Search results for: lower back pain

Authors: Finbarr Murphy, Wei Xu, Xian Xu

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The embedding of digital technologies in the global economy has attracted increasing attention from economists. With a large and detailed dataset, this study examines the specific case where consumers have a choice between offline and digital channels in the context of insurance purchases. We find that digital channels screen consumers with lower unobserved risk. For the term life, endowment, and disease insurance products, the average risk of the policies purchased through digital channels was 75%, 21%, and 31%, respectively, lower than those purchased offline. As a consequence, the lower unobserved risk leads to weaker information asymmetry and higher profitability of digital channels. We highlight three mechanisms of the risk screening effect: heterogeneous marginal influence of channel features on insurance demand, the channel features directly related to risk control, and the link between the digital divide and risk. We also find that the risk screening effect mainly comes from the extensive margin, i.e., from new consumers. This paper contributes to three connected areas in the insurance context: the heterogeneous economic impacts of digital technology adoption, insurer-side risk selection, and insurance marketing.

Keywords: digital economy, information asymmetry, insurance, mobile application, risk screening

Procedia PDF Downloads 64

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

Procedia PDF Downloads 222

Authors: R. Sivasamy, G. Paulraj, S. Kalaimani, N.Thillaigovindan

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For profitable businesses, queues are double-edged swords and hence the pain of long wait times in a queue often frustrates customers. This paper suggests a technical way of reducing the pain of lines through a Poisson M/M1, M2/2 queueing system operated by two heterogeneous servers with an objective of minimising the mean sojourn time of customers served under the queue discipline ‘First Come First Served with an ‘m’ policy, i.e. FCFS-m policy’. Arrivals to the system form a Poisson process of rate λ and are served by two exponential servers. The service times of successive customers at server ‘j’ are independent and identically distributed (i.i.d.) random variables and each of it is exponentially distributed with rate parameter μj (j=1, 2). The primary condition for implementing the queue discipline ‘FCFS-m policy’ on these service rates μj (j=1, 2) is that either (m+1) µ2 > µ1> m µ2 or (m+1) µ1 > µ2> m µ1 must be satisfied. Further waiting customers prefer the server-1 whenever it becomes available for service, and the server-2 should be installed if and only if the queue length exceeds the value ‘m’ as a threshold. Steady-state results on queue length and waiting time distributions have been obtained. A simple way of tracing the optimal service rate μ*2 of the server-2 is illustrated in a specific numerical exercise to equalize the average queue length cost with that of the service cost. Assuming that the server-1 has to dynamically adjust the service rates as μ1 during the system size is strictly less than T=(m+2) while μ2=0, and as μ1 +μ2 where μ2>0 if the system size is more than or equal to T, corresponding steady state results of M/M1+M2/1 queues have been deduced from those of M/M1,M2/2 queues. To conclude this investigation has a viable application, results of M/M1+M2/1 queues have been used in processing of those waiting messages into a single computer node and to measure the power consumption by the node.

Keywords: two heterogeneous servers, M/M1, M2/2 queue, service cost and queue length cost, M/M1+M2/1 queue

Procedia PDF Downloads 355

Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes

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Based on a theoretical assessment of current literature, virtual reality (VR) could help to treat sporting injuries in a number of ways. However, it is important to obtain rehabilitation specialists’ perspectives in order to design, develop and validate suitable content for a VR application focused on treatment. Subsequently, a one-day observation and interview study focused on the use of VR for the treatment of lower limb musculoskeletal conditions in athletes was conducted at St George’s Park England National Football Centre with rehabilitation specialists. The current paper established the methods suitable for obtaining practitioner’s viewpoints through observation and interview in this context. Particular detail was provided regarding the method of qualitatively processing interview results using the qualitative data analysis software tool NVivo, in order to produce a narrative of overarching themes. The observations and overarching themes identified could be used as a framework and success criteria of a VR application developed in future research. In conclusion, this work explained the methods deemed suitable for obtaining practitioner’s viewpoints through observation and interview. This was required in order to highlight characteristics and features of a VR application designed to treat lower limb musculoskeletal injury of athletes and could be built upon to direct future work.

Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality

Procedia PDF Downloads 243

Authors: Skezeer John B. Paz, Ederlina G. Nocon

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Finding an optimal binary linear code is a central problem in coding theory. A binary linear code C = [n, k, d] is called optimal if there is no linear code with higher minimum distance d given the length n and the dimension k. There are bounds giving limits for the minimum distance d of a linear code of fixed length n and dimension k. The lower bound which can be taken by construction process tells that there is a known linear code having this minimum distance. The upper bound is given by theoretic results such as Griesmer bound. One way to find an optimal binary linear code is to make the lower bound of d equal to its higher bound. That is, to construct a binary linear code which achieves the highest possible value of its minimum distance d, given n and k. Some optimal binary linear codes were presented by Andries Brouwer in his published table on bounds of the minimum distance d of binary linear codes for 1 ≤ n ≤ 256 and k ≤ n. This was further improved by Markus Grassl by giving a detailed construction process for each code exhibiting the lower bound. In this paper, we construct new optimal binary linear codes by using some construction processes on existing binary linear codes. Particularly, we developed an algorithm applied to the codes already constructed to extend the list of optimal binary linear codes up to 257 ≤ n ≤ 300 for k ≤ 7.

Keywords: bounds of linear codes, Griesmer bound, construction of linear codes, optimal binary linear codes

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Authors: Elvin Lim

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This article integrates the debate about presidential powers with the debate about federalism, arguing that there are two ways of exercising presidential powers, one working in tandem with expanding federal powers, and the other working against it. Alexander Hamilton and Thomas Jefferson—the former a Federalist and the latter echoing the views of many Anti-Federalists—disagreed not only on the constitutional basis of prerogative, but also on the ends for which it should be deployed. This tension has always existed in American politics, and is reproduced today. Modern Democrats and Republicans both want a strong executive, but the Democrats who want a strong executive to pass legislation to expand the reach of the federal government; naturally, they must rely on an equally empowered Congress to do so. Republicans generally do not want an intrusive federal government, which is why their defense of a strong presidency does not come alongside a call for a strong Congress. This distinction cannot be explained without recourse to foundational yet opposing views about the appropriate role of federal power. When we bring federalism back in, we see that there are indeed two presidencies; one neo-Federalist, in favor of moderate presidential prerogative alongside a robust Congress directed collectively to a national state-building agenda and expanding the federal prerogative; another, neo-Anti-Federalist, in favor of expansive presidential prerogative and an ideologically sympathetic Congress equally suspicious of federal power to retard or roll back national state-building in favour of states rights.

Keywords: US presidency, federalism, prerogative, anti-federalism

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Authors: Siriwan Saksiriruthai

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This paper reviews and analyzes impact of foreign migration on innovation for Thailand. With the analysis of decades of industrial and economic development, Thailand has attracted investment by providing cheap labor and low cost of production. Foreign migrant substantially contribute to the development by supplying lower wages with low-skilled workers. However, it is revealed that foreign low-skilled labor influx has a negative effect on innovation. Firms concentrate on benefits from low cost of production and are not motivated to invest for innovation. Therefore, with the emerging of new economies where lower wage laborers are offered, Thailand has to promote innovation to maintain economic development sustainability.

Keywords: migration, innovation, Thailand, foreign

Procedia PDF Downloads 362

Authors: Mesfin Getu Woldetensay

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Representatives and commercially viable natural gas liquids (NGLs) recovery processes were studied under various feed conditions that are classified as lean and rich. The conventional turbo- expander process scheme (ISS) was taken as a base case. The performance of this scheme was compared against with the gas sub-cooled process (GSP), cold residue-gas (CRR) and recycle split-vapor (RSV), enhanced NGL recovery process (IPSI-1) and enhanced NGL recovery process with internal refrigeration (IPSI-2). The development made for the GSP, CRR and RSV are at the top section of the demethanizer column whereas the IPSI-1 and IPSI-2 improvement focus in the lower section. HYSYS process flowsheet was initially developed for all the processes including the ISS under a common criteria that could help to demonstrate the performance comparison. Accordingly, a number of simulation runs were made for the selected eight types of feed. Results show that the reboiler duty requirement using rich feeds for GSP, CRR and RSV is quite high compared to IPSI-1 and IPSI-2. The latter shows relatively lower duty due to the presence of self-refrigeration system that allows the inlet feed to be used for achieving cooling without the need to use propane refrigerant. The energy consumption for lean feed is much lower than that of the rich feed in all process schemes.

Keywords: composition, lean, rich, duty

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Authors: Ebrahim Tilahun, Erkan Sahinkaya, Bariş Calli̇

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Raw biogas is a valuable renewable energy source however it usually needs removal of the impurities. The presence of hydrogen sulfide (H2S) in the biogas has detrimental corrosion effects on the cogeneration units. Removal of H2S from the biogas can therefore significantly improve the biogas quality. In this work, a conventional bioscrubber (CBS), and a dense membrane bioscrubber (DMBS) were comparatively evaluated in terms of H2S removal efficiency (RE), CH4 enrichment and alkaline consumption at gas residence times ranging from 5 to 20 min. Both bioscrubbers were fed with a synthetic biogas containing H2S (1%), CO2 (39%) and CH4 (60%). The results show that high RE (98%) was obtained in the DMBS when gas residence time was 20 min, whereas slightly lower CO2 RE was observed. While in CBS system the outlet H2S concentration was always lower than 250 ppmv, and its H2S RE remained higher than 98% regardless of the gas residence time, although the high alkaline consumption and frequent absorbent replacement limited its cost-effectiveness. The result also indicates that in DMBS when the gas residence time increased to 20 min, the CH4 content in the treated biogas enriched upto 80%. However, while operating the CBS unit the CH4 content of the raw biogas (60%) decreased by three fold. The lower CH4 content in CBS was probably caused by extreme dilution of biogas with air (N2 and O2). According to the results obtained here the DMBS system is a robust and effective biotechnology in comparison with CBS. Hence, DMBS has a better potential for real scale applications.

Keywords: biogas, bioscrubber, desulfurization, PDMS membrane

Procedia PDF Downloads 211

Authors: Chung Yan Natalia Yeung, Man Kit Indy Ho, Kin Yu Stan Chan, Ho Pui Kipper Lam, Man Wah Genie Tong, Tze Chung Jim Luk

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Excessive foot pronation is a well-known risk factor of knee and foot injuries such as patellofemoral pain, patellar and Achilles tendinopathy, and plantar fasciitis. Low-Dye taping (LDT) application is not uncommon for basketball players to control excessive foot pronation for pain control and injury prevention. The primary potential benefits of using LDT include providing additional supports to medial longitudinal arch and restricting the excessive midfoot and subtalar motion in weight-bearing activities such as running and landing. Meanwhile, restrictions provided by the rigid tape may also potentially limit functional joint movements and sports performance. Coaches and athletes need to weigh the potential benefits and harmful effects before making a decision if applying LDT technique is worthwhile or not. However, the influence of using LDT on basketball-related performance such as explosive and reactive strength is not well understood. Therefore, the purpose of this study was to investigate the change of drop jump (DJ) and countermovement jump (CMJ) performance before and after LDT application for collegiate male basketball players. In this within-subject crossover study, 12 healthy male basketball players (age: 21.7 ± 2.5 years) with at least 3-year regular basketball training experience were recruited. Navicular drop (ND) test was adopted as the screening and only those with excessive pronation (ND ≥ 10mm) were included. Participants with recent lower limb injury history were excluded. Recruited subjects were required to perform both ND, DJ (on a platform of 40cm height) and CMJ (without arms swing) tests in series during taped and non-taped conditions in the counterbalanced order. Reactive strength index (RSI) was calculated by using the flight time divided by the ground contact time measured. For DJ and CMJ tests, the best of three trials was used for analysis. The difference between taped and non-taped conditions for each test was further calculated through standardized effect ± 90% confidence intervals (CI) with clinical magnitude-based inference (MBI). Paired samples T-test showed significant decrease in ND (-4.68 ± 1.44mm; 95% CI: -3.77, -5.60; p < 0.05) while MBI demonstrated most likely beneficial and large effect (standardize effect: -1.59 ± 0.27) in LDT condition. For DJ test, significant increase in both flight time (25.25 ± 29.96ms; 95% CI: 6.22, 44.28; p < 0.05) and RSI (0.22 ± 0.22; 95% CI: 0.08, 0.36; p < 0.05) were observed. In taped condition, MBI showed very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.49) in flight time, possibly beneficial and small effect (standardized effect: -0.26 ± 0.29) in ground contact time and very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.42) in RSI. No significant difference in CMJ was observed (95% CI: -2.73, 2.08; p > 0.05). For basketball players with pes planus, applying LDT could substantially support the foot by elevating the navicular height and potentially provide acute beneficial effects in reactive strength performance. Meanwhile, no significant harmful effect on CMJ was observed. Basketball players may consider applying LDT before the game or training to enhance the reactive strength performance. However since the observed effects in this study could not generalize to other players without excessive foot pronation, further studies on players with normal foot arch or navicular height are recommended.

Keywords: flight time, pes planus, pronated foot, reactive strength index

Procedia PDF Downloads 144

Authors: Danielle C. B. Honorato, Rafael H. Carvalho, Adriana L. Soares, Ana Paula F. R. L. Bracarense, Paulo D. Guarnieri, Massami Shimokomaki, Elza I. Ida

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Over the past decade, the Brazilian production of turkey meat increased by more than 50%, indicating that the turkey meat is considered a great potential for the Brazilian economy contributing to the growth of agribusiness at the marketing international scenario. However, significant color changes may occur during its processing leading to the pale, soft and exudative (PSE) appearance on the surface of breast meat due to the low water holding capacity (WHC). Changes in PSE meat functional properties occur due to the myofibrils proteins denaturation caused by a rapid postmortem glycolysis resulting in a rapid pH decline while the carcass temperature is still warm. The aim of this study was to analyze the physical, chemical and histological characteristics of PSE turkey meat obtained from a Brazilian commercial processing plant. The turkey breasts samples were collected (n=64) at the processing line and classified as PSE at L* ≥ 53 value. The pH was also analyzed after L* measurement. In sequence, PSE meat samples were evaluated for WHC, cooking loss (CL), shear force (SF), myofibril fragmentation index (MFI), protein denaturation (PD) and histological evaluation. The abnormal color samples presented lower pH values, 16% lower fiber diameter, 11% lower SF and 2% lower WHC than those classified as normal. The CL, PD and MFI were, respectively, 9%, 18% and 4% higher in PSE samples. The Pearson correlation between the L* values and CL, PD and MFI was positive, while that SF and pH values presented negative correlation. Under light microscopy, a shrinking of PSE muscle cell diameter was approximately 16% shorter in relation to normal samples and an extracellular enlargement of endomysium and perimysium sheaths as the consequence of higher water contents lost as observed previously by lower WHC values. Thus, the results showed that PSE turkey breast meat presented significant changes in their physical, chemical and histological characteristics that may impair its functional properties.

Keywords: functional properties, histological evaluation, meat quality, PSE

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Authors: Mauricio Plaza, Willian Aperador

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Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with a closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is a performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

Keywords: amputation, prosthesis, mobility, hemipelvectomy

Procedia PDF Downloads 401

Authors: Vladimir Kulyukin, Tanwir Zaman, Sarat Kiran Andhavarapu

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Research on nutrition label use identifies four factors that impede comprehension and retention of nutrition information by consumers: label’s location on the package, presentation of information within the label, label’s surface size, and surrounding visual clutter. In this paper, a system is presented that makes nutrition label use more effective for nutrition information comprehension and retention. The system’s front end is a smartphone application. The system’s back end is a four node Linux cluster for image recognition and data storage. Image frames captured on the smartphone are sent to the back end for skewed or aligned barcode recognition. When barcodes are recognized, corresponding nutrition labels are retrieved from a cloud database and presented to the user on the smartphone’s touchscreen. Each displayed nutrition label is positioned centrally on the touchscreen with no surrounding visual clutter. Wikipedia links to important nutrition terms are embedded to improve comprehension and retention of nutrition information. Standard touch gestures (e.g., zoom in/out) available on mainstream smartphones are used to manipulate the label’s surface size. The nutrition label database currently includes 200,000 nutrition labels compiled from public web sites by a custom crawler. Stress test experiments with the node cluster are presented. Implications for proactive nutrition management and food policy are discussed.

Keywords: mobile computing, cloud computing, nutrition label use, nutrition management, barcode scanning

Procedia PDF Downloads 355

Authors: Sammy Xiaoyan Ying

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Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

Procedia PDF Downloads 280

Authors: Shadi Fathi, Moura Mehravar, Mujib Rahman

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Over the years,increased demands on railways, the emergence of high-speed trains and heavy axle loads, ageing, and deterioration of the existing tracks, is imposing costly maintenance actions on the railway sector. The need for developing a fast andcost-efficient non-destructive assessment method for the structural evaluation of railway tracksis therefore critically important. The layer modulus is the main parameter used in the structural design and evaluation of the railway track substructure (foundation). Among many recently developed NDTs, Falling Weight Deflectometer (FWD) test, widely used in pavement evaluation, has shown promising results for railway track substructure monitoring. The surface deflection data collected by FWD are used to estimate the modulus of substructure layers through the back-analysis technique. Although there are different commerciallyavailableback-analysis programs are used for pavement applications, there are onlya limited number of research-based techniques have been so far developed for railway track evaluation. In this paper, the suitability, accuracy, and reliability of the BAKFAAsoftware are investigated. The main rationale for selecting BAKFAA as it has a relatively straightforward user interfacethat is freely available and widely used in highway and airport pavement evaluation. As part of the study, a finite element (FE) model of a railway track section near Leominsterstation, Herefordshire, UK subjected to the FWD test, was developed and validated against available field data. Then, a virtual experimental database (including 218 sets of FWD testing data) was generated using theFE model and employed as the measured database for the BAKFAA software. This database was generated considering various layers’ moduli for each layer of track substructure over a predefined range. The BAKFAA predictions were compared against the cone penetration test (CPT) data (available from literature; conducted near to Leominster station same section as the FWD was performed). The results reveal that BAKFAA overestimatesthe layers’ moduli of each substructure layer. To adjust the BAKFA with the CPT data, this study introduces a correlation model to make the BAKFAA applicable in railway applications.

Keywords: back-analysis, bakfaa, railway track substructure, falling weight deflectometer (FWD), cone penetration test (CPT)

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

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Authors: P. Makendran, M. Pragadeesh, N. Narash, N. Manikandan, A. Rajasri, V. Sanal Kumar

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The growing severity of government-obligatory emissions legislation has required continuous improvement in catalysts performance and the associated reactor systems. IC engines emit a lot of harmful gases into the atmosphere. These gases are toxic in nature and a catalytic converter is used to convert these toxic gases into less harmful gases. The catalytic converter converts these gases by Oxidation and reduction reaction. Stoichiometric engines usually use the three-way catalyst (TWC) for simultaneously destroying all of the emissions. CO and NO react to form CO2 and N2 over one catalyst, and the remaining CO and HC are oxidized in a subsequent one. Literature review reveals that typically precious metals are used as a catalyst. The actual reactor is composed of a washcoated honeycomb-style substrate, with the catalyst being contained in the washcoat. The main disadvantage of a catalytic converter is that it exerts a back pressure to the exhaust gases while entering into them. The objective of this paper is to optimize the back pressure developed by the catalytic converter through geometric optimization of catalystic converter. This can be achieved by designing a catalyst with a optimum cone angle and a more surface area of the catalyst substrate. Additionally, the arrangement of the pores in the catalyst substrate can be changed. The numerical studies have been carried out using k-omega turbulence model with varying inlet angle of the catalytic converter and the length of the catalyst substrate. We observed that the geometry optimization is a meaningful objective for the lucrative design optimization of a catalytic converter for industrial applications.

Keywords: catalytic converter, emission control, reactor systems, substrate for emission control

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Authors: Amal Abo El-Maaty, Amira Mohamed, Nashwa Abu-Aita, Hisham Morgan

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For estimating markers of overweight or obesity of brood mares used for riding and training, 17 mares of different body conditions were subjected to blood sampling and ultrasound examination to measure rump fat thickness and monitor ovulation for six consecutive weeks. Also length (L), heart girth (G) and withers height (H) were measured to estimate body weight (BW), body fat %, body fat mass (BFM) and body mass index (BMI). Mares were classified into three groups according to both body condition score (BCS) and rump back fat (BF). Overweight mares (O) were having BCS > 7 and BF thickness >7mm, moderate body condition (M) mares were having BCS >3and ≤7and BF <3and <7mm, and emaciated mares (E) were having BCS ≤3 and BF ≤3mm. glucose, triglycerides, nitric oxide, ovarian, thyroid, insulin, insulin like growth factor-I (IGF-1), and leptin hormones were measured. Results revealed that BCS, G, L, L*G*H, BW, BF, fat %, BFM were significantly (P<0.0001) decreasing linearly from O to E. T4 concentrations of E were significantly high (P=0.04) compared to M and O but T3 concentrations tended to decrease in E (P>0.05). Insulin and IGF-1 concentrations tended to be high in O (P>0.05) and decrease with the decrease of body condition. M had (P=0.007) the highest leptin, but E mares had the lowest P4 concentrations (P=0.01). Concentrations of glucose and NO decreased with the decrease of BCS and BF but triglycerides of O were insignificantly high. In conclusion, exercise could prevent the development of metabolic syndrome in horses and back fat and morphometric measurements were the easiest and simple assessment of overweight and deviation to obesity.

Keywords: body condition score, insulin, leptin, mares, rump fat

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

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Authors: Virender Singh Gurau, Akash Deep, Sarbjot S. Sandhu

Abstract:

Vegetable oils are produced from numerous oil seed crops. While all vegetable oils have high energy content, most require some processing to assure safe use in internal combustion engines. Some of these oils already have been evaluated as substitutes for diesel fuels. In the present research work Bitter Apricot kernel oil was employed as a feedstock for the production of biodiesel. The physicochemical properties of the Bitter Apricot kernel oil methyl ester were investigated as per ASTM D6751. From the series of engine testing, it is concluded that the brake thermal efficiency (BTE) with biodiesel blend was little lower than that of diesel. BSEC is slightly higher for Bitter apricot kernel oil methyl ester blends than neat diesel. For biodiesel blends, CO emission was lower than diesel fuel as B 20 reduced CO emissions by 18.75%. Approximately 11% increase in NOx emission was observed with 20% biodiesel blend. It is observed that HC emissions tend to decrease for biodiesel based fuels and Smoke opacity was found lower for biodiesel blends in comparison to diesel fuel.

Keywords: biodiesel, transesterification, bitter apricot kernel oil, performance and emission testing

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Authors: Boris Kolev, Matt Kokan, Mohammad Deriszadeh, Farshid Bateni

Abstract:

Due to the increasing demand for real estate and the need for efficient land utilization in Greater Vancouver, developers have been increasingly considering the construction of high-rise structures with multiple below-grade parking. The temporary excavations required to allow for the construction of underground levels have recently reached up to 40 meters in depth. One of the challenges with deep excavations is the prediction of wall displacements and ground settlements due to their effect on the integrity of City utilities, infrastructure, and adjacent buildings. A large database of survey monitoring data has been collected for deep excavations in various soil conditions and shoring systems. The majority of the data collected is for tie-back anchors and shotcrete lagging systems. The data were categorized, analyzed and the results were evaluated to find a relationship between the most dominant parameters controlling the displacement, such as depth of excavation, soil properties, and the tie-back anchor loading and arrangement. For a select number of deep excavations, finite element modeling was considered for analyses. The lateral displacements from the simulation results were compared to the recorded survey monitoring data. The study concludes with a discussion and comparison of the available empirical and numerical modeling methodologies for evaluating lateral displacements in deep excavations.

Keywords: deep excavations, lateral displacements, numerical modeling, shoring walls, tieback anchors

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Authors: Catarina Belchior, Catarina Martins, Sara Mendes, Ana Rita S. Valente, Elsa Marta Soares

Abstract:

Introduction: The negative feelings and attitudes that a person who stutters can develop are extremely relevant when considering assessment and intervention in Speech and Language Therapy. This relates to the fact that the person who stutters can experience feelings such as shame, fear and negative beliefs when communicating. Considering the complexity and importance of integrating diverse aspects in stuttering intervention, it is central to identify those emotions as early as possible. Therefore, this research aimed to achieve the translation, adaptation to European Portuguese and to analyze the content validation of the Preschooler Awareness Stuttering Survey (Abbiati, Guitar & Hutchins, 2015), an instrument that allows the assessment of the impact of stuttering on preschool children who stutter considering feelings and attitudes. Methodology: Cross-sectional descriptive qualitative research. The following methodological procedures were followed: translation, back-translation, panel of experts and pilot study. This abstract describes the results of the first three phases of this process. The translation was accomplished by two Speech Language Therapists (SLT). Both professionals have more than five years of experience and are users of English language. One of them has a broad experience in the field of stuttering. Back-translation was conducted by two bilingual individuals without experience in health or any knowledge about the instrument. The panel of experts was composed by 3 different SLT, experts in the field of stuttering. Results and Discussion: In the translation and back-translation process it was possible to verify differences in semantic and idiomatic equivalences of several concepts and expressions, as well as the need to include new information to enhance the understanding of the application of the instrument. The meeting between the two translators and the researchers allowed the achievement of a consensus version that was used in back-translation. Considering adaptation and content validation, the main change made by the experts was the conceptual equivalence of the questions and answers of the instrument's sheets. Considering that in the translated consensus version the questions began with various nouns such as 'is' or 'the cow' and that the answers did not contain the adverb 'much' as in the original instrument, the panel agreed that it would be more appropriate if the questions all started with 'how' and that all the answers should present the adverb 'much'. This decision was made to ensure that the translate instrument would be similar to the original and so that the results obtained could be comparable between the original and the translated instrument. There was also elaborated one semantic equivalence between concepts. The panel of experts found that all other items and specificities of the instrument were adequate, concluding the adequacy of the instrument considering its objectives and its intended target population. Conclusion: This research aspires to diversify the existing validated resources in this scope, adding a new instrument that allows the assessment of preschool children who stutter. Consequently, it is hoped that this instrument will provide a real and reliable assessment that can lead to an appropriate therapeutic intervention according to the characteristics and needs of each child.

Keywords: stuttering, assessment, feelings and attitudes, speech language therapy

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Authors: Byeal-I Han, Michael Lee

Abstract:

Ageing is associated with an increased risk of diseases such as cancer, and neurodegenerative disorders. Increased autophagy delays ageing and extends longevity. In this study, we investigated the role of autophagy in longevity using human foreskin fibroblast HS68 cells, in which a senescence-like growth arrest can be induced. In particular, cellular senescence is manifested by the irreversible cell cycle arrest, and may contribute to the ageing of organisms. The senescence state was measured with staining for senescence-associated β-galactosidase (SA-β-gal) activity that represents a sensitive and reliable marker to quantify senescent cells. We detected a significantly increased percentage (%) of SA-β-gal positive cells in HS68 cultures at passage 40 (63%) when compared with younger ones at passage 15 (0.5%). As expected, HS68 cells at passage 40 exhibited much lower proliferation rate than cells at passage 15. The basal levels of LC3 were measured by immunoblotting showing a comparison of LC3-I and LC3-II levels at 3 age-points in serially passaged HS68 cells. LC3-II/LC3-I ratio at different passage levels relative to β-actin levels of each band confirmed that cells at passage 34 showed lower conversion of non-autophagic LC3-I to autophagic LC3-II than the cells at passage 16. Furthermore, Cyto-ID autophagy assay also revealed that late passage cells showed lower autophagy than the early passage cells. Together, our findings suggest that senescence induction might be associated with decreased autophagy.

Keywords: ageing, autophagy, senescence, HS68

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Authors: N. V. V. S. D. Prasad

Abstract:

Field experiments were conducted at Regional Agricultural Research Station, Lam, Guntur, Andhra Pradesh, India for two seasons during 2011-13 to evaluate the efficacy of flupyradifurone SL 200 a new class of insecticide in butenolide group against leaf hoppers, aphids and whitefly in Cotton. The test insecticide flupyradifurone 200 was evaluated at three doses @ 150, 200 and 250 g ai/ha ha along with imidacloprid 200 SL @ 20g ai/ha, acetamiprid 20 SP @ 20g ai/ha, thiamethoxam 25 WG @ 25g ai/ha and monocrotophos 36 SL @ 360 g ai/ha as standards. Flupyradifurone SL 200 even at lower dose of 150g ai/ha exhibited superior efficacy against cotton leafhopper, Amrasca devastans than the neonicotinoids which are widely used for control of sucking pests in cotton. Against cotton aphids, Aphis gossypii. Flupyradifurone SL 200 @ 200 and 250 g ai/ha ha was proved to be effective and the lower dose @ 150g ai/ha performed better than some of the neonicotinoids. The effect of flupyradifurone SL 200 on cotton against whitefly, Bemisia tabaci was evident at higher doses of 200 and 250 g ai/ha and superior to all standard treatments, however, the lower dose is at par with neonicotinoids. The seed cotton yield of flupyradifurone 200 SL at all the doses tested was superior than imidacloprid 200 SL @ 20g ai/ha and acetamiprid 20 SP @ 20g ai/ha. There is no significant difference among the insecticidal treatments with regards to natural enemies. The results clearly suggest that flupyradifurone is a new tool to combat sucking pest problems in cotton and can well fit in IRM strategies in light of wide spread insecticide resistance in cotton sucking pests.

Keywords: cotton, flupyradifurone, neonicotinoids, sucking pests

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Authors: Affordability, Expenditure Patterns towards Sustainable Consumption in Malaysia

Abstract:

Safe drinking water is needed for survival. Households have to pay the water bill monthly. However, lower income households are sometimes unable to afford the cost. This study examines water access and affordability among households in Malaysia and the determinants of water affordability using cross-sectional data and multiple regression. The paper expects that the bill for basic water consumption is inversely related to average income. This means that policy makers need to redesign the water tariff to improve the quality of life of lower income households.

Keywords: affordability, sustainable consumption, income, water tariff

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Authors: Junjie Wu, Hongjuan Hou, Eric Hu, Yongping Yang

Abstract:

Solar aided power generation (SAPG) technology has been proven as an efficient way to make use of solar energy for power generation purpose. In an SAPG plant, a solar field consisting of parabolic solar collectors is normally used to supply the solar heat in order to displace the high pressure/temperature extraction steam. To understand the performance of such a SAPG plant, a new simulation model was developed by the authors recently, in which the boiler was treated, as a series of heat exchangers unlike other previous models. Through the simulations using the new model, it was found the outlet properties of reheated steam, e.g. temperature, would decrease due to the introduction of the solar heat. The changes make the (lower stage) turbines work under off-design condition. As a result, the whole plant’s performance may not be optimal. In this paper, the second solar filed was proposed to increase the inlet temperature of steam to be reheated, in order to bring the outlet temperature of reheated steam back to the designed condition. A 600MW SAPG plant was simulated as a case study using the new model to understand the impact of the second solar field on the plant performance. It was found in the study, the 2nd solar field would improve the plant’s performance in terms of cycle efficiency and solar-to-electricity efficiency by 1.91% and 6.01%. The solar-generated electricity produced by per aperture area under the design condition was 187.96W/m2, which was 26.14% higher than the previous design.

Keywords: solar-aided power generation system, off-design performance, coal-saving performance, boiler modelling, integration schemes

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

Abstract:

Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

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Authors: Wei Wen Yang, Emily Chia Yu Su

Abstract:

Dengue fever is a mosquito-borne tropical infectious disease caused by the dengue virus. After infection, symptoms usually start from three to fourteen days. Dengue virus may cause a high fever and at least two of the following symptoms, severe headache, severe eye pain, joint pains, muscle or bone pain, vomiting, feature skin rash, and mild bleeding manifestation. In addition, recovery will take at least two to seven days. Dengue fever has rapidly spread in tropical and subtropical areas in recent years. Several phenomena around the world such as global warming, urbanization, and international travel are the main reasons in boosting the spread of dengue. In Taiwan, epidemics occur annually, especially during summer and fall seasons. On the other side, Singapore government also has announced the amounts number of dengue cases spreading in Singapore. As the serious epidemic of dengue fever outbreaks in Taiwan and Singapore, countries around the Asia-Pacific region are becoming high risks of susceptible to the outbreaks and local hub of spreading the virus. To improve public safety and public health issues, firstly, we are going to use Microsoft Excel and SAS EG to do data preprocessing. Secondly, using support vector machines and decision trees builds predict model, and analyzes the infectious cases between Taiwan and Singapore. By comparing different factors causing vector mosquito from model classification and regression, we can find similar spreading patterns where the disease occurred most frequently. The result can provide sufficient information to predict the future dengue infection outbreaks and control the diffusion of dengue fever among countries.

Keywords: dengue fever, Taiwan, Singapore, Aedes aegypti

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