Search results for: multi criteria decision making (MCDM)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12182

Search results for: multi criteria decision making (MCDM)

3602 An Eastern Philosophical Dimension of an English Language Teacher's Professionalism: A Narrative Analysis

Authors: Siddhartha Dhungana

Abstract:

This article primarily explores dimensions in English language teacher's professionalism so that a teacher could reflect and make a strategic professional devotion to implement effective educational programs for the present and the future. The paper substantially incorporates the eastern Hindu practices, especially life values from the Bhagavad Gita, as a basis of teacher’s professional enrichment. Basically, it applies three categorical practices, i.e., Karma Yoga, Jnana Yoga, and Bhakti Yoga, in teachers’ professionality to illustrate, ignite further ahead and sharpen academic journey, professional journey, and professional devotion reflecting common practices. In this journey, a teacher comes to a stage of professional essence as s/he surpasses Karma Yoga, Jnana Yoga, and Bhakti Yoga with their basic quality formation. To illustrate their essence-making process, the three narrative stories for each category mentioned above are analyzed. The data collected from a research participant who has a high level of professional success and who inspires all English Language teachers in Nepal to develop stories for narrative analysis. The narrative analysis is based on eastern themes that are supported by Vygotsky's concept of developmental psychology. Moreover, the structural analysis is based on Gary Barkhuizen's narrative analysis.

Keywords: Karma Yoga, Jnana Yoga, Bhakti Yoga, Vygotsky's concepts, narrative analysis

Procedia PDF Downloads 138
3601 Twitter Sentiment Analysis during the Lockdown on New-Zealand

Authors: Smah Almotiri

Abstract:

One of the most common fields of natural language processing (NLP) is sentimental analysis. The inferred feeling in the text can be successfully mined for various events using sentiment analysis. Twitter is viewed as a reliable data point for sentimental analytics studies since people are using social media to receive and exchange different types of data on a broad scale during the COVID-19 epidemic. The processing of such data may aid in making critical decisions on how to keep the situation under control. The aim of this research is to look at how sentimental states differed in a single geographic region during the lockdown at two different times.1162 tweets were analyzed related to the COVID-19 pandemic lockdown using keywords hashtags (lockdown, COVID-19) for the first sample tweets were from March 23, 2020, until April 23, 2020, and the second sample for the following year was from March 1, 2020, until April 4, 2020. Natural language processing (NLP), which is a form of Artificial intelligence, was used for this research to calculate the sentiment value of all of the tweets by using AFINN Lexicon sentiment analysis method. The findings revealed that the sentimental condition in both different times during the region's lockdown was positive in the samples of this study, which are unique to the specific geographical area of New Zealand. This research suggests applying machine learning sentimental methods such as Crystal Feel and extending the size of the sample tweet by using multiple tweets over a longer period of time.

Keywords: sentiment analysis, Twitter analysis, lockdown, Covid-19, AFINN, NodeJS

Procedia PDF Downloads 164
3600 Optimizing Groundwater Pumping for a Complex Groundwater/Surface Water System

Authors: Emery A. Coppola Jr., Suna Cinar, Ferenc Szidarovszky

Abstract:

Over-pumping of groundwater resources is a serious problem world-wide. In addition to depleting this valuable resource, hydraulically connected sensitive ecological resources like wetlands and surface water bodies are often impacted and even destroyed by over-pumping. Effectively managing groundwater in a way that satisfy human demand while preserving natural resources is a daunting challenge that will only worsen with growing human populations and climate change. As presented in this paper, a numerical flow model developed for a hypothetical but realistic groundwater/surface water system was combined with formal optimization. Response coefficients were used in an optimization management model to maximize groundwater pumping in a complex, multi-layered aquifer system while protecting against groundwater over-draft, streamflow depletion, and wetland impacts. Pumping optimization was performed for different constraint sets that reflect different resource protection preferences, yielding significantly different optimal pumping solutions. A sensitivity analysis on the optimal solutions was performed on select response coefficients to identify differences between wet and dry periods. Stochastic optimization was also performed, where uncertainty associated with changing irrigation demand due to changing weather conditions are accounted for. One of the strengths of this optimization approach is that it can efficiently and accurately identify superior management strategies that minimize risk and adverse environmental impacts associated with groundwater pumping under different hydrologic conditions.

Keywords: numerical groundwater flow modeling, water management optimization, groundwater overdraft, streamflow depletion

Procedia PDF Downloads 217
3599 Probabilistic Approach to the Spatial Identification of the Environmental Sources behind Mortality Rates in Europe

Authors: Alina Svechkina, Boris A. Portnov

Abstract:

In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

Procedia PDF Downloads 149
3598 A Proposal to Tackle Security Challenges of Distributed Systems in the Healthcare Sector

Authors: Ang Chia Hong, Julian Khoo Xubin, Burra Venkata Durga Kumar

Abstract:

Distributed systems offer many benefits to the healthcare industry. From big data analysis to business intelligence, the increased computational power and efficiency from distributed systems serve as an invaluable resource in the healthcare sector to utilize. However, as the usage of these distributed systems increases, many issues arise. The main focus of this paper will be on security issues. Many security issues stem from distributed systems in the healthcare industry, particularly information security. The data of people is especially sensitive in the healthcare industry. If important information gets leaked (Eg. IC, credit card number, address, etc.), a person’s identity, financial status, and safety might get compromised. This results in the responsible organization losing a lot of money in compensating these people and even more resources expended trying to fix the fault. Therefore, a framework for a blockchain-based healthcare data management system for healthcare was proposed. In this framework, the usage of a blockchain network is explored to store the encryption key of the patient’s data. As for the actual data, it is encrypted and its encrypted data, called ciphertext, is stored in a cloud storage platform. Furthermore, there are some issues that have to be emphasized and tackled for future improvements, such as a multi-user scheme that could be proposed, authentication issues that have to be tackled or migrating the backend processes into the blockchain network. Due to the nature of blockchain technology, the data will be tamper-proof, and its read-only function can only be accessed by authorized users such as doctors and nurses. This guarantees the confidentiality and immutability of the patient’s data.

Keywords: distributed, healthcare, efficiency, security, blockchain, confidentiality and immutability

Procedia PDF Downloads 165
3597 Women's Challenges in Access to Urban Spaces and Infrastructures: A Comparative Study of the Urban Infrastructures Conforming to Women's Needs in Tehran and Istanbul

Authors: Parastoo Kazemiyan

Abstract:

Over the past 80 years, in compliance with the advent of modernity in Iran and Turkey, the presence of women in economic and social arenas has creates serious challenges in the capacity of urban spaces to respond to their presence and transport because urban spaces up until then were based on masculine criteria and therefore, women could use such spaces in the company of their fathers or husbands. However, as modernity expanded by Reza Shah and Ataturk, women found the opportunity to work and be present in urban spaces alongside men and their presence in economic and social domains resulted in their presence in these spaces in the early and late hours of the day. Therefore, the city had to be transformed in structural, social, and environmental terms to accommodate women's activities and presence in various urban arenas, which was a huge step in transition from a masculine man-based culture to an all-inclusive human-based culture in these two countries. However, the optimization of urban space was subject to political changes in the two countries, leading to significant differences in designing urban spaces in Tehran and Istanbul. What shows the importance and novelty of the present study lie in the differences in urban planning and optimization in the two capital cities, which gave rise to different outcomes in desirability and quality of living in these two capital cities. Due to the importance of the topic, one of the most significant factors in desirability and acceptability of urban space for women was examined using a descriptive-analytic method based on qualitative methodology in Tehran and Istanbul. The results showed that the infrastructural factors in Istanbul, including safety of access, variety, and number of public transport modes, transparency, and supervision over public spaces have provided women with a safer and more constant presence compared to Tehran. It seems that challenges involved in providing access to urban spaces in Tehran in terms of infrastructure and function have made Tehran unable to respond to the most basic needs of its female citizens.

Keywords: gender differences, urban space security, access to transportation systems, women's challenges

Procedia PDF Downloads 106
3596 Outcome Analysis of Surgical and Nonsurgical Treatment on Indicated Operative Chronic Subdural Hematoma: Serial Case in Cipto Mangunkusumo Hospital Indonesia

Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli

Abstract:

Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.

Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome

Procedia PDF Downloads 314
3595 Investigation on Solar Thermoelectric Generator Using D-Mannitol/Multi-Walled Carbon Nanotubes Composite Phase Change Materials

Authors: Zihua Wu, Yueming He, Xiaoxiao Yu, Yuanyuan Wang, Huaqing Xie

Abstract:

The match of Solar thermoelectric generator (STEG) and phase change materials (PCM) can enhance the solar energy storage and reduce environmental impact from the day-and-night transformation and weather changes. This work utilizes D-mannitol (DM) matrix as the suitable PCM for coupling with thermoelectric generator to achieve the middle-temperature solar energy storage performance at 165℃-167℃. DM/MWCNT composite phase change materials prepared by ball milling not only can keep a high phase change enthalpy of DM material but also have great photo-thermal conversion efficiency of 82%. Based on the self-made storage device container, the effect of PCM thickness on the solar energy storage performance is further discussed and analyzed. The experimental results prove that PCM-STEG coupling system can output more electric energy than pure STEG system because PCM can decline the heat transfer and storage thermal energy to further generate the electric energy through thermal-to-electric conversion when the light is removed. The increase of PCM thickness can reduce the heat transfer and enhance thermal storage, and then the power generation performance of PCM-STEG coupling system can be improved. As the increase of light intensity, the output electric energy of the coupling system rises accordingly, and the maximum amount of electrical energy can reach by 113.85 J at 1.6 W/cm2. The study of the PCM-STEG coupling system has certain reference for the development of solar energy storage and application.

Keywords: solar energy, solar thermoelectric generator, phase change materials, solar-to-electric energy, DM/MWCNT

Procedia PDF Downloads 52
3594 Analysis of Heat Transfer and Energy Saving Characteristics for Bobsleigh/Skeleton Ice Track

Authors: Zichu Liu, Zhenhua Quan, Xin Liu, Yaohua Zhao

Abstract:

Enhancing the heat transfer characteristics of the bobsleigh/skeleton ice track and reducing the energy consumption of the bobsleigh/skeleton ice track plays an important role in energy saving of the refrigeration systems. In this study, a track ice-making test rig was constructed to verify the accuracy of the established ice track heat transfer model. The different meteorological conditions on the variations in the heat transfer characteristics of the ice surface, ice temperature, and evaporation temperature with or without Terrain Weather Protection System (TWPS) were investigated, and the influence of the TWPS with and without low emissivity materials on these indexes was also compared. In addition, the influence of different pipe spacing and diameters of refrigeration pipe on the heat transfer resistance of the track is also analyzed. The results showed that compared with the ice track without sunshade facilities, TWPS could reduce the heat transfer between ice surface and air by 17.6% in the transition season, and TWPS with low emissivity material could reduce the heat transfer by 37%. The thermal resistance of the ice track decreased by 8.9×10⁻⁴ m²·°C/W, and the refrigerant evaporation temperature increased by 0.25 °C when the cooling pipes spacing decreased by every 10 mm. The thermal resistance decreased by 1.46×10⁻³ m²·°C/W, and the refrigerant evaporation temperature increased by 0.3 °C when the pipe diameter increased by one nominal diameter.

Keywords: bobsleigh/skeleton ice track, calculation model, heat transfer characteristics, refrigeration

Procedia PDF Downloads 84
3593 Multimedia Technologies Utilisation as Predictors of Lecturers’ Teaching Effectiveness in Colleges of Education in South-West, Nigeria

Authors: Abel Olusegun Egunjobi, Olusegun Oyeleye Adesanya

Abstract:

Teaching effectiveness of lecturers in a tertiary institution in Nigeria is one of the determinants of the lecturer’s productivity. In this study, therefore, lecturers’ teaching effectiveness was examined vis-à-vis their multimedia technologies utilisation in Colleges of Education (CoE) in South-West, Nigeria. This is for the purpose of ascertaining the relationship and contribution of multimedia technologies utilisation to lecturers’ teaching effectiveness in Nigerian colleges of education. The descriptive survey research design was adopted in the study, while a multi-stage sampling procedure was used in the study. A stratified sampling technique was used to select colleges of education, and a simple random sampling method was employed to select lecturers from the selected colleges of education. A total of 862 lecturers (627 males and 235 females) were selected from the colleges of education used for the study. The instrument used was lecturers’ questionnaire on multimedia technologies utilisation and teaching effectiveness with a reliability coefficient of 0.85 at 0.05 level of significance. The data collected were analysed using descriptive statistics, multiple regression, and t-test. The findings showed that the level of multimedia technologies utilisation in colleges of education was low, whereas lecturers’ teaching effectiveness was high. Findings also revealed that the lecturers used multimedia technologies purposely for personal and professional developments, so also for up to date news on economic and political matters. Also, findings indicated that laptop, Ipad, CD-ROMs, and computer instructional software were the multimedia technologies frequently utilised by the lecturers. There was also a significant difference in the teaching effectiveness between lecturers in the Federal and State COE. The government should, therefore, make adequate provision for multimedia technologies in the COE in Nigeria for lecturers’ utilisation in their instructions so as to boost their students’ learning outcomes.

Keywords: colleges of education, lecturers’ teaching effectiveness, multimedia technologies utilisation, Southwest Nigeria

Procedia PDF Downloads 121
3592 Trauma System in England: An Overview and Future Directions

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

Abstract:

Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

Procedia PDF Downloads 167
3591 Optimum Switch Temperature for Phase Change Materials in Buildings

Authors: El Hadi Bouguerra, Nouredine Retiel

Abstract:

To avoid or at least to attenuate the global warming, it is essential to reduce the energy consumption of the buildings where the biggest potential of savings exists. The impending danger can come from the increase in the needs of air conditioning not only because of the climate warming but also the fast equipping of emerging or developing countries. Passive solutions exist and others are in promising development and therefore, must be applied wherever it is possible. Even if they do not always avoid the resort to an active cooling (mechanical), they allow lowering the load at an acceptable level which can be possibly taken in relay by the renewable energies. These solutions have the advantage to be relatively less expensive and especially adaptable to the existing housing. However, it is the internal convection resistance that controls the heat exchange between the phase change materials (PCM) and the indoor temperature because of the very low heat coefficients of natural convection. Therefore, it is reasonable to link the switch temperature Tm to the temperature of the substrate (walls and ceiling) because conduction heat transfer is dominant. In this case, external conditions (heat sources such as solar irradiation and ambient temperatures) and conductivities of envelope constituents are the most important factors. The walls are not at the same temperature year round; therefore, it is difficult to set a unique switch temperature for the whole season, making the average values a key parameter. With this work, the authors’ aim is to see which parameters influence the optimum switch temperature of a PCM and additionally, if a better selection of PCMs relating to their optimum temperature can enhance their energetic performances.

Keywords: low energy building, energy conservation, phase change materials, PCM

Procedia PDF Downloads 241
3590 Identification of Watershed Landscape Character Types in Middle Yangtze River within Wuhan Metropolitan Area

Authors: Huijie Wang, Bin Zhang

Abstract:

In China, the middle reaches of the Yangtze River are well-developed, boasting a wealth of different types of watershed landscape. In this regard, landscape character assessment (LCA) can serve as a basis for protection, management and planning of trans-regional watershed landscape types. For this study, we chose the middle reaches of the Yangtze River in Wuhan metropolitan area as our study site, wherein the water system consists of rich variety in landscape types. We analyzed trans-regional data to cluster and identify types of landscape characteristics at two levels. 55 basins were analyzed as variables with topography, land cover and river system features in order to identify the watershed landscape character types. For watershed landscape, drainage density and degree of curvature were specified as special variables to directly reflect the regional differences of river system features. Then, we used the principal component analysis (PCA) method and hierarchical clustering algorithm based on the geographic information system (GIS) and statistical products and services solution (SPSS) to obtain results for clusters of watershed landscape which were divided into 8 characteristic groups. These groups highlighted watershed landscape characteristics of different river systems as well as key landscape characteristics that can serve as a basis for targeted protection of watershed landscape characteristics, thus helping to rationally develop multi-value landscape resources and promote coordinated development of trans-regions.

Keywords: GIS, hierarchical clustering, landscape character, landscape typology, principal component analysis, watershed

Procedia PDF Downloads 207
3589 Coastal Vulnerability under Significant Sea Level Rise: Risk and Adaptation Measures for Mumbai

Authors: Malay Kumar Pramanik

Abstract:

Climate change induced sea level rise increases storm surge, erosion, and inundation, which are stirred by an intricate interplay of physical environmental components at the coastal region. The Mumbai coast is much vulnerable to accelerated regional sea level change due to its highly dense population, highly developed economy, and low topography. To determine the significant causes behind coastal vulnerability, this study analyzes four different iterations of CVI by incorporating the pixel-based differentially weighted rank values of the selected five geological (CVI5), three physical (CVI8 with including geological variables), and four socio-economic variables (CVI4). However, CVI5 and CVI8 results yielded broadly similar natures, but after including socio-economic variables (CVI4), the results CVI (CVI12) has been changed at Mumbai and Kurla coastal portion that indicates the study coastal areas are mostly sensible with socio-economic variables. Therefore, the results of CVI12 show that out of 274.1 km of coastline analyzed, 55.83 % of the coast is very low vulnerable, 60.91 % of the coast is moderately vulnerable while 50.75 % is very high vulnerable. Finding also admits that in the context of growing urban population and the increasing rate of economic activities, socio-economic variables are most important variable to use for validating and testing the CVI. Finally, some recommendations are presented for concerned decision makers and stakeholders to develop appropriate coastal management plans, nourishment projects and mitigation measures considering socio-economic variables.

Keywords: coastal vulnerability index, sea level change, Mumbai coast, geospatial approach, coastal management, climate change

Procedia PDF Downloads 118
3588 Major Constraints to Adoption of Improved Post-harvest Technologies among Smallholder Farmers in Developing Countries: A Systematic Review

Authors: Muganyizi Jonas Bisheko, G. Rejikumar

Abstract:

Reducing post-harvest losses could be a sustainable solution to enhance the food and income security of smallholder farmers in developing countries. While various research institutions have come up with a number of innovative post-harvest technologies for reducing post-harvest losses, most of them have not been extensively adopted by smallholder farmers. Despite this gap, the synthesized information about the major constraints of post-harvest technology is scarce. This study has been conducted to fill this gap and show the implications of the findings for future post-harvest research. The developed search strategy retrieved 2201 studies. However, after excluding duplicates, title, abstract and full article screening, a total of 41 documents were identified. The major findings are: (i) there is an outstanding deficiency of systematic evidence of the effect of climate change, off-farm income and sources of post-harvest information on the adoption of improved post-harvest technologies; (ii) there is very limited information on adoption constraints pertaining to matters of policy, rules and regulations; (iii) there is very thin literature on behavioral constraints associated with limited adoption of improved post-harvest technologies; (iv) most of the studies focused on post-harvest storage technologies (47%) followed by overall post-harvest management practices (25%), processing technologies (19%) and packaging technologies (3%). Much of the information was found on Cereals (58%), especially maize (44%); (v) geographically, Sub-Saharan Africa accounted for 79% of the reviewed interventions, while South Asia occupied only 21%. The findings of this review are intended to guide various post-harvest technologists and decision-makers in addressing the challenge of huge post-harvest losses.

Keywords: constraints, post-harvest loss, post-harvest technology , smallholder farmer

Procedia PDF Downloads 212
3587 High Prevalence of Multi-drug Resistant Diarrheagenic Escherichia coli among Hospitalised Diarrheal Patients in Kolkata, India

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

Abstract:

Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

Procedia PDF Downloads 144
3586 Molecular Simulation Study on the Catalytic Role of Silicon-Doped Graphene in Carbon Dioxide Hydrogenation

Authors: Wilmer Esteban Vallejo Narváez, Serguei Fomine

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The theoretical investigation of Si-doped graphene nanoflakes (NFs) was conducted to understand their catalytic impact on CO₂ reduction using molecular hydrogen at the Density Functional Theory (DFT) level. The introduction of silicon by substituting carbon induces defects in the NF structure, resulting in a polyradical ground state. This silicon defect significantly boosts reactivity towards substrates, making Si-doped graphene NFs more catalytically active in CO₂ reduction to formic acid compared to silicene. Notably, Si-doped graphene demonstrates a preference for formic acid over carbon monoxide, mirroring the behavior of silicene. Furthermore, investigations into formic acid-to-formaldehyde and formaldehyde-to-methanol conversions reveal instances where Si-doped graphene outperforms silicene in terms of efficacy. In the final reduction step, the methanol-to-methane reaction unfolds in four stages, with the rate-determining step involving hydrogen transfer from silicon to methyl. Notably, the activation energy for this step is lower in Si-doped graphene compared to silicene. Consequently, Si-doped graphene NFs emerge as superior catalysts with lower activation energies overall. Remarkably, throughout these catalytic processes, Si-doped graphene maintains environmental stability, further highlighting its enhanced catalytic activity without compromising graphene's inherent stability.

Keywords: silicon-doped graphene, CO₂ reduction, DFT, catalysis

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3585 Rethink Urban Resilience: An Introductory Study Towards Resilient Spatial Structure of Refugees Neighborhoods

Authors: Salwa Mohammad Alawneh

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The ongoing humanitarian crises spur rapid and unpredicted refugee influxes resulting in demographic changes in cities. Regarding different urban systems are vulnerable in refugee neighborhoods. With the consequent social, economic, and spatial challenges, cities must respond with a more durable and sustainable approach based on urban resilience. The paper systematically approaches urban resilience to contribute to refugee spaces by reflecting on the overall urban systems of their neighborhoods. The research will review the urban resilience literature to develop an evaluation framework. The developed framework applies urban resilience more holistically in refugee neighborhoods and expands to the urban systems of social, economic, and spatial. However, the main highlight of this paper is the resilient spatial structure in refugee neighborhoods to face the internal and complex stress of refugee waves and their demographic changes. Finding a set of resilient spatial measurements and focusing on urban forms at a neighborhood scale provide vulnerability reduction and enhance adaptation capacity. As a model example, the paper applies these measurements and facilitates geospatial technologies to one of the refugee neighborhoods in Amman, Jordan, namely Al-Jubilee. The application in Al-Jubilee helps to demonstrate a road map towards a developmental pattern in design and planning by different decision-makers of inter-governmental and humanitarian organizations. In this regard, urban resilience improves the humanitarian assistantship of refugee settings beyond providing the essential needs. In conclusion, urban resilience responds to the different challenges of refugee neighborhoods by supporting urban stability, improving livability, and maintaining both urban functions and security.

Keywords: urban resilience of refugee, resilient urban form, refugee neighborhoods, humanitarian assistantship, refugee in Jordan

Procedia PDF Downloads 143
3584 Single Layer Carbon Nanotubes Array as an Efficient Membrane for Desalination: A Molecular Dynamics Study

Authors: Elisa Y. M. Ang, Teng Yong Ng, Jingjie Yeo, Rongming Lin, Zishun Liu, K. R. Geethalakshmi

Abstract:

By stacking carbon nanotubes (CNT) one on top of another, single layer CNT arrays can perform water-salt separation with ultra-high permeability and selectivity. Such outer-wall CNT slit membrane is named as the transverse flow CNT membrane. By adjusting the slit size between neighboring CNTs, the membrane can be configured to sieve out different solutes, right down to the separation of monovalent salt ions from water. Molecular dynamics (MD) simulation results show that the permeability of transverse flow CNT membrane is more than two times that of conventional axial-flow CNT membranes, and orders of magnitude higher than current reverse osmosis membrane. In addition, by carrying out MD simulations with different CNT size, it was observed that the variance in desalination performance with CNT size is small. This insensitivity of the transverse flow CNT membrane’s performance to CNT size is a distinct advantage over axial flow CNT membrane designs. Not only does the membrane operate well under constant pressure desalination operation, but MD simulations further indicate that oscillatory operation can further enhance the membrane’s desalination performance, making it suitable for operation such as electrodialysis reversal. While there are still challenges that need to be overcome, particularly on the physical fabrication of such membrane, it is hope that this versatile membrane design can bring the idea of using low dimensional structures for desalination closer to reality.

Keywords: carbon nanotubes, membrane desalination, transverse flow carbon nanotube membrane, molecular dynamics

Procedia PDF Downloads 177
3583 Spiritual Warriors: Christian Testimony and Psychotherapy in Ritual Abuse Memoir

Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

Procedia PDF Downloads 106
3582 Examination of Public Hospital Unions Technical Efficiencies Using Data Envelopment Analysis and Machine Learning Techniques

Authors: Songul Cinaroglu

Abstract:

Regional planning in health has gained speed for developing countries in recent years. In Turkey, 89 different Public Hospital Unions (PHUs) were conducted based on provincial levels. In this study technical efficiencies of 89 PHUs were examined by using Data Envelopment Analysis (DEA) and machine learning techniques by dividing them into two clusters in terms of similarities of input and output indicators. Number of beds, physicians and nurses determined as input variables and number of outpatients, inpatients and surgical operations determined as output indicators. Before performing DEA, PHUs were grouped into two clusters. It is seen that the first cluster represents PHUs which have higher population, demand and service density than the others. The difference between clusters was statistically significant in terms of all study variables (p ˂ 0.001). After clustering, DEA was performed for general and for two clusters separately. It was found that 11% of PHUs were efficient in general, additionally 21% and 17% of them were efficient for the first and second clusters respectively. It is seen that PHUs, which are representing urban parts of the country and have higher population and service density, are more efficient than others. Random forest decision tree graph shows that number of inpatients is a determinative factor of efficiency of PHUs, which is a measure of service density. It is advisable for public health policy makers to use statistical learning methods in resource planning decisions to improve efficiency in health care.

Keywords: public hospital unions, efficiency, data envelopment analysis, random forest

Procedia PDF Downloads 112
3581 Identification of the Antimicrobial Property of Double Metal Oxide/Bioactive Glass Nanocomposite Against Multi Drug Resistant Staphylococcus aureus Causing Implant Infections

Authors: M. H. Pazandeh, M. Doudi, S. Barahimi, L. Rahimzadeh Torabi

Abstract:

The use of antibiotics is essential in reducing the occurrence of adverse effects and inhibiting the emergence of antibiotic resistance in microbial populations. The necessity for a novel methodology concerning local administration of antibiotics has arisen, with particular focus on dealing with localized infections prompted by bacterial colonization of medical devices or implant materials. Bioactive glasses (BG) are extensively employed in the field of regenerative medicine, encompassing a diverse range of materials utilized for drug delivery systems. In the present investigation, various drug carriers for imipenem and tetracycline, namely single systems BG/SnO2, BG/NiO with varying proportions of metal oxide, and nanocomposite BG/SnO2/NiO, were synthesized through the sol-gel technique. The antibacterial efficacy of the synthesized samples was assessed through the utilization of the disk diffusion method with the aim of neutralizing Staphylococcus aureus as the bacterial model. The current study involved the examination of the bioactivity of two samples, namely BG10SnO2/10NiO and BG20SnO2, which were chosen based on their heightened bacterial inactivation properties. This evaluation entailed the employment of two techniques: the measurement of the pH of simulated body fluid (SBF) solution and the analysis of the sample tablets through X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transform infrared (FTIR) spectroscopy. The sample tablets were submerged in SBF for varying durations of 7, 14, and 28 days. The bioactivity of the composite bioactive glass sample was assessed through characterization of alterations in its surface morphology, structure, and chemical composition. This evaluation was performed using scanning electron microscopy (SEM), Fourier-transform infrared (FTIR) spectroscopy, and X-ray diffraction spectroscopy. Subsequently, the sample was immersed in simulated liquids to simulate its behavior in biological environments. The specific body fat percentage (SBF) was assessed over a 28-day period. The confirmation of the formation of a hydroxyapatite surface layer serves as a distinct indicator of bioactivity. The infusion of antibiotics into the composite bioactive glass specimen was done separately, and then the release kinetics of tetracycline and imipenem were tested in simulated body fluid (SBF). Antimicrobial effectiveness against various bacterial strains have been proven in numerous instances using both melt and sol-gel techniques to create multiple bioactive glass compositions. An elevated concentration of calcium ions within a solution has been observed to cause an increase in the pH level. In aqueous suspensions, bioactive glass particles manifest a significant antimicrobial impact. The composite bioactive glass specimen exhibits a gradual and uninterrupted release, which is highly desirable for a drug delivery system over a span of 72 hours. The reduction in absorption, which signals the loss of a portion of the antibiotic during the loading process from the initial phosphate-buffered saline solution, indicates the successful bonding of the two antibiotics to the surfaces of the bioactive glass samples. The sample denoted as BG/10SnO2/10NiO exhibits a higher loading of particles compared to the sample designated as BG/20SnO2 in the context of bioactive glass. The enriched sample demonstrates a heightened bactericidal impact on the bacteria under investigation while concurrently preserving its antibacterial characteristics. Tailored bioactive glass that incorporates hydroxyapatite, with a regulated and efficient release of drugs targeting bacterial infections, holds promise as a potential framework for bone implant scaffolds following rigorous clinical evaluation, thereby establishing potential future biomedical uses. During the modification process, the introduction of metal oxides into bioactive glass resulted in improved antibacterial characteristics, particularly in the composite bioactive glass sample that displayed the highest level of efficiency.

Keywords: antibacterial, bioactive glasses, implant infections, multi drug resistant

Procedia PDF Downloads 80
3580 Sustainability of Photovoltaic Recycling Planning

Authors: Jun-Ki Choi

Abstract:

The usage of valuable resources and the potential for waste generation at the end of the life cycle of photovoltaic (PV) technologies necessitate a proactive planning for a PV recycling infrastructure. To ensure the sustainability of PV in large scales of deployment, it is vital to develop and institute low-cost recycling technologies and infrastructure for the emerging PV industry in parallel with the rapid commercialization of these new technologies. There are various issues involved in the economics of PV recycling and this research examine those at macro and micro levels, developing a holistic interpretation of the economic viability of the PV recycling systems. This study developed mathematical models to analyze the profitability of recycling technologies and to guide tactical decisions for allocating optimal location of PV take-back centers (PVTBC), necessary for the collection of end of life products. The economic decision is usually based on the level of the marginal capital cost of each PVTBC, cost of reverse logistics, distance traveled, and the amount of PV waste collected from various locations. Results illustrated that the reverse logistics costs comprise a major portion of the cost of PVTBC; PV recycling centers can be constructed in the optimally selected locations to minimize the total reverse logistics cost for transporting the PV wastes from various collection facilities to the recycling center. In the micro- process level, automated recycling processes should be developed to handle the large amount of growing PV wastes economically. The market price of the reclaimed materials are important factors for deciding the profitability of the recycling process and this illustrates the importance of the recovering the glass and expensive metals from PV modules.

Keywords: photovoltaic, recycling, mathematical models, sustainability

Procedia PDF Downloads 234
3579 Vitamin D Supplementation Potentiates the Clinical Benefits of Metformin and Pioglitazone in Indian Women with Polycystic Ovary Syndrome

Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

Abstract:

Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

Procedia PDF Downloads 365
3578 InSAR Times-Series Phase Unwrapping for Urban Areas

Authors: Hui Luo, Zhenhong Li, Zhen Dong

Abstract:

The analysis of multi-temporal InSAR (MTInSAR) such as persistent scatterer (PS) and small baseline subset (SBAS) techniques usually relies on temporal/spatial phase unwrapping (PU). Unfortunately, it always fails to unwrap the phase for two reasons: 1) spatial phase jump between adjacent pixels larger than π, such as layover and high discontinuous terrain; 2) temporal phase discontinuities such as time varied atmospheric delay. To overcome these limitations, a least-square based PU method is introduced in this paper, which incorporates baseline-combination interferograms and adjacent phase gradient network. Firstly, permanent scatterers (PS) are selected for study. Starting with the linear baseline-combination method, we obtain equivalent 'small baseline inteferograms' to limit the spatial phase difference. Then, phase different has been conducted between connected PSs (connected by a specific networking rule) to suppress the spatial correlated phase errors such as atmospheric artifact. After that, interval phase difference along arcs can be computed by least square method and followed by an outlier detector to remove the arcs with phase ambiguities. Then, the unwrapped phase can be obtained by spatial integration. The proposed method is tested on real data of TerraSAR-X, and the results are also compared with the ones obtained by StaMPS(a software package with 3D PU capabilities). By comparison, it shows that the proposed method can successfully unwrap the interferograms in urban areas even when high discontinuities exist, while StaMPS fails. At last, precise DEM errors can be got according to the unwrapped interferograms.

Keywords: phase unwrapping, time series, InSAR, urban areas

Procedia PDF Downloads 137
3577 Survey of Hawke's Bay Tourism Based Businesses: Tsunami Understanding and Preparation

Authors: V. A. Ritchie

Abstract:

The loss of life and livelihood experienced after the magnitude 9.3 Sumatra earthquake and tsunami on 26 December 2004 and magnitude 9 earthquake and tsunami in northeastern Japan on 11 March 2011, has raised global awareness and brought tsunami phenomenology, nomenclature, and representation into sharp focus. At the same time, travel and tourism continue to increase, contributing around 1 in 11 jobs worldwide. This increase in tourism is especially true for coastal zones, placing pressure on decision-makers to downplay tsunami risks and at the same time provide adequate tsunami warning so that holidaymakers will feel confident enough to visit places of high tsunami risk. This study investigates how well tsunami preparedness messages are getting through for tourist-based businesses in Hawke’s Bay New Zealand, a region of frequent seismic activity and a high probability of experiencing a nearshore tsunami. The aim of this study is to investigate whether tourists based businesses are well informed about tsunamis, how well they understand that information and to what extent their clients are included in awareness raising and evacuation processes. In high-risk tsunami zones, such as Hawke’s Bay, tourism based businesses face competitive tension between short term business profitability and longer term reputational issues related to preventable loss of life from natural hazards, such as tsunamis. This study will address ways to accommodate culturally and linguistically relevant tourist awareness measures without discouraging tourists or being too costly to implement.

Keywords: tsunami risk and response, travel and tourism, business preparedness, cross cultural knowledge transfer

Procedia PDF Downloads 136
3576 Performance Optimization on Waiting Time Using Queuing Theory in an Advanced Manufacturing Environment: Robotics to Enhance Productivity

Authors: Ganiyat Soliu, Glen Bright, Chiemela Onunka

Abstract:

Performance optimization plays a key role in controlling the waiting time during manufacturing in an advanced manufacturing environment to improve productivity. Queuing mathematical modeling theory was used to examine the performance of the multi-stage production line. Robotics as a disruptive technology was implemented into a virtual manufacturing scenario during the packaging process to study the effect of waiting time on productivity. The queuing mathematical model was used to determine the optimum service rate required by robots during the packaging stage of manufacturing to yield an optimum production cost. Different rates of production were assumed in a virtual manufacturing environment, cost of packaging was estimated with optimum production cost. An equation was generated using queuing mathematical modeling theory and the theorem adopted for analysis of the scenario is the Newton Raphson theorem. Queuing theory presented here provides an adequate analysis of the number of robots required to regulate waiting time in order to increase the number of output. Arrival rate of the product was fast which shows that queuing mathematical model was effective in minimizing service cost and the waiting time during manufacturing. At a reduced waiting time, there was an improvement in the number of products obtained per hour. The overall productivity was improved based on the assumptions used in the queuing modeling theory implemented in the virtual manufacturing scenario.

Keywords: performance optimization, productivity, queuing theory, robotics

Procedia PDF Downloads 127
3575 The Quality of Public Space in Mexico City: Current State and Trends

Authors: Mildred Moreno Villanueva

Abstract:

Public space is essential to strengthen the social and urban fabric and the social cohesion; there lies the importance of its study. Hence, the aim of this paper is to analyze the quality of public space in the XXI century in both quantitative and qualitative terms. In this article, the concept of public space includes open spaces such as parks, public squares and walking areas. To make this analysis we take Mexico City as the case study. It has a population of nearly 9 million inhabitants and it is composed of sixteen boroughs. For this analysis, we consider both, existing public spaces and the government intervention for building and improvement of new and existent public spaces. Results show that on the one hand, quantitatively there is not an equitable distribution of public spaces because of both, the growth of the city itself, as well as for the absence of political will to create public spaces. Another factor is the evolution of this city, which has been growing merely in a 'patched pattern', where public space has played no role at all with a total absence of urban design. On the other hand, qualitatively, even the boroughs with the most public spaces have not shown interest in making these spaces qualitatively inclusive and open to the general population aiming for integration. Therefore, urban projects that privatize public space seem to be the rule, rather than a rehabilitation effort of the existent public spaces. Hence, state intervention should reinforce its role as an agent of social change acting in the benefit of the majority of the inhabitants with the promotion of more inclusive public spaces.

Keywords: exclusion, inclusion, Mexico City, public space

Procedia PDF Downloads 601
3574 Primary Analysis of a Randomized Controlled Trial of Topical Analgesia Post Haemorrhoidectomy

Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill

Abstract:

Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.

Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer

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3573 Flow-Oriented Incentive Spirometry in the Reversal of Diaphragmatic Dysfunction in Bariatric Surgery Postoperative Period

Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

Abstract:

There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

Procedia PDF Downloads 356