Search results for: initial teacher training
745 On the Development of Evidential Contrasts in the Greater Himalayan Region
Authors: Marius Zemp
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Evidentials indicate how the speaker obtained the information conveyed in a statement. Detailed diachronic-functional accounts of evidential contrasts found in the Greater Himalayan Region (GHR) reveal that contrasting evidentials are not only defined against each other but also that most of them once had different aspecto-temporal (TA) values which must have aligned when their contrast was conventionalized. Based on these accounts, the present paper sheds light on hitherto unidentified mechanisms of grammatical change. The main insights of the present study were facilitated by ‘functional reconstruction’, which (i) revolves around morphemes which appear to be used in divergent ways within a language and/or across different related languages, (ii) persistently devises hypotheses as to how these functional divergences may have developed, and (iii) retains those hypotheses which most plausibly and economically account for the data. Based on the dense and detailed grammatical literature on the Tibetic language family, the author of this study is able to reconstruct the initial steps by which its evidentiality systems developed: By the time Proto-Tibetan started to be spread across much of Central Asia in the 7th century CE, verbal concatenations with and without a connective -s had become common. As typical for resultative constructions around the globe, Proto-Tibetan *V-s-’dug ‘was there, having undergone V’ (employing the simple past of ’dug ‘stay, be there’) allowed both for a perfect reading (‘the state resulting from V holds at the moment of speech’) and an inferential reading (‘(I infer from its result that) V has taken place’). In Western Tibetic, *V-s-’dug grammaticalized in its perfect meaning as it became contrasted with perfect *V-s-yod ‘is there, having undergone V’ (employing the existential copula yod); that is, *V-s-’dug came to mean that the speaker directly witnessed the profiled result of V, whereas *V-s-yod came to mean that the speaker does not depend on direct evidence of the result, as s/he simply knows that it holds. In Eastern Tibetic, on the other hand, V-s-’dug grammaticalized in its inferential past meaning as it became contrasted with past *V-thal ‘went past V-ing’ (employing the simple past of thal ‘go past’); that is, *V-s-’dug came to mean that the profiled past event was inferred from its result, while *V-thal came to mean that it was directly witnessed. Hence, depending on whether it became contrasted with a perfect or a past construction, resultative V-s-’dug grammaticalized either its direct evidential perfect or its inferential past function. This means that in both cases, evidential readings of constructions with distinct but overlapping TA-values became contrasted, and in order for their contrasting meanings to grammaticalize, the constructions had to agree on their tertium comparationis, which was their shared TA-value. By showing that other types of evidential contrasts in the GHR are also TA-aligned, while no single markers (or privative contrasts) are found to have grammaticalized evidential functions, the present study suggests that, at least in this region of the world, evidential meanings grammaticalize only in equipollent contrasts, which always end up TA-aligned.Keywords: evidential contrasts, functional-diachronic accounts, grammatical change, himalayan languages, tense/aspect-alignment
Procedia PDF Downloads 128744 Adapting Cyber Physical Production Systems to Small and Mid-Size Manufacturing Companies
Authors: Yohannes Haile, Dipo Onipede, Jr., Omar Ashour
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The main thrust of our research is to determine Industry 4.0 readiness of small and mid-size manufacturing companies in our region and assist them to implement Cyber Physical Production System (CPPS) capabilities. Adopting CPPS capabilities will help organizations realize improved quality, order delivery, throughput, new value creation, and reduced idle time of machines and work centers of their manufacturing operations. The key metrics for the assessment include the level of intelligence, internal and external connections, responsiveness to internal and external environmental changes, capabilities for customization of products with reference to cost, level of additive manufacturing, automation, and robotics integration, and capabilities to manufacture hybrid products in the near term, where near term is defined as 0 to 18 months. In our initial evaluation of several manufacturing firms which are profitable and successful in what they do, we found low level of Physical-Digital-Physical (PDP) loop in their manufacturing operations, whereas 100% of the firms included in this research have specialized manufacturing core competencies that have differentiated them from their competitors. The level of automation and robotics integration is low to medium range, where low is defined as less than 30%, and medium is defined as 30 to 70% of manufacturing operation to include automation and robotics. However, there is a significant drive to include these capabilities at the present time. As it pertains to intelligence and connection of manufacturing systems, it is observed to be low with significant variance in tying manufacturing operations management to Enterprise Resource Planning (ERP). Furthermore, it is observed that the integration of additive manufacturing in general, 3D printing, in particular, to be low, but with significant upside of integrating it in their manufacturing operations in the near future. To hasten the readiness of the local and regional manufacturing companies to Industry 4.0 and transitions towards CPPS capabilities, our working group (ADMAR Working Group) in partnership with our university have been engaged with the local and regional manufacturing companies. The goal is to increase awareness, share know-how and capabilities, initiate joint projects, and investigate the possibility of establishing the Center for Cyber Physical Production Systems Innovation (C2P2SI). The center is intended to support the local and regional university-industry research of implementing intelligent factories, enhance new value creation through disruptive innovations, the development of hybrid and data enhanced products, and the creation of digital manufacturing enterprises. All these efforts will enhance local and regional economic development and educate students that have well developed knowledge and applications of cyber physical manufacturing systems and Industry 4.0.Keywords: automation, cyber-physical production system, digital manufacturing enterprises, disruptive innovation, new value creation, physical-digital-physical loop
Procedia PDF Downloads 140743 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review
Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska
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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT
Procedia PDF Downloads 114742 Poly(ε-Caprolactone)-Based Bilayered Scaffolds Prepared by Electrospinning for Tissue Engineering of Small-Diameter Vascular Grafts
Authors: Mohammed Fayez Al Rez
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Nowadays, there is an unmet clinical need for new small-diameter vascular grafts to overcome the drawbacks of traditional methods used for treatment of widespread cardiovascular diseases. Vascular tissue engineering (VTE) is a promising approach that can be utilized to develop viable vascular grafts by in vitro seeding of functional cells onto a scaffold allowing them to attach, proliferate and differentiate. To achieve this purpose, the scaffold should provide cells with the initial necessary extracellular matrix environment and structure until being able to reconstruct the required vascular tissue. Therefore, producing scaffolds with suitable features is crucial for guiding cells properly to develop the desired tissue-engineered vascular grafts for clinical applications. The main objective of this work is fabrication and characterization of tubular small-diameter ( < 6 mm) bilayered scaffolds for VTE. The scaffolds were prepared via mixing electrospinning approach of biodegradable poly(ε-caprolactone) (PCL) polymer – due to its favorable physicochemical properties – to mimic the natural environment-extracellular matrix. Firstly, tubular nanofibrous construct with inner diameter of 3, 4 or 5 mm was electrospun as inner layer, and secondly, microfibrous construct was electrospun as outer layer directly on the first produced inner layer. To improve the biological properties of PCL, a group of the electrospun scaffolds was immersed in type-1 collagen solution. The morphology and structure of the resulting fibrous scaffolds were investigated by scanning electron microscope. The electrospun nanofibrous inner layer contained fibers measuring 219±35 nm in diameter, while the electrospun microfibrous outer layer contained fibers measuring 1011 ± 150 nm. Furthermore, mechanical, thermal and physical tests were conducted with both electrospun bilayered scaffold types where revealed improved properties. Biological investigations using endothelial, smooth muscle and fibroblast cell line showed good biocompatibility of both tested electrospun scaffolds. Better attachment and proliferation were obviously found when cells were cultured on the scaffolds immersed with collagen due to increasing the hydrophilicity of the PCL. The easy, inexpensive and versatile electrospinning approach used in this work was able to successfully produce double layered tubular elastic structures containing both nanofibers and microfibers to imitate the native vascular structure. The PCL – as a suitable and approved biomaterial for many biomedical and tissue engineering applications – can ensure favorable mechanical properties of scaffolds used for VTE. The VTE approach using electrospun bilayered scaffolds offers optimal solutions and holds significant promises for treatment of many cardiovascular diseases.Keywords: electrospinning, poly(ε-caprolactone) (PCL), tissue-engineered vascular graft, tubular bilayered scaffolds, vascular cells
Procedia PDF Downloads 294741 Learning with Music: The Effects of Musical Tension on Long-Term Declarative Memory Formation
Authors: Nawras Kurzom, Avi Mendelsohn
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The effects of background music on learning and memory are inconsistent, partly due to the intrinsic complexity and variety of music and partly to individual differences in music perception and preference. A prominent musical feature that is known to elicit strong emotional responses is musical tension. Musical tension can be brought about by building anticipation of rhythm, harmony, melody, and dynamics. Delaying the resolution of dominant-to-tonic chord progressions, as well as using dissonant harmonics, can elicit feelings of tension, which can, in turn, affect memory formation of concomitant information. The aim of the presented studies was to explore how forming declarative memory is influenced by musical tension, brought about within continuous music as well as in the form of isolated chords with varying degrees of dissonance/consonance. The effects of musical tension on long-term memory of declarative information were studied in two ways: 1) by evoking tension within continuous music pieces by delaying the release of harmonic progressions from dominant to tonic chords, and 2) by using isolated single complex chords with various degrees of dissonance/roughness. Musical tension was validated through subjective reports of tension, as well as physiological measurements of skin conductance response (SCR) and pupil dilation responses to the chords. In addition, music information retrieval (MIR) was used to quantify musical properties associated with tension and its release. Each experiment included an encoding phase, wherein individuals studied stimuli (words or images) with different musical conditions. Memory for the studied stimuli was tested 24 hours later via recognition tasks. In three separate experiments, we found positive relationships between tension perception and physiological measurements of SCR and pupil dilation. As for memory performance, we found that background music, in general, led to superior memory performance as compared to silence. We detected a trade-off effect between tension perception and memory, such that individuals who perceived musical tension as such displayed reduced memory performance for images encoded during musical tension, whereas tense music benefited memory for those who were less sensitive to the perception of musical tension. Musical tension exerts complex interactions with perception, emotional responses, and cognitive performance on individuals with and without musical training. Delineating the conditions and mechanisms that underlie the interactions between musical tension and memory can benefit our understanding of musical perception at large and the diverse effects that music has on ongoing processing of declarative information.Keywords: musical tension, declarative memory, learning and memory, musical perception
Procedia PDF Downloads 98740 Geochemical Modeling of Mineralogical Changes in Rock and Concrete in Interaction with Groundwater
Authors: Barbora Svechova, Monika Licbinska
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Geochemical modeling of mineralogical changes of various materials in contact with an aqueous solution is an important tool for predicting the processes and development of given materials at the site. The modeling focused on the mutual interaction of groundwater at the contact with the rock mass and its subsequent influence on concrete structures. The studied locality is located in Slovakia in the area of the Liptov Basin, which is a significant inter-mountain lowland, which is bordered on the north and south by the core mountains belt of the Tatras, where in the center the crystalline rises to the surface accompanied by Mesozoic cover. Groundwater in the area is bound to structures with complicated geological structures. From the hydrogeological point of view, it is an environment with a crack-fracture character. The area is characterized by a shallow surface circulation of groundwater without a significant collector structure, and from a chemical point of view, groundwater in the area has been classified as calcium bicarbonate with a high content of CO2 and SO4 ions. According to the European standard EN 206-1, these are waters with medium aggression towards the concrete. Three rock samples were taken from the area. Based on petrographic and mineralogical research, they were evaluated as calcareous shale, micritic limestone and crystalline shale. These three rock samples were placed in demineralized water for one month and the change in the chemical composition of the water was monitored. During the solution-rock interaction there was an increase in the concentrations of all major ions, except nitrates. There was an increase in concentration after a week, but at the end of the experiment, the concentration was lower than the initial value. Another experiment was the interaction of groundwater from the studied locality with a concrete structure. The concrete sample was also left in the water for 1 month. The results of the experiment confirmed the assumption of a reduction in the concentrations of calcium and bicarbonate ions in water due to the precipitation of amorphous forms of CaCO3 on the surface of the sample.Vice versa, it was surprising to increase the concentration of sulphates, sodium, iron and aluminum due to the leaching of concrete. Chemical analyzes from these experiments were performed in the PHREEQc program, which calculated the probability of the formation of amorphous forms of minerals. From the results of chemical analyses and hydrochemical modeling of water collected in situ and water from experiments, it was found: groundwater at the site is unsaturated and shows moderate aggression towards reinforced concrete structures according to EN 206-1a, which will affect the homogeneity and integrity of concrete structures; from the rocks in the given area, Ca, Na, Fe, HCO3 and SO4. Unsaturated waters will dissolve everything as soon as they come into contact with the solid matrix. The speed of this process then depends on the physicochemical parameters of the environment (T, ORP, p, n, water retention time in the environment, etc.).Keywords: geochemical modeling, concrete , dissolution , PHREEQc
Procedia PDF Downloads 197739 Natural Mexican Zeolite Modified with Iron to Remove Arsenic Ions from Water Sources
Authors: Maritza Estela Garay-Rodriguez, Mirella Gutierrez-Arzaluz, Miguel Torres-Rodriguez, Violeta Mugica-Alvarez
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Arsenic is an element present in the earth's crust and is dispersed in the environment through natural processes and some anthropogenic activities. Naturally released into the environment through the weathering and erosion of sulphides mineral, some activities such as mining, the use of pesticides or wood preservatives potentially increase the concentration of arsenic in air, water, and soil. The natural arsenic release of a geological material is a threat to the world's drinking water sources. In aqueous phase is found in inorganic form, as arsenate and arsenite mainly, the contamination of groundwater by salts of this element originates what is known as endemic regional hydroarsenicism. The International Agency for Research on Cancer (IARC) categorizes the inorganic As within group I, as a substance with proven carcinogenic action for humans. It has been found the presence of As in groundwater in several countries such as Argentina, Mexico, Bangladesh, Canada and the United States. Regarding the concentration of arsenic in drinking water according to the World Health Organization (WHO) and the Environmental Protection Agency (EPA) establish maximum concentrations of 10 μg L⁻¹. In Mexico, in some states as Hidalgo, Morelos and Michoacán concentrations of arsenic have been found in bodies of water around 1000 μg L⁻¹, a concentration that is well above what is allowed by Mexican regulations with the NOM-127- SSA1-1994 that establishes a limit of 25 μg L⁻¹. Given this problem in Mexico, this research proposes the use of a natural Mexican zeolite (clinoptilolite type) native to the district of Etla in the central valley region of Oaxaca, as an adsorbent for the removal of arsenic. The zeolite was subjected to a conditioning with iron oxide by the precipitation-impregnation method with 0.5 M iron nitrate solution, in order to increase the natural adsorption capacity of this material. The removal of arsenic was carried out in a column with a fixed bed of conditioned zeolite, since it combines the advantages of a conventional filter with those of a natural adsorbent medium, providing a continuous treatment, of low cost and relatively easy to operate, for its implementation in marginalized areas. The zeolite was characterized by XRD, SEM/EDS, and FTIR before and after the arsenic adsorption tests, the results showed that the modification methods used are adequate to prepare adsorbent materials since it does not modify its structure, the results showed that with a particle size of 1.18 mm, an initial concentration of As (V) ions of 1 ppm, a pH of 7 and at room temperature, a removal of 98.7% was obtained with an adsorption capacity of 260 μg As g⁻¹ zeolite. The results obtained indicated that the conditioned zeolite is favorable for the elimination of arsenate in water containing up to 1000 μg As L⁻¹ and could be suitable for removing arsenate from pits of water.Keywords: adsorption, arsenic, iron conditioning, natural zeolite
Procedia PDF Downloads 172738 Towards Creative Movie Title Generation Using Deep Neural Models
Authors: Simon Espigolé, Igor Shalyminov, Helen Hastie
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Deep machine learning techniques including deep neural networks (DNN) have been used to model language and dialogue for conversational agents to perform tasks, such as giving technical support and also for general chit-chat. They have been shown to be capable of generating long, diverse and coherent sentences in end-to-end dialogue systems and natural language generation. However, these systems tend to imitate the training data and will only generate the concepts and language within the scope of what they have been trained on. This work explores how deep neural networks can be used in a task that would normally require human creativity, whereby the human would read the movie description and/or watch the movie and come up with a compelling, interesting movie title. This task differs from simple summarization in that the movie title may not necessarily be derivable from the content or semantics of the movie description. Here, we train a type of DNN called a sequence-to-sequence model (seq2seq) that takes as input a short textual movie description and some information on e.g. genre of the movie. It then learns to output a movie title. The idea is that the DNN will learn certain techniques and approaches that the human movie titler may deploy that may not be immediately obvious to the human-eye. To give an example of a generated movie title, for the movie synopsis: ‘A hitman concludes his legacy with one more job, only to discover he may be the one getting hit.’; the original, true title is ‘The Driver’ and the one generated by the model is ‘The Masquerade’. A human evaluation was conducted where the DNN output was compared to the true human-generated title, as well as a number of baselines, on three 5-point Likert scales: ‘creativity’, ‘naturalness’ and ‘suitability’. Subjects were also asked which of the two systems they preferred. The scores of the DNN model were comparable to the scores of the human-generated movie title, with means m=3.11, m=3.12, respectively. There is room for improvement in these models as they were rated significantly less ‘natural’ and ‘suitable’ when compared to the human title. In addition, the human-generated title was preferred overall 58% of the time when pitted against the DNN model. These results, however, are encouraging given the comparison with a highly-considered, well-crafted human-generated movie title. Movie titles go through a rigorous process of assessment by experts and focus groups, who have watched the movie. This process is in place due to the large amount of money at stake and the importance of creating an effective title that captures the audiences’ attention. Our work shows progress towards automating this process, which in turn may lead to a better understanding of creativity itself.Keywords: creativity, deep machine learning, natural language generation, movies
Procedia PDF Downloads 326737 Tourists' Perception to the Service Quality of White Water Rafting in Bali: Case Study of Ayung River
Authors: Ni Putu Evi Wijayanti, Made Darmiati, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono
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This research study discusses the tourists’ perception to white water rafting service quality in Bali (Case Study: Ayung River). The aim is to determine the tourists’ perception to: firstly, the services quality of white water rafting trip in Bali, secondly, is to determine which dimensions of the service quality that need to take main handling priority in accordance with the level of important service of white water rafting company’s working performance toward the service quality of rafting in Bali especially on Ayung Riveri, lastly, is to know the efforts are needed to improve the service quality of white water rafting trip for tourist in Bali, specifically on Ayung River. This research uses the concept of the service quality with five principal dimensions, namely: Tangibles, Reliability, Responsiveness, Assurance, Empathy. Location of the research is tourist destination area of the Ayung River, that lies between the boundary of Badung Regency at Western part and Gianyar Regency eastern side. There are three rafting companies located on the Ayung River. This research took 100 respondents who were selected as a sample by using purposive sampling method. Data were collected through questionnaires distributed to domestic tourists then tabulated using the weighting scale (Likert scale) and analyzed using analysis of the benefit performance (important performance analysis) in the form of Cartesian diagram. The results of the research are translated into three points. Firstly, there are 23 indicators assessed by the service aspect of domestic tourists where the highest value is the aspect of familiarity between the tourist and employees with points (0.29) and the lowest score is the aspect of the clarity of the Ayung River water discharge value (-0.35). This shows that the indicator has not been fully able to meet the expectations of service aspects of the rating. Secondly, the dimensions of service quality that requires serious attention is the dimension of tangibles. The third point is the efforts that needs to be done adapted to the results of the Cartesian diagram breaks down into four quadrants. Based on the results of the research suggested to the manager of the white water rafting tour in order to continuously improve the service quality to tourists, performing new innovations in terms of product variations, provide insight and training to its employees to increase their competence, especially in the field of excellent service so that the satisfaction rating can be achieved.Keywords: perception, rafting, service quality, tourist satisfaction
Procedia PDF Downloads 244736 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy
Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes
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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation
Procedia PDF Downloads 392735 Exploration into Bio Inspired Computing Based on Spintronic Energy Efficiency Principles and Neuromorphic Speed Pathways
Authors: Anirudh Lahiri
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Neuromorphic computing, inspired by the intricate operations of biological neural networks, offers a revolutionary approach to overcoming the limitations of traditional computing architectures. This research proposes the integration of spintronics with neuromorphic systems, aiming to enhance computational performance, scalability, and energy efficiency. Traditional computing systems, based on the Von Neumann architecture, struggle with scalability and efficiency due to the segregation of memory and processing functions. In contrast, the human brain exemplifies high efficiency and adaptability, processing vast amounts of information with minimal energy consumption. This project explores the use of spintronics, which utilizes the electron's spin rather than its charge, to create more energy-efficient computing systems. Spintronic devices, such as magnetic tunnel junctions (MTJs) manipulated through spin-transfer torque (STT) and spin-orbit torque (SOT), offer a promising pathway to reducing power consumption and enhancing the speed of data processing. The integration of these devices within a neuromorphic framework aims to replicate the efficiency and adaptability of biological systems. The research is structured into three phases: an exhaustive literature review to build a theoretical foundation, laboratory experiments to test and optimize the theoretical models, and iterative refinements based on experimental results to finalize the system. The initial phase focuses on understanding the current state of neuromorphic and spintronic technologies. The second phase involves practical experimentation with spintronic devices and the development of neuromorphic systems that mimic synaptic plasticity and other biological processes. The final phase focuses on refining the systems based on feedback from the testing phase and preparing the findings for publication. The expected contributions of this research are twofold. Firstly, it aims to significantly reduce the energy consumption of computational systems while maintaining or increasing processing speed, addressing a critical need in the field of computing. Secondly, it seeks to enhance the learning capabilities of neuromorphic systems, allowing them to adapt more dynamically to changing environmental inputs, thus better mimicking the human brain's functionality. The integration of spintronics with neuromorphic computing could revolutionize how computational systems are designed, making them more efficient, faster, and more adaptable. This research aligns with the ongoing pursuit of energy-efficient and scalable computing solutions, marking a significant step forward in the field of computational technology.Keywords: material science, biological engineering, mechanical engineering, neuromorphic computing, spintronics, energy efficiency, computational scalability, synaptic plasticity.
Procedia PDF Downloads 43734 Developing Cultural Competence as Part of Nursing Studies: Language, Customs and Health Issues
Authors: Mohammad Khatib, Salam Hadid
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Introduction: Developing nurses' cultural competence begins in their basic training and requires them to participate in an array of activities which raise their awareness and stimulate their interest, desire and curiosity about different cultures, by creating opportunities for intercultural meetings promoting the concept of 'culture' and its components, including recognition of cultural diversity and the legitimacy of the other. Importantly, professionals need to acquire specific cultural knowledge and thorough understanding of the values, norms, customs, beliefs and symbols of different cultures. Similarly, they need to be given opportunities to practice the verbal and non-verbal communication skills of other cultures according to their cultural codes. Such a system is being implemented as part of nursing studies at Zefat Academic College in two study frameworks; firstly, a course integrating nursing theory and practice in multicultural nursing; secondly, a course in learning the languages spoken in Israel focusing on medical and nursing terminology. Methods: Students participating in the 'Transcultural Nursing' course come from a variety of backgrounds: Jews, or Arabs, religious, or secular; Muslim, Christian, new immigrants, Ethiopians or from other cultural affiliations. They are required to present and discuss cultural practices that affect health. In addition, as part of the language course, students learn and teach their friends 5 spoken languages (Arabic, Russian, Amharian, Yidish, and Sign language) focusing on therapeutic interaction and communication using the vocabulary and concepts necessary for the therapeutic encounter. An evaluation of the process and the results was done using a structured questionnaire which includes series of questions relating to the contributions of the courses to their cultural knowledge, awareness and skills. 155 students completed the questionnaire. Results: A preliminary assessment of this educational system points an increase in cultural awareness and knowledge among the students as well as in their willingness to recognize the other's difference. A positive atmosphere of multiculturalism is reflected in students' mutual interest and respect was created. Students showed a deep understanding of cultural issues relating to health and care (consanguinity and genetics, food customs; cultural events, reincarnation, traditional treatments etc.). Most of the students were willing to recommend the courses to others and suggest some changes relating learning methods (more simulations, role playing and activities).Keywords: cultural competence, nursing education, culture, language
Procedia PDF Downloads 277733 A Multifactorial Algorithm to Automate Screening of Drug-Induced Liver Injury Cases in Clinical and Post-Marketing Settings
Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey
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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing
Procedia PDF Downloads 152732 Quantum Mechanics as A Limiting Case of Relativistic Mechanics
Authors: Ahmad Almajid
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The idea of unifying quantum mechanics with general relativity is still a dream for many researchers, as physics has only two paths, no more. Einstein's path, which is mainly based on particle mechanics, and the path of Paul Dirac and others, which is based on wave mechanics, the incompatibility of the two approaches is due to the radical difference in the initial assumptions and the mathematical nature of each approach. Logical thinking in modern physics leads us to two problems: - In quantum mechanics, despite its success, the problem of measurement and the problem of wave function interpretation is still obscure. - In special relativity, despite the success of the equivalence of rest-mass and energy, but at the speed of light, the fact that the energy becomes infinite is contrary to logic because the speed of light is not infinite, and the mass of the particle is not infinite too. These contradictions arise from the overlap of relativistic and quantum mechanics in the neighborhood of the speed of light, and in order to solve these problems, one must understand well how to move from relativistic mechanics to quantum mechanics, or rather, to unify them in a way different from Dirac's method, in order to go along with God or Nature, since, as Einstein said, "God doesn't play dice." From De Broglie's hypothesis about wave-particle duality, Léon Brillouin's definition of the new proper time was deduced, and thus the quantum Lorentz factor was obtained. Finally, using the Euler-Lagrange equation, we come up with new equations in quantum mechanics. In this paper, the two problems in modern physics mentioned above are solved; it can be said that this new approach to quantum mechanics will enable us to unify it with general relativity quite simply. If the experiments prove the validity of the results of this research, we will be able in the future to transport the matter at speed close to the speed of light. Finally, this research yielded three important results: 1- Lorentz quantum factor. 2- Planck energy is a limited case of Einstein energy. 3- Real quantum mechanics, in which new equations for quantum mechanics match and exceed Dirac's equations, these equations have been reached in a completely different way from Dirac's method. These equations show that quantum mechanics is a limited case of relativistic mechanics. At the Solvay Conference in 1927, the debate about quantum mechanics between Bohr, Einstein, and others reached its climax, while Bohr suggested that if particles are not observed, they are in a probabilistic state, then Einstein said his famous claim ("God does not play dice"). Thus, Einstein was right, especially when he didn't accept the principle of indeterminacy in quantum theory, although experiments support quantum mechanics. However, the results of our research indicate that God really does not play dice; when the electron disappears, it turns into amicable particles or an elastic medium, according to the above obvious equations. Likewise, Bohr was right also, when he indicated that there must be a science like quantum mechanics to monitor and study the motion of subatomic particles, but the picture in front of him was blurry and not clear, so he resorted to the probabilistic interpretation.Keywords: lorentz quantum factor, new, planck’s energy as a limiting case of einstein’s energy, real quantum mechanics, new equations for quantum mechanics
Procedia PDF Downloads 77731 Case Study on the Effects of Early Mobilization in the Post-Surgical Recovery of Athletes with Open Triangular Fibrocartilage Complex Repair
Authors: Blair Arthur Agero Jr., Lucia Garcia Heras
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The triangular fibrocartilage complex (TFCC) is one of the crucial stabilizing ligaments of the wrist. The TFCC is also subject to excessive stress amongst performance athletes and enthusiasts. The excessive loading of the TFCC may lead to a partial or complete rupture that requires surgery. The recovery from an open TFCC surgical repair may take several months. Immobilization of the repaired wrist for a given period is part of all the current protocols in the post-surgical treatment. The immobilization to prevent the rotation of the forearm can last from six weeks to eight weeks with the wrist held in a neutral position. In all protocols reviewed, the pronosupination is only initiated between the 6th week and 8th week or even later after the cast is removed. The prolonged immobilization can cause stiffness of the wrist and hand. Furthermore, the entire period of post-surgical hand therapy has its economic impact, especially for performing athletes. However, delayed mobilization, specifically rotation of the wrist, is necessary to allow ligament healing. This study aims to report the effects of early mobilization of the wrist in athletes who had an open surgical repair of the TFCC. The surgery was done by the co-author, and the hand therapy was implemented by the main author. The cases documented spans from 2014 to 2019 and were all performed in Dubai, United Arab Emirates. All selected participants in this case study were provided with a follow-up questionnaire to ascertain their current condition since their surgery. The respondents reported high satisfaction in the results of their treatment and have verified zero re-rupture of their TFCC despite mobilizing and rotating the wrist at the third-week post-surgery during their hand therapy. There is also a negligible number of respondents who reported a limitation in their ranges of pronosupination. This case study suggests that early mobilization of the wrist after an open TFCC surgical repair can be more beneficial to the patient as opposed to the traditional treatment of prolonged immobilization. However, it should be considered that the patients selected in this case study are professional performance athletes and advanced fitness enthusiasts. Athletes are known to withstand vigorous physical stress in their training that may correlate to their ability to better cope with the progressive stress that was implemented during their hand therapy. Nevertheless, this approach has its merits, and application of it may be adjusted for patients with a similar injury and surgical procedure.Keywords: hand therapy, performance athlete, TFCC repair, wrist ligament
Procedia PDF Downloads 150730 A Proper Continuum-Based Reformulation of Current Problems in Finite Strain Plasticity
Authors: Ladislav Écsi, Roland Jančo
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Contemporary multiplicative plasticity models assume that the body's intermediate configuration consists of an assembly of locally unloaded neighbourhoods of material particles that cannot be reassembled together to give the overall stress-free intermediate configuration since the neighbourhoods are not necessarily compatible with each other. As a result, the plastic deformation gradient, an inelastic component in the multiplicative split of the deformation gradient, cannot be integrated, and the material particle moves from the initial configuration to the intermediate configuration without a position vector and a plastic displacement field when plastic flow occurs. Such behaviour is incompatible with the continuum theory and the continuum physics of elastoplastic deformations, and the related material models can hardly be denoted as truly continuum-based. The paper presents a proper continuum-based reformulation of current problems in finite strain plasticity. It will be shown that the incompatible neighbourhoods in real material are modelled by the product of the plastic multiplier and the yield surface normal when the plastic flow is defined in the current configuration. The incompatible plastic factor can also model the neighbourhoods as the solution of the system of differential equations whose coefficient matrix is the above product when the plastic flow is defined in the intermediate configuration. The incompatible tensors replace the compatible spatial plastic velocity gradient in the former case or the compatible plastic deformation gradient in the latter case in the definition of the plastic flow rule. They act as local imperfections but have the same position vector as the compatible plastic velocity gradient or the compatible plastic deformation gradient in the definitions of the related plastic flow rules. The unstressed intermediate configuration, the unloaded configuration after the plastic flow, where the residual stresses have been removed, can always be calculated by integrating either the compatible plastic velocity gradient or the compatible plastic deformation gradient. However, the corresponding plastic displacement field becomes permanent with both elastic and plastic components. The residual strains and stresses originate from the difference between the compatible plastic/permanent displacement field gradient and the prescribed incompatible second-order tensor characterizing the plastic flow in the definition of the plastic flow rule, which becomes an assignment statement rather than an equilibrium equation. The above also means that the elastic and plastic factors in the multiplicative split of the deformation gradient are, in reality, gradients and that there is no problem with the continuum physics of elastoplastic deformations. The formulation is demonstrated in a numerical example using the regularized Mooney-Rivlin material model and modified equilibrium statements where the intermediate configuration is calculated, whose analysis results are compared with the identical material model using the current equilibrium statements. The advantages and disadvantages of each formulation, including their relationship with multiplicative plasticity, are also discussed.Keywords: finite strain plasticity, continuum formulation, regularized Mooney-Rivlin material model, compatibility
Procedia PDF Downloads 123729 The Life Skills Project: Client-Centered Approaches to Life Skills Acquisition for Homeless and At-Risk Populations
Authors: Leah Burton, Sara Cumming, Julianne DiSanto
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Homelessness is a widespread and complex problem in Canada and around the globe. Many Canadians will face homelessness at least once in their lifetime, with several experiencing subsequent bouts or cyclical patterns of housing precarity. While a Housing First approach to homelessness is a long-standing and widely accepted best practice, it is also recognized that the acquisition of life skills is an effective way to reduce cycles of homelessness. Indeed, when individuals are provided with a range of life skills—such as (but not limited to) financial literacy, household management, interpersonal skills, critical thinking, and resource management—they are given the tools required to maintain long-term Housing for a lifetime; thus reducing a repetitive need for services. However, there is limited research regarding the best ways to teach life skills, a problem that has been further complicated in a post-pandemic world, where services are being delivered online or in a hybrid model of care. More than this, it is difficult to provide life skills on a large scale without losing a client-centered approach to services. This lack of client-centeredness is also seen in the lack of attention to culturally sensitive life skills, which consider the diverse needs of individuals and imbed equity, diversity, and inclusion (EDI) within the skills being taught. This study aims to fill these identified gaps in the literature by employing a community-engaged (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, EDI-informed life skill learning management system. A triangulation methodology was utilized for this research. An environmental scan was conducted for current best practices, and over 100 front-line staff (including workers, managers, and executive directors who work with homeless populations) participated in two separate Creative Problem Solving Sessions. Over 200 individuals with experience in homelessness completed quantitative and open-ended surveys. All sections of this research aimed to discover the areas of skills that individuals need to maintain Housing and to ascertain what a more client-driven EDI approach to life skills training should include. This presentation will showcase the findings on which life skills are deemed essential for homeless and precariously housed individuals.Keywords: homelessness, housing first, life skills, community engaged research, client- centered
Procedia PDF Downloads 101728 Improving Sanitation and Hygiene Using a Behavioral Change Approach in Public and Private Schools in Kampala, Uganda
Authors: G. Senoga, D. Nakimuli, B. Ndagire, B. Lukwago, D. Kyamagwa
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Background: The COVID-19 epidemic affected the education sector, with some private schools closing while other children missed schooling for fear contracting COVID-19. Post COVID-19, PSIU in collaborated with Kampala City Council Authority Directorate of Education and Social Science, Water and Sanitation department, and Directorate of Public Health and Environment to improve sanitation and hygiene among pupils and staff in 50 public and private school system in Kampala city. The “Be Clean, Stay Healthy Campaign” used a behavioral change approach in educating, reinforcing and engaging learners on proper hand washing behaviors, proper toilet usage and garbage disposal. In April 2022, 40 Washa lots were constructed, to reduce the pupil - hand wash station ratio; distributed KCCA approved printed materials; oriented 50 teachers, WASH committees to execute and implement hygiene promotion. To ensure sustainability, WASH messages were memorized and practiced through hand washing songs, Pledge, prayer, Poems, Skits, Music, dance and drama, coupled with participatory, practical demonstrations using peer to peer approach, guest speakers at assemblies and in classes. This improved hygiene and sanitation practices. Premised on this, PSI conducted an end line assessment to explore the impact of a hand washing campaign in regards to improvements in hand washing practices and hand hygiene among pupils, accessibility, functionality and usage of the constructed hygiene and sanitation facilities. Method: A cross-sectional post intervention assessment using a mixed methods approach, targeting headteachers, wash committee members and pupils less <17 years was used. Quantitative approaches with a mix of open-ended questions were used in purposively selected respondents in 50 schools. Primary three to primary seven pupils were randomly selected, data was analyzed using the Statistical Package for Social Scientists (SPSS) Outcomes and Findings: 46,989 pupils (51% female), 1,127 and 524 teaching and non-teaching staff were reached by the intervention, respectively. 96% of schools trained on sanitation, sustainable water usage and hygiene constituted 17-man school WASH committees with teacher, parents and pupils representatives. (31%) of the WASH committees developed workplans, (78%) held WASH meetings monthly. This resulted into improved sanitation, water usage, waste management, proper use of toilets, and improved pupils’ health with reduced occurrences of stomach upsets, diarrhoea initially attributed to improper use of latrines and general waste management. Teachers reported reduced number of school absenteeism due to improved hygiene and general waste management at school, especially proper management of sanitary pads. School administrations response rate in purchase of hygiene equipment’s and detergents like soap improved. Regular WASH meetings in classes, teachers and community supervision ensured WASH facilities are used appropriately. Conclusion and Recommendations: Practical behaviour change innovations improves pupil’s knowledge and understanding of hygiene messages and usage. Over 70% of pupils had clear recall of key WASH Messages. There is need for continuous water flow in the Washa lots, harvesting rain water would reduce water bills while complementing National water supply coupled with increasing on Washa lots in densely populated schools.Keywords: handwashing, hygyiene, sanitation, behaviour change
Procedia PDF Downloads 90727 USBware: A Trusted and Multidisciplinary Framework for Enhanced Detection of USB-Based Attacks
Authors: Nir Nissim, Ran Yahalom, Tomer Lancewiki, Yuval Elovici, Boaz Lerner
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Background: Attackers increasingly take advantage of innocent users who tend to use USB devices casually, assuming these devices benign when in fact they may carry an embedded malicious behavior or hidden malware. USB devices have many properties and capabilities that have become the subject of malicious operations. Many of the recent attacks targeting individuals, and especially organizations, utilize popular and widely used USB devices, such as mice, keyboards, flash drives, printers, and smartphones. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched via USB devices. Significance: We propose USBWARE, a project that focuses on the vulnerabilities of USB devices and centers on the development of a comprehensive detection framework that relies upon a crucial attack repository. USBWARE will allow researchers and companies to better understand the vulnerabilities and attacks associated with USB devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The framework of USBWARE is aimed at accurate detection of both known and unknown USB-based attacks by a process that efficiently enhances the framework's detection capabilities over time. The framework will integrate two main security approaches in order to enhance the detection of USB-based attacks associated with a variety of USB devices. The first approach is aimed at the detection of known attacks and their variants, whereas the second approach focuses on the detection of unknown attacks. USBWARE will consist of six independent but complimentary detection modules, each detecting attacks based on a different approach or discipline. These modules include novel ideas and algorithms inspired from or already developed within our team's domains of expertise, including cyber security, electrical and signal processing, machine learning, and computational biology. The establishment and maintenance of the USBWARE’s dynamic and up-to-date attack repository will strengthen the capabilities of the USBWARE detection framework. The attack repository’s infrastructure will enable researchers to record, document, create, and simulate existing and new USB-based attacks. This data will be used to maintain the detection framework’s updatability by incorporating knowledge regarding new attacks. Based on our experience in the cyber security domain, we aim to design the USBWARE framework so that it will have several characteristics that are crucial for this type of cyber-security detection solution. Specifically, the USBWARE framework should be: Novel, Multidisciplinary, Trusted, Lightweight, Extendable, Modular and Updatable and Adaptable. Major Findings: Based on our initial survey, we have already found more than 23 types of USB-based attacks, divided into six major categories. Our preliminary evaluation and proof of concepts showed that our detection modules can be used for efficient detection of several basic known USB attacks. Further research, development, and enhancements are required so that USBWARE will be capable to cover all of the major known USB attacks and to detect unknown attacks. Conclusion: USBWARE is a crucial detection framework that must be further enhanced and developed.Keywords: USB, device, cyber security, attack, detection
Procedia PDF Downloads 397726 The Impact of Physical Exercise on Gestational Diabetes and Maternal Weight Management: A Meta-Analysis
Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei
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Physiological changes during pregnancy, such as alterations in the circulatory, respiratory, and musculoskeletal systems, can negatively impact daily physical activity. This reduced activity is often associated with an increased risk of adverse maternal health outcomes, particularly gestational diabetes mellitus (GDM) and excessive weight gain. This meta-analysis aims to evaluate the effectiveness of structured physical exercise interventions during pregnancy in reducing the risk of GDM and managing maternal weight gain. A comprehensive search was conducted across six major databases: PubMed, Cochrane Library, EMBASE, Web of Science, ScienceDirect, and ClinicalTrials.gov, covering the period from database inception until 2023. Randomized controlled trials (RCTs) that explored the effects of physical exercise programs on pregnant women with low physical activity levels were included. The search was performed using EndNote and results were managed using RevMan (Review Manager) for meta-analysis. RCTs involving healthy pregnant women with low levels of physical activity or sedentary lifestyles were selected. These RCTs must have incorporated structured exercise programs during pregnancy and reported on outcomes related to GDM and maternal weight gain. From an initial pool of 5,112 articles, 65 RCTs (involving 11,400 pregnant women) met the inclusion criteria. Data extraction was performed, followed by a quality assessment of the selected studies using the Cochrane Risk of Bias tool. The meta-analysis was conducted using RevMan software, where pooled relative risks (RR) and weighted mean differences (WMD) were calculated using a random-effects model to address heterogeneity across studies. Sensitivity analyses, subgroup analyses (based on factors such as exercise intensity, duration, and pregnancy stage), and publication bias assessments were also conducted. Structured physical exercise during pregnancy led to a significant reduction in the risk of developing GDM (RR = 0.68; P < 0.001), particularly when the exercise program was performed throughout the pregnancy (RR = 0.62; P = 0.035). In addition, maternal weight gain was significantly reduced (WMD = −1.18 kg; 95% CI −1.54 to −0.85; P < 0.001). There were no significant adverse effects reported for either the mother or the neonate, confirming that exercise interventions are safe for both. This meta-analysis highlights the positive impact of regular moderate physical activity during pregnancy in reducing the risk of GDM and managing maternal weight gain. These findings suggest that physical exercise should be encouraged as a routine part of prenatal care. However, more research is required to refine exercise recommendations and determine the most effective interventions based on individual risk factors and pregnancy stages.Keywords: gestational diabetes, maternal weight management, meta-analysis, randomized controlled trials
Procedia PDF Downloads 11725 Investigation of the Effects of 10-Week Nordic Hamstring Exercise Training and Subsequent Detraining on Plasma Viscosity and Oxidative Stress Levels in Healthy Young Men
Authors: H. C. Ozdamar , O. Kilic-Erkek, H. E. Akkaya, E. Kilic-Toprak, M. Bor-Kucukatay
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Nordic hamstring exercise (NHE) is used to increase hamstring muscle strength, prevent injuries. The aim of this study was to reveal the acute, long-term effects of 10-week NHE, followed by 5, 10-week detraining on anthropometric measurements, flexibility, anaerobic power, muscle architecture, damage, fatigue, oxidative stress, plasma viscosity (PV), blood lactate levels. 40 sedentary, healthy male volunteers underwent 10 weeks of progressive NHE followed by 5, 10 weeks of detraining. Muscle architecture was determined by ultrasonography, stiffness by strain elastography. Anaerobic power was assessed by double-foot standing, long jump, vertical jump, flexibility by sit-lie, hamstring flexibility tests. Creatine kinase activity, oxidant/antioxidant parameters were measured from venous blood by a commercial kit, whereas PV was determined using a cone-plate viscometer. The blood lactate level was measured from the fingertip. NHE allowed subjects to lose weight, this effect was reversed by detraining for 5 weeks. Exercise caused an increase in knee angles measured by a goniometer, which wasn’t affected by detraining. 10-week NHE caused a partially reversed increase in anaerobic performance upon detraining. NHE resulted in increment of biceps femoris long head (BFub) area, pennation angle, which was reversed by detraining of 10-weeks. Blood lactate levels, muscle pain, fatigue were increased after each exercise session. NHE didn’t change oxidant/antioxidant parameters; 5-week detraining resulted in an increase in total oxidant capacity (TOC) and oxidative stress index (OSI). Detraining of 10 weeks caused a reduction of these parameters. Acute exercise caused a reduction in PV at 1 to 10 weeks. Pre-exercise PV measured on the 10th week was lower than the basal value. Detraining caused the increment of PV. The results may guide the selection of the exercise type to increase performance and muscle strength. Knowing how much of the gains will be lost after a period of detraining can contribute to raising awareness of the continuity of the exercise. This work was supported by PAU Scientific Research Projects Coordination Unit (Project number: 2018SABE034)Keywords: anaerobic power, detraining, Nordic hamstring exercise, oxidative stress, plasma viscosity
Procedia PDF Downloads 126724 Relationship between the Development of Sepsis, Systemic Inflammatory Response Syndrome and Body Mass Index among Adult Trauma Patients at University Hospital in Cairo
Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy
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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma
Procedia PDF Downloads 249723 Active Abdominal Compression Device for Treatment of Orthostatic Hypotension
Authors: Vishnu Emani, Andreas Escher, Ellen Roche
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Background: Orthostatic hypotension (OH) is an autonomic disorder marked by a sudden drop in blood pressure upon standing resulting from autonomic dysfunction. OH is especially prevalent in elderly populations, affecting more than 30% of Americans over the age of 70. OH is one of the most significant risk factors for accidental falls in elderly populations, making it a crucial focus for medical and device therapies. Pharmacologic therapy with midodrine and fludrocortisone may alleviate hypotension but have significant adverse side effects. Abdominal passive compression devices (binders) are more effective than lower extremity compression stockings at mitigating postural hypotension, by improving venous return to the heart. However, abdominal binders are difficult to don and uncomfortable to wear, leading to poor compliance. A disadvantage of passive compression devices is their inability to selectively compress during the crucial moment of standing. it have recently developed an active compression device that applies external pressure on the abdomen during transition from prone to supine position and conducted initial prototype testing. Methods: An active abdominal compression device was developed utilizing a simple, servo-driven strap-tightening mechanism to supply tension onto foam fabric, which applies pressure to the abdomen. Healthy volunteers (n=5) were utilized for prototype testing and were subjected to three conditions: no compression, passive compression (i.e. standard abdominal binder), and active compression (device prototype). Abdominal applied pressure during device activation was measured by strain-gauge manometer placed between the skin and binder. Systolic (SBP) and mean (MAP) arterial blood pressure was measured by standard blood pressure cuff in supine position followed by repeat measurements at 1 minute intervals for 5 minutes following upright position. A survey tool was administered to determine scores (1-10) for comfort and ease of donning abdominal binders. Results: Abdominal pressure increased from 0 to 15±3 mmHg upon device activation for both passive and active compression devices. During transition from supine to upright position, both active and passive compression devices demonstrated significantly higher MAP compared to the no-compression condition (67±4, 68±5, 62±5 respectively P<0.05), but there was no statistically significant difference in SBP or MAP when comparing active to passive compression. Active compression demonstrated significantly higher comfort scores (8.3±1) compared to passive compression (3.2±2) but lower when compared to no compression (10). Subjects universally reported that active compression device was easier to don compared to passive device. Conclusions: Active or passive abdominal compression prevents hypotension associated with postural changes. Active compression is associated with increased comfort and ease of donning compared to passive compression devices. Future trials are warranted to investigate the efficacy of our device in patients with OH.Keywords: orthostatic hypotension, compression binder, abdominal binder, active abdominal compression
Procedia PDF Downloads 24722 Nigerian Media Coverage of the Chibok Girls Kidnap: A Qualitative News Framing Analysis of the Nation Newspaper
Authors: Samuel O. Oduyela
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Over the last ten years, many studies have examined the media coverage of terrorism across the world. Nevertheless, most of these studies have been inclined to the western narrative, more so in relation to the international media. This study departs from that partiality to explore the Nigerian press and its coverage of the Boko Haram. The study intends to illustrate how the Nigerian press has reported its homegrown terrorism within its borders. On 14 April 2014, the Shekau-led Boko Haram kidnapped over 200 female students from Chibok in the Borno State. This study analyses a structured sample of news stories, feature articles, editorial comments, and opinions from the Nation newspaper. The study examined the representation of the Chibok girls kidnaps by concentrating on four main viewpoints. The news framing of the Chibok girls’ kidnap under Presidents Goodluck Jonathan (2014) and Mohammadu Buhari (2016-2018), the sourcing model present in the news reporting of the kidnap and the challenges Nation reporters face in reporting Boko Haram. The study adopted the use of qualitative news framing analysis to provide further insights into significant developments established from the examination of news contents. The study found that the news reportage mainly focused on the government response to Chibok girls kidnap, international press and Boko Haram. Boko Haram was also framed, as a political conspiracy, as prevailing, and as instilling fear. Political, and economic influence appeared to be a significant determinant of the reportage. The study found that the Nation newspaper's portrayal of the crisis under President Jonathan differed significantly from under President Buhari. While the newspaper framed the action of President Jonathan as lacklustre, dismissive, and confusing, it was less critical of President Buhari's government's handling of the crisis. The Nation newspaper failed to promote or explore non-violent approaches. News reports of the kidnap, thus, were presented mainly from a political and ethnoreligious perspective. The study also raised questions of what roles should journalists play in covering conflicts? Should they merely report comments on and interpret it, or should they be actors in the resolution or, more importantly, the prevention of conflicts? The study underlined the need for the independence of the media, more training for journalists to advance a more nuanced and conflict-sensitive news coverage in the Nigerian context.Keywords: boko haram, chibok girls kidnap, conflict in nigeria, media framing
Procedia PDF Downloads 148721 The Use of Platelet-rich Plasma in the Treatment of Diabetic Foot Ulcers: A Scoping Review
Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet
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Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP
Procedia PDF Downloads 75720 A Holistic View of Microbial Community Dynamics during a Toxic Harmful Algal Bloom
Authors: Shi-Bo Feng, Sheng-Jie Zhang, Jin Zhou
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The relationship between microbial diversity and algal bloom has received considerable attention for decades. Microbes undoubtedly affect annual bloom events and impact the physiology of both partners, as well as shape ecosystem diversity. However, knowledge about interactions and network correlations among broader-spectrum microbes that lead to the dynamics in a complete bloom cycle are limited. In this study, pyrosequencing and network approaches simultaneously assessed the associate patterns among bacteria, archaea, and microeukaryotes in surface water and sediments in response to a natural dinoflagellate (Alexandrium sp.) bloom. In surface water, among the bacterial community, Gamma-Proteobacteria and Bacteroidetes dominated in the initial bloom stage, while Alpha-Proteobacteria, Cyanobacteria, and Actinobacteria become the most abundant taxa during the post-stage. In the archaea biosphere, it clustered predominantly with Methanogenic members in the early pre-bloom period while the majority of species identified in the later-bloom stage were ammonia-oxidizing archaea and Halobacteriales. In eukaryotes, dinoflagellate (Alexandrium sp.) was dominated in the onset stage, whereas multiply species (such as microzooplankton, diatom, green algae, and rotifera) coexistence in bloom collapse stag. In sediments, the microbial species biomass and richness are much higher than the water body. Only Flavobacteriales and Rhodobacterales showed a slight response to bloom stages. Unlike the bacteria, there are small fluctuations of archaeal and eukaryotic structure in the sediment. The network analyses among the inter-specific associations show that bacteria (Alteromonadaceae, Oceanospirillaceae, Cryomorphaceae, and Piscirickettsiaceae) and some zooplankton (Mediophyceae, Mamiellophyceae, Dictyochophyceae and Trebouxiophyceae) have a stronger impact on the structuring of phytoplankton communities than archaeal effects. The changes in population were also significantly shaped by water temperature and substrate availability (N & P resources). The results suggest that clades are specialized at different time-periods and that the pre-bloom succession was mainly a bottom-up controlled, and late-bloom period was controlled by top-down patterns. Additionally, phytoplankton and prokaryotic communities correlated better with each other, which indicate interactions among microorganisms are critical in controlling plankton dynamics and fates. Our results supplied a wider view (temporal and spatial scales) to understand the microbial ecological responses and their network association during algal blooming. It gives us a potential multidisciplinary explanation for algal-microbe interaction and helps us beyond the traditional view linked to patterns of algal bloom initiation, development, decline, and biogeochemistry.Keywords: microbial community, harmful algal bloom, ecological process, network
Procedia PDF Downloads 114719 Technology for Good: Deploying Artificial Intelligence to Analyze Participant Response to Anti-Trafficking Education
Authors: Ray Bryant
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3Strands Global Foundation (3SGF), a non-profit with a mission to mobilize communities to combat human trafficking through prevention education and reintegration programs, launched a groundbreaking study that calls out the usage and benefits of artificial intelligence in the war against human trafficking. Having gathered more than 30,000 stories from counselors and school staff who have gone through its PROTECT Prevention Education program, 3SGF sought to develop a methodology to measure the effectiveness of the training, which helps educators and school staff identify physical signs and behaviors indicating a student is being victimized. The program further illustrates how to recognize and respond to trauma and teaches the steps to take to report human trafficking, as well as how to connect victims with the proper professionals. 3SGF partnered with Levity, a leader in no-code Artificial Intelligence (AI) automation, to create the research study utilizing natural language processing, a branch of artificial intelligence, to measure the effectiveness of their prevention education program. By applying the logic created for the study, the platform analyzed and categorized each story. If the story, directly from the educator, demonstrated one or more of the desired outcomes; Increased Awareness, Increased Knowledge, or Intended Behavior Change, a label was applied. The system then added a confidence level for each identified label. The study results were generated with a 99% confidence level. Preliminary results show that of the 30,000 stories gathered, it became overwhelmingly clear that a significant majority of the participants now have increased awareness of the issue, demonstrated better knowledge of how to help prevent the crime, and expressed an intention to change how they approach what they do daily. In addition, it was observed that approximately 30% of the stories involved comments by educators expressing they wish they’d had this knowledge sooner as they can think of many students they would have been able to help. Objectives Of Research: To solve the problem of needing to analyze and accurately categorize more than 30,000 data points of participant feedback in order to evaluate the success of a human trafficking prevention program by using AI and Natural Language Processing. Methodologies Used: In conjunction with our strategic partner, Levity, we have created our own NLP analysis engine specific to our problem. Contributions To Research: The intersection of AI and human rights and how to utilize technology to combat human trafficking.Keywords: AI, technology, human trafficking, prevention
Procedia PDF Downloads 59718 Hybrid Solutions in Physicochemical Processes for the Removal of Turbidity in Andean Reservoirs
Authors: María Cárdenas Gaudry, Gonzalo Ramces Fano Miranda
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Sediment removal is very important in the purification of water, not only for reasons of visual perception but also because of its association with odor and taste problems. The Cuchoquesera reservoir, which is in the Andean region of Ayacucho (Peru) at an altitude of 3,740 meters above sea level, visually presents suspended particles and organic impurities indicating that it contains water of dubious quality to deduce that it is suitable for direct consumption of human beings. In order to quantitatively know the degree of impurities, water quality monitoring was carried out from February to August 2018, in which four sampling stations were established in the reservoir. The selected measured parameters were electrical conductivity, total dissolved solids, pH, color, turbidity, and sludge volume. The indicators of the studied parameters exceed the permissible limits except for electrical conductivity (190 μS/cm) and total dissolved solids (255 mg/L). In this investigation, the best combination and the optimal doses of reagents were determined that allowed the removal of sediments from the waters of the Cuchoquesera reservoir, through the physicochemical process of coagulation-flocculation. In order to improve this process during the rainy season, six combinations of reagents were evaluated, made up of three coagulants (ferric chloride, ferrous sulfate, and aluminum sulfate) and two natural flocculants: prickly pear powder (Opuntia ficus-indica) and tara gum (Caesalpinia spinoza). For each combination of reagents, jar tests were developed following the central composite experimental design (CCED), where the design factors were the doses of coagulant and flocculant and the initial turbidity. The results of the jar tests were adjusted to mathematical models, obtaining that to treat the water from the Cuchoquesera reservoir, with a turbidity of 150 UTN and a color of 137 U Pt-Co, 27.9 mg/L of the coagulant aluminum sulfate with 3 mg/L of the natural tara gum flocculant to produce a purified water quality of 1.7 UTN of turbidity and 3.2 U Pt-Co of apparent color. The estimated cost of the dose of coagulant and flocculant found was 0.22 USD/m³. This is how “grey-green” technologies can be used as a combination in nature-based solutions in water treatment, in this case, to achieve potability, making it more sustainable, especially economically, if green technology is available at the site of application of the nature-based hybrid solution. This research is a demonstration of the compatibility of natural coagulants/flocculants with other treatment technologies in the integrated/hybrid treatment process, such as the possibility of hybridizing natural coagulants with other types of coagulants.Keywords: prickly pear powder, tara gum, nature-based solutions, aluminum sulfate, jar test, turbidity, coagulation, flocculation
Procedia PDF Downloads 108717 Tumor Size and Lymph Node Metastasis Detection in Colon Cancer Patients Using MR Images
Authors: Mohammadreza Hedyehzadeh, Mahdi Yousefi
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Colon cancer is one of the most common cancer, which predicted to increase its prevalence due to the bad eating habits of peoples. Nowadays, due to the busyness of people, the use of fast foods is increasing, and therefore, diagnosis of this disease and its treatment are of particular importance. To determine the best treatment approach for each specific colon cancer patients, the oncologist should be known the stage of the tumor. The most common method to determine the tumor stage is TNM staging system. In this system, M indicates the presence of metastasis, N indicates the extent of spread to the lymph nodes, and T indicates the size of the tumor. It is clear that in order to determine all three of these parameters, an imaging method must be used, and the gold standard imaging protocols for this purpose are CT and PET/CT. In CT imaging, due to the use of X-rays, the risk of cancer and the absorbed dose of the patient is high, while in the PET/CT method, there is a lack of access to the device due to its high cost. Therefore, in this study, we aimed to estimate the tumor size and the extent of its spread to the lymph nodes using MR images. More than 1300 MR images collected from the TCIA portal, and in the first step (pre-processing), histogram equalization to improve image qualities and resizing to get the same image size was done. Two expert radiologists, which work more than 21 years on colon cancer cases, segmented the images and extracted the tumor region from the images. The next step is feature extraction from segmented images and then classify the data into three classes: T0N0، T3N1 و T3N2. In this article, the VGG-16 convolutional neural network has been used to perform both of the above-mentioned tasks, i.e., feature extraction and classification. This network has 13 convolution layers for feature extraction and three fully connected layers with the softmax activation function for classification. In order to validate the proposed method, the 10-fold cross validation method used in such a way that the data was randomly divided into three parts: training (70% of data), validation (10% of data) and the rest for testing. It is repeated 10 times, each time, the accuracy, sensitivity and specificity of the model are calculated and the average of ten repetitions is reported as the result. The accuracy, specificity and sensitivity of the proposed method for testing dataset was 89/09%, 95/8% and 96/4%. Compared to previous studies, using a safe imaging technique (MRI) and non-use of predefined hand-crafted imaging features to determine the stage of colon cancer patients are some of the study advantages.Keywords: colon cancer, VGG-16, magnetic resonance imaging, tumor size, lymph node metastasis
Procedia PDF Downloads 59716 Laparoscopic Resection Shows Comparable Outcomes to Open Thoracotomy for Thoracoabdominal Neuroblastomas: A Meta-Analysis and Systematic Review
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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