Search results for: focal loss
2970 “Congratulations, I Am Sorry for Your Loss”. A Qualitative Study to Help Healthcare Providers Search for Words When a Baby Dies
Authors: Liesbeth Van Kelst, Jozefiene Jansens
Abstract:
Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.Keywords: communication, death, perinatal loss, stillbirth
Procedia PDF Downloads 2252969 Exploring Career Guidance Program for Students with Special Needs
Authors: Rahayu Azkiya
Abstract:
Career guidance is an integral part of education that aims to help students understand their interests, talents, and potential and provide direction in choosing an appropriate career path. Approximately 76 million people are working out of 17 million people with disabilities in 2022, and this number has become a focal point as career guidance is crucial among people with special needs. Therefore, this study explores how the career guidance program is implemented and what challenges are faced by teachers. This study employs a qualitative case study in one of the senior high schools for special needs (SMLB) in Depok, Indonesia. Meanwhile, the data analysis was done through thematic analysis. Data has been obtained through the interviews of two teachers who focused on the physically impaired and deaf. The results of this study show that (1) the school has implemented career guidance well, the students were selected in the first year to look for their talents and interests, and for the second and third years, students are trained to master their abilities. (2) There are still many challenges teachers face in implementing career guidance programs, such as a need for more human resources for both students and teachers, high curriculum demands, and simple facilities that hinder student progress. Therefore, this research shows that every child is unique, so schools must meet the standards of student needs and re-evaluate the various challenges that teachers and students still face. This research is expected to serve as an analysis material for the government's policy towards special needs schools in Indonesia.Keywords: Students with Special Needs, Career Guidance Program, Implementation, Challenges
Procedia PDF Downloads 492968 Macular Ganglion Cell Inner Plexiform Layer Thinning
Authors: Hye-Young Shin, Chan Kee Park
Abstract:
Background: To compare the thinning patterns of the ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) as measured using Cirrus high-definition optical coherence tomography (HD-OCT) in patients with visual field (VF) defects that respect the vertical meridian. Methods: Twenty eyes of eleven patients with VF defects that respect the vertical meridian were enrolled retrospectively. The thicknesses of the macular GCIPL and pRNFL were measured using Cirrus HD-OCT. The 5% and 1% thinning area index (TAI) was calculated as the proportion of abnormally thin sectors at the 5% and 1% probability level within the area corresponding to the affected VF. The 5% and 1% TAI were compared between the GCIPL and pRNFL measurements. Results: The color-coded GCIPL deviation map showed a characteristic vertical thinning pattern of the GCIPL, which is also seen in the VF of patients with brain lesions. The 5% and 1% TAI were significantly higher in the GCIPL measurements than in the pRNFL measurements (all P < 0.01). Conclusions: Macular GCIPL analysis clearly visualized a characteristic topographic pattern of retinal ganglion cell (RGC) loss in patients with VF defects that respect the vertical meridian, unlike pRNFL measurements. Macular GCIPL measurements provide more valuable information than pRNFL measurements for detecting the loss of RGCs in patients with retrograde degeneration of the optic nerve fibers.Keywords: brain lesion, macular ganglion cell, inner plexiform layer, spectral-domain optical coherence tomography
Procedia PDF Downloads 3372967 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)
Authors: Ali Showail Ali Alasmari
Abstract:
Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia
Procedia PDF Downloads 1042966 Greatly Improved Dielectric Properties of Poly'vinylidene fluoride' Nanocomposites Using Ag-BaTiO₃ Hybrid Nanoparticles as Filler
Authors: K. Silakaew, P. Thongbai
Abstract:
There is an increasing need for high–permittivity polymer–matrix composites (PMC) owing to the rapid development of the electronics industry. Unfortunately, the dielectric permittivity of PMC is still too low ( < 80). Moreover, the dielectric loss tangent is usually high (tan > 0.1) when the dielectric permittivity of PMC increased. In this research work, the dielectric properties of poly(vinylidene fluoride) (PVDF)–based nanocomposites can be significantly improved by incorporating by silver–BaTiO3 (Ag–BT) ceramic hybrid nanoparticles. The Ag–BT/PVDF nanocomposites were fabricated using various volume fractions of Ag–BT hybrid nanoparticles (fAg–BT = 0–0.5). The Ag–BT/PVDF nanocomposites were characterized using several techniques. The main phase of Ag and BT can be detected by the XRD technique. The microstructure of the Ag–BT/PVDF nanocomposites was investigated to reveal the dispersion of Ag–BT hybrid nanoparticles because the dispersion state of a filler can have an effect on the dielectric properties of the nanocomposites. It was found that the filler hybrid nanoparticles were well dispersed in the PVDF matrix. The phase formation of PVDF phases was identified using the XRD and FTIR techniques. We found that the fillers can increase the polar phase of a PVDF polymer. The fabricated Ag–BT/PVDF nanocomposites are systematically characterized to explain the dielectric behavior in Ag–BT/PVDF nanocomposites. Interestingly, largely enhanced dielectric permittivity (>240) and suppressed loss tangent (tan<0.08) over a wide frequency range (102 – 105 Hz) are obtained. Notably, the dielectric permittivity is slightly dependent on temperature. The greatly enhanced dielectric permittivity was explained by the interfacial polarization between the Ag and PVDF interface, and due to a high permittivity of BT particles.Keywords: BaTiO3, PVDF, polymer composite, dielectric properties
Procedia PDF Downloads 1922965 DCDNet: Lightweight Document Corner Detection Network Based on Attention Mechanism
Authors: Kun Xu, Yuan Xu, Jia Qiao
Abstract:
The document detection plays an important role in optical character recognition and text analysis. Because the traditional detection methods have weak generalization ability, and deep neural network has complex structure and large number of parameters, which cannot be well applied in mobile devices, this paper proposes a lightweight Document Corner Detection Network (DCDNet). DCDNet is a two-stage architecture. The first stage with Encoder-Decoder structure adopts depthwise separable convolution to greatly reduce the network parameters. After introducing the Feature Attention Union (FAU) module, the second stage enhances the feature information of spatial and channel dim and adaptively adjusts the size of receptive field to enhance the feature expression ability of the model. Aiming at solving the problem of the large difference in the number of pixel distribution between corner and non-corner, Weighted Binary Cross Entropy Loss (WBCE Loss) is proposed to define corner detection problem as a classification problem to make the training process more efficient. In order to make up for the lack of Dataset of document corner detection, a Dataset containing 6620 images named Document Corner Detection Dataset (DCDD) is made. Experimental results show that the proposed method can obtain fast, stable and accurate detection results on DCDD.Keywords: document detection, corner detection, attention mechanism, lightweight
Procedia PDF Downloads 3542964 Anti-Osteoporotic Effect of Deer Antler in Ovariectomized Rats
Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem
Abstract:
The deer velvet antler is well known for its traditional medicinal value and is widely used in the clinic. It has been considered to possess bone-strengthening activity. The goal of this study was to investigate the anti-osteoporotic effect of deer antler velvet on ovariectomized rats (OVX), and their possible mechanism of the action. In the first step, the in vitro effects of DAE on bone loss were determined. The proliferation, collagen content and alkaline phosphatase (ALP) activity of human osteoblastic MG-63 cells and osteoclastogenesis from bone marrow-derived precursor cells were measured. The in vivo experiment confirmed the positive effect of DAE on bone tissue. 3-month old female Sparague-Dawley rats were either sham operated or OVX, and administered DAE (20 and 100 mg/kg) for 4 weeks. DAE increased MG-63 cell proliferation and ALP activity in a dose-dependent manner. Collagen content was also increased by DAE treatment. However, the effect of DAE on bone resorption was not observed. OVX rats supplemented with DAE showed osteoprotective effects as the bone ALP level was increased and c-terminal telopeptide level was decreased by 100 mg/kg DAE treatment compared with OVX controls. Moreover, the tartrate-resistant acid phosphatase-5b level was also decreased by DAE treatment. The present study suggests that DAE is effective in preventing bone loss in OVX rats, and may be potential therapeutic agents for the treatment of postmenopausal osteoporosis.Keywords: bone ALP, c-terminal telopeptide, deer antler, osteoporosis, ovariectomy, tartrate-resistant acid phosphatase-5b
Procedia PDF Downloads 2452963 Formulation of Value Added Beff Meatballs with the Addition of Pomegranate (Punica granatum) Extract as a Source of Natural Antioxident
Authors: M. A. Hashem, I. Jahan
Abstract:
The experiment was conducted to find out the effect of different levels of Pomegranate (Punica granatum) extract and synthetic antioxidant BHA (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs in order to make functional food. For this purpose, ground beef samples were divided into five treatment groups. They were treated as control group, 0.1% synthetic antioxidant group, 0.1%, 0.2% and 0.3% pomegranate extract group as T1, T2, T3, T4 and T5 respectively. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value (POV) and microbiological examination were determined in order to evaluate the effect of pomegranate extract as natural antioxidant and antimicrobial activities compared to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE and Ash content were decreased significantly (p<0.05) at different treatment levels. FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability decreased significantly (p<0.05) at different days of intervals. Raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels and at different days of intervals comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS value and microbial analysis it can be concluded that pomegranate extract at 0.1%, 0.2% and 0.3% can be used instead of synthetic antioxidant BHA in beef meatballs. On the basis of sensory evaluation, nutrient quality, physicochemical properties, biochemical analysis and microbial analysis 0.3% Pomegranate extract can be recommended for formulation of value added beef meatball enriched with natural antioxidant.Keywords: antioxidant, pomegranate, BHA, value added meat products
Procedia PDF Downloads 2462962 Isolation and Molecular IdentıFıCation of Polyethylene Degrading Bacteria From Soil and Degradation Detection by FTIR Analysis
Authors: Morteza Haghi, Cigdem Yilmazbas, Ayse Zeynep Uysal, Melisa Tepedelen, Gozde Turkoz Bakirci
Abstract:
Today, the increase in plastic waste accumulation is an inescapable consequence of environmental pollution; the disposal of these wastes has caused a significant problem. Variable methods have been utilized; however, biodegradation is the most environmentally friendly and low-cost method. Accordingly, the present study aimed to isolate the bacteria capable of biodegradation of plastics. In doing so, we applied the liquid carbon-free basal medium (LCFBM) prepared with deionized water for the isolation of bacterial species obtained from soil samples taken from the Izmir Menemen region. Isolates forming biofilms on plastic were selected and named (PLB3, PLF1, PLB1B) and subjected to a degradation test. FTIR analysis, 16s rDNA amplification, sequencing, identification of isolates were performed. Finally, at the end of the process, a mass loss of 16.6% in PLB3 isolate and 25% in PLF1 isolate was observed, while no mass loss was detected in PLB1B isolate. Only PLF1 and PLB1B created transparent zones on plastic texture. Considering the FTIR result, PLB3 changed plastic structure by 13.6% and PLF1 by 17%, while PLB1B did not change the plastic texture. According to the 16s rDNA sequence analysis, FLP1, PLB1B, and PLB3 isolates were identified as Streptomyces albogriseolus, Enterobacter cloacae, and Klebsiella pneumoniae, respectively.Keywords: polyethylene, biodegradation, bacteria, 16s rDNA, FTIR
Procedia PDF Downloads 2022961 Glaucoma Detection in Retinal Tomography Using the Vision Transformer
Authors: Sushish Baral, Pratibha Joshi, Yaman Maharjan
Abstract:
Glaucoma is a chronic eye condition that causes vision loss that is irreversible. Early detection and treatment are critical to prevent vision loss because it can be asymptomatic. For the identification of glaucoma, multiple deep learning algorithms are used. Transformer-based architectures, which use the self-attention mechanism to encode long-range dependencies and acquire extremely expressive representations, have recently become popular. Convolutional architectures, on the other hand, lack knowledge of long-range dependencies in the image due to their intrinsic inductive biases. The aforementioned statements inspire this thesis to look at transformer-based solutions and investigate the viability of adopting transformer-based network designs for glaucoma detection. Using retinal fundus images of the optic nerve head to develop a viable algorithm to assess the severity of glaucoma necessitates a large number of well-curated images. Initially, data is generated by augmenting ocular pictures. After that, the ocular images are pre-processed to make them ready for further processing. The system is trained using pre-processed images, and it classifies the input images as normal or glaucoma based on the features retrieved during training. The Vision Transformer (ViT) architecture is well suited to this situation, as it allows the self-attention mechanism to utilise structural modeling. Extensive experiments are run on the common dataset, and the results are thoroughly validated and visualized.Keywords: glaucoma, vision transformer, convolutional architectures, retinal fundus images, self-attention, deep learning
Procedia PDF Downloads 1912960 Wind Energy Loss Phenomenon Over Volumized Building Envelope with Porous Air Portals
Authors: Ying-chang Yu, Yuan-lung Lo
Abstract:
More and more building envelopes consist of the construction of balconies, canopies, handrails, sun-shading, vertical planters or gardens, maintenance platforms, display devices, lightings, ornaments, and also the most commonly seen double skin system. These components form a uniform but three-dimensional disturbance structure and create a complex surface wind field in front of the actual watertight building interface. The distorted wind behavior would affect the façade performance and building ventilation. Comparing with sole windscreen walls, these three-dimensional structures perform like distributed air portal assembly, and each portal generates air turbulence and consume wind pressure and energy simultaneously. In this study, we attempted to compare the behavior of 2D porous windscreens without internal construction, porous tubular portal windscreens, porous tapered portal windscreens, and porous coned portal windscreens. The wind energy reduction phenomenon is then compared to the different distributed air portals. The experiments are conducted in a physical wind tunnel with 1:25 in scale to simulate the three-dimensional structure of a real building envelope. The experimental airflow was set up to smooth flow. The specimen is designed as a plane with a distributed tubular structure behind, and the control group uses different tubular shapes but the same fluid volume to observe the wind damping phenomenon of various geometries.Keywords: volumized building envelope, porous air portal, wind damping, wind tunnel test, wind energy loss
Procedia PDF Downloads 1332959 A 10-Year In-Depth Follow-up of Post-lingual Hearing Loss Patients with Chinese Domestic Cochlear Implants
Authors: Jianan Li, Lusen Shi, Haiqiao Du, Wei Chen, Qian Wang, Shuoshuo Kang, Shiming Yang
Abstract:
Background: Follow-up of cochlear implant effectiveness is mainly focused on 3 years postoperatively, and studies with more than 5 years of observation are rare, especially for local Chinese brands. Objectives: Nurotron (Chinese domestic cochlear implant brand) CI recipients who participated in the clinical trial in 2009 were followed-up for 10 years prospectively, providing data to guide doctors and patients. Material and Methods: From December 2009 to April 2010, 57 subjects underwent Nurotron Venus CI surgery at multiple centers and were continued to be followed up and assessed at 1, 2, 3, 4, 5, and 10 years after switching on. Results: All recipients were successfully implanted with CIs with no difficulty in subsequent use, with one reported case of re-implantation 9 years after implantation. The aided hearing thresholds were significantly improved one month after switching on (p<0.0001) and remained stable afterward for 10 years. Speech recognition scores were significantly higher than pre-operative results (p<0.05) and continued to improve till 3 years after switching on. At 10 years of post-operation, most subjects had improved QOL scores in most sub-items. Conclusions and Significance: Nurotron Venus CI System provides long-term, stable results in hearing speech assistance capabilities and can improve the quality of life of CI recipients.Keywords: cochlear implantation, hearing loss, post lingual, follow up
Procedia PDF Downloads 152958 High Responsivity of Zirconium boride/Chromium Alloy Heterostructure for Deep and Near UV Photodetector
Authors: Sanjida Akter, Ambali Alade Odebowale, Andrey E. Miroshnichenko, Haroldo T. Hattori
Abstract:
Photodetectors (PDs) play a pivotal role in optoelectronics and optical devices, serving as fundamental components that convert light signals into electrical signals. As the field progresses, the integration of advanced materials with unique optical properties has become a focal point, paving the way for the innovation of novel PDs. This study delves into the exploration of a cutting-edge photodetector designed for deep and near ultraviolet (UV) applications. The photodetector is constructed with a composite of Zirconium Boride (ZrB2) and Chromium (Cr) alloy, deposited onto a 6H nitrogen-doped silicon carbide substrate. The determination of the optimal alloy thickness is achieved through Finite-Difference Time-Domain (FDTD) simulation, and the synthesis of the alloy is accomplished using radio frequency (RF) sputtering. Remarkably, the resulting photodetector exhibits an exceptional responsivity of 3.5 A/W under an applied voltage of -2 V, at wavelengths of 405 nm and 280 nm. This heterostructure not only exemplifies high performance but also provides a versatile platform for the development of near UV photodetectors capable of operating effectively in challenging conditions, such as environments characterized by high power and elevated temperatures. This study contributes to the expanding landscape of photodetector technology, offering a promising avenue for the advancement of optoelectronic devices in demanding applications.Keywords: responsivity, silicon carbide, ultraviolet photodetector, zirconium boride
Procedia PDF Downloads 662957 An Assessment of Bathymetric Changes in the Lower Usuma Reservoir, Abuja, Nigera
Authors: Rayleigh Dada Abu, Halilu Ahmad Shaba
Abstract:
Siltation is a serious problem that affects public water supply infrastructures such as dams and reservoirs. It is a major problem which threatens the performance and sustainability of dams and reservoirs. It reduces the dam capacity for flood control, potable water supply, changes water stage, reduces water quality and recreational benefits. The focus of this study is the Lower Usuma reservoir. At completion the reservoir had a gross storage capacity of 100 × 106 m3 (100 million cubic metres), a maximum operational level of 587.440 m a.s.l., with a maximum depth of 49 m and a catchment area of 241 km2 at dam site with a daily designed production capacity of 10,000 cubic metres per hour. The reservoir is 1,300 m long and feeds the treatment plant mainly by gravity. The reservoir became operational in 1986 and no survey has been conducted to determine its current storage capacity and rate of siltation. Hydrographic survey of the reservoir by integrated acoustic echo-sounding technique was conducted in November 2012 to determine the level and rate of siltation. The result obtained shows that the reservoir has lost 12.0 meters depth to siltation in 26 years of its operation; indicating 24.5% loss in installed storage capacity. The present bathymetric survey provides baseline information for future work on siltation depth and annual rates of storage capacity loss for the Lower Usuma reservoir.Keywords: sedimentation, lower Usuma reservoir, acoustic echo sounder, bathymetric survey
Procedia PDF Downloads 5152956 The OverStitch and OverStitch SX Endoscopic Suturing System in Bariatric Surgery, Closing Perforations and Fistulas and Revision Procedures
Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh
Abstract:
Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula
Procedia PDF Downloads 632955 Living Lab as a Service: Developing Context Induced, Co-creational Innovation Routines as a Process Tool for Nature Based Solutions
Authors: Immanuel Darkwa
Abstract:
Climate change and environmental degradation are existential threats requiring urgent transnational action. The SDGs, as well as regional initiatives the like European Green Deal, as ambitious as they are, put an emphasis on innovatively tackling threats posed by climate change regionally. While co-creational approaches are being propagated, there is no reference blueprint for how potential solutions, particularly nature-based solutions, may be developed and implemented within urban-settings. Using a single case study in Zagreb, Croatia, this paper proposes a workshop-tool for a Living Lab as a Service model for sustainable Nature-Based-Thinking, Nature–Centred-Design and Nature based solutions. The approach is based on a co-creational methodology developed through literature synthesis, expert interviews, focus group discussions, surveys and synthesized through rigorous research analysis and participatory observation. The ensuing tool involves workshop-processes, tested with through-the-process identified stakeholders with distinctive roles and functions. The resulting framework proposes a Nature-Based-Centred-Thinking process tool involving ‘green’ routines supported by a focal unit and a collaborative network, and that allows for the development of nature-based solutions.Keywords: living labs, nature-based solutions, nature- based design, innovation processes, innovation routines and tools
Procedia PDF Downloads 762954 Emergentist Metaphorical Creativity: Towards a Model of Analysing Metaphorical Creativity in Interactive Talk
Authors: Afef Badri
Abstract:
Metaphorical creativity does not constitute a static property of discourse. It is an interactive dynamic process created online. There has been a lack of research concerning online produced metaphorical creativity. This paper intends to account for metaphorical creativity in online talk-in-interaction as a dynamic process that emerges as discourse unfolds. It brings together insights from the emergentist approach to the study of metaphor in verbal interactions and insights from conceptual blending approach as a model for analysing online metaphorical constructions to propose a model for studying metaphorical creativity in interactive talk. The model is based on three focal points. First, metaphorical creativity is a dynamic emergent and open-to-change process that evolves in real time as interlocutors constantly blend and re-blend previous metaphorical contributions. Second, it is not a product of isolated individual minds but a joint achievement that is co-constructed and co-elaborated by interlocutors. The third and most important point is that the emergent process of metaphorical creativity is tightly shaped by contextual variables surrounding talk-in-interaction. It is grounded in the framework of interpretation of interlocutors. It is constrained by preceding contributions in a way that creates textual cohesion of the verbal exchange and it is also a goal-oriented process predefined by the communicative intention of each participant in a way that reveals the ideological coherence/incoherence of the entire conversation.Keywords: communicative intention, conceptual blending, the emergentist approach, metaphorical creativity
Procedia PDF Downloads 2592953 Infrared Thermography as an Informative Tool in Energy Audit and Software Modelling of Historic Buildings: A Case Study of the Sheffield Cathedral
Authors: Ademuyiwa Agbonyin, Stamatis Zoras, Mohammad Zandi
Abstract:
This paper investigates the extent to which building energy modelling can be informed based on preliminary information provided by infrared thermography using a thermal imaging camera in a walkthrough audit. The case-study building is the Sheffield Cathedral, built in the early 1400s. Based on an informative qualitative report generated from the thermal images taken at the site, the regions showing significant heat loss are input into a computer model of the cathedral within the integrated environmental solution (IES) virtual environment software which performs an energy simulation to determine quantitative heat losses through the building envelope. Building data such as material thermal properties and building plans are provided by the architects, Thomas Ford and Partners Ltd. The results of the modelling revealed the portions of the building with the highest heat loss and these aligned with those suggested by the thermal camera. Retrofit options for the building are also considered, however, may not see implementation due to a desire to conserve the architectural heritage of the building. Results show that thermal imaging in a walk-through audit serves as a useful guide for the energy modelling process. Hand calculations were also performed to serve as a 'control' to estimate losses, providing a second set of data points of comparison.Keywords: historic buildings, energy retrofit, thermal comfort, software modelling, energy modelling
Procedia PDF Downloads 1702952 The Influence of Different Flux Patterns on Magnetic Losses in Electric Machine Cores
Authors: Natheer Alatawneh
Abstract:
The finite element analysis of magnetic fields in electromagnetic devices shows that the machine cores experience different flux patterns including alternating and rotating fields. The rotating fields are generated in different configurations range between circular and elliptical with different ratios between the major and minor axis of the flux locus. Experimental measurements on electrical steel exposed to different flux patterns disclose different magnetic losses in the samples under test. Consequently, electric machines require special attention during the cores loss calculation process to consider the flux patterns. In this study, a circular rotational single sheet tester is employed to measure the core losses in electric steel sample of M36G29. The sample was exposed to alternating field, circular field, and elliptical fields with axis ratios of 0.2, 0.4, 0.6 and 0.8. The measured data was implemented on 6-4 switched reluctance motor at three different frequencies of interest to the industry as 60 Hz, 400 Hz, and 1 kHz. The results disclose a high margin of error that may occur during the loss calculations if the flux patterns issue is neglected. The error in different parts of the machine associated with considering the flux patterns can be around 50%, 10%, and 2% at 60Hz, 400Hz, and 1 kHz, respectively. The future work will focus on the optimization of machine geometrical shape which has a primary effect on the flux pattern in order to minimize the magnetic losses in machine cores.Keywords: alternating core losses, electric machines, finite element analysis, rotational core losses
Procedia PDF Downloads 2522951 Effect of Cigarette Smoke on Micro-Architecture of Respiratory Organs with and without Dietary Probiotics
Authors: Komal Khan, Hafsa Zaneb, Saima Masood, Muhammad Younus, Sanan Raza
Abstract:
Cigarette smoke induces many physiological and pathological changes in respiratory tract like goblet cell hyperplasia and regional distention of airspaces. It is also associated with elevation of inflammatory profiles in different airway compartments. As probiotics are generally known to promote mucosal tolerance, it was postulated that prophylactic use of probiotics can be helpful in reduction of respiratory damage induced by cigarette smoke exposure. Twenty-four adult mice were randomly divided into three groups (cigarette-smoke (CS) group, cigarette-smoke+ Lactobacillus (CS+ P) group, control (Cn) group), each having 8 mice. They were exposed to cigarette smoke for 28 days (6 cigarettes/ day for 6 days/week). Wright-Giemsa staining of bronchoalveolar lavage fluid (BALF) was performed in three mice per group. Tissue samples of trachea and lungs of 7 mice from each group were processed by paraffin embedding technique for haematoxylin & eosin (H & E) and alcian blue- periodic acid-Schiff (AB-PAS) staining. Then trachea (goblet cell number, ratio and loss of cilia) and lungs (airspace distention) were studied. The results showed that the number of goblet cells was increased in CS group as a result of defensive mechanism of the respiratory system against irritating substances. This study also revealed that the cells of CS group having acidic glycoprotein were found to be higher in quantity as compared to those containing neutral glycoprotein. However, CS + P group showed a decrease in goblet cell index due to enhanced immunity by prophylactically used probiotics. Moreover, H & E stained tracheas showed significant loss of cilia in CS group due to propelling of mucous but little loss in CS + P group because of having good protective tracheal epithelium. In lungs, protection of airspaces was also much more evident in CS+ P group as compared to CS group having distended airspaces, especially at 150um distance from terminal bronchiole. In addition, a comprehensive analysis of inflammatory cells population of BALF showed neutrophilia and eosinophilia was significantly reduced in CS+ P group. This study proved that probiotics are found to be useful for reduction of changes in micro-architecture of the respiratory system. Thus, dietary supplementation of probiotic as prophylactic measure can be useful in achieving immunomodulatory effects.Keywords: cigarette smoke, probiotics, goblet cells, airspace enlargement, BALF
Procedia PDF Downloads 3642950 Analysis of Crisis Management Systems of United Kingdom and Turkey
Authors: Recep Sait Arpat, Hakan Güreşci
Abstract:
Emergency, disaster and crisis management terms are generally perceived as the same processes. This conflict effects the approach and delegating policy of the political order. Crisis management starts in the aftermath of the mismanagement of disaster and emergency. In the light of the information stated above in this article Turkey and United Kingdom(UK)’s crisis management systems are analyzed. This article’s main aim is to clarify the main points of the emergency management system of United Kingdom and Turkey’s disaster management system by comparing them. To do this: A prototype model of the political decision making processes of the countries is drawn, decision making mechanisms and the planning functions are compared. As a result it’s found that emergency management policy in Turkey is reactive whereas it’s proactive in UK; as the delegating policy Turkey’s system is similar to UK; levels of emergency situations are similar but not the same; the differences are stemming from the civil order and nongovernmental organizations effectiveness; UK has a detailed government engagement model to emergencies, which shapes the doctrine of the approach to emergencies, and it’s successful in gathering and controlling the whole state’s efforts; crisis management is a sub-phase of UK emergency management whereas it’s accepted as a outmoded management perception and the focal point of crisis management perception in UK is security crisis and natural disasters while in Turkey it is natural disasters. In every anlysis proposals are given to Turkey.Keywords: crisis management, disaster management, emergency management, turkey, united kingdom
Procedia PDF Downloads 3722949 Music Education for Blacks (Africans) in Apartheid and Post-Apartheid South Africa
Authors: Bernett Nkwayi Mulungo
Abstract:
There are vast community music projects in South African townships, and their courses range from music theory aural practical individual and ensemble lessons on orchestral instruments and recorders – these instruments being primarily “Western”. Despite this relative success – indeed one of the few in the realm of arts in post-apartheid South Africa – what remains troubling is the dominance of western thought (as music theory) and modes of teaching music that maintain the idea of music study as alien in black communities. This identified problem speaks to a significant theme, namely: Arts education for community development, which is my area of interest. Primarily for, it is a timely platform to firmly entrench appreciation, understanding, and, most undoubtedly, the value(s) of the arts to the youth. Drawing on one’s experience as a lecturer in (and graduate from) a South African tertiary institution and as a teacher in a community project, this research will interrogate the content of some of the program(s): from the theoretical material taught in music theory classes to the practical repertoire taught and/or performed. The focal point of this research is on how this content informs or speaks to its intended “beneficiaries” – the African youth. Through these and other considerations, the paper aims to sketch the potentially radical consequences that transformed music education at community and earlier levels will have for higher education music studies in South Africa.Keywords: decolonization, Africanization, indigenous knowledge, community engagement
Procedia PDF Downloads 802948 Effect of Class V Cavity Configuration and Loading Situation on the Stress Concentration
Authors: Jia-Yu Wu, Chih-Han Chang, Shu-Fen Chuang, Rong-Yang Lai
Abstract:
Objective: This study was to examine the stress distribution of tooth with different class V restorations under different loading situations and geometry by 3D finite element (FE) analysis. `Methods: A series of FE models of mandibular premolars containing class V cavities were constructed using micro-CT. The class V cavities were assigned as the combinations of different cavity depths x occlusal -gingival heights: 1x2, 1x4, 2x2, and 2x4 mm. Three alveolar bone loss conditions were examined: 0, 1, and 2 mm. 200 N force was exerted on the buccal cusp tip under various directions (vertical, V; obliquely 30° angled, O; oblique and parallel the individual occlusal cavity wall, P). A 3-D FE analysis was performed and the von-Mises stress was used to summarize the data of stress distribution and maximum stress. Results: The maximal stress did not vary in different alveolar bone heights. For each geometry, the maximal stress was found at bilateral corners of the cavity. The peak stress of restorations was significantly higher under load P compared to those under loads V and O while the latter two were similar. 2x2mm cavity exhibited significantly increased (2.88 fold) stress under load P compared to that under load V, followed by 1x2mm (2.11 fold), 2x4mm (1.98 fold) and 1x4mm (1.1fold). Conclusion: Load direction causes the greatest impact on the results of stress, while the effect of alveolar bone loss is minor. Load direction parallel to the cavity wall may enhance the stress concentration especially in deep and narrow class cavities.Keywords: class v restoration, finite element analysis, loading situation, stress
Procedia PDF Downloads 2432947 Enhancing Urban Sustainability through Integrated Green Spaces: A Focus on Tehran
Authors: Azadeh Mohajer Milani
Abstract:
Urbanization constitutes an irreversible global trend, presenting myriad challenges such as heightened energy consumption, pollution, congestion, and the depletion of natural resources. Today's urban landscapes have emerged as focal points for economic, social, and environmental challenges, underscoring the pressing need for sustainable development. This article delves into the realm of sustainable urban development, concentrating on the pivotal role played by integrated green spaces as an optimal solution to address environmental concerns within cities. The study utilizes Tehran as a case study. Our findings underscore the imperative of preserving and expanding green spaces in urban areas, coupled with the establishment of well-designed ecological networks, to enhance environmental quality and elevate the sustainability of cities. Notably, Tehran's urban green spaces exhibit a disjointed design, lacking a cohesive network to connect various patches and corridors, resulting in significant environmental impacts. The results emphasize the necessity of a balanced and proportional distribution of urban green spaces and the creation of a cohesive patch-corridor-matrix network tailored to the ecological and social needs of residents. This approach is crucial for fostering a more sustainable and livable urban environment for all species, with a specific focus on humans.Keywords: ecology, sustainable urban development, sustainable landscape, urban green space network
Procedia PDF Downloads 832946 Prevalence of Cyp2d6 and Its Implications for Personalized Medicine in Saudi Arabs
Authors: Hamsa T. Tayeb, Mohammad A. Arafah, Dana M. Bakheet, Duaa M. Khalaf, Agnieszka Tarnoska, Nduna Dzimiri
Abstract:
Background: CYP2D6 is a member of the cytochrome P450 mixed-function oxidase system. The enzyme is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, especially in breast cancer and psychiatric therapy. Different phenotypes have been described displaying alleles that lead to a complete loss of enzyme activity, reduced function (poor metabolizers – PM), hyperfunctionality (ultrarapid metabolizers–UM) and therefore drug intoxication or loss of drug effect. The prevalence of these variants may vary among different ethnic groups. Furthermore, the xTAG system has been developed to categorized all patients into different groups based on their CYP2D6 substrate metabolization. Aim of the study: To determine the prevalence of the different CYP2D6 variants in our population, and to evaluate their clinical relevance in personalized medicine. Methodology: We used the Luminex xMAP genotyping system to sequence 305 Saudi individuals visiting the Blood Bank of our Institution and determine which polymorphisms of CYP2D6 gene are prevalent in our region. Results: xTAG genotyping showed that 36.72% (112 out of 305 individuals) carried the CYP2D6_*2. Out of the 112 individuals with the *2 SNP, 6.23% had multiple copies of *2 SNP (19 individuals out of 305 individuals), resulting in an UM phenotype. About 33.44% carried the CYP2D6_*41, which leads to decreased activity of the CYP2D6 enzyme. 19.67% had the wild-type alleles and thus had normal enzyme function. Furthermore, 15.74% carried the CYP2D6_*4, which is the most common nonfunctional form of the CYP2D6 enzyme worldwide. 6.56% carried the CYP2D6_*17, resulting in decreased enzyme activity. Approximately 5.73% carried the CYP2D6_*10, consequently decreasing the enzyme activity, resulting in a PM phenotype. 2.30% carried the CYP2D6_*29, leading to decreased metabolic activity of the enzyme, and 2.30% carried the CYP2D6_*35, resulting in an UM phenotype, 1.64% had a whole-gene deletion CYP2D6_*5, thus resulting in the loss of CYP2D6 enzyme production, 0.66% carried the CYP2D6_*6 variant. One individual carried the CYP2D6_*3(B), producing an inactive form of the enzyme, which leads to decrease of enzyme activity, resulting in a PM phenotype. Finally, one individual carried the CYP2D6_*9, which decreases the enzyme activity. Conclusions: Our study demonstrates that different CYP2D6 variants are highly prevalent in ethnic Saudi Arabs. This finding sets a basis for informed genotyping for these variants in personalized medicine. The study also suggests that xTAG is an appropriate procedure for genotyping the CYP2D6 variants in personalized medicine.Keywords: CYP2D6, hormonal breast cancer, pharmacogenetics, polymorphism, psychiatric treatment, Saudi population
Procedia PDF Downloads 5722945 Ear Protectors and Their Action in Protecting Hearing System of Workers against Occupational Noise
Authors: F. Forouharmajd, S. Pourabdian, N. Ziayi Ghahnavieh
Abstract:
For many years, the ear protectors have been used to preventing the audio and non-audio effects of received noise from occupation environments. Despite performing hearing protection programs, there are many people which still suffer from noise-induced hearing loss. This study was conducted with the aim of determination of human hearing system response to received noise and the effectiveness of ear protectors on preventing of noise-induced hearing loss. Sound pressure microphones were placed in a simulated ear canal. The severity of noise measured inside and outside of ear canal. The noise reduction values due to installing ear protectors were calculated in the octave band frequencies and LabVIEW programmer. The results of noise measurement inside and outside of ear canal showed a different in received sound levels by ear canal. The effectiveness of ear protectors has been considerably reduced for the low frequency limits. A change in resonance frequency also was observed after using ear protectors. The study indicated the ear canal structure may affect the received noise and it may lead a difference between the received sound from the measured sound by a sound level meter, and hearing system. It means the human hearing system may probably respond different from a sound level meter. Hearing protectors’ efficiency declines by increasing the noise levels, and thus, they are not suitable to protect workers against industrial noise particularly low frequency noise. Hearing protectors may be solely a reason to damaging of hearing system in a special frequency via changing of human hearing system acoustical structure. We need developing the subjective method of hearing protectors testing, because their evaluation is not designed based on industrial noise or in the field.Keywords: ear protector, hearing system, occupational noise, workers
Procedia PDF Downloads 1692944 Macroscopic Lesions and Histological Changes Caused by Non-Biodegradable Foreign Bodies in the Rumen of Cattle
Authors: Rouabah Zahra, Tlidjane Madjid, Belkacem Lilia, Hafid Nadia, Mallem Mouna
Abstract:
The goal of the current study was to evaluate the gross and histopathological changes caused by the presence of non-biodegradable foreign bodies (plastic bags) in the rumen-reticulum of cattle. To identify this problem, we conducted this study at a slaughterhouse on a total of 212 cattle without any previous selection. After slaughter and draining of the rumen, foreign bodies and macroscopic lesions were investigated, and rumen samples were taken for histopathological examination. Gross examination of the rumen-reticulum with non-biodegradable foreign bodies revealed congestion, hemorrhage, stunting, sagging, atrophy, and thinning of the papillae had been observed. Areas of erosion and ulceration were also observed in the rumen-reticulum of all cattle harboring a large quantity of plastic bags. Ulcerations and nodular formations were also present. The rumen-reticulum wall was thinner than normal and had a light-mottled wall and compressed papillae. The histopathological examination revealed a wide variety of lesions. We observed especially lesions of fragmentary or segmental ruptures, destruction, necrosis, degeneration and focal hyperplasia of the keratinized epithelium. The papillae are shortened, enlarged, atrophied, folded, and compressed. The length of the taste buds was reduced. These observed histopathological changes can be attributed to mechanical irritation induced by plastic bags or released chemicals by these non-biodegradable foreign bodies.Keywords: cattle, non-biodegradable foreign bodies, lesions, rumen
Procedia PDF Downloads 642943 Optimal Wind Based DG Placement Considering Monthly Changes Modeling in Wind Speed
Authors: Belal Mohamadi Kalesar, Raouf Hasanpour
Abstract:
Proper placement of Distributed Generation (DG) units such as wind turbine generators in distribution system are still very challenging issue for obtaining their maximum potential benefits because inappropriate placement may increase the system losses. This paper proposes Particle Swarm Optimization (PSO) technique for optimal placement of wind based DG (WDG) in the primary distribution system to reduce energy losses and voltage profile improvement with four different wind levels modeling in year duration. Also, wind turbine is modeled as a DFIG that will be operated at unity power factor and only one wind turbine tower will be considered to install at each bus of network. Finally, proposed method will be implemented on widely used 69 bus power distribution system in MATLAB software environment under four scenario (without, one, two and three WDG units) and for capability test of implemented program it is supposed that all buses of standard system can be candidate for WDG installing (large search space), though this program can consider predetermined number of candidate location in WDG placement to model financial limitation of project. Obtained results illustrate that wind speed increasing in some months will increase output power generated but this can increase / decrease power loss in some wind level, also results show that it is required about 3MW WDG capacity to install in different buses but when this is distributed in overall network (more number of WDG) it can cause better solution from point of view of power loss and voltage profile.Keywords: wind turbine, DG placement, wind levels effect, PSO algorithm
Procedia PDF Downloads 4482942 Influence of Hearing Aids on Non-medically Treatable Deafness
Authors: Donatien Niragira
Abstract:
The progress of technology creates new expectations for patients. The world of deafness is no exception. In recent years, there have been considerable advances in the field of technologies aimed at assisting failing hearing. According to the usual medical vocabulary, hearing aids are actually orthotics. They do not replace an organ but compensate for a functional impairment. The Amplifier Hearing amplification is useful for a large number of people with hearing loss. Hearing aids restore speech audibility. However, their benefits vary depending on the quality of residual hearing. The hearing aid is not a "cure" for deafness. It cannot correct all affected hearing abilities. It should be considered as an aid to communication. The urge to judge from the audiogram alone should be resisted here, as audiometry only indicates the ability to detect non-verbal sounds. To prevent hearing aids from ending up in the drawer, it is important to ensure that the patient's disability situations justify the use of this type of orthosis. If the problems of receptive Pre-fitting counseling are crucial: the person with hearing loss must be informed of the advantages and disadvantages of amplification in his or her case. Their expectations must be realistic. They also need to be aware that the adaptation process requires a good deal of patience and perseverance. They should be informed about the various models and types of hearing aids, including all the aesthetic, functional and financial considerations. If the person's motivation "survives" pre-fitting counseling, we are in the presence of a good candidate for amplification. In addition to its relevance, it shows that the results found in this study significantly improve the quality of audibility in the patient, from where this technology must be made accessible everywhere in the world.Keywords: auditives protheses, hearing, aids, no medicaly treatable deafnes
Procedia PDF Downloads 572941 A Service Evaluation Exploring the Effectiveness of a Tier 3 Weight Management Programme Offering Face-To-Face and Remote Dietetic Support
Authors: Rosemary E. Huntriss, Lucy Jones
Abstract:
Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.Keywords: dietitian, digital health, obesity, weight management
Procedia PDF Downloads 141