Search results for: Long Short Term Memory
2099 Preparing a Library of Abnormal Masses for Designing a Long-Lasting Anatomical Breast Phantom for Ultrasonography Training
Authors: Nasibullina A., Leonov D.
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The ultrasonography method is actively used for the early diagnosis of various le-sions in the human body, including the mammary gland. The incidence of breast cancer has increased by more than 20%, and mortality by 14% since 2008. The correctness of the diagnosis often directly depends on the qualifications and expe-rience of a diagnostic medical sonographer. That is why special attention should be paid to the practical training of future specialists. Anatomical phantoms are ex-cellent teaching tools because they accurately imitate the characteristics of real hu-man tissues and organs. The purpose of this work is to create a breast phantom for practicing ultrasound diagnostic skills in grayscale and elastography imaging, as well as ultrasound-guided biopsy sampling. We used silicone-like compounds ranging from 3 to 17 on the Shore scale hardness units to simulate soft tissue and lesions. Impurities with experimentally selected concentrations were added to give the phantom the necessary attenuation and reflection parameters. We used 3D modeling programs and 3D printing with PLA plastic to create the casting mold. We developed a breast phantom with inclusions of varying shape, elasticity and echogenicity. After testing the created phantom in B-mode and elastography mode, we performed a survey asking 19 participants how realistic the sonograms of the phantom were. The results showed that the closest to real was the model of the cyst with 9.5 on the 0-10 similarity scale. Thus, the developed breast phantom can be used for ultrasonography, elastography, and ultrasound-guided biopsy training.Keywords: breast ultrasound, mammary gland, mammography, training phantom, tissue-mimicking materials
Procedia PDF Downloads 952098 Perforation Analysis of the Aluminum Alloy Sheets Subjected to High Rate of Loading and Heated Using Thermal Chamber: Experimental and Numerical Approach
Authors: A. Bendarma, T. Jankowiak, A. Rusinek, T. Lodygowski, M. Klósak, S. Bouslikhane
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The analysis of the mechanical characteristics and dynamic behavior of aluminum alloy sheet due to perforation tests based on the experimental tests coupled with the numerical simulation is presented. The impact problems (penetration and perforation) of the metallic plates have been of interest for a long time. Experimental, analytical as well as numerical studies have been carried out to analyze in details the perforation process. Based on these approaches, the ballistic properties of the material have been studied. The initial and residual velocities laser sensor is used during experiments to obtain the ballistic curve and the ballistic limit. The energy balance is also reported together with the energy absorbed by the aluminum including the ballistic curve and ballistic limit. The high speed camera helps to estimate the failure time and to calculate the impact force. A wide range of initial impact velocities from 40 up to 180 m/s has been covered during the tests. The mass of the conical nose shaped projectile is 28 g, its diameter is 12 mm, and the thickness of the aluminum sheet is equal to 1.0 mm. The ABAQUS/Explicit finite element code has been used to simulate the perforation processes. The comparison of the ballistic curve was obtained numerically and was verified experimentally, and the failure patterns are presented using the optimal mesh densities which provide the stability of the results. A good agreement of the numerical and experimental results is observed.Keywords: aluminum alloy, ballistic behavior, failure criterion, numerical simulation
Procedia PDF Downloads 3172097 Thermal and Mechanical Properties of Polycaprolactone-Soy Lecithin Modified Bentonite Nanocomposites
Authors: Danila Merino, Leandro N. Ludueña, Vera A. Alvarez
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Clays are commonly used to reinforce polymeric materials. In order to modify them, long-chain quaternary-alkylammonium salts have been widely employed. However, the application of these clays in biological fields is limited by the toxicity and poor biocompatibility presented by these modifiers. Meanwhile, soy lecithin, acts as a natural biosurfactant and environment-friendly biomodifier. In this report, we analyse the effect of content of soy lecithin-modified bentonite on the properties of polycaprolactone (PCL) nanocomposites. Commercial grade PCL (CAPA FB 100) was supplied by Perstorp, with Mw = 100000 g/mol. Minarmco S.A. and Melar S.A supplied bentonite and soy lecithin, respectively. Clays with 18, 30 and 45 wt% of organic content were prepared by exchanging 4 g of Na-Bent with 1, 2 and 4 g of soy lecithin aqueous and acid solution (pH=1, with HCl) at 75ºC for 2 h. Then, they were washed and lyophilized for 72 h. Samples were labeled A, B and C. Nanocomposites with 1 and 2 wt.% of each clay were prepared by melt-intercalation followed by compression-moulding. An intensive Brabender type mixer with two counter-rotating roller rotors was used. Mixing temperature was 100 ºC; speed of rotation was 100 rpm. and mixing time was 10 min. Compression moulding was carried out in a hydraulic press under 75 Kg/mm2 for 10 minutes at 100 ºC. The thickness of the samples was about 1 mm. Thermal and mechanical properties were analysed. PCL nanocomposites with 1 and 2% of B presented the best mechanical properties. It was observed that an excessive organic content produced an increment on the rigidity of PCL, but caused a detrimental effect on the tensile strength and elongation at break of the nanocomposites. Thermogravimetrical analyses suggest that all reinforced samples have higher resistance to degradation than neat PCL.Keywords: chemical modification, clay, nanocomposite, characterization
Procedia PDF Downloads 2032096 A Comparative Evaluation of Stone Spout Management Systems in Heritage and Non-heritage Areas of the Kathmandu Valley, Nepal
Authors: Mira Tripathi, Ken Hughey, Hamish G. Rennie
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Management of water resources is a major challenge throughout the world and in many long-established societies people still use traditional water harvesting and management techniques. Despite often being seen as efficient and cost effective, traditional methods are in decline or have been abandoned in many countries. Nevertheless, traditional approaches continue to be useful in some countries such as Nepal. The extent to which such traditional measures, in this case via stone spouts, may survive modernization, while fulfilling socio-cultural, tourism, and other needs is the focus of the research. The research develops an understanding of the socio-cultural, tourism and other values of stone spouts for the people of urban and peri-urban heritage and non-heritage areas of the Kathmandu Valley to help ongoing sustainable management of remaining spouts. Three research questions are addressed: the impacts of changes in social and cultural norms and values; development activities; and, the incremental and ongoing loss of traditional stone spout infrastructure. A meta-theory framework has been developed which synthesizes Institutional, Attachment, Central Place and Common Property theories, which form analytical lenses for the mixed-method research approach. From the exploration of the meta-theory approach, it was found that no spouts are in pristine condition but those in non-heritage areas are in better condition than those in heritage areas. “Utility value” is the main driver that still motivates people to conserve spouts.Keywords: stone spouts, social and cultural norms and values, meta-theory, Kathmandu Valley
Procedia PDF Downloads 3132095 Stigma Associated with Invisible Disabilities and Its Effect on Intended Disclosure in the Workplace
Authors: Jessica Lynne Hicksted
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Disability discrimination is a long-standing issue that, despite protections, continues to result in unemployment, underemployment, and lack of advancement for disabled persons. Visible stigma is researched substantially; however, less is known about the impact of stigma associated with identities that can be concealed. Although researchers have investigated this issue, currently there is no tool to measure this phenomenon. The purpose of this quantitative study was to create and validate a new tool to measure stigma associated with invisible disabilities. The study is grounded by Roberts’ conceptual model of professional image construction integrating social identity, impression management, and organizational behavior; Meisenbach’s stigma management communication theory addressing the vulnerabilities and resilience to stigma communication by focusing on how individuals encounter and react to perceived stigmas; and Kelley and Michela’s causal attribution theory. Participants included 1,412 adults in the United States 18 years or older currently employed or who have been employed within the last 5 years. Confirmatory factor analysis of the new Workplace Invisible Disabilities Experience scale showed excellent fit of the factor structure to the data, X₂/df = 1.855, CFI = .955, RMSEA = .045, p = .0001. The scale has three subscales, Ableism, Advocacy, and Acceptance, with excellent internal consistency reliability. Total score, Advocacy, and Acceptance were associated with intention to disclose. Implications for positive social change include helping organizations to understand the extent of invisible disability stigma that can help improve workplace performance and satisfaction.Keywords: invisible disabilities, accommodations, acceptance, social change, workplace inclusion
Procedia PDF Downloads 722094 Safe Zone: A Framework for Detecting and Preventing Drones Misuse
Authors: AlHanoof A. Alharbi, Fatima M. Alamoudi, Razan A. Albrahim, Sarah F. Alharbi, Abdullah M Almuhaideb, Norah A. Almubairik, Abdulrahman Alharby, Naya M. Nagy
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Recently, drones received a rapid interest in different industries worldwide due to its powerful impact. However, limitations still exist in this emerging technology, especially privacy violation. These aircrafts consistently threaten the security of entities by entering restricted areas accidentally or deliberately. Therefore, this research project aims to develop drone detection and prevention mechanism to protect the restricted area. Until now, none of the solutions have met the optimal requirements of detection which are cost-effectiveness, high accuracy, long range, convenience, unaffected by noise and generalization. In terms of prevention, the existing methods are focusing on impractical solutions such as catching a drone by a larger drone, training an eagle or a gun. In addition, the practical solutions have limitations, such as the No-Fly Zone and PITBULL jammers. According to our study and analysis of previous related works, none of the solutions includes detection and prevention at the same time. The proposed solution is a combination of detection and prevention methods. To implement the detection system, a passive radar will be used to properly identify the drone against any possible flying objects. As for the prevention, jamming signals and forceful safe landing of the drone integrated together to stop the drone’s operation. We believe that applying this mechanism will limit the drone’s invasion of privacy incidents against highly restricted properties. Consequently, it effectively accelerates drones‘ usages at personal and governmental levels.Keywords: detection, drone, jamming, prevention, privacy, RF, radar, UAV
Procedia PDF Downloads 2142093 Highly Efficient Iron Oxide-Sulfonated Graphene Oxide Catalyst for Esterification and Trans-Esterification Reactions
Authors: Reena D. Souza, Tripti Vats, Prem F. Siril
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Esterification of free fatty acid (oleic acid) and transesterification of waste cooking oil (WCO) with ethanol over graphene oxide (GO), GO-Fe2O3, sulfonated GO (GO-SO3H), and Fe2O3/GO-SO3H catalysts were examined in the present study. Iron oxide supported graphene-based acid catalyst (Fe2O3/GO-SO3H) exhibited highest catalytic activity. GO was prepared by modified Hummer’s process. The GO-Fe2O3 nanocomposites were prepared by the addition of NaOH to a solution containing GO and FeCl3. Sulfonation was done using concentrated sulfuric acid. Transmissionelectron microscopy (TEM) and atomic force microscopy (AFM) imaging revealed the presence of Fe2O3 particles having size in the range of 50-200 nm. Crystal structure was analyzed by XRD and defect states of graphene were characterized using Raman spectroscopy. The effects of the reaction variables such as catalyst loading, ethanol to acid ratio, reaction time and temperature on the conversion of fatty acids were studied. The optimum conditions for the esterification process were molar ratio of alcohol to oleic acid at 12:1 with 5 wt% of Fe2O3/GO-SO3H at 1000C with a reaction time of 4h yielding 99% of ethyl oleate. This is because metal oxide supported solid acid catalysts have advantages of having both strong Brønsted as well as Lewis acid properties. The biodiesel obtained by transesterification of WCO was characterized by 1H NMR and Gas Chromatography techniques. XRD patterns of the recycled catalyst evidenced that the catalyst structure was unchanged up to the 5th cycle, which indicated the long life of the catalyst.Keywords: Fe₂O₃/GO-SO₃H, Graphene Oxide, GO-Fe₂O₃, GO-SO₃H, WCO
Procedia PDF Downloads 2792092 Action Research through Drama in Education on Adolescents’ Career Self-Efficacy and Decision-Making Skills Development
Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou
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The purpose of this multi-phased action research PhD study in Greece was to investigate if and how Drama in Education (DiE) – used as an innovative group counselling method – may have positive effects on secondary education students’career self-efficacy and career decision-making skills development. Using both quantitative and qualitative research tools, high quality data were gathered at various stages of the research and were analysed through multivariate methods and open-source computer aided data analysis software such as R Studio, QualCoder, and SPSS packages. After a five-month-long educational intervention based on DiE method, it was found that 9th, 10th, and 11th gradersameliorated their self-efficacy and learned the process of making an informed career decision – through targeted information gathering about themselves and possible study paths – thus, developing career problem-solving and career management skills. Gender differences were non statistically important, while differences in grades showed a minor influence on some of the measured factorssuch as general career indecisiveness and self-evaluation. Students in the 11th grade scored significantly higher than younger students in the career self-efficacy scale and have stronger faith in their abilities e.g., choosing general over vocational school and major study orientation. The study has shown that DiE can be effective in group career guidance, especially concerning the pillars of self-awareness, self-efficacy, and career decision-making processes.Keywords: career decision-making skills, career self-efficacy, CDDQ scale, CDMSE-SF scale, drama in education method
Procedia PDF Downloads 1282091 An Impregnated Active Layer Mode of Solution Combustion Synthesis as a Tool for the Solution Combustion Mechanism Investigation
Authors: Zhanna Yermekova, Sergey Roslyakov
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Solution combustion synthesis (SCS) is the unique method which multiple times has proved itself as an effective and efficient approach for the versatile synthesis of a variety of materials. It has significant advantages such as relatively simple handling process, high rates of product synthesis, mixing of the precursors on a molecular level, and fabrication of the nanoproducts as a result. Nowadays, an overwhelming majority of solution combustion investigations performed through the volume combustion synthesis (VCS) where the entire liquid precursor is heated until the combustion self-initiates throughout the volume. Less amount of the experiments devoted to the steady-state self-propagating mode of SCS. Under the beforementioned regime, the precursor solution is dried until the gel-like media, and later on, the gel substance is locally ignited. In such a case, a combustion wave propagates in a self-sustaining mode as in conventional solid combustion synthesis. Even less attention is given to the impregnated active layer (IAL) mode of solution combustion. An IAL approach to the synthesis is implying that the solution combustion of the precursors should be initiated on the surface of the third chemical or inside the third substance. This work is aiming to emphasize an underestimated role of the impregnated active layer mode of the solution combustion synthesis for the fundamental studies of the combustion mechanisms. It also serves the purpose of popularizing the technical terms and clarifying the difference between them. In order to do so, the solution combustion synthesis of γ-FeNi (PDF#47-1417) alloy has been accomplished within short (seconds) one-step reaction of metal precursors with hexamethylenetetramine (HTMA) fuel. An idea of the special role of the Ni in a process of alloy formation was suggested and confirmed with the particularly organized set of experiments. The first set of experiments were conducted in a conventional steady-state self-propagating mode of SCS. An alloy was synthesized as a single monophasic product. In two other experiments, the synthesis was divided into two independent processes which are possible under the IAL mode of solution combustion. The sequence of the process was changed according to the equations which are describing an Experiment A and B below: Experiment A: Step 1. Fe(NO₃)₃*9H₂O + HMTA = FeO + gas products; Step 2. FeO + Ni(NO₃)₂*6H₂O + HMTA = Ni + FeO + gas products; Experiment B: Step 1. Ni(NO₃)₂*6H₂O + HMTA = Ni + gas products; Step 2. Ni + Fe(NO₃)₃*9H₂O + HMTA = Fe₃Ni₂+ traces (Ni + FeO). Based on the IAL experiment results, one can see that combustion of the Fe(NO₃)₃9H₂O on the surface of the Ni is leading to the alloy formation while presence of the already formed FeO does not affect the Ni(NO₃)₂*6H₂O + HMTA reaction in any way and Ni is the main product of the synthesis.Keywords: alloy, hexamethylenetetramine, impregnated active layer mode, mechanism, solution combustion synthesis
Procedia PDF Downloads 1362090 Realising the Socio-Economic Rights of Refugees Under Human Rights Law: A Case Study of South Africa
Authors: Taguekou Kenfack Alexie
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For a long time, refugee protection has constituted one of the main concerns of the international community as a whole and for the South African government in particular.The focus of this paper is on the challenges refugees face in accessing their rights in South Africa. In particular, it analyses the legal framework for the protection of the socio economic rights of refugees under international law, regional and domestic law and the extent to which the rights have been realized. The main hypothesis of the study centered on the fact that the social protection of refugees in South Africa is in conformity with international standards. To test this hypothesis, the qualitative research method was applied. Refugee related legal instruments were analyzed as well as academic publications, organizational reports and internet sources. The data analyzed revealed that there has been enormous progress in meeting international standards in the areas of education, emergency relief and assistance, protection of women and refugee children. The results also indicated that much remain to be desired in such areas as nutrition, shelter, health care, freedom of movement and very importantly, employment and social security. The paper also seeks to address the obstacles which prevent the proper treatment of refugees and to make recommendations as how the South African government can better regulate the treatment of refugees living in its territory.Recommendations include the amendment of the legal instruments that provide the normative framework for protection and improvement of protection policies to reflect the changing dynamics.Keywords: international community, refugee, socioeconomic rights, social protection
Procedia PDF Downloads 2832089 Modelling Heat Transfer Characteristics in the Pasteurization Process of Medium Long Necked Bottled Beers
Authors: S. K. Fasogbon, O. E. Oguegbu
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Pasteurization is one of the most important steps in the preservation of beer products, which improves its shelf life by inactivating almost all the spoilage organisms present in it. However, there is no gain saying the fact that it is always difficult to determine the slowest heating zone, the temperature profile and pasteurization units inside bottled beer during pasteurization, hence there had been significant experimental and ANSYS fluent approaches on the problem. This work now developed Computational fluid dynamics model using COMSOL Multiphysics. The model was simulated to determine the slowest heating zone, temperature profile and pasteurization units inside the bottled beer during the pasteurization process. The results of the simulation were compared with the existing data in the literature. The results showed that, the location and size of the slowest heating zone is dependent on the time-temperature combination of each zone. The results also showed that the temperature profile of the bottled beer was found to be affected by the natural convection resulting from variation in density during pasteurization process and that the pasteurization unit increases with time subject to the temperature reached by the beer. Although the results of this work agreed with literatures in the aspects of slowest heating zone and temperature profiles, the results of pasteurization unit however did not agree. It was suspected that this must have been greatly affected by the bottle geometry, specific heat capacity and density of the beer in question. The work concludes that for effective pasteurization to be achieved, there is a need to optimize the spray water temperature and the time spent by the bottled product in each of the pasteurization zones.Keywords: modeling, heat transfer, temperature profile, pasteurization process, bottled beer
Procedia PDF Downloads 2072088 Power Production Performance of Different Wave Energy Converters in the Southwestern Black Sea
Authors: Ajab G. Majidi, Bilal Bingölbali, Adem Akpınar
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This study aims to investigate the amount of energy (economic wave energy potential) that can be obtained from the existing wave energy converters in the high wave energy potential region of the Black Sea in terms of wave energy potential and their performance at different depths in the region. The data needed for this purpose were obtained using the calibrated nested layered SWAN wave modeling program version 41.01AB, which was forced with Climate Forecast System Reanalysis (CFSR) winds from 1979 to 2009. The wave dataset at a time interval of 2 hours was accumulated for a sub-grid domain for around Karaburun beach in Arnavutkoy, a district of Istanbul city. The annual sea state characteristic matrices for the five different depths along with a vertical line to the coastline were calculated for 31 years. According to the power matrices of different wave energy converter systems and characteristic matrices for each possible installation depth, the probability distribution tables of the specified mean wave period or wave energy period and significant wave height were calculated. Then, by using the relationship between these distribution tables, according to the present wave climate, the energy that the wave energy converter systems at each depth can produce was determined. Thus, the economically feasible potential of the relevant coastal zone was revealed, and the effect of different depths on energy converter systems is presented. The Oceantic at 50, 75 and 100 m depths and Oyster at 5 and 25 m depths presents the best performance. In the 31-year long period 1998 the most and 1989 is the least dynamic year.Keywords: annual power production, Black Sea, efficiency, power production performance, wave energy converter
Procedia PDF Downloads 1372087 Optimized Techniques for Reducing the Reactive Power Generation in Offshore Wind Farms in India
Authors: Pardhasaradhi Gudla, Imanual A.
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The generated electrical power in offshore needs to be transmitted to grid which is located in onshore by using subsea cables. Long subsea cables produce reactive power, which should be compensated in order to limit transmission losses, to optimize the transmission capacity, and to keep the grid voltage within the safe operational limits. Installation cost of wind farm includes the structure design cost and electrical system cost. India has targeted to achieve 175GW of renewable energy capacity by 2022 including offshore wind power generation. Due to sea depth is more in India, the installation cost will be further high when compared to European countries where offshore wind energy is already generating successfully. So innovations are required to reduce the offshore wind power project cost. This paper presents the optimized techniques to reduce the installation cost of offshore wind firm with respect to electrical transmission systems. This technical paper provides the techniques for increasing the current carrying capacity of subsea cable by decreasing the reactive power generation (capacitance effect) of the subsea cable. There are many methods for reactive power compensation in wind power plants so far in execution. The main reason for the need of reactive power compensation is capacitance effect of subsea cable. So if we diminish the cable capacitance of cable then the requirement of the reactive power compensation will be reduced or optimized by avoiding the intermediate substation at midpoint of the transmission network.Keywords: offshore wind power, optimized techniques, power system, sub sea cable
Procedia PDF Downloads 1982086 Experimental and Theoretical Characterization of Supramolecular Complexes between 7-(Diethylamino)Quinoline-2(1H)-One and Cucurbit[7] Uril
Authors: Kevin A. Droguett, Edwin G. Pérez, Denis Fuentealba, Margarita E. Aliaga, Angélica M. Fierro
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Supramolecular chemistry is a field of growing interest. Moreover, studying the formation of host-guest complexes between macrocycles and dyes is highly attractive due to their potential applications. Examples of the above are drug delivery, catalytic process, and sensing, among others. There are different dyes of interest in the literature; one example is the quinolinone derivatives. Those molecules have good optical properties and chemical and thermal stability, making them suitable for developing fluorescent probes. Secondly, several macrocycles can be seen in the literature. One example is the cucurbiturils. This water-soluble macromolecule family has a hydrophobic cavity and two identical carbonyl portals. Additionally, the thermodynamic analysis of those supramolecular systems could help understand the affinity between the host and guest, their interaction, and the main stabilization energy of the complex. In this work, two 7-(diethylamino) quinoline-2 (1H)-one derivative (QD1-2) and their interaction with cucurbit[7]uril (CB[7]) were studied from an experimental and in-silico point of view. For the experimental section, the complexes showed a 1:1 stoichiometry by HRMS-ESI and isothermal titration calorimetry (ITC). The inclusion of the derivatives on the macrocycle lends to an upward shift in the fluorescence intensity, and the pKa value of QD1-2 exhibits almost no variation after the formation of the complex. The thermodynamics of the inclusion complexes was investigated using ITC; the results demonstrate a non-classical hydrophobic effect with a minimum contribution from the entropy term and a constant binding on the order of 106 for both ligands. Additionally, dynamic molecular studies were carried out during 300 ns in an explicit solvent at NTP conditions. Our finding shows that the complex remains stable during the simulation (RMSD ~1 Å), and hydrogen bonds contribute to the stabilization of the systems. Finally, thermodynamic parameters from MMPBSA calculations were obtained to generate new computational insights to compare with experimental results.Keywords: host-guest complexes, molecular dynamics, quinolin-2(1H)-one derivatives dyes, thermodynamics
Procedia PDF Downloads 942085 Removal of Lead (Pb) by the Microorganism Isolated from the Effluent of Lead Acid Battery Scrap
Authors: Harikrishna Yadav Nanganuru, Narasimhulu Korrapati
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The demand for the lead (Pb) in the battery industry has been growing for last twenty years. On an average about 2.35 million tons of lead is used in the battery industry. According to the survey of supply and demand battery industry is using 75% of lead produced every year. Due to the increase in battery scrap, secondary lead production has been increasing in this decade. Europe and USA together account for 75% of the world’s secondary lead production. The effluent from used battery scrap consists of high concentrations of lead. Unauthorized disposal of spent batteries, which contain intolerable concentration of lead, into landfills or municipal water canals causes release of Pb into the environment. Lead is one of the toxic heavy metals that have large damaging effects on the human health. Due to its persistence and toxicity, the presence of Pb in drinking water is considered as a special concern. Accumulation of Pb in the human body for long period of time can result in the malfunctioning of some organs. Many technologies have been developed for the removal of lead using microorganisms. In this paper, effluent was taken from the spent battery scrap and was characterized by inductively coupled plasma atomic emission spectrometer. Microorganisms play an important role in removal of lead from the contaminated sites. So, the bacteria were isolated from the effluent. Optimum conditions for the microbial growth and applied for the lead removal. These bacterial cells were immobilized and used for the removal of Pb from the known concentration of metal solution. Scanning electron microscopic (SEM) studies were shown that the Pb was efficiently adsorbed by the immobilized bacteria. From the results of Atomic Absorption Spectroscopy (AAS), 83.40 percentage of Pb was removed in a batch culture.Keywords: adsorption, effluent, immobilization, lead (Pb)
Procedia PDF Downloads 4592084 Carbapenem Usage in Medical Wards: An Antibiotic Stewardship Feedback Project
Authors: Choon Seong Ng, P. Petrick, C. L. Lau
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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital
Procedia PDF Downloads 2062083 Fault Tolerant and Testable Designs of Reversible Sequential Building Blocks
Authors: Vishal Pareek, Shubham Gupta, Sushil Chandra Jain
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With increasing high-speed computation demand the power consumption, heat dissipation and chip size issues are posing challenges for logic design with conventional technologies. Recovery of bit loss and bit errors is other issues that require reversibility and fault tolerance in the computation. The reversible computing is emerging as an alternative to conventional technologies to overcome the above problems and helpful in a diverse area such as low-power design, nanotechnology, quantum computing. Bit loss issue can be solved through unique input-output mapping which require reversibility and bit error issue require the capability of fault tolerance in design. In order to incorporate reversibility a number of combinational reversible logic based circuits have been developed. However, very few sequential reversible circuits have been reported in the literature. To make the circuit fault tolerant, a number of fault model and test approaches have been proposed for reversible logic. In this paper, we have attempted to incorporate fault tolerance in sequential reversible building blocks such as D flip-flop, T flip-flop, JK flip-flop, R-S flip-flop, Master-Slave D flip-flop, and double edge triggered D flip-flop by making them parity preserving. The importance of this proposed work lies in the fact that it provides the design of reversible sequential circuits completely testable for any stuck-at fault and single bit fault. In our opinion our design of reversible building blocks is superior to existing designs in term of quantum cost, hardware complexity, constant input, garbage output, number of gates and design of online testable D flip-flop have been proposed for the first time. We hope our work can be extended for building complex reversible sequential circuits.Keywords: parity preserving gate, quantum computing, fault tolerance, flip-flop, sequential reversible logic
Procedia PDF Downloads 5472082 Mix Proportioning and Strength Prediction of High Performance Concrete Including Waste Using Artificial Neural Network
Authors: D. G. Badagha, C. D. Modhera, S. A. Vasanwala
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There is a great challenge for civil engineering field to contribute in environment prevention by finding out alternatives of cement and natural aggregates. There is a problem of global warming due to cement utilization in concrete, so it is necessary to give sustainable solution to produce concrete containing waste. It is very difficult to produce designated grade of concrete containing different ingredient and water cement ratio including waste to achieve desired fresh and harden properties of concrete as per requirement and specifications. To achieve the desired grade of concrete, a number of trials have to be taken, and then after evaluating the different parameters at long time performance, the concrete can be finalized to use for different purposes. This research work is carried out to solve the problem of time, cost and serviceability in the field of construction. In this research work, artificial neural network introduced to fix proportion of concrete ingredient with 50% waste replacement for M20, M25, M30, M35, M40, M45, M50, M55 and M60 grades of concrete. By using the neural network, mix design of high performance concrete was finalized, and the main basic mechanical properties were predicted at 3 days, 7 days and 28 days. The predicted strength was compared with the actual experimental mix design and concrete cube strength after 3 days, 7 days and 28 days. This experimentally and neural network based mix design can be used practically in field to give cost effective, time saving, feasible and sustainable high performance concrete for different types of structures.Keywords: artificial neural network, high performance concrete, rebound hammer, strength prediction
Procedia PDF Downloads 1582081 'Typical' Criminals: A Schutzian Influenced Theoretical Framework Exploring Type and Stereotype Formation
Authors: Mariam Shah
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The way the human mind interprets and comprehends the world it occupies has long been a topic of discussion amongst philosophers and phenomenologists. This paper will focus predominantly on the ideologies espoused by the phenomenologist Alfred Schutz and will investigate how we attribute meaning to an event through the process of typification, and the production and usage of ‘types' and ‘stereotypes.' This paper will then discuss how subjective ideologies innate within us result in unique and subjective decision outcomes, based on a phenomenologically influenced theoretical framework which will illustrate how we form ‘types’ in order to ‘typecast’ and form judgements of everything and everyone we experience. The framework used will be founded in theory espoused by Alfred Schutz, and will review the different types of knowledge we rely on innately to inform our judgements, the relevance we attribute to the information which we acquire, and how we consciously and unconsciously apply this framework to everyday situations. An assessment will then be made of the potential impact that these subjective meaning structures can present when dispensing justice in criminal courts. This paper will investigate how these subjective meaning structures can influence our consciousness on both a conscious and unconscious level, and how this could potentially result in bias judicial outcomes due to negative ‘types’ or ‘stereotypes.' This paper will ultimately illustrate that we unconsciously and unreflexively use pre-formed types and stereotypes to inform our judgements and give meaning to what we have just experienced.Keywords: Alfred Schutz, criminal courts, decision making, judicial decision making, phenomenology, Schutzian stereotypes, types, typification
Procedia PDF Downloads 2282080 Conservation of Rare, Endangered and Threaten Medicinal Plants: Participatory Approach
Authors: G. Raviraja Shetty, K. G. Poojitha, Pranay Kumar
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Biodiversity refers to the numbers, variety and variability of living organisms and ecosystem. The climatic and altitudinal variations, coupled with varied ecological habitats of this country, have contributed to the development of immensely rich vegetation with a unique diversity in medicinal plants which provides an important source of medicinal raw materials for traditional medicine systems as well as for pharmaceutical industries in the country and abroad. World Health Organization has listed over 21000 plant species used around the world for medicinal purpose. In India, about 2500 plant species are being used in indigenous system of medicine. The red data book lists 427 Indian Medicinal plant entries on endangered species, of which 28 are considered extinct, 124 endangered, 81 rare, and 34 insufficiently known. It is abundantly clear from the experience of all govt agencies that on their own they cannot efficiently conserve the biodiversity. Participatory Approach with the involvement of local people in conservation is found to be more effective these days. Involvement of local people reduces the cost involved in conservation. Local communities have long tradition of resource use in particular area, hold in depth knowledge and experience of plant which can be invaluable for conservation efforts.Medicinal plants occupy a vital sector of health care system in India and represent a major national resource.There is an immense need for conservation of diversity of medicinal plant wealth for the present and fore coming generations, by adapting the suitable strategy with most appropriate method of conservation.Keywords: conservation, biodiversity, participatory, medicinal plants
Procedia PDF Downloads 4842079 Government of Ghana’s Budget: An Assessment of Its Compliance with Fundamental Budgeting Principles
Authors: Mohammed Sani Abdulai
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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality
Procedia PDF Downloads 2032078 Specific Biomarker Level and Function Outcome Changes in Treatment of Patients with Frozen Shoulder Using Dextrose Prolotherapy Injection
Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan
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The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1
Procedia PDF Downloads 1202077 Comparative Study of Globalization and Homogenous Society: South Korea and Greek Society Reaction to Foreign Culture
Authors: Putri Mentari Racharjo
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The development of current technology is simplifying globalization process. An easier globalization process and mobilization are increasing interactions among individuals and societies in different countries. It is also easier for foreign culture to enter a country and create changes to the society. Differences brought by foreign culture will most likely affect any society. It will be easier for heterogeneous society to accept new culture, considering that they have various cultures, and they are used to differences. So it will be easier for a heterogeneous society to accept new culture as long as the culture is not contrary to their essential values. However for a homogenous society, where they have only one language and culture, it will take a longer adjustment time to fully accept the new culture. There will be a tendency for homogenous societies to react in a more negative way to new culture. Greece and South Korea are the examples for homogeneous societies. Greece, a destination country for immigrants, is having a hard time adjusting themselves to accept many immigrants with many cultures. There are various discrimination cases of immigrants in Greece, when the Greek society cannot fully accept the new culture brought by immigrants. South Korea, a newly popular country with K-pop and K-dramas, is attracting people from all over the world to come to South Korea. However a homogenous South Korean society is also having a hard time to fully accept foreign cultures, resulting in many discrimination cases based on race and culture in South Korea. With a qualitative method through a case study and literature review, this article will discuss about Greek and South Korean societies reaction to new cultures as an effect of globalization.Keywords: foreign culture, globalization, greece, homogenous society, South Korea
Procedia PDF Downloads 3352076 Performance of Fiber-Reinforced Polymer as an Alternative Reinforcement
Authors: Salah E. El-Metwally, Marwan Abdo, Basem Abdel Wahed
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Fiber-reinforced polymer (FRP) bars have been proposed as an alternative to conventional steel bars; hence, the use of these non-corrosive and nonmetallic reinforcing bars has increased in various concrete projects. This concrete material is lightweight, has a long lifespan, and needs minor maintenance; however, its non-ductile nature and weak bond with the surrounding concrete create a significant challenge. The behavior of concrete elements reinforced with FRP bars has been the subject of several experimental investigations, even with their high cost. This study aims to numerically assess the viability of using FRP bars, as longitudinal reinforcement, in comparison with traditional steel bars, and also as prestressing tendons instead of the traditional prestressing steel. The nonlinear finite element analysis has been utilized to carry out the current study. Numerical models have been developed to examine the behavior of concrete beams reinforced with FRP bars or tendons against similar models reinforced with either conventional steel or prestressing steel. These numerical models were verified by experimental test results available in the literature. The obtained results revealed that concrete beams reinforced with FRP bars, as passive reinforcement, exhibited less ductility and less stiffness than similar beams reinforced with steel bars. On the other hand, when FRP tendons are employed in prestressing concrete beams, the results show that the performance of these beams is similar to those beams prestressed by conventional active reinforcement but with a difference caused by the two tendon materials’ moduli of elasticity.Keywords: reinforced concrete, prestressed concrete, nonlinear finite element analysis, fiber-reinforced polymer, ductility
Procedia PDF Downloads 192075 Effects of Foliar Application of Glycine Betaine under Nickel Toxicity of Oat (Avena Sativa L.)
Authors: Khizar Hayat Bhatti, Fiza Javed, Misbah Zafar
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Oat (Avena sativa L.) is a major cereal plant belonging to the family Poaceae. It is a very important source of carbohydrates, starch, minerals, vitamins and proteins that are beneficial for general health. Plants grow in the heavy metals contaminated soils that results in decline in growth. Glycine betaine application may improve plant growth, survival and resistance to metabolic disturbances due to stresses. Heavy metals, like nickels, have been accumulated for a long time in the soil because of industrial waste and sewage. The experiment was intended to alleviate the detrimental effects of heavy metal nickel stress on two oat varieties ‘Sgd-2011 and Hay’ using Glycine betain. Nickel was induced through soil application while GB was applied as foliar spray. After 10 days of nickel treatment, an exogenous spray of glycine betaine on the intact plant leaves. Data analysis was carried out using a Completely Randomized Design (CRD) with three replications in this study. For the analysis of all the data of the current research, Mini-Tab 19 software was used to compare the mean value of all treatments and Microsoft Excel software for generating the bars graphs. Significant accelerated plant growth was recorded when Ni exposed plants were treated with GB. Based on data findings, 3mM GB caused significant recovery from Ni stress doses. Overall results also demonstrated that the sgd-2011 variety of oats had the greatest outcomes for all parameters.Keywords: CRD, foliar spray method, glycine betaine, heavy metals, nickel, ROS
Procedia PDF Downloads 122074 Evaluation of Flexural Cracking Width of Steel Fibre Reinforced Concrete Beams
Authors: Touhami Tahenni
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Excessively wide cracks are harmful to the serviceability of reinforced concrete (RC) beams and may lead to durability problems in the longer term. They also reduce the rigidity of RC sections, rendering the tensile concrete ineffective structurally. To reduce the negative effects of cracks, steel fibers are added to concrete mixes in the same manner as aggregates. In the present work, steel fibers reinforced concrete (SFRC) beams, made of normal strength and high strength concretes, were tested in a four-point bending test using a digital image correlation technique. The beams had different volume fractions of fibres and different aspect ratios (fiber length/fiber diameter). The evaluation of flexural cracking widths was determined using Gom-Aramis software. The experimental crack widths were compared with theoretical values predicted by the technical document of Rilem TC 162-TDF. The model proposed in this document seems to be the only one that considers the efficiency of steel fibres in restraining the crack widths. However, the model of Rilem takes into account only the aspect ratio of steel fibres to predict the crack width of SFRC beams. It has been reported in several pieces of research that the contribution of steel fibres to the limitation of flexural cracking widths is based on three essential parameters namely, the volume fraction, the orientation and the aspect ratio of fibres. Referring to the literature on the flexural cracking behavior of SFRC beams and the experimental observations of the present work, a correction of the Rilem model by the introduction of these parameters in the formula is proposed. The crack widths predicted by the new empirical model were compared with the experimental results and assessed against other test data on SFRC beams taken from the literature. The modified Rilem model gives better results and is found more satisfactory in predicting the crack widths of fibres concrete.Keywords: stee fibres, reinforced concrete, flexural cracking, tensile strength, crack width
Procedia PDF Downloads 992073 Evaluation of Critical Rate in Mature Oil Field with Dynamic Oil Rim Fluid Contacts in the Niger Delta
Authors: Stanley Ibuchukwu Onwukwe
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Most reservoir in mature oil fields are vulnerable to challenges of water and/or gas coning as the size of their oil column reduces due to long period of oil production. These often result to low oil production and excessive water and/or gas production. Since over 50 years of oil production in the Niger delta, it is apparent that most of the oil fields in the region have reached their mature stages, thereby susceptible to coning tendencies. As a result of these, a good number of wells have been shut-in and abandoned, with significant amount of oil left unproduced. Analysis of the movement of fluid contacts in the reservoir is a significant aspect of reservoir studies and can assist in the management of coning tendencies and production performance of reservoirs in a mature field. This study, therefore, seeks to evaluate the occurrence of coning through the movement of fluid contacts (GOC and OWC) and determine the critical rate for controlling coning tendencies in mature oil field. This study applies the principle of Nodal analysis to calibrate the thin oil column of a reservoir of a mature field, and was graphically evaluated using the Joshi’s equation of critical rate for gas-oil system and oil-water system respectively. A representative Proxy equation was developed and sensitivity analysis carried out to determine the trend of critical rate as the oil column is been depleted. The result shows the trend in the movement of the GOC and OWC, and the critical rate, beyond which will result in excessive water and gas production, resulting to decreasing oil production from the reservoir. This result of this study can be used as a first pass assessment in the development of mature oil field reservoirs anticipated to experience water and/or gas coning during production.Keywords: coning, fluid contact movement, mature oil field, oil production
Procedia PDF Downloads 2452072 High-Frequency Monitoring Results of a Piled Raft Foundation under Wind Loading
Authors: Laurent Pitteloud, Jörg Meier
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Piled raft foundations represent an efficient and reliable technique for transferring high vertical and horizontal loads to the subsoil. Piled raft foundations were successfully implemented for several high-rise buildings worldwide over the last decades. For the structural design of this foundation type the stiffnesses of both the piles and the raft have to be determined for the static (e.g. dead load, live load) and the dynamic load cases (e.g. earthquake). In this context the question often arises, to which proportion wind loads are to be considered as dynamic loads. Usually a piled raft foundation has to be monitored in order to verify the design hypotheses. As an additional benefit, the analysis of this monitoring data may lead to a better understanding of the behaviour of this foundation type for future projects in similar subsoil conditions. In case the measurement frequency is high enough, one may also draw conclusions on the effect of wind loading on the piled raft foundation. For a 41-storey office building in Basel, Switzerland, the preliminary design showed that a piled raft foundation was the best solution to satisfy both design requirements, as well as economic aspects. A high-frequency monitoring of the foundation including pile loads, vertical stresses under the raft, as well as pore water pressures was performed over 5 years. In windy situations the analysis of the measurements shows that the pile load increment due to wind consists of a static and a cyclic load term. As piles and raft react with different stiffnesses under static and dynamic loading, these measurements are useful for the correct definition of stiffnesses of future piled raft foundations. This paper outlines the design strategy and the numerical modelling of the aforementioned piled raft foundation. The measurement results are presented and analysed. Based on the findings, comments and conclusions on the definition of pile and raft stiffnesses for vertical and wind loading are proposed.Keywords: design, dynamic, foundation, monitoring, pile, raft, wind load
Procedia PDF Downloads 2002071 Performing the Landscape: Temporary and Performative Practices in Landscape Production
Authors: Miguel Costa
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Despite the "time" element being an intrinsic characteristic of the work with the landscape, its execution and completion are also often dependent on external factors, i.e., the slow bureaucratic procedures required for the implementation of a project. In the urban areas of the city, these conditions are even more present — some landscape projects are articulated with the architectural/urban design, transporting itself long, expensive and inflexible processes related with the constant transformations of contemporary urban culture, where the needs and expectations could change before the project is finished. However, despite the renewed interest and growing concern for issues related to the landscapes (particularly since the European Landscape Convention, its scope and fields of action, extended to all the landscapes and not just the selected ones), still lacks the need for a greater inclusion of citizens in its protection and construction processes as well as a greater transparency and clarity of the consequences and results of their active participation. This article aims to reflect on the production processes of urban landscapes, on its completion runtime and its relationship with the citizens by introducing temporary projects as a fieldwork methodology, as well as using the contribution of different professional practices and knowledge for its monitoring, execution, and implementation. These strategies address a more interdisciplinary, transdisciplinary and performative approach, not only from the ephemeral experience of objects and actions but also from the processes and the dynamic events that are organized from these objects and actions over the landscape. The goal is to discuss the results of these approaches on its different dimensions: critical dimension; experimental and strategic dimension; pedagogical dimension; political dimension; cultural.Keywords: landscape fieldwork, interdisciplinarity, public inclusion, public participation, temporary projects, transdisciplinarity
Procedia PDF Downloads 3242070 Acupuncture in the Treatment of Parkinson's Disease-Related Fatigue: A Pilot Randomized, Controlled Study
Authors: Keng H. Kong, Louis C. Tan, Wing L. Aw, Kay Y. Tay
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Background: Fatigue is a common problem in patients with Parkinson's disease, with reported prevalence of up to 70%. Fatigue can be disabling and has adverse effects on patients' quality of life. There is currently no satisfactory treatment of fatigue. Acupuncture is effective in the treatment of fatigue, especially that related to cancer. Its role in Parkinson's disease-related fatigue is uncertain. Aims: To evaluate the clinical efficacy of acupuncture treatment in Parkinson's disease-related fatigue. Hypothesis: We hypothesize that acupuncture is effective in alleviating Parkinson's disease-related fatigue. Design: A single center, randomized, controlled study with two parallel arms. Participants: Forty participants with idiopathic Parkinson's disease will be enrolled. Interventions: Participants will be randomized to receive verum (real) acupuncture or placebo acupuncture. The retractable non-invasive sham needle will be used in the placebo group. The intervention will be administered twice a week for five weeks. Main outcome measures: The primary outcome will be the change in general fatigue score of the multidimensional fatigue inventory at week 5. Secondary outcome measures include other subscales of the multidimensional fatigue inventory, movement disorders society-unified Parkinson's disease rating scale, Parkinson's disease questionnaire-39 and geriatric depression scale. All outcome measures will be assessed at baseline (week 0), completion of intervention (week 5) and 4 weeks after completion of intervention (week 9). Results: To date, 23 participants have been recruited and nine have completed the study. The mean age is 63.5±14.2 years, mean duration of Parkinson’s disease is 6.4±1.8 years and mean MDS-UPDRS score is 8.3±2.8. The mean general fatigue score of the multidimensional fatigue inventory is 13.5±4.6. No significant adverse event related to acupuncture is noted. Potential significance: If the results are as expected, this study will provide preliminary scientific evidence for the efficacy of acupuncture in Parkinson's Disease-related fatigue, and opens the door for a larger multicentre trial to be performed. In the longer term, it may lead to the integration of acupuncture in the care of patients with Parkinson's disease.Keywords: acupuncture, fatigue, Parkinson's disease, trial
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