, with projections indicating that by 2050, 68% of the world's population will inhabit densely populated urban centers. Concurrently, the popularity of e-commerce shopping has surged, evidenced by a 51% increase in total e-commerce sales from 2017 to 2021. Consequently, distribution and logistics systems, integral to effective supply chain management, confront escalating hurdles in efficiently delivering and distributing products within bustling urban environments. Additionally, events like environmental challenges and the COVID-19 pandemic have indicated that decision-makers are facing numerous sources of uncertainty. Therefore, to design an efficient and reliable logistics system, uncertainty must be considered. In this study, it examine fleet sizing and routing while considering uncertainty in demand rate. Fleet sizing is typically a strategic-level decision, while routing is an operational-level one. In this study, a carrier must make two types of decisions: strategic-level decisions regarding the number and types of drones to be purchased, and operational-level decisions regarding planning routes based on available fleet and realized demand. If the available fleets are insufficient to serve some customers, the carrier must outsource that delivery at a relatively high cost, calculated per order. With this hierarchy of decisions, it can model the problem using two-stage stochastic programming. The first-stage decisions involve planning the number and type of drones to be purchased, while the second-stage decisions involve planning routes. To solve this model, it employ logic-based benders decomposition, which decomposes the problem into a master problem and a set of sub-problems. The master problem becomes a mixed integer programming model to find the best fleet sizing decisions, and the sub-problems become capacitated vehicle routing problems considering battery status. Additionally, it assume a heterogeneous fleet based on load and battery capacity, and it consider that battery health deteriorates over time as it plan for multiple periods.

Keywords: drone-delivery, stochastic demand, VRP, fleet sizing

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Authors: Dini Dewi Heniarti

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Military Court which is a judicial institution within the military institution has a heavy duty. Military court has to ensuring a fair legal process for military personnel (due process of law) and enforces military discipline. Military justice must also ensure protects the rights of military personnel. In Indonesia tren of military court changes in vision. The debate is happened on the jurisdiction of military court that allegedly has the potential existence of impunity. The Decree of People’s Consultative Assembly Number VII/MPR/2000 which states that the army general who committed the crime should not be tried in military court is one that underlies the proposed amendment limits the jurisdiction of military court. For the identify of the background in a specific format that is limited to juridical review. The goals this research is to gain knowledge, deep understanding and the concept of jurisdiction of military courts for military members who committed general crimes in adjudication procedure from the perspective of legal reform as alternative to establish independency of military judiciary. This research using Rule of Law as Grand Theory, Development Legal Theory as a Middle Theory and Criminal Justice System and concept of jurisdiction as supporting as Applied Theory. This study using a normative juridical approach, and equipped by primary data juridical approach of historical and comparative approach. The author uses descriptive analytical specifications. The main data used in this research is secondary data, which includes primary legal materials, secondary legal material and legal materials tertiary. Analysis primary data and qualitative data is done legally. Technique checking the validity of the data in this study used multiple methods with the research triangulation. This paper will demonstrate the problems concerning the jurisdiction of military courts for military personnel who committed general crimes in perspective of military justice reform Indonesia and adjudication procedures for military member who committed general crimes in the military justice system in Indonesia, as alternative to establish independency of judiciary in military justice in Indonesia. Comparative approached the military justice system from another countries is aimed to development military justice in Indonesia.

Keywords: jurisdiction, military courts, military justice, independency of judiciary

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Authors: Luqman Shah

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The myopic gender discrimination is now a well-documented and recognized fact. However, gender is only one facet of an individual’s multiple identities. The aim of this work is to investigate gender discrimination highlighted in print media in the subcontinent with a specific focus on Pakistan and India. In this study, an approach is adopted by using the James Paul Gee model for the identification of gender discrimination. As a matter of fact, gender discrimination is not consistent in its nature and intensity across global societies and varies as social, geographical, and cultural background change. The World has been changed enormously in every aspect of life, and there are also obvious changes towards gender discrimination, prejudices, and biases, but still, the world has a long way to go to recognize women as equal as men in every sphere of life. The history of the world is full of gender-based incidents and violence. Now the time came that this issue must be seriously addressed and to eradicate this evil, which will lead to harmonize society and consequently heading towards peace and prosperity. The study was carried out by a mixed model research method. The data was extracted from the contents of five Pakistani English newspapers out of a total of 23 daily English newspapers, and likewise, five Indian daily English newspapers out of 52 those were published 2018-2019. Two news stories from each of these newspapers, in total, twenty news stories were taken as sampling for this research. Content and semiotic analysis techniques were used to analyze through James Paul Gee's seven building tasks of language. The resources of renowned e-papers are utilized, and the highlighted cases in Pakistani newspapers of Indian gender-based stories and vice versa are scrutinized as per the requirement of this research paper. For analysis of the written stretches of discourse taken from e-papers and processing of data for the focused problem, James Paul Gee 'Seven Building Tasks of Language' is used. Tabulation of findings is carried to pinpoint the issue with certainty. Findings after processing the data showed that there is a gross human rights violation on the basis of gender discrimination. The print media needs a more realistic representation of what is what not what seems to be. The study recommends the equality and parity of genders.

Keywords: gender discrimination, print media, Paul Gee model, subcontinent

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Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

Procedia PDF Downloads 135

Authors: Brock Liden, Eric Janowitz

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Introduction: Diabetic peripheral neuropathy (DPN) affects 70% of individuals with diabetes1. DPN causes a loss of protective sensation, which can lead to tissue damage and diabetic foot ulcer (DFU) formation2. These ulcers can result in infections and lower-extremity amputations of toes, the entire foot, and the lower leg. Even after a DFU is healed, recurrence is common, with 49% of DFU patients developing another ulcer within a year and 68% within 5 years3. This case series examines the use of sensory insoles and newly available plantar data (pressure, temperature, step count, adherence) and remote patient monitoring in patients at risk of DFU. Methods: Participants were provided with custom-made sensory insoles to monitor plantar pressure, temperature, step count, and daily use and were provided with real-time cues for pressure offloading as they went about their daily activities. The sensory insoles were used to track subject compliance, ulceration, and response to feedback from real-time alerts. Patients were remotely monitored by a qualified healthcare professional and were contacted when areas of concern were seen and provided coaching on reducing risk factors and overall support to improve foot health. Results: Of the 40 participants provided with the sensory insole system, 4 presented with a DFU. Based on flags generated from the available plantar data, patients were contacted by the remote monitor to address potential concerns. A standard clinical escalation protocol detailed when and how concerns should be escalated to the provider by the remote monitor. Upon escalation to the provider, patients were brought into the clinic as needed, allowing for any issues to be addressed before more serious complications might arise. Conclusion: This case series explores the use of innovative sensory technology to collect plantar data (pressure, temperature, step count, and adherence) for DFU detection and early intervention. The results from this case series suggest the importance of sensory technology and remote patient monitoring in providing proactive, preventative care for patients at risk of DFU. This robust plantar data, with the addition of remote patient monitoring, allow for patients to be seen in the clinic when concerns arise, giving providers the opportunity to intervene early and prevent more serious complications, such as wounds, from occurring.

Keywords: diabetic foot ulcer, DFU prevention, digital therapeutics, remote patient monitoring

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Authors: Umut Kokbas, Mustafa Nisari

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Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by activated B cells that transform into plasma cells and result in them. Antibodies are critical molecules of the immune response to fight, which help the immune system specifically recognize and destroy antigens such as bacteria, viruses, and toxins. Immunoglobulin classes differ in their biological properties, structures, targets, functions, and distributions. Five major classes of antibodies have been identified in mammals: IgA, IgD, IgE, IgG, and IgM. Evaluation of the immunoglobulin isotype can provide a useful insight into the complex humoral immune response. Evaluation and knowledge of immunoglobulin structure and classes are also important for the selection and preparation of antibodies for immunoassays and other detection applications. The immunoglobulin test measures the level of certain immunoglobulins in the blood. IgA, IgG, and IgM are usually measured together. In this way, they can provide doctors with important information, especially regarding immune deficiency diseases. Hypogammaglobulinemia (HGG) is one of the main groups of primary immunodeficiency disorders. HGG is caused by various defects in B cell lineage or function that result in low levels of immunoglobulins in the bloodstream. This affects the body's immune response, causing a wide range of clinical features, from asymptomatic diseases to severe and recurrent infections, chronic inflammation and autoimmunity Transient infant hypogammaglobulinemia (THGI), IgM deficiency (IgMD), Bruton agammaglobulinemia, IgA deficiency (SIgAD) HGG samples are a few. Most patients can continue their normal lives by taking prophylactic antibiotics. However, patients with severe infections require intravenous immune serum globulin (IVIG) therapy. The IgE level may rise to fight off parasitic infections, as well as a sign that the body is overreacting to allergens. Also, since the immune response can vary with different antigens, measuring specific antibody levels also aids in the interpretation of the immune response after immunization or vaccination. Immune deficiencies usually occur in childhood. In Immunology and Allergy clinics, apart from the classical methods, it will be more useful in terms of diagnosis and follow-up of diseases, if it is fast, reliable and especially in childhood hypogammaglobulinemia, sampling from children with a method that is more convenient and uncomplicated. The antibodies were attached to the electrode surface via the poly hydroxyethyl methacrylamide cysteine nanopolymer. It was used to evaluate the anodic peak results obtained in the electrochemical study. According to the data obtained, immunoglobulin determination can be made with a biosensor. However, in further studies, it will be useful to develop a medical diagnostic kit with biomedical engineering and to increase its sensitivity.

Keywords: biosensor, immunosensor, immunoglobulin, infection

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Authors: Amulya Srivatsa, Gayatri Prakash, Deeksha Sarda, Varshni Nandakumar, Duncan Salmon

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Delivery of Patient-Directed Wound Care Via Mobile Application-Based Qualitative Analysis Chronic wounds are difficult for patients to manage at-home due to their unpredictable healing process. These wounds are associated with increased morbidity and negatively affect physical and mental health. The solution is a mobile application that will have an algorithm-based checklist to determine the state of the wound based on different factors that vary from person to person. Once this information is gathered, the application will recommend a plan of care to the user and subsequent steps to be taken. The mobile application will allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which will then be uploaded to the EHR to notify the patient’s provider. This scan utilizes a photo taken by the user, who is prompted appropriately. Furthermore, users will enter demographic information and answer multiple choice and drop-down menus describing the wound state. The proposed solution can save patients from unnecessary trips to the hospital for chronic wound care. The next iteration of the application can incorporate AI to allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which can be shared with the patient’s provider to allow for more efficient treatment. Ultimately, this product can provide immediate and economical medical advice for patients that suffer from chronic wounds. Research Objectives: The application should be capable of qualitative analysis of a wound and recommend a plan of care to the user. Additionally, the results of the wound analysis should automatically upload to the patient’s EMR. Research Methodologies: The app has two components: the first is a checklist with tabs for varying factors that assists users in the assessment of their skin. Subsequently, the algorithm will create an at-home regimen for patients to follow to manage their wounds. Research Contributions: The app aims to return autonomy back to the patient and reduce the number of visits to a physician for chronic wound care. The app also serves to educate the patient on how best to care for their wounds.

Keywords: wound, app, qualitative, analysis, home, chronic

Procedia PDF Downloads 67

Authors: Bright Chukwunwike Uzuegbunam, Wojciech Paslawski, Hans Agren, Christer Halldin, Wolfgang Weber, Markus Luster, Thomas Arzberger, Behrooz Hooshyar Yousefi

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There is a need to develop a PET tracer that will enable to diagnosis and track the progression of Alpha-synucleinopathies (Parkinson’s disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA]) in living subjects over time. Alpha-synuclein aggregates (a-syn), which are present in all the stages of disease progression, for instance, in PD, are a suitable target for in vivo PET imaging. For this reason, we have developed some promising a-syn tracers based on a disarylbisthiazole (DABTA) scaffold. The precursors are synthesized via a modified Hantzsch thiazole synthesis. The precursors were then radiolabeled via one- or two-step radiofluorination methods. The ligands were initially screened using a combination of molecular dynamics and quantum/molecular mechanics approaches in order to calculate the binding affinity to a-syn (in silico binding experiments). Experimental in vitro binding assays were also performed. The ligands were further screened in other experiments such as log D, in vitro plasma protein binding & plasma stability, biodistribution & brain metabolite analyses in healthy mice. Radiochemical yields were up to 30% - 72% in some cases. Molecular docking revealed possible binding sites in a-syn and also the free energy of binding to those sites (-28.9 - -66.9 kcal/mol), which correlated to the high binding affinity of the DABTAs to a-syn (Ki as low as 0.5 nM) and selectivity (> 100-fold) over Aβ and tau, which usually co-exist with a-synin some pathologies. The log D values range from 2.88 - 2.34, which correlated with free-protein fraction of 0.28% - 0.5%. Biodistribution experiments revealed that the tracers are taken up (5.6 %ID/g - 7.3 %ID/g) in the brain at 5 min (post-injection) p.i., and cleared out (values as low as 0.39 %ID/g were obtained at 120 min p.i. Analyses of the mice brain 20 min p.i. Revealed almost no radiometabolites in the brain in most cases. It can be concluded that in silico study presents a new venue for the rational development of radioligands with suitable features. The results obtained so far are promising and encourage us to further validate the DABTAs in autoradiography, immunohistochemistry, and in vivo imaging in non-human primates and humans.

Keywords: alpha-synuclein aggregates, alpha-synucleinopathies, PET imaging, tracer development

Procedia PDF Downloads 235

Authors: Shinta Holdsworth, Jan Axmacher, Darren J. Mann

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Beetles represent the most diverse insect taxon, and they contribute significantly to a wide range of vital ecological functions. Examples include decomposition by bark beetles, nitrogen recycling and dung processing by dung beetles or pest control by predatory ground beetles. Nonetheless, research into the distribution patterns, species richness and functional diversity of beetles particularly from tropical regions remains extremely limited. In our research, we aim to investigate the distribution and diversity patterns of beetles and the roles they play in small tropical island ecosystems in the Kepulauan Seribu Marine National Park and on Java. Our research furthermore provides insights into the effects anthropogenic activities have on the assemblage composition and diversity of beetles on the small islands. We recorded a substantial number of highly abundant small island species, including a substantial number of unique small island species across the study area, highlighting these islands’ potential importance for the regional conservation of genetic resources. The highly varied patterns observed in relation to the use of different trapping types - pitfall traps and flight interception traps (FITs) - underscores the need for complementary trapping strategies that combine multiple methods for beetle community surveys in tropical islands. The significant impacts of human activities have on the small island beetle faunas were also highlighted in our research. More island beetle species encountered in settlement than forest areas shows clear trend of positive links between anthropogenic activities and the overall beetle species richness. However, undisturbed forests harboured a high number of unique species, also in comparison to disturbed forests. Finally, our study suggests that, with regards to different feeding guilds, the diversity of herbivorous beetles on islands is strongly affected by the different levels of forest cover encountered.

Keywords: beetle diversity, forest disturbance, island biogeography, island settlement

Procedia PDF Downloads 220

Authors: Hernández Marieta, Aguayo Mauricio, Pedreros María, Llompart Ovidio

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The hydrological cycle is influenced by multiple factors, including climate change, land use changes, and anthropogenic activities, all of which threaten water availability and quality worldwide. In recent decades, numerous investigations have used landscape metrics and hydrological modeling to demonstrate the influence of landscape patterns on the hydrological cycle components' natural dynamics. Many of these investigations have determined the repercussions on the quality and availability of water, sedimentation, and erosion regime, mainly in Asian basins. In fact, there is progress in this branch of science, but there are still unanswered questions for our region. This study examines the hydrological response in Chilean basins under various land use change scenarios (LUCC) and the influence of climate change. The components of the water cycle were modeled using a physically distributed type hydrological and hydraulic simulation model based on and oriented to mountain basins TETIS model. Future climate data were derived from Chilean regional simulations using the WRF-MIROC5 model, forced with the RCP 8.5 scenario, at a 25 km resolution for the periods 2030-2060 and 2061-2091. LUCC scenarios were designed based on nature-based solutions, landscape pattern influences, current national and international water conservation legislation, and extreme scenarios of non-preservation and conservation of native forests. The scenarios that demonstrate greater water availability, even under climate change, are those promoting the restoration of native forests in over 30% of the basins, even alongside agricultural activities. Current legislation promoting the restoration of native forests only in riparian zones (30-60 m or 200 m in steeper areas) will not be resilient enough to address future water shortages. Evapotranspiration, direct runoff, and water availability at basin outlets showed the greatest variations due to LUCC. The relationship between hydrological modeling and landscape configuration is an effective tool for establishing future territorial planning that prioritizes water resource protection.

Keywords: TETIS, landscape pattern, hydrological process, water availability, Chilean basins

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Authors: Neslihan Demirci, Serdar Durdağı

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Mycobacterium tuberculosis is still a worldwide disease-causing agent that, according to WHO, led to the death of 1.5 million people from tuberculosis (TB) in 2020. The bacteria reside in macrophages located specifically in the lung. There is a known quadruple drug therapy regimen for TB consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Over the past 60 years, there have been great contributions to treatment options, such as recently approved delamanid (OPC67683) and bedaquiline (TMC207/R207910), targeting mycolic acid and ATP synthesis, respectively. Also, there are natural compounds that can block the tryptophanyl-tRNA synthetase (TrpRS) enzyme, chuangxinmycin, and indolmycin. Yet, already the drug resistance is reported for those agents. In this study, the newly released TrpRS enzyme structure is investigated for potential inhibitor drugs from already synthesized molecules to help the treatment of resistant cases and to propose an alternative drug for the quadruple drug therapy of tuberculosis. Maestro, Schrodinger is used for docking and molecular dynamic simulations. In-house library containing ~8000 compounds among FDA-approved indole-containing compounds, a total of 57 obtained from the ChemBL were used for both ATP and tryptophan binding pocket docking. Best of indole-containing 57 compounds were subjected to hit expansion and compared later with virtual screening workflow (VSW) results. After docking, VSW was done. Glide-XP docking algorithm was chosen. When compared, VSW alone performed better than the hit expansion module. Best scored compounds were kept for ten ns molecular dynamic simulations by Desmond. Further, 100 ns molecular dynamic simulation was performed for elected molecules according to Z-score. The top three MMGBSA-scored compounds were subjected to steered molecular dynamic (SMD) simulations by Gromacs. While SMD simulations are still being conducted, ponesimod (for multiple sclerosis), vilanterol (β₂ adrenoreceptor agonist), and silodosin (for benign prostatic hyperplasia) were found to have a significant affinity for tuberculosis TrpRS, which is the propulsive force for the urge to expand the research with in vitro studies. Interestingly, top-scored ponesimod has been reported to have a side effect that makes the patient prone to upper respiratory tract infections.

Keywords: drug repurposing, molecular dynamics, tryptophanyl-tRNA synthetase, tuberculosis

Procedia PDF Downloads 123

Authors: Susan Dodd

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This presentation details the methodology for teachers to identify and support a population of students who have historically been overlooked in regards to their educational needs. The twice exceptional (2e) student is a learner who is considered gifted and also has a learning disability, as defined by the Individuals with Disabilities Education Act (IDEA). Many of these students remain underserved throughout their educational careers because their exceptionalities may mask each other, resulting in a special population of students who are not achieving to their fullest potential. There are three common scenarios that may make the identification of a 2e student challenging. First, the student may have been identified as gifted, and her disability may go unnoticed. She could also be considered an under-achiever, or she may be able to compensate for her disability under the school works becomes more challenging. In the second scenario, the student may be identified as having a learning disability and is only receiving remedial services where his giftedness will not be highlighted. His overall IQ scores may be misleading because they were impacted by his learning disability. In the third scenario, the student is able to compensate for her ability well enough to maintain average scores, and she goes undetected as both gifted and learning disabled. Research in the area identifies the complexity involved in identifying 2e students, and how multiple forms of assessment are required. It is important for teachers to be aware of the common characteristics exhibited by many 2e students, so these learners can be identified and appropriately served. Once 2e students have been identified, teachers are then challenged to meet the varying needs of these exceptional learners. Strength-based teaching entails simultaneously providing gifted instruction as well as individualized accommodations for those students. Research in this field has yielded strategies that have proven helpful for teaching 2e students, as well as other students who may be struggling academically. Differentiated instruction, while necessary in all classrooms, is especially important for 2e students, as is encouragement for academic success. Teachers who take the time to really know their students will have a better understanding of each student’s strengths and areas for growth, and therefore tailor instruction to extend the intellectual capacities for optimal achievement. Teachers should also understand that some learning activities can prove very frustrating to students, and these activities can be modified based on individual student needs. Because 2e students can often become discouraged by their learning challenges, it is especially important for teachers to assist students in recognizing their own strengths and maintaining motivation for learning. Although research on the needs of 2e students has spanned across two decades, this population remains underserved in many educational institutions. Teacher awareness of the identification of and the support strategies for 2e students is critical for their success.

Keywords: gifted, learning disability, special needs, twice exceptional

Procedia PDF Downloads 179

Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

Procedia PDF Downloads 103

Authors: A. Kaćunić, M. Ćosić, N. Kuzmanić

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Interaction between mixing and crystallization is often ignored despite the fact that it affects almost every aspect of the operation including nucleation, growth, and maintenance of the crystal slurry. This is especially pronounced in multiple impeller systems where flow complexity is increased. By choosing proper mixing parameters, what closely depends on the knowledge of the hydrodynamics in a mixing vessel, the process of batch cooling crystallization may considerably be improved. The values that render useful information when making this choice are mixing time and power consumption. The predominant motivation for this work was to investigate the extent to which radial dual impeller configuration influences mixing time, power consumption and consequently the values of metastable zone width and nucleation rate. In this research, crystallization of borax was conducted in a 15 dm3 baffled batch cooling crystallizer with an aspect ratio (H/T) of 1.3. Mixing was performed using two straight blade turbines (4-SBT) mounted on the same shaft that generated radial fluid flow. Experiments were conducted at different values of N/NJS ratio (impeller speed/ minimum impeller speed for complete suspension), D/T ratio (impeller diameter/crystallizer diameter), c/D ratio (lower impeller off-bottom clearance/impeller diameter), and s/D ratio (spacing between impellers/impeller diameter). Mother liquor was saturated at 30°C and was cooled at the rate of 6°C/h. Its concentration was monitored in line by Na-ion selective electrode. From the values of supersaturation that was monitored continuously over process time, it was possible to determine the metastable zone width and subsequently the nucleation rate using the Mersmann’s nucleation criterion. For all applied dual impeller configurations, the mixing time was determined by potentiometric method using a pulse technique, while the power consumption was determined using a torque meter produced by Himmelstein & Co. Results obtained in this investigation show that dual impeller configuration significantly influences the values of mixing time, power consumption as well as the metastable zone width and nucleation rate. A special attention should be addressed to the impeller spacing considering the flow interaction that could be more or less pronounced depending on the spacing value.

Keywords: dual impeller crystallizer, mixing time, power consumption, metastable zone width, nucleation rate

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Authors: Shan Zhang, Peter Suechting

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Predicting trade patterns is critical to decision-making in public and private domains, especially in the current context of trade disputes among major economies. In the past, U.S. recycling has relied heavily on strong demand for recyclable materials overseas. However, starting in 2017, a series of new recycling policies (bans and higher inspection standards) was enacted by multiple countries that were the primary importers of recyclables from the U.S. prior to that point. As the global trade flow of recycling shifts, some new importers, mostly developing countries in South and Southeast Asia, have been overwhelmed by the sheer quantities of scrap materials they have received. As the leading exporter of recyclable materials, the U.S. now has a pressing need to build its recycling industry domestically. With respect to the global trade in scrap materials used for recycling, the interest in this paper is (1) predicting how the export of recyclable materials from the U.S. might vary over time, and (2) predicting how international trade flows for recyclables might change in the future. Focusing on three major recyclable materials with a history of trade, this study uses data-driven and machine learning (ML) algorithms---supervised (shrinkage and tree methods) and unsupervised (neural network method)---to decipher the international trade pattern of recycling. Forecasting the potential trade values of recyclables in the future could help importing countries, to which those materials will shift next, to prepare related trade policies. Such policies can assist policymakers in minimizing negative environmental externalities and in finding the optimal amount of recyclables needed by each country. Such forecasts can also help exporting countries, like the U.S understand the importance of healthy domestic recycling industry. The preliminary result suggests that gravity models---in addition to particular selection macroeconomic predictor variables--are appropriate predictors of the total export value of recyclables. With the inclusion of variables measuring aspects of the political conditions (trade tariffs and bans), predictions show that recyclable materials are shifting from more policy-restricted countries to less policy-restricted countries in international recycling trade. Those countries also tend to have high manufacturing activities as a percentage of their GDP.

Keywords: environmental economics, machine learning, recycling, international trade

Procedia PDF Downloads 168

Authors: Jui-Hsueh Hu

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This study investigated various models of refusal speech acts among three target groups: French learners of Mandarin Chinese (FM), Taiwanese native Mandarin speakers (TM), and native French speakers (NF). The refusal responses were analyzed in terms of their options, frequencies, and sequences and the contents of their semantic formulas. This study also examined differences in refusal strategies, as determined by social status and social distance, among the three groups. The difficulties of refusal speech acts encountered by FM were then generalized. The results indicated that Mandarin instructors of NF should focus on the different reasons for the pragmatic failure of French learners and should assist these learners in mastering refusal speech acts that rely on abundant cultural information. In this study, refusal policies were mainly classified according to the research of Beebe et al. (1990). Discourse completion questionnaires were collected from TM, FM, and NF, and their responses were compared to determine how refusal policies differed among the groups. This study not only emphasized the dissimilarities of refusal strategies between native Mandarin speakers and second-language Mandarin learners but also used NF as a control group. The results of this study demonstrated that regarding overall strategies, FM were biased toward NF in terms of strategy choice, order, and content, resulting in pragmatic transfer under the influence of social factors such as 'social status' and 'social distance,' strategy choices of FM were still closer to those of NF, and the phenomenon of pragmatic transfer of FM was revealed. Regarding the refusal difficulties among the three groups, the F-test in the analysis of variance revealed statistical significance was achieved for Role Playing Items 13 and 14 (P < 0.05). A difference was observed in the average number of refusal difficulties between the participants. However, after multiple comparisons, it was found that item 13 (unrecognized heterosexual junior colleague requesting contacts) was significantly more difficult for NF than for TM and FM; item 14 (contacts requested by an unrecognized classmate of the opposite sex) was significantly more difficult to refuse for NF than for TM. This study summarized the pragmatic language errors that most FM often perform, including the misuse or absence of modal words, hedging expressions, and empty words at the end of sentences, as the reasons for pragmatic failures. The common social pragmatic failures of FM include inaccurately applying the level of directness and formality.

Keywords: French Mandarin, interlanguage refusal, pragmatic transfer, speech acts

Procedia PDF Downloads 254

Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

Procedia PDF Downloads 325

Authors: S. Pathak, R. Lazarus

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A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

Procedia PDF Downloads 379