Search results for: loss year
591 Freshwater Pinch Analysis for Optimal Design of the Photovoltaic Powered-Pumping System
Authors: Iman Janghorban Esfahani
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Due to the increased use of irrigation in agriculture, the importance and need for highly reliable water pumping systems have significantly increased. The pumping of the groundwater is essential to provide water for both drip and furrow irrigation to increase the agricultural yield, especially in arid regions that suffer from scarcities of surface water. The most common irrigation pumping systems (IPS) consume conventional energies through the use of electric motors and generators or connecting to the electricity grid. Due to the shortage and transportation difficulties of fossil fuels, and unreliable access to the electricity grid, especially in the rural areas, and the adverse environmental impacts of fossil fuel usage, such as greenhouse gas (GHG) emissions, the need for renewable energy sources such as photovoltaic systems (PVS) as an alternative way of powering irrigation pumping systems is urgent. Integration of the photovoltaic systems with irrigation pumping systems as the Photovoltaic Powered-Irrigation Pumping System (PVP-IPS) can avoid fossil fuel dependency and the subsequent greenhouse gas emissions, as well as ultimately lower energy costs and improve efficiency, which made PVP-IPS systems as an environmentally and economically efficient solution for agriculture irrigation in every region. The greatest problem faced by integration of PVP with IPS systems is matching the intermittence of the energy supply with the dynamic water demand. The best solution to overcome the intermittence is to incorporate a storage system into the PVP-IPS to provide water-on-demand as a highly reliable stand-alone irrigation pumping system. The water storage tank (WST) is the most common storage device for PVP-IPS systems. In the integrated PVP-IPS with a water storage tank (PVP-IPS-WST), a water storage tank stores the water pumped by the IPS in excess of the water demand and then delivers it when demands are high. The Freshwater pinch analysis (FWaPA) as an alternative to mathematical modeling was used by other researchers for retrofitting the off-grid battery less photovoltaic-powered reverse osmosis system. However, the Freshwater pinch analysis has not been used to integrate the photovoltaic systems with irrigation pumping system with water storage tanks. In this study, FWaPA graphical and numerical tools were used for retrofitting an existing PVP-IPS system located in Salahadin, Republic of Iraq. The plant includes a 5 kW submersible water pump and 7.5 kW solar PV system. The Freshwater Composite Curve as the graphical tool and Freashwater Storage Cascade Table as the numerical tool were constructed to determine the minimum required outsourced water during operation, optimal amount of delivered electricity to the water pump, and optimal size of the water storage tank for one-year operation data. The results of implementing the FWaPA on the case study show that the PVP-IPS system with a WST as the reliable system can reduce outsourced water by 95.41% compare to the PVP-IPS system without storage tank.Keywords: irrigation, photovoltaic, pinch analysis, pumping, solar energy
Procedia PDF Downloads 138590 Creation and Evaluation of an Academic Blog of Tools for the Self-Correction of Written Production in English
Authors: Brady, Imelda Katherine, Da Cunha Fanego, Iria
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Today's university students are considered digital natives and the use of Information Technologies (ITs) forms a large part of their study and learning. In the context of language studies, applications that help with revisions of grammar or vocabulary are particularly useful, especially if they are open access. There are studies that show the effectiveness of this type of application in the learning of English as a foreign language and that using IT can help learners become more autonomous in foreign language acquisition, given that these applications can enhance awareness of the learning process; this means that learners are less dependent on the teacher for corrective feedback. We also propose that the exploitation of these technologies also enhances the work of the language instructor wishing to incorporate IT into his/her practice. In this context, the aim of this paper is to present the creation of a repository of tools that provide support in the writing and correction of texts in English and the assessment of their usefulness on behalf of university students enrolled in the English Studies Degree. The project seeks to encourage the development of autonomous learning through the acquisition of skills linked to the self-correction of written work in English. To comply with the above, our methodology follows five phases. First of all, a selection of the main open-access online applications available for the correction of written texts in English is made: AutoCrit, Hemingway, Grammarly, LanguageTool, OutWrite, PaperRater, ProWritingAid, Reverso, Slick Write, Spell Check Plus and Virtual Writing Tutor. Secondly, the functionalities of each of these tools (spelling, grammar, style correction, etc.) are analyzed. Thirdly, explanatory materials (texts and video tutorials) are prepared on each tool. Fourth, these materials are uploaded into a repository of our university in the form of an institutional blog, which is made available to students and the general public. Finally, a survey was designed to collect students’ feedback. The survey aimed to analyse the usefulness of the blog and the quality of the explanatory materials as well as the degree of usefulness that students assigned to each of the tools offered. In this paper, we present the results of the analysis of data received from 33 students in the 1st semester of the 21-22 academic year. One result we highlight in our paper is that the students have rated this resource very highly, in addition to offering very valuable information on the perceived usefulness of the applications provided for them to review. Our work, carried out within the framework of a teaching innovation project funded by our university, emphasizes that teachers need to design methodological strategies that help their students improve the quality of their productions written in English and, by extension, to improve their linguistic competence.Keywords: academic blog, open access tools, online self-correction, written production in English, university learning
Procedia PDF Downloads 103589 Implementation of Smart Card Automatic Fare Collection Technology in Small Transit Agencies for Standards Development
Authors: Walter E. Allen, Robert D. Murray
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Many large transit agencies have adopted RFID technology and electronic automatic fare collection (AFC) or smart card systems, but small and rural agencies remain tied to obsolete manual, cash-based fare collection. Small countries or transit agencies can benefit from the implementation of smart card AFC technology with the promise of increased passenger convenience, added passenger satisfaction and improved agency efficiency. For transit agencies, it reduces revenue loss, improves passenger flow and bus stop data. For countries, further implementation into security, distribution of social services or currency transactions can provide greater benefits. However, small countries or transit agencies cannot afford expensive proprietary smart card solutions typically offered by the major system suppliers. Deployment of Contactless Fare Media System (CFMS) Standard eliminates the proprietary solution, ultimately lowering the cost of implementation. Acumen Building Enterprise, Inc. chose the Yuma County Intergovernmental Public Transportation Authority (YCIPTA) existing proprietary YCAT smart card system to implement CFMS. The revised system enables the purchase of fare product online with prepaid debit or credit cards using the Payment Gateway Processor. Open and interoperable smart card standards for transit have been developed. During the 90-day Pilot Operation conducted, the transit agency gathered the data from the bus AcuFare 200 Card Reader, loads (copies) the data to a USB Thumb Drive and uploads the data to the Acumen Host Processing Center for consolidation of the data into the transit agency master data file. The transition from the existing proprietary smart card data format to the new CFMS smart card data format was transparent to the transit agency cardholders. It was proven that open standards and interoperability design can work and reduce both implementation and operational costs for small transit agencies or countries looking to expand smart card technology. Acumen was able to avoid the implementation of the Payment Card Industry (PCI) Data Security Standards (DSS) which is expensive to develop and costly to operate on a continuing basis. Due to the substantial additional complexities of implementation and the variety of options presented to the transit agency cardholder, Acumen chose to implement only the Directed Autoload. To improve the implementation efficiency and the results for a similar undertaking, it should be considered that some passengers lack credit cards and are averse to technology. There are more than 1,300 small and rural agencies in the United States. This grows by 10 fold when considering small countries or rural locations throughout Latin American and the world. Acumen is evaluating additional countries, sites or transit agency that can benefit from the smart card systems. Frequently, payment card systems require extensive security procedures for implementation. The Project demonstrated the ability to purchase fare value, rides and passes with credit cards on the internet at a reasonable cost without highly complex security requirements.Keywords: automatic fare collection, near field communication, small transit agencies, smart cards
Procedia PDF Downloads 284588 Assessing Prescribed Burn Severity in the Wetlands of the Paraná River -Argentina
Authors: Virginia Venturini, Elisabet Walker, Aylen Carrasco-Millan
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Latin America stands at the front of climate change impacts, with forecasts projecting accelerated temperature and sea level rises compared to the global average. These changes are set to trigger a cascade of effects, including coastal retreat, intensified droughts in some nations, and heightened flood risks in others. In Argentina, wildfires historically affected forests, but since 2004, wetland fires have emerged as a pressing concern. By 2021, the wetlands of the Paraná River faced a dangerous situation. In fact, during the year 2021, a high-risk scenario was naturally formed in the wetlands of the Paraná River, in Argentina. Very low water levels in the rivers, and excessive standing dead plant material (fuel), triggered most of the fires recorded in the vast wetland region of the Paraná during 2020-2021. During 2008 fire events devastated nearly 15% of the Paraná Delta, and by late 2021 new fires burned more than 300,000 ha of these same wetlands. Therefore, the goal of this work is to explore remote sensing tools to monitor environmental conditions and the severity of prescribed burns in the Paraná River wetlands. Thus, two prescribed burning experiments were carried out in the study area (31°40’ 05’’ S, 60° 34’ 40’’ W) during September 2023. The first experiment was carried out on Sept. 13th, in a plot of 0.5 ha which dominant vegetation were Echinochloa sp., and Thalia, while the second trial was done on Sept 29th in a plot of 0.7 ha, next to the first burned parcel; here the dominant vegetation species were Echinochloa sp. and Solanum glaucophyllum. Field campaigns were conducted between September 8th and November 8th to assess the severity of the prescribed burns. Flight surveys were conducted utilizing a DJI® Inspire II drone equipped with a Sentera® NDVI camera. Then, burn severity was quantified by analyzing images captured by the Sentera camera along with data from the Sentinel 2 satellite mission. This involved subtracting the NDVI images obtained before and after the burn experiments. The results from both data sources demonstrate a highly heterogeneous impact of fire within the patch. Mean severity values obtained with drone NDVI images of the first experience were about 0.16 and 0.18 with Sentinel images. For the second experiment, mean values obtained with the drone were approximately 0.17 and 0.16 with Sentinel images. Thus, most of the pixels showed low fire severity and only a few pixels presented moderated burn severity, based on the wildfire scale. The undisturbed plots maintained consistent mean NDVI values throughout the experiments. Moreover, the severity assessment of each experiment revealed that the vegetation was not completely dry, despite experiencing extreme drought conditions.Keywords: prescribed-burn, severity, NDVI, wetlands
Procedia PDF Downloads 70587 Evaluation of the Suitability of a Microcapsule-Based System for the Manufacturing of Self-Healing Low-Density Polyethylene
Authors: Małgorzata Golonka, Jadwiga Laska
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Among self-healing materials, the most unexplored group are thermoplastic polymers. These polymers are used not only to produce packaging with a relatively short life but also to obtain coatings, insulation, casings, or parts of machines and devices. Due to its exceptional resistance to weather conditions, hydrophobicity, sufficient mechanical strength, and ease of extrusion, polyethylene is used in the production of polymer pipelines and as an insulating layer for steel pipelines. Polyethylene or PE coated steel pipelines can be used in difficult conditions such as underground or underwater installations. Both installation and use under such conditions are associated with high stresses and consequently the formation of microdamages in the structure of the material, loss of its integrity and final applicability. The ideal solution would be to include a self-healing system in the polymer material. In the presented study the behavior of resin-coated microcapsules in the extrusion process of low-density polyethylene was examined. Microcapsules are a convenient element of the repair system because they can be filled with appropriate reactive substances to ensure the repair process, but the main problem is their durability under processing conditions. Rapeseed oil, which has a relatively high boiling point of 240⁰C and low volatility, was used as the core material that simulates the reactive agents. The capsule shell, which is a key element responsible for its mechanical strength, was obtained by in situ polymerising urea-formaldehyde, melamine-urea-formaldehyde or melamine-formaldehyde resin on the surface of oil droplets dispersed in water. The strength of the capsules was compared based on the shell material, and in addition, microcapsules with single- and multilayer shells were obtained using different combinations of the chemical composition of the resins. For example, the first layer of appropriate tightness and stiffness was made of melamine-urea-formaldehyde resin, and the second layer was a melamine-formaldehyde reinforcing layer. The size, shape, distribution of capsule diameters and shell thickness were determined using digital optical microscopy and electron microscopy. The efficiency of encapsulation (i.e., the presence of rapeseed oil as the core) and the tightness of the shell were determined by FTIR spectroscopic examination. The mechanical strength and distribution of microcapsules in polyethylene were tested by extruding samples of crushed low-density polyethylene mixed with microcapsules in a ratio of 1 and 2.5% by weight. The extrusion process was carried out in a mini extruder at a temperature of 150⁰C. The capsules obtained had a diameter range of 70-200 µm. FTIR analysis confirmed the presence of rapeseed oil in both single- and multilayer shell microcapsules. Microscopic observations of cross sections of the extrudates confirmed the presence of both intact and cracked microcapsules. However, the melamine-formaldehyde resin shells showed higher processing strength compared to that of the melamine-urea-formaldehyde coating and the urea-formaldehyde coating. Capsules with a urea-formaldehyde shell work very well in resin coating systems and cement composites, i.e., in pressureless processing and moulding conditions. The addition of another layer of melamine-formaldehyde coating to both the melamine-urea-formaldehyde and melamine-formaldehyde resin layers significantly increased the number of microcapsules undamaged during the extrusion process. The properties of multilayer coatings were also determined and compared with each other using computer modelling.Keywords: self-healing polymers, polyethylene, microcapsules, extrusion
Procedia PDF Downloads 31586 Overcoming Adversity: Women with Disabled Children and Microfinance Solutions
Authors: Aarif Hussain, Afnan Tariq
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In recent years, microfinance has emerged as a critical tool for promoting financial inclusion and empowering marginalized communities, particularly women. In India, where poverty and lack of access to financial services continue to be significant challenges for many, microfinance has the potential to provide much-needed support to women with disabled children. These women face unique challenges, including discrimination, lack of access to education and employment, and limited support systems, making it even more difficult for them to break out of poverty and provide for their families. Microfinance, by providing small loans, savings products, and other financial services, can help these women to start or grow businesses, build assets, and achieve financial independence. India has adhered to an SHG-bank linkage model of microfinance since 1980, and programs like IRDP and SGSY were initiatives in the same direction. In the year 2011, India launched DAY-NRLM, a restructured version of SGSY. DAY-NRLM is an SHG-based microfinance program targeting the rural women of India. It aims to organise these poor women into SHGs and link them to banking institutions for creating sustainable livelihoods. The program has a reservation for disabled women but has no special status for mothers with disabled children. The impact of microfinance on women with disabilities and their families has been well documented. Studies have shown that women participating in microfinance programs are more likely to start businesses, increase their income, and improve their standard of living. Furthermore, these women are more likely to invest in their children's education and health, which can have long-term positive effects on their family’s well-being. In the Union territory of Jammu and Kashmir, the programme started in 2013 and is running smoothly to date. Women with children having a disability have not been documented as a category within the programme. The core aspect of this study is to delve into these women’s lives and analyse the impact of SHG membership on their lives and their children. The participants were selected purposively. For data collection, in-depth interviews were conducted. The findings of the paper show that microfinance has the potential to play a significant role in promoting financial inclusion and empowering women with children having disabilities in Kashmir. By providing access to small loans, savings products, and other financial services, microfinance can help these women to start or grow businesses, build assets, and achieve financial independence. However, more work is needed to ensure that these women have equal access to financial services and opportunities and that microfinance institutions are equipped to effectively serve this population. Working together to address these challenges can create a brighter future for women with children having disabilities and their families in India.Keywords: DAY-NRLM, microfinance, SHGs, women, disabled children
Procedia PDF Downloads 72585 Correlation Between Different Radiological Findings and Histopathological diagnosis of Breast Diseases: Retrospective Review Conducted Over Sixth Years in King Fahad University Hospital in Eastern Province, Saudi Arabia
Authors: Sadeem Aljamaan, Reem Hariri, Rahaf Alghamdi, Batool Alotaibi, Batool Alsenan, Lama Althunayyan, Areej Alnemer
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The aim of this study is to correlate between radiological findings and histopathological results in regard to the breast imaging-reporting and data system scores, size of breast masses, molecular subtypes and suspicious radiological features, as well as to assess the concordance rate in histological grade between core biopsy and surgical excision among breast cancer patients, followed by analyzing the change of concordance rate in relation to neoadjuvant chemotherapy in a Saudi population. A retrospective review was conducted over 6-year period (2017-2022) on all breast core biopsies of women preceded by radiological investigation. Chi-squared test (χ2) was performed on qualitative data, the Mann-Whitney test for quantitative non-parametric variables, and the Kappa test for grade agreement. A total of 641 cases were included. Ultrasound, mammography, and magnetic resonance imaging demonstrated diagnostic accuracies of 85%, 77.9% and 86.9%; respectively. magnetic resonance imaging manifested the highest sensitivity (72.2%), and the lowest was for ultrasound (61%). Concordance in tumor size with final excisions was best in magnetic resonance imaging, while mammography demonstrated a higher tendency of overestimation (41.9%), and ultrasound showed the highest underestimation (67.7%). The association between basal-like molecular subtypes and the breast imaging-reporting and data system score 5 classifications was statistically significant only for magnetic resonance imaging (p=0.04). Luminal subtypes demonstrated a significantly higher percentage of speculation in mammography. Breast imaging-reporting and data system score 4 manifested a substantial number of benign pathologies in all the 3 modalities. A fair concordance rate (k= 0.212 & 0.379) was demonstrated between excision and the preceding core biopsy grading with and without neoadjuvant therapy, respectively. The results demonstrated a down-grading in cases post-neoadjuvant therapy. In cases who did not receive neoadjuvant therapy, underestimation of tumor grade in biopsy was evident. In summary, magnetic resonance imaging had the highest sensitivity, specificity, positive predictive value and accuracy of both diagnosis and estimation of tumor size. Mammography demonstrated better sensitivity than ultrasound and had the highest negative predictive value, but ultrasound had better specificity, positive predictive value and accuracy. Therefore, the combination of different modalities is advantageous. The concordance rate of core biopsy grading with excision was not impacted by neoadjuvant therapy.Keywords: breast cancer, mammography, MRI, neoadjuvant, pathology, US
Procedia PDF Downloads 82584 The Misuse of Free Cash and Earnings Management: An Analysis of the Extent to Which Board Tenure Mitigates Earnings Management
Authors: Michael McCann
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Managerial theories propose that, in joint stock companies, executives may be tempted to waste excess free cash on unprofitable projects to keep control of resources. In order to conceal their projects' poor performance, they may seek to engage in earnings management. On the one hand, managers may manipulate earnings upwards in order to post ‘good’ performances and safeguard their position. On the other, since managers pursuit of unrewarding investments are likely to lead to low long-term profitability, managers will use negative accruals to reduce current year’s earnings, smoothing earnings over time in order to conceal the negative effects. Agency models argue that boards of directors are delegated by shareholders to ensure that companies are governed properly. Part of that responsibility is ensuring the reliability of financial information. Analyses of the impact of board characteristics, particularly board independence on the misuse of free cash flow and earnings management finds conflicting evidence. However, existing characterizations of board independence do not account for such directors gaining firm-specific knowledge over time, influencing their monitoring ability. Further, there is little analysis of the influence of the relative experience of independent directors and executives on decisions surrounding the use of free cash. This paper contributes to this literature regarding the heterogeneous characteristics of boards by investigating the influence of independent director tenure on earnings management and the relative tenures of independent directors and Chief Executives. A balanced panel dataset comprising 51 companies across 11 annual periods from 2005 to 2015 is used for the analysis. In each annual period, firms were classified as conducting earnings management if they had discretionary accruals in the bottom quartile (downwards) and top quartile (upwards) of the distributed values for the sample. Logistical regressions were conducted to determine the marginal impact of independent board tenure and a number of control variables on the probability of conducting earnings management. The findings indicate that both absolute and relative measures of board independence and experience do not have a significant impact on the likelihood of earnings management. It is the level of free cash flow which is the major influence on the probability of earnings management. Higher free cash flow increases the probability of earnings management significantly. The research also investigates whether board monitoring of earnings management is contingent on the level of free cash flow. However, the results suggest that board monitoring is not amplified when free cash flow is higher. This suggests that the extent of earnings management in companies is determined by a range of company, industry and situation-specific factors.Keywords: corporate governance, boards of directors, agency theory, earnings management
Procedia PDF Downloads 236583 Thermodynamic Modeling of Cryogenic Fuel Tanks with a Model-Based Inverse Method
Authors: Pedro A. Marques, Francisco Monteiro, Alessandra Zumbo, Alessia Simonini, Miguel A. Mendez
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Cryogenic fuels such as Liquid Hydrogen (LH₂) must be transported and stored at extremely low temperatures. Without expensive active cooling solutions, preventing fuel boil-off over time is impossible. Hence, one must resort to venting systems at the cost of significant energy and fuel mass loss. These losses increase significantly in propellant tanks installed on vehicles, as the presence of external accelerations induces sloshing. Sloshing increases heat and mass transfer rates and leads to significant pressure oscillations, which might further trigger propellant venting. To make LH₂ economically viable, it is essential to minimize these factors by using advanced control techniques. However, these require accurate modelling and a full understanding of the tank's thermodynamics. The present research aims to implement a simple thermodynamic model capable of predicting the state of a cryogenic fuel tank under different operating conditions (i.e., filling, pressurization, fuel extraction, long-term storage, and sloshing). Since this model relies on a set of closure parameters to drive the system's transient response, it must be calibrated using experimental or numerical data. This work focuses on the former approach, wherein the model is calibrated through an experimental campaign carried out on a reduced-scale model of a cryogenic tank. The thermodynamic model of the system is composed of three control volumes: the ullage, the liquid, and the insulating walls. Under this lumped formulation, the governing equations are derived from energy and mass balances in each region, with mass-averaged properties assigned to each of them. The gas-liquid interface is treated as an infinitesimally thin region across which both phases can exchange mass and heat. This results in a coupled system of ordinary differential equations, which must be closed with heat and mass transfer coefficients between each control volume. These parameters are linked to the system evolution via empirical relations derived from different operating regimes of the tank. The derivation of these relations is carried out using an inverse method to find the optimal relations that allow the model to reproduce the available data. This approach extends classic system identification methods beyond linear dynamical systems via a nonlinear optimization step. Thanks to the data-driven assimilation of the closure problem, the resulting model accurately predicts the evolution of the tank's thermodynamics at a negligible computational cost. The lumped model can thus be easily integrated with other submodels to perform complete system simulations in real time. Moreover, by setting the model in a dimensionless form, a scaling analysis allowed us to relate the tested configurations to a representative full-size tank for naval applications. It was thus possible to compare the relative importance of different transport phenomena between the laboratory model and the full-size prototype among the different operating regimes.Keywords: destratification, hydrogen, modeling, pressure-drop, pressurization, sloshing, thermodynamics
Procedia PDF Downloads 95582 Capturing Healthcare Expert’s Knowledge Digitally: A Scoping Review of Current Approaches
Authors: Sinead Impey, Gaye Stephens, Declan O’Sullivan
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Mitigating organisational knowledge loss presents challenges for knowledge managers. Expert knowledge is embodied in people and captured in ‘routines, processes, practices and norms’ as well as in the paper system. These knowledge stores have limitations in so far as they make knowledge diffusion beyond geography or over time difficult. However, technology could present a potential solution by facilitating the capture and management of expert knowledge in a codified and sharable format. Before it can be digitised, however, the knowledge of healthcare experts must be captured. Methods: As a first step in a larger project on this topic, a scoping review was conducted to identify how expert healthcare knowledge is captured digitally. The aim of the review was to identify current healthcare knowledge capture practices, identify gaps in the literature, and justify future research. The review followed a scoping review framework. From an initial 3,430 papers retrieved, 22 were deemed relevant and included in the review. Findings: Two broad approaches –direct and indirect- with themes and subthemes emerged. ‘Direct’ describes a process whereby knowledge is taken directly from subject experts. The themes identified were: ‘Researcher mediated capture’ and ‘Digital mediated capture’. The latter was further distilled into two sub-themes: ‘Captured in specified purpose platforms (SPP)’ and ‘Captured in a virtual community of practice (vCoP)’. ‘Indirect’ processes rely on extracting new knowledge using artificial intelligence techniques from previously captured data. Using this approach, the theme ‘Generated using artificial intelligence methods’ was identified. Although presented as distinct themes, some papers retrieved discuss combining more than one approach to capture knowledge. While no approach emerged as superior, two points arose from the literature. Firstly, human input was evident across themes, even with indirect approaches. Secondly, a range of challenges common among approaches was highlighted. These were (i) ‘Capturing an expert’s knowledge’- Difficulties surrounding capturing an expert’s knowledge related to identifying the ‘expert’ say from the very experienced and how to capture their tacit or difficult to articulate knowledge. (ii) ‘Confirming quality of knowledge’- Once captured, challenges noted surrounded how to validate knowledge captured and, therefore, quality. (iii) ‘Continual knowledge capture’- Once knowledge is captured, validated, and used in a system; however, the process is not complete. Healthcare is a knowledge-rich environment with new evidence emerging frequently. As such, knowledge needs to be reviewed, updated, or removed (redundancy) as appropriate. Although some methods were proposed to address this, such as plausible reasoning or case-based reasoning, conclusions could not be drawn from the papers retrieved. It was, therefore, highlighted as an area for future research. Conclusion: The results described two broad approaches – direct and indirect. Three themes were identified: ‘Researcher mediated capture (Direct)’; ‘Digital mediated capture (Direct)’ and ‘Generated using artificial intelligence methods (Indirect)’. While no single approach was deemed superior, common challenges noted among approaches were: ‘capturing an expert’s knowledge’, ‘confirming quality of knowledge’, and ‘continual knowledge capture’. However, continual knowledge capture was not fully explored in the papers retrieved and was highlighted as an important area for future research. Acknowledgments: This research is partially funded by the ADAPT Centre under the SFI Research Centres Programme (Grant 13/RC/2106) and is co-funded under the European Regional Development Fund.Keywords: expert knowledge, healthcare, knowledge capture and knowledge management
Procedia PDF Downloads 136581 Rt-Pcr Negative COVID-19 Infection in a Bodybuilding Competitor Using Anabolic Steroids: A Case Report
Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite
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This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care
Procedia PDF Downloads 118580 The Community Stakeholders’ Perspectives on Sexual Health Education for Young Adolescents in Western New York, USA: A Qualitative Descriptive Study
Authors: Sadandaula Rose Muheriwa Matemba, Alexander Glazier, Natalie M. LeBlanc
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In the United States, up to 10% of girls and 22 % of boys 10-14 years have had sex, 5% of them had their first sex before 11 years, and the age of first sexual encounter is reported to be 8 years. Over 4,000 adolescent girls, 10-14 years, become pregnant every year, and 2.6% of the abortions in 2019 were among adolescents below 15 years. Despite these negative outcomes, little research has been conducted to understand the sexual health education offered to young adolescents ages 10-14. Early sexual health education is one of the most effective strategies to help lower the rate of early pregnancies, HIV infections, and other sexually transmitted. Such knowledge is necessary to inform best practices for supporting the healthy sexual development of young adolescents and prevent adverse outcomes. This qualitative descriptive study was conducted to explore the community stakeholders’ experiences in sexual health education for young adolescents ages 10-14 and ascertain the young adolescents’ sexual health support needs. Maximum variation purposive sampling was used to recruit a total sample of 13 community stakeholders, including health education teachers, members of youth-based organizations, and Adolescent Clinic providers in Rochester, New York State, in the United States of America from April to June 2022. Data were collected through semi-structured individual in-depth interviews and were analyzed using MAXQDA following a conventional content analysis approach. Triangulation, team analysis, and respondent validation to enhance rigor were also employed to enhance study rigor. The participants were predominantly female (92.3%) and comprised of Caucasians (53.8%), Black/African Americans (38.5%), and Indian-American (7.7%), with ages ranging from 23-59. Four themes emerged: the perceived need for early sexual health education, preferred timing to initiate sexual health conversations, perceived age-appropriate content for young adolescents, and initiating sexual health conversations with young adolescents. The participants described encouraging and concerning experiences. Most participants were concerned that young adolescents are living in a sexually driven environment and are not given the sexual health education they need, even though they are open to learning sexual health materials. There was consensus on the need to initiate sexual health conversations early at 4 years or younger, standardize sexual health education in schools and make age-appropriate sexual health education progressive. These results show that early sexual health education is essential if young adolescents are to delay sexual debut, prevent early pregnancies, and if the goal of ending the HIV epidemic is to be achieved. However, research is needed on a larger scale to understand how best to implement sexual health education among young adolescents and to inform interventions for implementing contextually-relevant sexuality education for this population. These findings call for increased multidisciplinary efforts in promoting early sexual health education for young adolescents.Keywords: community stakeholders’ perspectives, sexual development, sexual health education, young adolescents
Procedia PDF Downloads 80579 Recognition of Spelling Problems during the Text in Progress: A Case Study on the Comments Made by Portuguese Students Newly Literate
Authors: E. Calil, L. A. Pereira
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The acquisition of orthography is a complex process, involving both lexical and grammatical questions. This learning occurs simultaneously with the domain of multiple textual aspects (e.g.: graphs, punctuation, etc.). However, most of the research on orthographic acquisition focus on this acquisition from an autonomous point of view, separated from the process of textual production. This means that their object of analysis is the production of words selected by the researcher or the requested sentences in an experimental and controlled setting. In addition, the analysis of the Spelling Problems (SP) are identified by the researcher on the sheet of paper. Considering the perspective of Textual Genetics, from an enunciative approach, this study will discuss the SPs recognized by dyads of newly literate students, while they are writing a text collaboratively. Six proposals of textual production were registered, requested by a 2nd year teacher of a Portuguese Primary School between January and March 2015. In our case study we discuss the SPs recognized by the dyad B and L (7 years old). We adopted as a methodological tool the Ramos System audiovisual record. This system allows real-time capture of the text in process and of the face-to-face dialogue between both students and their teacher, and also captures the body movements and facial expressions of the participants during textual production proposals in the classroom. In these ecological conditions of multimodal registration of collaborative writing, we could identify the emergence of SP in two dimensions: i. In the product (finished text): SP identification without recursive graphic marks (without erasures) and the identification of SPs with erasures, indicating the recognition of SP by the student; ii. In the process (text in progress): identification of comments made by students about recognized SPs. Given this, we’ve analyzed the comments on identified SPs during the text in progress. These comments characterize a type of reformulation referred to as Commented Oral Erasure (COE). The COE has two enunciative forms: Simple Comment (SC) such as ' 'X' is written with 'Y' '; or Unfolded Comment (UC), such as ' 'X' is written with 'Y' because...'. The spelling COE may also occur before or during the SP (Early Spelling Recognition - ESR) or after the SP has been entered (Later Spelling Recognition - LSR). There were 631 words entered in the 6 stories written by the B-L dyad, 145 of them containing some type of SP. During the text in progress, the students recognized orally 174 SP, 46 of which were identified in advance (ESRs) and 128 were identified later (LSPs). If we consider that the 88 erasure SPs in the product indicate some form of SP recognition, we can observe that there were twice as many SPs recognized orally. The ESR was characterized by SC when students asked their colleague or teacher how to spell a given word. The LSR presented predominantly UC, verbalizing meta-orthographic arguments, mostly made by L. These results indicate that writing in dyad is an important didactic strategy for the promotion of metalinguistic reflection, favoring the learning of spelling.Keywords: collaborative writing, erasure, learning, metalinguistic awareness, spelling, text production
Procedia PDF Downloads 164578 Alternative Fuel Production from Sewage Sludge
Authors: Jaroslav Knapek, Kamila Vavrova, Tomas Kralik, Tereza Humesova
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The treatment and disposal of sewage sludge is one of the most important and critical problems of waste water treatment plants. Currently, 180 thousand tonnes of sludge dry matter are produced in the Czech Republic, which corresponds to approximately 17.8 kg of stabilized sludge dry matter / year per inhabitant of the Czech Republic. Due to the fact that sewage sludge contains a large amount of substances that are not beneficial for human health, the conditions for sludge management will be significantly tightened in the Czech Republic since 2023. One of the tested methods of sludge liquidation is the production of alternative fuel from sludge from sewage treatment plants and paper production. The paper presents an analysis of economic efficiency of alternative fuel production from sludge and its use for fluidized bed boiler with nominal consumption of 5 t of fuel per hour. The evaluation methodology includes the entire logistics chain from sludge extraction, through mechanical moisture reduction to about 40%, transport to the pelletizing line, moisture drying for pelleting and pelleting itself. For economic analysis of sludge pellet production, a time horizon of 10 years corresponding to the expected lifetime of the critical components of the pelletizing line is chosen. The economic analysis of pelleting projects is based on a detailed analysis of reference pelleting technologies suitable for sludge pelleting. The analysis of the economic efficiency of pellet is based on the simulation of cash flows associated with the implementation of the project over the life of the project. For the entered value of return on the invested capital, the price of the resulting product (in EUR / GJ or in EUR / t) is searched to ensure that the net present value of the project is zero over the project lifetime. The investor then realizes the return on the investment in the amount of the discount used to calculate the net present value. The calculations take place in a real business environment (taxes, tax depreciation, inflation, etc.) and the inputs work with market prices. At the same time, the opportunity cost principle is respected; waste disposal for alternative fuels includes the saved costs of waste disposal. The methodology also respects the emission allowances saved due to the displacement of coal by alternative (bio) fuel. Preliminary results of testing of pellet production from sludge show that after suitable modifications of the pelletizer it is possible to produce sufficiently high quality pellets from sludge. A mixture of sludge and paper waste has proved to be a more suitable material for pelleting. At the same time, preliminary results of the analysis of the economic efficiency of this sludge disposal method show that, despite the relatively low calorific value of the fuel produced (about 10-11 MJ / kg), this sludge disposal method is economically competitive. This work has been supported by the Czech Technology Agency within the project TN01000048 Biorefining as circulation technology.Keywords: Alternative fuel, Economic analysis, Pelleting, Sewage sludge
Procedia PDF Downloads 136577 De-Pigmentary Effect of Ayurvedic Treatment on Hyper-Pigmentation of Skin Due to Chloroquine: A Case Report
Authors: Sunil Kumar, Rajesh Sharma
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Toxic epidermal necrolysis, pruritis, rashes, lichen planus like eruption, hyper pigmentation of skin are rare toxic effects of choloroquine used over a long time. Skin and mucus membrane hyper pigmentation is generally of a bluish black or grayish color and irreversible after discontinuation of the drug. According to Ayurveda, Dushivisha is the name given to any poisonous substance which is not fully endowed with the qualities of poison by nature (i.e. it acts as an impoverished or weak poison) and because of its mild potency, it remains in the body for many years causing various symptoms, one among them being discoloration of skin.The objective of this case report is to investigate the effect of Ayurvedic management of chloroquine induced hyper-pigmentation on the line of treatment of Dushivisha. Case Report: A 26-year-old female was suffering from hyper-pigmentation of the skin over the neck, forehead, temporo-mandibular joints, upper back and posterior aspect of both the arms since 8 years had history of taking Chloroquine came to Out Patient Department of National Institute of Ayurveda, Jaipur, India in Jan. 2015. The routine investigations (CBC, ESR, Eosinophil count) were within normal limits. Punch biopsy skin studied for histopathology under hematoxylin and eosin staining showed epidermis with hyper-pigmentation of the basal layer. In the papillary dermis as well as deep dermis there were scattered melanophages along with infiltration by mononuclear cells. There was no deposition of amyloid-like substances. These histopathological findings were suggestive of Chloroquine induced hyper-pigmentation. The case was treated on the line of treatment of Dushivisha and was given Vamana and Virechana (therapeutic emesis and purgation) every six months followed by Snehana karma (oleation therapy) with Panchatikta Ghrit and Swedana (sudation). Arogyavardhini Vati -1 g, Dushivishari Vati 500 mg, Mahamanjisthadi Quath 20 ml were given twelve hourly and Aragwadhadi Quath 25 ml at bed time orally. The patient started showing lightening of the pigments after six months and almost complete remission after 12 months of the treatment. Conclusion: This patient presented with the Dushivisha effect of Chloroquineandwas administered two relevant procedures from Panchakarma viz. Vamana and Virechana. Both Vamana and Virechanakarma here referred to Shodhana karma (purification procedures) eliminates accumulated toxins from the body. In this process, oleation dislodge the toxins from the tissues and sudation helps to bring them to the alimentary tract. The line of treatment did not target direct hypo pigmentary effects; rather aimed to eliminate the Dushivisha. This gave promising results in this condition.Keywords: Ayurveda, chloroquine, Dushivisha, hyper-pigmentation
Procedia PDF Downloads 235576 Regulation Effect of Intestinal Microbiota by Fermented Processing Wastewater of Yuba
Authors: Ting Wu, Feiting Hu, Xinyue Zhang, Shuxin Tang, Xiaoyun Xu
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As a by-product of yuba, processing wastewater of Yuba (PWY) contains many bioactive components such as soybean isoflavones, soybean polysaccharides and soybean oligosaccharides, which is a good source of prebiotics and has a potential of high value utilization. The use of Lactobacillus plantarum to ferment PWY can be considered as a potential biogenic element, which can regulate the balance of intestinal microbiota. In this study, firstly, Lactobacillus plantarum was used to ferment PWY to improve its content of active components and antioxidant activity. Then, the health effect of fermented processing wastewater of yuba (FPWY) was measured in vitro. Finally, microencapsulation technology was used applied to improve the sustained release of FPWY and reduce the loss of active components in the digestion process, as well as to improving the activity of FPWY. The main results are as follows: (1) FPWY presented a good antioxidant capacity with DPPH free radical scavenging ability (0.83 ± 0.01 mmol Trolox/L), ABTS free radical scavenging ability (7.47 ± 0.35 mmol Trolox/L) and iron ion reducing ability (1.11 ± 0.07 mmol Trolox/L). Compared with non-fermented processing wastewater of yuba (NFPWY), there was no significant difference in the content of total soybean isoflavones, but the content of glucoside soybean isoflavones decreased, and aglyconic soybean isoflavones increased significantly. After fermentation, PWY can effectively reduce the soluble monosaccharides, disaccharides and oligosaccharides, such as glucose, fructose, galactose, trehalose, stachyose, maltose, raffinose and sucrose. (2) FPWY can significantly enhance the growth of beneficial bacteria such as Bifidobacterium, Ruminococcus and Akkermansia, significantly inhibit the growth of harmful bacteria E.coli, regulate the structure of intestinal microbiota, and significantly increase the content of short-chain fatty acids such as acetic acid, propionic acid, butyric acid, isovaleric acid. Higher amount of lactic acid in the gut can be further broken down into short chain fatty acids. (3) In order to improve the stability of soybean isoflavones in FPWY during digestion, sodium alginate and chitosan were used as wall materials for embedding. The FPWY freeze-dried powder was embedded by the method of acute-coagulation bath. The results show that when the core wall ratio is 3:1, the concentration of chitosan is 1.5%, the concentration of sodium alginate is 2.0%, and the concentration of calcium is 3%, the embossing rate is 53.20%. In the simulated in vitro digestion stage, the release rate of microcapsules reached 59.36% at the end of gastric digestion and 82.90% at the end of intestinal digestion. Therefore, the core materials with good sustained-release performance of microcapsules were almost all released. The structural analysis results of FPWY microcapsules show that the microcapsules have good mechanical properties. Its hardness, springness, cohesiveness, gumminess, chewiness and resilience were 117.75± 0.21 g, 0.76±0.02, 0.54±0.01, 63.28±0.71 g·sec, 48.03±1.37 g·sec, 0.31±0.01, respectively. Compared with the unembedded FPWY, the infrared spectrum results showed that the microcapsules had embedded effect on the FPWY freeze-dried powder.Keywords: processing wastewater of yuba, lactobacillus plantarum, intestinal microbiota, microcapsule
Procedia PDF Downloads 77575 Prolactin and Its Abnormalities: Its Implications on the Male Reproductive Tract and Male Factor Infertility
Authors: Rizvi Hasan
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Male factor infertility due to abnormalities in prolactin levels is encountered in a significant proportion. This was a case-control study carried out to determine the effects of prolactin abnormalities in normal males with infertility, recruiting 297 male infertile patients with informed written consent. All underwent a Basic Seminal Fluid Analysis (BSA) and endocrine profiles of FSH, LH, testosterone and prolactin (PRL) hormones using the random access chemiluminescent immunoassay method (normal range 2.5-17ng/ml). Age, weight, and height matched voluntary controls were recruited for comparison. None of the cases had anatomical, medical or surgical disorders related to infertility. Among the controls; mean age 33.2yrs ± 5.2, BMI 21.04 ± 1.39kgm-2, BSA 34×106, a number of children fathered 2±1, PRL 6.78 ± 2.92ng/ml. Of the 297 patients, 28 were hyperprolactinaemic while one was hypoprolactinaemic. All the hyperprolactinaemic patients had oligoasthenospermia, abnormal morphology and decreased viability. The serum testosterone levels were markedly lowered in 26 (92.86%) of the hyperprolactinaemic subjects. In the other 2 hyperprolactinaemic subjects and the single hypoprolactinaemic subject, the serum testosterone levels were normal. FSH and LH were normal in all patients. The 29 male patients with abnormalities in their serum PRL profiles were followed up for 12 months. The 28 patients suffering from hyperprolactinaemia were treated with oral bromocriptine in a dose of 2.5 mg twice daily. The hypoprolactinaemic patient defaulted treatment. From the follow-up, it was evident that 19 (67.86%) of the treated patients responded after 3 months of therapy while 4 (14.29%) showed improvement after approximately 6 months of bromocriptine therapy. One patient responded after 1 year of therapy while 2 patients showed improvements although not up to normal levels within the same period. Response to treatment was assessed by improvement in their BSA parameters. Prolactin abnormalities affect the male reproductive system and semen parameters necessitating further studies to ascertain the exact role of prolactin on the male reproductive tract. A parallel study was carried out incorporating 200 male white rats that were grouped and subjected to variations in their serum PRL levels. At the end of 100 days of treatment, these rats were subjected to morphological studies of their male reproductive tracts.Varying morphological changes depending on the levels of PRL changes induced were evident. Notable changes were arrest of spermatogenesis at the spermatid stage, a reduced testicular cellularity, a reduction in microvilli of the pseudostratified epithelial lining of the epididymis, while measurement of the tubular diameter showed a 30% reduction compared to normal tissue. There were no changes in the vas deferens, seminal vesicles, and the prostate. It is evident that both hyperprolactinaemia and hypoprolactinaemia have a direct effect on the morphology and function of the male reproductive tract. The morphological studies carried out on the groups of rats who were subjected to variations in their PRL levels could be the basis for infertility in male human beings.Keywords: male factor infertility, morphological studies, prolactin, seminal fluid analysis
Procedia PDF Downloads 345574 Transcriptional Differences in B cell Subpopulations over the Course of Preclinical Autoimmunity Development
Authors: Aleksandra Bylinska, Samantha Slight-Webb, Kevin Thomas, Miles Smith, Susan Macwana, Nicolas Dominguez, Eliza Chakravarty, Joan T. Merrill, Judith A. James, Joel M. Guthridge
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Background: Systemic Lupus Erythematosus (SLE) is an interferon-related autoimmune disease characterized by B cell dysfunction. One of the main hallmarks is a loss of tolerance to self-antigens leading to increased levels of autoantibodies against nuclear components (ANAs). However, up to 20% of healthy ANA+ individuals will not develop clinical illness. SLE is more prevalent among women and minority populations (African, Asian American and Hispanics). Moreover, African Americans have a stronger interferon (IFN) signature and develop more severe symptoms. The exact mechanisms involved in ethnicity-dependent B cell dysregulation and the progression of autoimmune disease from ANA+ healthy individuals to clinical disease remains unclear. Methods: Peripheral blood mononuclear cells (PBMCs) from African (AA) and European American (EA) ANA- (n=12), ANA+ (n=12) and SLE (n=12) individuals were assessed by multimodal scRNA-Seq/CITE-Seq methods to examine differential gene signatures in specific B cell subsets. Library preparation was done with a 10X Genomics Chromium according to established protocols and sequenced on Illumina NextSeq. The data were further analyzed for distinct cluster identification and differential gene signatures in the Seurat package in R and pathways analysis was performed using Ingenuity Pathways Analysis (IPA). Results: Comparing all subjects, 14 distinct B cell clusters were identified using a community detection algorithm and visualized with Uniform Manifold Approximation Projection (UMAP). The proportion of each of those clusters varied by disease status and ethnicity. Transitional B cells trended higher in ANA+ healthy individuals, especially in AA. Ribonucleoprotein high population (HNRNPH1 elevated, heterogeneous nuclear ribonucleoprotein, RNP-Hi) of proliferating Naïve B cells were more prevalent in SLE patients, specifically in EA. Interferon-induced protein high population (IFIT-Hi) of Naive B cells are increased in EA ANA- individuals. The proportion of memory B cells and plasma cells clusters tend to be expanded in SLE patients. As anticipated, we observed a higher signature of cytokine-related pathways, especially interferon, in SLE individuals. Pathway analysis among AA individuals revealed an NRF2-mediated Oxidative Stress response signature in the transitional B cell cluster, not seen in EA individuals. TNFR1/2 and Sirtuin Signaling pathway genes were higher in AA IFIT-Hi Naive B cells, whereas they were not detected in EA individuals. Interferon signaling was observed in B cells in both ethnicities. Oxidative phosphorylation was found in age-related B cells (ABCs) for both ethnicities, whereas Death Receptor Signaling was found only in EA patients in these cells. Interferon-related transcription factors were elevated in ABCs and IFIT-Hi Naive B cells in SLE subjects of both ethnicities. Conclusions: ANA+ healthy individuals have altered gene expression pathways in B cells that might drive apoptosis and subsequent clinical autoimmune pathogenesis. Increases in certain regulatory pathways may delay progression to SLE. Further, AA individuals have more elevated activation pathways that may make them more susceptible to SLE. Procedia PDF Downloads 177573 Association of Body Composition Parameters with Lower Limb Strength and Upper Limb Functional Capacity in Quilombola Remnants
Authors: Leonardo Costa Pereira, Frederico Santos Santana, Mauro Karnikowski, Luís Sinésio Silva Neto, Aline Oliveira Gomes, Marisete Peralta Safons, Margô Gomes De Oliveira Karnikowski
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In Brazil, projections of population aging follow all world projections, the birth rate tends to be surpassed by the mortality rate around the year 2045. Historically, the population of Brazilian blacks suffered for several centuries from the oppression of dominant classes. A group, especially of blacks, stands out in relation to territorial, historical and social aspects, and for centuries they have isolated themselves in small communities, in order to maintain their freedom and culture. The isolation of the Quilombola communities generated socioeconomic effects as well as the health of these blacks. Thus, the objective of the present study is to verify the association of body composition parameters with lower and upper limb strength and functional capacity in Quilombola remnants. The research was approved by ethics committee (1,771,159). Anthropometric evaluations of hip and waist circumference, body mass and height were performed. In order to verify the body composition, the relationship between stature and body mass (BM) was performed, generating the body mass index (BMI), as well as the dual-energy X-ray absorptiometry (DEXA) test. The Time Up and Go (TUG) test was used to evaluate the functional capacity, and a maximum repetition test (1MR) for knee extension and handgrip (HG) was applied for strength magnitude analysis. Statistical analysis was performed using the statistical package SPSS 22.0. Shapiro Wilk's normality test was performed. For the possible correlations, the suggestions of the Pearson or Spearman tests were adopted. The results obtained after the interpretation identified that the sample (n = 18) was composed of 66.7% of female individuals with mean age of 66.07 ± 8.95 years. The sample’s body fat percentage (%BF) (35.65 ± 10.73) exceeds the recommendations for age group, as well as the anthropometric parameters of hip (90.91 ± 8.44cm) and waist circumference (80.37 ± 17.5cm). The relationship between height (1.55 ± 0.1m) and body mass (63.44 ± 11.25Kg) generated a BMI of 24.16 ± 7.09Kg/m2, that was considered normal. The TUG performance was 10.71 ± 1.85s. In the 1MR test, 46.67 ± 13.06Kg and in the HG 23.93±7.96Kgf were obtained, respectively. Correlation analyzes were characterized by the high frequency of significant correlations for height, dominant arm mass (DAM), %BF, 1MR and HG variables. In addition, correlations between HG and BM (r = 0.67, p = 0.005), height (r = 0.51, p = 0.004) and DAM (r = 0.55, p = 0.026) were also observed. The strength of the lower limbs correlates with BM (r = 0.69, p = 0.003), height (r = 0.62, p = 0.01) and DAM (r = 0.772, p = 0.001). In this way, we can conclude that not only the simple spatial relationship of mass and height can influence in predictive parameters of strength or functionality, being important the verification of the conditions of the corporal composition. For this population, height seems to be a good predictor of strength and body composition.Keywords: African Continental Ancestry Group, body composition, functional capacity, strength
Procedia PDF Downloads 276572 Nutritional Status of Children in a Rural Food Environment, Haryana: A Paradox for the Policy Action
Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora
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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.Keywords: transition, food environment, lifestyle, undernutrition, overnutrition
Procedia PDF Downloads 181571 Financial Analysis of the Foreign Direct in Mexico
Authors: Juan Peña Aguilar, Lilia Villasana, Rodrigo Valencia, Alberto Pastrana, Martin Vivanco, Juan Peña C
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Each year a growing number of companies entering Mexico in search of the domestic market share. These activities, including stores, telephone long distance and local raw materials and energy, and particularly the financial sector, have managed to significantly increase its weight in the flows of FDI in Mexico , however, you should consider whether these trends FDI are positive for the Mexican economy and these activities increase Mexican exports in the medium term , and its share in GDP , gross fixed capital formation and employment. In general stresses that these activities, by far, have been unable to significantly generate linkages with the rest of the economy, a process that has not favored with competitiveness policies and activities aimed at these neutral or horizontal. Since the nineties foreign direct investment (FDI) has shown a remarkable dynamism, both internationally and in Latin America and in Mexico. Only in Mexico the first recipient of FDI in importance in Latin America during 1990-1995 and was displaced by Brazil since FDI increased from levels below 1 % of GDP during the eighties to around 3 % of GDP during the nineties. Its impact has been significant not only from a macroeconomic perspective , it has also allowed the generation of a new industrial production structure and organization, parallel to a significant modernization of a segment of the economy. The case of Mexico also is particularly interesting and relevant because the destination of FDI until 1993 had focused on the purchase of state assets during privatization process. This paper aims to present FDI flows in Mexico and analyze the different business strategies that have been touched and encouraged by the FDI. On the one hand, looking briefly discuss regulatory issues and source and recipient of FDI sectors. Furthermore, the paper presents in more detail the impacts and changes that generated the FDI contribution of FDI in the Mexican economy , besides the macroeconomic context and later legislative changes that resulted in the current regulations is examined around FDI in Mexico, including aspects of the Free Trade Agreement (NAFTA). It is worth noting that foreign investment can not only be considered from the perspective of the receiving economic units. Instead, these flows also reflect the strategic interests of transnational corporations (TNCs) and other companies seeking access to markets and increased competitiveness of their production networks and global distribution, among other reasons. Similarly it is important to note that foreign investment in its various forms is critically dependent on historical and temporal aspects. Thus, the same functionality can vary significantly depending on the specific characteristics of both receptor units as sources of FDI, including macroeconomic, institutional, industrial organization, and social aspects, among others.Keywords: foreign direct investment (FDI), competitiveness, neoliberal regime, globalization, gross domestic product (GDP), NAFTA, macroeconomic
Procedia PDF Downloads 451570 Study on Aerosol Behavior in Piping Assembly under Varying Flow Conditions
Authors: Anubhav Kumar Dwivedi, Arshad Khan, S. N. Tripathi, Manish Joshi, Gaurav Mishra, Dinesh Nath, Naveen Tiwari, B. K. Sapra
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In a nuclear reactor accident scenario, a large number of fission products may release to the piping system of the primary heat transport. The released fission products, mostly in the form of the aerosol, get deposited on the inner surface of the piping system mainly due to gravitational settling and thermophoretic deposition. The removal processes in the complex piping system are controlled to a large extent by the thermal-hydraulic conditions like temperature, pressure, and flow rates. These parameters generally vary with time and therefore must be carefully monitored to predict the aerosol behavior in the piping system. The removal process of aerosol depends on the size of particles that determines how many particles get deposit or travel across the bends and reach to the other end of the piping system. The released aerosol gets deposited onto the inner surface of the piping system by various mechanisms like gravitational settling, Brownian diffusion, thermophoretic deposition, and by other deposition mechanisms. To quantify the correct estimate of deposition, the identification and understanding of the aforementioned deposition mechanisms are of great importance. These mechanisms are significantly affected by different flow and thermodynamic conditions. Thermophoresis also plays a significant role in particle deposition. In the present study, a series of experiments were performed in the piping system of the National Aerosol Test Facility (NATF), BARC using metal aerosols (zinc) in dry environments to study the spatial distribution of particles mass and number concentration, and their depletion due to various removal mechanisms in the piping system. The experiments were performed at two different carrier gas flow rates. The commercial CFD software FLUENT is used to determine the distribution of temperature, velocity, pressure, and turbulence quantities in the piping system. In addition to the in-built models for turbulence, heat transfer and flow in the commercial CFD code (FLUENT), a new sub-model PBM (population balance model) is used to describe the coagulation process and to compute the number concentration along with the size distribution at different sections of the piping. In the sub-model coagulation kernels are incorporated through user-defined function (UDF). The experimental results are compared with the CFD modeled results. It is found that most of the Zn particles (more than 35 %) deposit near the inlet of the plenum chamber and a low deposition is obtained in piping sections. The MMAD decreases along the length of the test assembly, which shows that large particles get deposited or removed in the course of flow, and only fine particles travel to the end of the piping system. The effect of a bend is also observed, and it is found that the relative loss in mass concentration at bends is more in case of a high flow rate. The simulation results show that the thermophoresis and depositional effects are more dominating for the small and larger sizes as compared to the intermediate particles size. Both SEM and XRD analysis of the collected samples show the samples are highly agglomerated non-spherical and composed mainly of ZnO. The coupled model framed in this work could be used as an important tool for predicting size distribution and concentration of some other aerosol released during a reactor accident scenario.Keywords: aerosol, CFD, deposition, coagulation
Procedia PDF Downloads 144569 Ecological and Historical Components of the Cultural Code of the City of Florence as Part of the Edutainment Project Velonotte International
Authors: Natalia Zhabo, Sergey Nikitin, Marina Avdonina, Mariya Nikitina
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The analysis of the activities of one of the events of the international educational and entertainment project Velonotte is provided: an evening bicycle tour with children around Florence. The aim of the project is to develop methods and techniques for increasing the sensitivity of the cycling participants and listeners of the radio broadcasts to the treasures of the national heritage, in this case, to the historical layers of the city and the ecology of the Renaissance epoch. The block of educational tasks is considered, and the issues of preserving the identity of the city are discussed. Methods. The Florentine event was prepared during more than a year. First of all the creative team selected such events of the history of the city which seem to be important for revealing the specifics of the city, its spirit - from antiquity to our days – including the forums of Internet with broad public opinion. Then a route (seven kilometers) was developed, which was proposed to the authorities and organizations of the city. The selection of speakers was conducted according to several criteria: they should be authors of books, famous scientists, connoisseurs in a certain sphere (toponymy, history of urban gardens, art history), capable and willing to talk with participants directly at the points of stops, in order to make a dialogue and so that performances could be organized with their participation. The music was chosen for each part of the itinerary to prepare the audience emotionally. Cards for coloring with images of the main content of each stop were created for children. A site was done to inform the participants and to keep photos, videos and the audio files with speakers’ speech afterward. Results: Held in April 2017, the event was dedicated to the 640th Anniversary of the Filippo Brunelleschi, Florentine architect, and to the 190th anniversary of the publication of Florence guide by Stendhal. It was supported by City of Florence and Florence Bike Festival. Florence was explored to transfer traditional elements of culture, sometimes unfairly forgotten from ancient times to Brunelleschi and Michelangelo and Tschaikovsky and David Bowie with lectures by professors of Universities. Memorable art boards were installed in public spaces. Elements of the cultural code are deeply internalized in the minds of the townspeople, the perception of the city in everyday life and human communication is comparable to such fundamental concepts of the self-awareness of the townspeople as mental comfort and the level of happiness. The format of a fun and playful walk with the ICT support gives new opportunities for enriching the city's cultural code of each citizen with new components, associations, connotations.Keywords: edutainment, cultural code, cycling, sensitization Florence
Procedia PDF Downloads 221568 Anabasine Intoxication and its Relation to Plant Development Stages
Authors: Thaís T. Valério Caetano, João Máximo De Siqueira, Carlos Alexandre Carollo, Arthur Ladeira Macedo, Vanessa C. Stein
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Nicotiana glauca, commonly known as wild tobacco or tobacco bush, belongs to the Solanaceae family. It is native to South America but has become naturalized in various regions, including Australia, California, Africa, and the Mediterranean. N. glauca is listed in the Global Invasive Species Database (GISD) and the Invasive Species Compendium (CABI). It is known for producing pyridine alkaloids, including anabasine, which is highly toxic. Anabasine is predominantly found in the leaves and can cause severe health issues such as neuromuscular blockade, respiratory arrest, and cardiovascular problems when ingested. Mistaken identity with edible plants like spinach has resulted in food poisoning cases in Israel and Brazil. Anabasine, a minor alkaloid constituent of tobacco, may contribute to tobacco addiction by mimicking or enhancing the effects of nicotine. Therefore, it is essential to investigate the production pattern of anabasine and its relationship to the developmental stages of the plant. This study aimed to establish the relationship between the phenological plant age, cultivation place, and the increase in anabasine concentration, which can lead to human intoxication cases. In this study, N. glauca plants were collected from three different rural areas in Brazil for a year to examine leaves at various stages of development. Samples were also obtained from cultivated plants in Marilândia, Minas Gerais, Brazil, as well as from Divinópolis, Minas Gerais, Brazil, and Arraial do Cabo, Rio de Janeiro, Brazil. In vitro cultivated plants on MS medium were included in the study. The collected leaves were dried, powdered, and stored. Alkaloid extraction was performed using a methanol and water mixture, followed by liquid-liquid extraction with chloroform. The anabasine content was determined using HPLC-DAD analysis with nicotine as a standard. The results indicated that anabasine production increases with the plant's development, peaking in adult leaves during the reproduction phase and declining afterward. In vitro, plants showed similar anabasine production to young leaves. The successful adaptation of N. glauca in new environments poses a global problem, and the correlation between anabasine production and the plant's developmental stages has been understudied. The presence of substances produced by the plant can pose a risk to other species, especially when mistaken for edible plants. The findings from this study shed light on the pattern of anabasine production and its association with plant development, contributing to a better understanding of the potential risks associated with N. glauca and the importance of accurate identification.Keywords: nicotiana glauca graham, global invasive species database, alkaloids, toxic
Procedia PDF Downloads 91567 Contentious Politics during a Period of Transition to Democracy from an Authoritarian Regime: The Spanish Cycle of Protest of November 1975-December 1978
Authors: Juan Sanmartín Bastida
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When a country experiences a period of transition from authoritarianism to democracy, involving an earlier process of political liberalization and a later process of democratization, a cycle of protest usually outbreaks, as there is a reciprocal influence between that kind of political change and the frequency and scale of social protest events. That is what happened in Spain during the first years of its transition to democracy from the Francoist authoritarian regime, roughly between November 1975 and December 1978. Thus, the object of this study is to show and explain how that cycle of protest started, developed, and finished in relation to such a political change, and offer specific information about the main features of all protest cycles: the social movements that arose during that period, the number of protest events by month, the forms of collective action that were utilized, the groups of challengers that engaged in contentious politics, the reaction of the authorities to the action and claims of those groups, etc. The study of this cycle of protest, using the primary sources and analytical tools that characterize the model of research of protest cycles, will make a contribution to the field of contentious politics and its phenomenon of cycles of contention, and more broadly to the political and social history of contemporary Spain. The cycle of protest and the process of political liberalization of the authoritarian regime began around the same time, but the first concluded long before the process of democratization was completed in 1982. The ascending phase of the cycle and therefore the process of liberalization started with the death of Francisco Franco and the proclamation of Juan Carlos I as King of Spain in November 1975; the peak of the cycle was around the first months of 1977; the descending phase started after the first general election of June 1977; and the level of protest stabilized in the last months of 1978, a year that finished with a referendum in which the Spanish people approved the current democratic constitution. It was then when we can consider that the cycle of protest came to an end. The primary sources are the news of protest events and social movements in the three main Spanish newspapers at the time, other written or audiovisual documents, and in-depth interviews; and the analytical tools are the political opportunities that encourage social protest, the available repertoire of contention, the organizations and networks that brought together people with the same claims and allowed them to engage in contentious politics, and the interpretative frames that justify, dignify and motivates their collective action. These are the main four factors that explain the beginning, development and ending of the cycle of protest, and therefore the accompanying social movements and events of collective action. Among those four factors, the political opportunities -their opening, exploitation, and closure-proved to be most decisive.Keywords: contentious politics, cycles of protest, political opportunities, social movements, Spanish transition to democracy
Procedia PDF Downloads 140566 Development of a Finite Element Model of the Upper Cervical Spine to Evaluate the Atlantoaxial Fixation Techniques
Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut
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The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.Keywords: cervical spine, finite element model, atlantoaxial, fixation technique
Procedia PDF Downloads 384565 Systematic Review of Technology-Based Mental Health Solutions for Modelling in Low and Middle Income Countries
Authors: Mukondi Esther Nethavhakone
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In 2020 World Health Organization announced the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19) pandemic. To curb or contain the spread of the novel coronavirus (COVID 19), global governments implemented social distancing and lockdown regulations. Subsequently, it was no longer business as per usual, life as we knew it had changed, and so many aspects of people's lives were negatively affected, including financial and employment stability. Mainly, because companies/businesses had to put their operations on hold, some had to shut down completely, resulting in the loss of income for many people globally. Finances and employment insecurities are some of the issues that exacerbated many social issues that the world was already faced with, such as school drop-outs, teenage pregnancies, sexual assaults, gender-based violence, crime, child abuse, elderly abuse, to name a few. Expectedly the majority of the population's mental health state was threatened. This resulted in an increased number of people seeking mental healthcare services. The increasing need for mental healthcare services in Low and Middle-income countries proves to be a challenge because it is a well-known fact due to financial constraints and not well-established healthcare systems, mental healthcare provision is not as prioritised as the primary healthcare in these countries. It is against this backdrop that the researcher seeks to find viable, cost-effective, and accessible mental health solutions for low and middle-income countries amid the pressures of any pandemic. The researcher will undertake a systematic review of the technology-based mental health solutions that have been implemented/adopted by developed countries during COVID 19 lockdown and social distancing periods. This systematic review study aims to determine if low and middle-income countries can adopt the cost-effective version of digital mental health solutions for the healthcare system to adequately provide mental healthcare services during critical times such as pandemics (when there's an overwhelming diminish in mental health globally). The researcher will undertake a systematic review study through mixed methods. It will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mixed-methods uses findings from both qualitative and quantitative studies in one review study. It will be beneficial to conduct this kind of study using mixed methods because it is a public health topic that involves social interventions and it is not purely based on medical interventions. Therefore, the meta-ethnographic (qualitative data) analysis will be crucial in understanding why and which digital methods work and for whom does it work, rather than only the meta-analysis (quantitative data) providing what digital mental health methods works. The data collection process will be extensive, involving the development of a database, table of summary of evidence/findings, and quality assessment process lastly, The researcher will ensure that ethical procedures are followed and adhered to, ensuring that sensitive data is protected and the study doesn't pose any harm to the participants.Keywords: digital, mental health, covid, low and middle-income countries
Procedia PDF Downloads 96564 Clinical Manifestations, Pathogenesis and Medical Treatment of Stroke Caused by Basic Mitochondrial Abnormalities (Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Episodes, MELAS)
Authors: Wu Liching
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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders
Procedia PDF Downloads 70563 Dialysis Access Surgery for Patients in Renal Failure: A 10-Year Institutional Experience
Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun
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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.Keywords: dialysis, fistula, nephrology, vascular surgery
Procedia PDF Downloads 114562 Captive Insurance in Hong Kong and Singapore: A Promising Risk Management Solution for Asian Companies
Authors: Jin Sheng
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This paper addresses a promising area of insurance sector to develop in Asia. Captive insurance, which provides risk-mitigation services for its parent company, has great potentials to develop in energy, infrastructure, agriculture, logistics, catastrophe, and alternative risk transfer (ART), and will greatly affect the framework of insurance industry. However, the Asian captive insurance market only takes a small proportion in the global market. The recent supply chain interruption case of Hanjin Shipping indicates the significance of risk management for an Asian company’s sustainability and resilience. China has substantial needs and great potentials to develop captive insurance, on account of the currency volatility, enterprises’ credit risks, and legal and operational risks of the Belt and Road initiative. Up to date, Mainland Chinese enterprises only have four offshore captives incorporated by CNOOC, Sinopec, Lenovo and CGN Power), three onshore captive insurance companies incorporated by CNPC, China Railway, and COSCO, as well as one industrial captive insurance organization - China Ship-owners Mutual Assurance Association. Its captive market grows slowly with one or two captive insurers licensed yearly after September 2011. As an international financial center, Hong Kong has comparative advantages in taxation, professionals, market access and well-established financial infrastructure to develop a functional captive insurance market. For example, Hong Kong’s income tax for an insurance company is 16.5%; while China's income tax for an insurance company is 25% plus business tax of 5%. Furthermore, restrictions on market entry and operations of China’s onshore captives make establishing offshore captives in international or regional captive insurance centers such as Singapore, Hong Kong, and other overseas jurisdictions to become attractive options. Thus, there are abundant business opportunities in this area. Using methodology of comparative studies and case analysis, this paper discusses the incorporation, regulatory issues, taxation and prospect of captive insurance market in Hong Kong, China and Singapore. Hong Kong and Singapore are both international financial centers with prominent advantages in tax concessions, technology, implementation, professional services, and well-functioning legal system. Singapore, as the domicile of 71 active captives, has been the largest captive insurance hub in Asia, as well as an established reinsurance hub. Hong Kong is an emerging captive insurance hub with 5 to 10 newly licensed captives each year, according to the Hong Kong Financial Services Development Council. It is predicted that Hong Kong will become a domicile for 50 captive insurers by 2025. This paper also compares the formation of a captive in Singapore with other jurisdictions such as Bermuda and Vermont.Keywords: Alternative Risk Transfer (ART), captive insurance company, offshore captives, risk management, reinsurance, self-insurance fund
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