Search results for: full scale tests
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11787

Search results for: full scale tests

3147 Benefits of Whole-Body Vibration Training on Lower-Extremity Muscle Strength and Balance Control in Middle-Aged and Older Adults

Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Jenn-Woei Hsieh, Ching-Yu Tseng

Abstract:

This study aimed to determine the effects of whole-body vibration (WBV) training on lower-extremity muscle strength and balance control performance among community-dwelling middle-aged and older adults in the United States. Twenty-nine participants without any contraindication of performing WBV exercise completed all the study procedures. Participants were randomly assigned to do body weight exercise with either an individualized vibration frequency and amplitude, a fixed vibration frequency and amplitude, or no vibration. Isokinetic knee extensor power, limits of stability, and sit-to-stand tests were performed at the baseline and after 8 weeks of training. Neither the individualized frequency-amplitude WBV training protocol nor the fixed frequency-amplitude WBV training protocol improved isokinetic knee extensor power. The limits of stability endpoint excursion score for the individualized frequency-amplitude group increased by 8.8 (12.9%; p = 0.025) after training. No significant differences were observed in fixed and control group. The maximum excursion score for the individualized frequency-amplitude group at baseline increased by 9.2 (11.5%; p = 0.006) after training. The average weight transfer time score significantly decreased by 0.21 s in the fixed group. The participants in the individualized group showed a significant increase (3.2%) in weight rising index score after 8 weeks of WBV training. These results suggest that 8 weeks of WBV training improved limit of stability and sit-to-stand performance. Future studies need to determine whether WBV training improves other factors that can influence posture control.

Keywords: whole-body vibration training, muscle strength, balance control, middle-aged and older adults

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3146 Building Information Management in Context of Urban Spaces, Analysis of Current Use and Possibilities

Authors: Lucie Jirotková, Daniel Macek, Andrea Palazzo, Veronika Malinová

Abstract:

Currently, the implementation of 3D models in the construction industry is gaining popularity. Countries around the world are developing their own modelling standards and implement the use of 3D models into their individual permitting processes. Another theme that needs to be addressed are public building spaces and their subsequent maintenance, where the usage of BIM methodology is directly offered. The significant benefit of the implementation of Building Information Management is the information transfer. The 3D model contains not only the spatial representation of the item shapes but also various parameters that are assigned to the individual elements, which are easily traceable, mainly because they are all stored in one place in the BIM model. However, it is important to keep the data in the models up to date to achieve useability of the model throughout the life cycle of the building. It is now becoming standard practice to use BIM models in the construction of buildings, however, the building environment is very often neglected. Especially in large-scale development projects, the public space of buildings is often forwarded to municipalities, which obtains the ownership and are in charge of its maintenance. A 3D model of the building surroundings would include both the above-ground visible elements of the development as well as the underground parts, such as the technological facilities of water features, electricity lines for public lighting, etc. The paper shows the possibilities of a model in the field of information for the handover of premises, the following maintenance and decision making. The attributes and spatial representation of the individual elements make the model a reliable foundation for the creation of "Smart Cities". The paper analyses the current use of the BIM methodology and presents the state-of-the-art possibilities of development.

Keywords: BIM model, urban space, BIM methodology, facility management

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3145 Reduced Lung Volume: A Possible Cause of Stuttering

Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal

Abstract:

Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.

Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering

Procedia PDF Downloads 263
3144 Inequality of Opportunities in the Health of the Adult Population of Russia

Authors: Marina Kartseva, Polina Kuznetsova

Abstract:

In our work, we estimate the contribution of inequality of opportunity to inequality in the health of the Russian population aged 25 to 74 years. The empirical basis of the study is the nationally representative data of the RLMS for 2018. Individual health is measured using a self-reported status on five-point scale. The startconditions are characterized by parental education and place of birth (country, type of settlement). Personal efforts to maintain health include the level of education, smoking status, and physical activity. To understand how start opportunities affect an individual's health, we use the methodology proposed in (Trannoy et al., 2010), which takes into account both direct and indirect (through the influence on efforts) effects. Regression analysis shows that all other things being equal, the starting capabilities of individuals have a significant impact on their health. In particular, parental education has a positive effect on self-reported health. Birth in another country, in another settlement, and in an urban area, on the contrary, reduceself-reported health. This allows to conclude that there exists an unfair inequality in health, namely inequality caused by factors that are independent of a person's own efforts. We estimate the contribution of inequality of opportunity to inequality in health using a nonparametric approach (Checchi, Peragine, 2010; Lazar, 2013). According to the obtained results, the contribution of unfair inequality as 72-74% for the population as a whole, being slightly higher for women (62-74% and 60-69% for men and women, respectively) and for older age (59- 62% and 67-75% for groups 25-44 years old and 45-74 years old, respectively). The obtained estimates are comparable with the results for other countries and indicate the importance of the problem of inequality of opportunities in health in Russia.

Keywords: inequality of opportunity, inequality in health, self-reported health, efforts, health-related lifestyle, Russia, RLMS

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3143 An Investigation into the Gaps in Green Building Education and Training Offerings in Nigeria

Authors: Adebayo A. Abimbola, Anifowose O. Joseph, Olanrewaju S. Taiwo

Abstract:

Green building (GB) practices have the potential to save energy, save money, and improve the quality of human habitat. They can also contribute to water conservation, more efficient use of raw materials, and ecosystem health around the globe. The Intergovernmental Panel on Climate Change (IPCC) singled out the building sector as having the most cost-effective opportunities for reducing carbon emissions—in fact, many building-related opportunities are cost-neutral, or even cost-positive, to the building owner. These benefits have made green building practices the fastest-growing trend in the building industry, but they still represent only a fraction of new construction, and the enormous stock of existing buildings has barely been touched at all. To effectively deliver the kind of (GB) that can become a force for positive change at global, regional and local scales, all workforce sectors need new skills that are both technical and interpersonal in nature. A prominent bottleneck is seen to be education and training. This paper investigates the major gaps in current GB education and training offerings in Nigeria. A questionnaire survey was developed to capture the perception of construction professionals and academics in relevant professions regarding the significance of the identified gaps as it affects GB education and training. Based on Likert scale ranking, research result shows that perception of training in specific technical fields and financial benefits and evaluation are identified as the top gaps in GB training and education offerings. The paper concludes with suggestions and actions that can enhance capabilities of the GB workforce in Nigeria.

Keywords: education and training, gaps, green building, workforce

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3142 The Effect of a Test Pump Supplement on the Physiological and Functional Performance of Futsal Women

Authors: Samaneh Rahsepar, Mehrzad Moghadasi

Abstract:

To evaluate the effect of Test Pump supplement on the physiological and functional performance of futsal women, twenty female futsal subjects were divided into two groups: placebo (n = 10) and supplement (n = 10) and were given buccal tablets for 7 days and 12 g daily supplement each day. The placebo group used starch powder during this period. Speed, agility with ball, agility without ball and dribbling time were measured before and after supplementation. In addition, the rate of heart rate and blood pressure changes were measured before and after the YOYO test. The results showed that the test pump had no significant effect on improving speed, agility with ball, agility without ball, dribbling time and heart rate changes and diastolic blood pressure, and only affect the maximum oxygen consumption and systolic blood pressure (P <0.05). In general, the use of the test-pump supplement does not have a significant effect on the physiological and functional performance of futsal women. The results of this study showed that the use of supplementary pump tests on women's futsal heart rate changes after loading period had a significant difference between the two groups in resting heart rate with heart rate after exercise and 5 minutes after exercise. However, it did not have a significant effect on the increase in heart rate. Supplementation significantly increased systolic blood pressure after exercise compared to resting blood pressure, as well as a significant increase in systolic blood pressure after exercise compared to resting systolic blood pressure and 5 minutes after exercise in both groups from the loading period. On the other hand, there was a significant difference in systolic blood pressure in both placebo and supplemented groups.

Keywords: test pump supplement, women, speed, dribble, agility, maximum oxygen consumption, cardiovascular

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3141 Rayleigh-Bénard-Taylor Convection of Newtonian Nanoliquid

Authors: P. G. Siddheshwar, T. N. Sakshath

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In the paper we make linear and non-linear stability analyses of Rayleigh-Bénard convection of a Newtonian nanoliquid in a rotating medium (called as Rayleigh-Bénard-Taylor convection). Rigid-rigid isothermal boundaries are considered for investigation. Khanafer-Vafai-Lightstone single phase model is used for studying instabilities in nanoliquids. Various thermophysical properties of nanoliquid are obtained using phenomenological laws and mixture theory. The eigen boundary value problem is solved for the Rayleigh number using an analytical method by considering trigonometric eigen functions. We observe that the critical nanoliquid Rayleigh number is less than that of the base liquid. Thus the onset of convection is advanced due to the addition of nanoparticles. So, increase in volume fraction leads to advanced onset and thereby increase in heat transport. The amplitudes of convective modes required for estimating the heat transport are determined analytically. The tri-modal standard Lorenz model is derived for the steady state assuming small scale convective motions. The effect of rotation on the onset of convection and on heat transport is investigated and depicted graphically. It is observed that the onset of convection is delayed due to rotation and hence leads to decrease in heat transport. Hence, rotation has a stabilizing effect on the system. This is due to the fact that the energy of the system is used to create the component V. We observe that the amount of heat transport is less in the case of rigid-rigid isothermal boundaries compared to free-free isothermal boundaries.

Keywords: nanoliquid, rigid-rigid, rotation, single phase

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3140 Water-Repellent Coating Based on Thermoplastic Polyurethane, Silica Nanoparticles and Graphene Nanoplatelets

Authors: S. Naderizadeh, A. Athanassiou, I. S. Bayer

Abstract:

This work describes a layer-by-layer spraying method to produce a non-wetting coating, based on thermoplastic polyurethane (TPU) and silica nanoparticles (Si-NPs). The main purpose of this work was to transform a hydrophilic polymer to superhydrophobic coating. The contact angle of pure TPU was measured about 77˚ ± 2, and water droplets did not roll away upon tilting even at 90°. But after applying a layer of Si-NPs on top of this, not only the contact angle increased to 165˚ ± 2, but also water droplets can roll away even below 5˚ tilting. The most important restriction in this study was the weak interfacial adhesion between polymer and nanoparticles, which had a bad effect on durability of the coatings. To overcome this problem, we used a very thin layer of graphene nanoplatelets (GNPs) as an interlayer between TPU and Si-NPs layers, followed by thermal treatment at 150˚C. The sample’s morphology and topography were characterized by scanning electron microscopy (SEM), EDX analysis and atomic force microscopy (AFM). It was observed that Si-NPs embedded into the polymer phase in the presence of GNPs layer. It is probably because of the high surface area and considerable thermal conductivity of the graphene platelets. The contact angle value for the sample containing graphene decreased a little bit respected to the coating without graphene and reached to 156.4˚ ± 2, due to the depletion of the surface roughness. The durability of the coatings against abrasion was evaluated by Taber® abrasion test, and it was observed that superhydrophobicity of the coatings remains for a longer time, in the presence of GNPs layer. Due to the simple fabrication method and good durability of the coating, this coating can be used as a durable superhydrophobic coating for metals and can be produced in large scale.

Keywords: graphene, silica nanoparticles, superhydrophobicity, thermoplastic polyurethane

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3139 The Differences and Similarities in Neurocognitive Deficits in Mild Traumatic Brain Injury and Depression

Authors: Boris Ershov

Abstract:

Depression is the most common mood disorder experienced by patients who have sustained a traumatic brain injury (TBI) and is associated with poorer cognitive functional outcomes. However, in some cases, similar cognitive impairments can also be observed in depression. There is not enough information about the features of the cognitive deficit in patients with TBI in relation to patients with depression. TBI patients without depressive symptoms (TBInD, n25), TBI patients with depressive symptoms (TBID, n31), and 28 patients with bipolar II disorder (BP) were included in the study. There were no significant differences in participants in respect to age, handedness and educational level. The patients clinical status was determined by using Montgomery–Asberg Depression Rating Scale (MADRS). All participants completed a cognitive battery (The Brief Assessment of Cognition in Affective Disorders (BAC-A)). Additionally, the Rey–Osterrieth Complex Figure (ROCF) was used to assess visuospatial construction abilities and visual memory, as well as planning and organizational skills. Compared to BP, TBInD and TBID showed a significant impairments in visuomotor abilities, verbal and visual memory. There were no significant differences between BP and TBID groups in working memory, speed of information processing, problem solving. Interference effect (cognitive inhibition) was significantly greater in TBInD and TBID compared to BP. Memory bias towards mood-related information in BP and TBID was greater in comparison with TBInD. These results suggest that depressive symptoms are associated with impairments some executive functions in combination at decrease of speed of information processing.

Keywords: bipolar II disorder, depression, neurocognitive deficits, traumatic brain injury

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3138 AI-Enabled Smart Contracts for Reliable Traceability in the Industry 4.0

Authors: Harris Niavis, Dimitra Politaki

Abstract:

The manufacturing industry was collecting vast amounts of data for monitoring product quality thanks to the advances in the ICT sector and dedicated IoT infrastructure is deployed to track and trace the production line. However, industries have not yet managed to unleash the full potential of these data due to defective data collection methods and untrusted data storage and sharing. Blockchain is gaining increasing ground as a key technology enabler for Industry 4.0 and the smart manufacturing domain, as it enables the secure storage and exchange of data between stakeholders. On the other hand, AI techniques are more and more used to detect anomalies in batch and time-series data that enable the identification of unusual behaviors. The proposed scheme is based on smart contracts to enable automation and transparency in the data exchange, coupled with anomaly detection algorithms to enable reliable data ingestion in the system. Before sensor measurements are fed to the blockchain component and the smart contracts, the anomaly detection mechanism uniquely combines artificial intelligence models to effectively detect unusual values such as outliers and extreme deviations in data coming from them. Specifically, Autoregressive integrated moving average, Long short-term memory (LSTM) and Dense-based autoencoders, as well as Generative adversarial networks (GAN) models, are used to detect both point and collective anomalies. Towards the goal of preserving the privacy of industries' information, the smart contracts employ techniques to ensure that only anonymized pointers to the actual data are stored on the ledger while sensitive information remains off-chain. In the same spirit, blockchain technology guarantees the security of the data storage through strong cryptography as well as the integrity of the data through the decentralization of the network and the execution of the smart contracts by the majority of the blockchain network actors. The blockchain component of the Data Traceability Software is based on the Hyperledger Fabric framework, which lays the ground for the deployment of smart contracts and APIs to expose the functionality to the end-users. The results of this work demonstrate that such a system can increase the quality of the end-products and the trustworthiness of the monitoring process in the smart manufacturing domain. The proposed AI-enabled data traceability software can be employed by industries to accurately trace and verify records about quality through the entire production chain and take advantage of the multitude of monitoring records in their databases.

Keywords: blockchain, data quality, industry4.0, product quality

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3137 Frequency Selective Filters for Estimating the Equivalent Circuit Parameters of Li-Ion Battery

Authors: Arpita Mondal, Aurobinda Routray, Sreeraj Puravankara, Rajashree Biswas

Abstract:

The most difficult part of designing a battery management system (BMS) is battery modeling. A good battery model can capture the dynamics which helps in energy management, by accurate model-based state estimation algorithms. So far the most suitable and fruitful model is the equivalent circuit model (ECM). However, in real-time applications, the model parameters are time-varying, changes with current, temperature, state of charge (SOC), and aging of the battery and this make a great impact on the performance of the model. Therefore, to increase the equivalent circuit model performance, the parameter estimation has been carried out in the frequency domain. The battery is a very complex system, which is associated with various chemical reactions and heat generation. Therefore, it’s very difficult to select the optimal model structure. As we know, if the model order is increased, the model accuracy will be improved automatically. However, the higher order model will face the tendency of over-parameterization and unfavorable prediction capability, while the model complexity will increase enormously. In the time domain, it becomes difficult to solve higher order differential equations as the model order increases. This problem can be resolved by frequency domain analysis, where the overall computational problems due to ill-conditioning reduce. In the frequency domain, several dominating frequencies can be found in the input as well as output data. The selective frequency domain estimation has been carried out, first by estimating the frequencies of the input and output by subspace decomposition, then by choosing the specific bands from the most dominating to the least, while carrying out the least-square, recursive least square and Kalman Filter based parameter estimation. In this paper, a second order battery model consisting of three resistors, two capacitors, and one SOC controlled voltage source has been chosen. For model identification and validation hybrid pulse power characterization (HPPC) tests have been carried out on a 2.6 Ah LiFePO₄ battery.

Keywords: equivalent circuit model, frequency estimation, parameter estimation, subspace decomposition

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3136 Use of Simulation in Medical Education: Role and Challenges

Authors: Raneem Osama Salem, Ayesha Nuzhat, Fatimah Nasser Al Shehri, Nasser Al Hamdan

Abstract:

Background: Recently, most medical schools around the globe are using simulation for teaching and assessing students’ clinical skills and competence. There are many obstacles that could face students and faculty when simulation sessions are introduced into undergraduate curriculum. Objective: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and perceived barriers in implementing stimulation sessions. Methods: To address the role of simulation, modalities used, and perceived challenges to implementation of simulation sessions, a self-administered pilot tested questionnaire with 18 items using a 5 point Likert scale was distributed. Participants included undergraduate male medical students (n=125) and female students (n=70) as well as the faculty members (n=14). Result: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students,' institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. Conclusion: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learning of the various skills.

Keywords: simulators, medical students, skills, simulated patients, performance, challenges, skill laboratory

Procedia PDF Downloads 401
3135 Count of Trees in East Africa with Deep Learning

Authors: Nubwimana Rachel, Mugabowindekwe Maurice

Abstract:

Trees play a crucial role in maintaining biodiversity and providing various ecological services. Traditional methods of counting trees are time-consuming, and there is a need for more efficient techniques. However, deep learning makes it feasible to identify the multi-scale elements hidden in aerial imagery. This research focuses on the application of deep learning techniques for tree detection and counting in both forest and non-forest areas through the exploration of the deep learning application for automated tree detection and counting using satellite imagery. The objective is to identify the most effective model for automated tree counting. We used different deep learning models such as YOLOV7, SSD, and UNET, along with Generative Adversarial Networks to generate synthetic samples for training and other augmentation techniques, including Random Resized Crop, AutoAugment, and Linear Contrast Enhancement. These models were trained and fine-tuned using satellite imagery to identify and count trees. The performance of the models was assessed through multiple trials; after training and fine-tuning the models, UNET demonstrated the best performance with a validation loss of 0.1211, validation accuracy of 0.9509, and validation precision of 0.9799. This research showcases the success of deep learning in accurate tree counting through remote sensing, particularly with the UNET model. It represents a significant contribution to the field by offering an efficient and precise alternative to conventional tree-counting methods.

Keywords: remote sensing, deep learning, tree counting, image segmentation, object detection, visualization

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3134 Effort-Reward-Imbalance and Self-Rated Health Among Healthcare Professionals in the Gambia

Authors: Amadou Darboe, Kuo Hsien-Wen

Abstract:

Background/Objective: The Effort-Reward Imbalance (ERI) model by Siegrist et al (1986) have been widely used to examine the relationship between psychosocial factors at work and health. It claimed that failed reciprocity in terms of high efforts and low rewards elicits strong negative emotions in combination with sustained autonomic activation and is hazardous to health. The aim of this study is to identify the association between Self-rated Health and Effort-reward Imbalance (ERI) among Nurses and Environmental Health officers in the Gambia. Method: a cross-sectional study was conducted using a multi-stage random sampling of 296 healthcare professionals (206 nurses and 90 environmental health officers) working in public health facilities. The 22 items Effort-reward imbalance questionnaire (ERI-L version 22.11.2012) will be used to collect data on the psychosocial factors defined by the model. In addition, self-rated health will be assessed by using structured questionnaires containing Likert scale items. Results: We found that self-rated health among environmental health officers has a significant negative correlation with extrinsic effort and a positive significant correlations with occupational reward and job satisfaction. However, among the nurses only job satisfaction was significantly correlated with self-rated health and was positive. Overall, Extrinsic effort has a significant negative correlation with reward and job satisfaction but a positive correlation with over-commitment. Conclusion: Because low reward and high over-commitment among the nursing group, It is necessary to modify working conditions through improving psychosocial factors, such as reasonable allocation of resources to increase pay or rewards from government.

Keywords: effort-reward imbalance model, healthcare professionals, self-rated health

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3133 The Role of Phycoremediation in the Sustainable Management of Aquatic Pollution

Authors: Raymond Ezenweani, Jeffrey Ogbebor

Abstract:

The menace of aquatic pollution has become increasingly of great concern and the effects of this pollution as a result of anthropogenic activities cannot be over emphasized. Phycoremediation is the application of algal remediation technology in the removal of harmful products from the environment. Harmful products also known as pollutants are usually introduced into the environment through variety of processes such as industrial discharge, agricultural runoff, flooding, and acid rain. This work has to do with the capability of algae in the efficient removal of different pollutants, ranging from hydrocarbons, eutrophication, agricultural chemicals and wastes, heavy metals, foul smell from septic tanks or dumps through different processes such as bioconversion, biosorption, bioabsorption and biodecomposition. Algae are capable of bioconversion of environmentally persistent compounds to degradable compounds and also capable of putting harmful bacteria growth into check in waste water remediation. Numerous algal organisms such as Nannochloropsis spp, Chlorella spp, Tetraselmis spp, Shpaerocystics spp, cyanobacteria and different macroalgae have been tested by different researchers in laboratory scale and shown to have 100% efficiency in environmental remediation. Algae as a result of their photosynthetic capacity are also efficient in air cleansing and management of global warming by sequestering carbon iv oxide in air and converting it into organic carbon, thereby making food available for the other organisms in the higher trophic level of the aquatic food chain. Algae play major role in the sustenance of the aquatic ecosystem by their virtue of being photosynthetic. They are the primary producers and their role in environmental sustainability is remarkable.

Keywords: Algae , Pollutant, ., Phycoremediation, Aquatic, Sustainability

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3132 Assessment of the Association between Serum Thrombospondin-1 Levels at the Time of Admission and the Severity of Neurological Deficit in Patients with Ischemic Stroke

Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

Abstract:

Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.

Keywords: thrombospondin, stroke, neuroprotection, biomarkers

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3131 A Comprehensive Analysis of the Rheological Properties of Polymer Hydrogels in Order to Explore Their Potential for Practical Utilization in Industries

Authors: Raana Babadi Fathipour

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Hydrogels are three-dimensional structures formed by the interweaving of polymeric materials, possessing the remarkable ability to imbibe copious amounts of water. Numerous methodologies have been devised for examining and understanding the properties of these synthesized gels. Amongst them, spectroscopic techniques such as ultraviolet/visible (UV/Vis) and Fourier-transform infrared (FTIR) spectroscopy offer a glimpse into molecular and atomic aspects. Additionally, diffraction methods like X-ray diffraction (XRD) enable one to measure crystallinity within the gel's structure, while microscopy tools encompassing scanning electron microscopy (SEM) and transmission electron microscopy (TEM) provide insights into surface texture and morphology. Furthermore, rheology serves as an invaluable tool for unraveling the viscoelastic behavior inherent in hydrogels—a parameter crucial not only to numerous industries, including pharmaceuticals, cosmetics, food processing, agriculture and water treatment, but also pivotal to related fields of research. Likewise, the ultimate configuration of the product is contingent upon its characterization at a microscopic scale in order to comprehend the intricacies of the hydrogel network's structure and interaction dynamics in response to external forces. Within this present scrutiny, our attention has been devoted to unraveling the intricate rheological tendencies exhibited by materials founded on synthetic, natural, and semi-synthetic hydrogels. We also explore their practical utilization within various facets of everyday life from an industrial perspective.

Keywords: rheology, hydrogels characterization, viscoelastic behavior, application

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3130 Lost Maritime Culture in the Netherlands: Linking Material and Immaterial Datasets for a Modern Day Perception of the Late Medieval Maritime Cultural Landscape of the Zuiderzee Region

Authors: Y. T. van Popta

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This paper focuses on the never thoroughly examined yet in native relevant late medieval maritime cultural landscape of the former Zuiderzee (A.D. 1170-1932) in the center part of the Netherlands. Especially the northeastern part of the region, nowadays known as the Noordoostpolder, testifies of the dynamic battle of the Dutch against the water. This highly dynamic maritime region developed from a lake district into a sea and eventually into a polder. By linking physical and cognitive datasets from the Noordoostpol-der region in a spatial environment, new information on a late medieval maritime culture is brought to light, giving the opportunity to: (i) create a modern day perception on the late medieval maritime cultural landscape of the region and (ii) to underline the value of interdisciplinary and spatial research in maritime archaeology in general. Since the large scale reclamations of the region (A.D. 1932-1968), many remains have been discovered of a drowned and eroded late medieval maritime culture, represented by lost islands, drowned settlements, cultivated lands, shipwrecks and socio-economic networks. Recent archaeological research has proved the existence of this late medieval maritime culture by the discovery of the remains of the drowned settlement Fenehuysen (Veenhuizen) and its surroundings. The fact that this settlement and its cultivated surroundings remained hidden for so long proves that a large part of the maritime cultural landscape is ‘invisible’ and can only be found by extensive interdisciplinary research.

Keywords: drowned settlements, late middle ages, lost islands, maritime cultural landscape, the Netherlands

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3129 Load Balancing Technique for Energy - Efficiency in Cloud Computing

Authors: Rani Danavath, V. B. Narsimha

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Cloud computing is emerging as a new paradigm of large scale distributed computing. Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., three service models, and four deployment networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. This cloud model is composed of five essential characteristics models. Load balancing is one of the main challenges in cloud computing, which is required to distribute the dynamic workload across multiple nodes, to ensure that no single node is overloaded. It helps in optimal utilization of resources, enhancing the performance of the system. The goal of the load balancing is to minimize the resource consumption and carbon emission rate, that is the direct need of cloud computing. This determined the need of new metrics energy consumption and carbon emission for energy-efficiency load balancing techniques in cloud computing. Existing load balancing techniques mainly focuses on reducing overhead, services, response time and improving performance etc. In this paper we introduced a Technique for energy-efficiency, but none of the techniques have considered the energy consumption and carbon emission. Therefore, our proposed work will go towards energy – efficiency. So this energy-efficiency load balancing technique can be used to improve the performance of cloud computing by balancing the workload across all the nodes in the cloud with the minimum resource utilization, in turn, reducing energy consumption, and carbon emission to an extent, which will help to achieve green computing.

Keywords: cloud computing, distributed computing, energy efficiency, green computing, load balancing, energy consumption, carbon emission

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3128 Study of Causes and Effects of Road Projects Abandonment in Nigeria

Authors: Monsuru Oyenola Popoola, Oladapo Samson Abiola, Wusamotu Alao Adeniji

Abstract:

The prevalent and incessant abandonment of road construction projects are alarming that it creates several negative effects to social, economic and environmental values of the project. The purpose of this paper is to investigate and determined the various causes and effects of abandoning road construction projects in Nigeria. Likert Scale questionnaire design was used to administered and analysed the data obtained for the stydy. 135 (Nr) questionnaires were completed and retrieved from the respondents, out of 200 (Nr) questionnaires sent out, representing a response rate of 67.5%. The analysis utilized the Relative Importance Index (R.I.I.) method and the results are presented in tabular form. The findings confirms that at least 20 factors were the causes of road projects abandonment in Nigeria with most including Leadership Instability, Improper Project Planning, Inconsistence in government policies and Design, Contractor Incompetence, Economy Instability and Inflation, Delay in remittance of money, Improper financial analysis, Poor risk management, Climatic Conditions, Improper Project Estimates etc. The findings also show that at least eight (8) effect were identified on the system, and these include; Waste of Financial Resources, Loss of economic value, Environmental degradation, Loss of economic value, Reduction in standard of living, Litigation and Arbitration, etc. The reflection is that allocating reasonable finance, developing appropriate and effective implementation plans and monitoring, evaluation and reporting on development project activities by key actors should enhance in resolving the problem of road projects abandonment.

Keywords: road construction, abandonment of road projects, climatic condition, project planning, contractor

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3127 The Effects of the Waste Plastic Modification of the Asphalt Mixture on the Permanent Deformation

Authors: Soheil Heydari, Ailar Hajimohammadi, Nasser Khalili

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The application of plastic waste for asphalt modification is a sustainable strategy to deal with the enormous plastic waste generated each year and enhance the properties of asphalt. The modification is either practiced by the dry process or the wet process. In the dry process, plastics are added straight into the asphalt mixture, and in the wet process, they are mixed and digested into bitumen. In this article, the effects of plastic inclusion in asphalt mixture, through the dry process, on the permanent deformation of the asphalt are investigated. The main waste plastics that are usually used in asphalt modification are taken into account, which is linear, low-density polyethylene, low-density polyethylene, high-density polyethylene, and polypropylene. Also, to simulate a plastic waste stream, different grades of each virgin plastic are mixed and used. For instance, four different grades of polypropylene are mixed and used as representative of polypropylene. A precisely designed mixing condition is considered to dry-mix the plastics into the mixture such that the polymer was melted and modified by the later introduced binder. In this mixing process, plastics are first added to the hot aggregates and mixed three times in different time intervals, then bitumen is introduced, and the whole mixture is mixed three times in fifteen minutes intervals. Marshall specimens were manufactured, and dynamic creep tests were conducted to evaluate the effects of modification on the permanent deformation of the asphalt mixture. Dynamic creep is a common repeated loading test conducted at different stress levels and temperatures. Loading cycles are applied to the AC specimen until failure occurs; with the amount of deformation constantly recorded, the cumulative, permanent strain is determined and reported as a function of the number of cycles. The results of this study showed that the dry inclusion of the waste plastics is very effective in enhancing the resistance against permanent deformation of the mixture. However, the mixing process must be precisely engineered to melt the plastics, and a homogenous mixture is achieved.

Keywords: permanent deformation, waste plastics, low-density polyethene, high-density polyethene, polypropylene, linear low-density polyethene, dry process

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3126 Citrobacter Braakii, a New Plant Pathogen, Causal Agent of Walnut Decline

Authors: Mohammadreza Hajialigol, Nargues Falahi Charkhabi, Fatemeh Shahryari, Saadat Sarikhani

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BACKGROUND AND OBJECTIVES Walnut canker is characterized by brown to blackish roundish blotches on the trunks and main branches, necrosis of inner bark and bleeding with dark brown to black-colored exudates. The present study aimed to identify the causative agents of walnut decline by their phenotypic features, approval of pathogenicity, the partial sequencing of the housekeeping genes in Razavi Khorasan. MATERIAL AND METHODS Ten Symptomatic samples were collected from walnut orchards of Razavi Khorasan in 2019. Pathogenicity of all isolated strains was carried out on walnut immature fruits cv. ‘Hartley’ and young green twigs of cv. ‘Chandler’. All pathogenic strains were subjected to physiological, morphological and biochemical tests. 16S rRNA and housekeeping genes (fusA, leuS, and pyrG) were partially amplified and sequenced. RESULTS Eight strains were able to cause necrosis and a dark-colored region in the mesocarp of immature walnut fruits, and three representative strains caused necrosis on young inoculated twigs. Strains utilized starch, however, did not utilized esculin, Tween 20, Tween 80, and gelatin. The partial 16S rRNA gene sequence of strain KH7 indicated 99.63 % similarity to that of Citrobacter braakii ATCC5113T. The phylogenetic analyses based on the partial sequencing of three housekeeping genes, fusA (633 bp), pyrG (305), and leuS (640 bp), demonstrated that strains KH1, KH3, and KH7 belong to C. braakii species in a monophyletic clade with high bootstrap support. CONCLUSION To the best of our knowledge, this is the first report of C. braakii as a new plant pathogen which cause walnut decline. Identification of bacteria associated with walnut decline will eventually improve our understanding of the etiology of the disease and may result in improved management techniques for control.

Keywords: emerging pathogens, Iran, juglans regia, MLSA

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3125 CFD Simulation Approach for Developing New Powder Dispensing Device

Authors: Revanth Rallapalli

Abstract:

Manually dispensing powders can be difficult as it requires gradually pouring and checking the amount on the scale to be dispensed. Current systems are manual and non-continuous in nature and are user-dependent and difficult to control powder dispensation. Recurrent dosing of powdered medicines in precise amounts quickly and accurately has been an all-time challenge. Various new powder dispensing mechanisms are being designed to overcome these challenges. A battery-operated screw conveyor mechanism is being innovated to overcome the above problems faced. These inventions are numerically evaluated at the concept development level by employing Computational Fluid Dynamics (CFD) of gas-solids multiphase flow systems. CFD has been very helpful in the development of such devices saving time and money by reducing the number of prototypes and testing. This paper describes a simulation of powder dispensation from the trocar’s end by considering the powder as secondary flow in the air, is simulated by using the technique called Dense Discrete Phase Model incorporated with Kinetic Theory of Granular Flow (DDPM-KTGF). By considering the volume fraction of powder as 50%, the transportation of powder from the inlet side to the trocar’s end side is done by rotation of the screw conveyor. The performance is calculated for a 1-sec time frame in an unsteady computation manner. This methodology will help designers in developing design concepts to improve the dispensation and the effective area within a quick turnaround time frame.

Keywords: multiphase flow, screw conveyor, transient, dense discrete phase model (DDPM), kinetic theory of granular flow (KTGF)

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3124 The Role of the Board of Directors and Chief Executive Officers in Leading and Embedding Corporate Social Responsibility within Corporate Governance Regulations

Authors: Khalid Alshaikh

Abstract:

In recent years, leadership, Corporate Governance (CG) and Corporate Social Responsibility (CSR) have been under scrutiny in the Libyan society. Scholars and institutions have commenced investigating the possible resolutions they can arrange to alleviate the economic, social and environmental problems the war has produced. Thus far, these constructs requisite an in-depth reinvestigation, reconceptualization, and analysis to clearly reconstruct their rules and regulations. With the demise of Qaddafi’s regime, levels, degrees, and efforts to apply CG regulations have varied in public and private commercial banks. CSR is a new organizational culture that still designs its route within these financial institutions. Detaching itself from any notion of dictatorship and autocratic traits, leadership counts on transformational and transactional styles. Therefore, this paper investigates the extent to which the Board of Directors and Chief Executive Officers (CEOs) redefine these concepts and how they entrench CSR within the framework of CG. The research methodology used both public and private banks as a case study and qualitative research to interview ten Board of Directors (BoDs) and eleven Chief executive managers to explore how leadership, CG, and CSR are defined and how leadership integrates CSR into CG structures. The findings suggest that the CG framework in Libya still requires great efforts to be developed. Full CG code implementation appears daunting. Also, the CSR is still influenced by the power of religion. Nevertheless, the Islamic perspective is more consistent with the social contract concept of the CSR. The Libyan commercial banks do not solely focus on the economic side of maximizing profits, but also concentrate on its morality. The issue is that CSR activities are not enough to achieve good charity publicly and needs strategies to address major social issues. Moreover, leadership is more transformational and transactional and endeavors to make economic, social and environmental changes, but these changes are curtailed by tradition and traditional values dominating the Libyan social life where religious and tribal practices establish the relationship between leaders and their subordinates. Finally, the findings reveal that transformational and transactional leadership styles encourage the incorporation of CSR into the CG regulations. The boardroom and executive management have such a particular role in flagging up how embedded corporate Social responsibility is in organizational culture across the commercial banks, yet it is still important that the BoDs and CEOs need to do much more to embed corporate social responsibility through their core functions. They need to boost their standing to be more influential and make sure that the right discussions about CSR happen with the right stakeholders involved.

Keywords: board of directors, chief executive officers, corporate governance, corporate social responsibility

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3123 Utilizing Laser Cutting Method in Men's' Custom-Made Casualwear

Authors: M A. Habit, S. A. Syed-Sahil, A. Bahari

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Abstract—Laser cutting is a method of manufacturing process that uses laser in order to cut materials. It provides and ensures extreme accuracy which has a clean cut effect, CO2 laser dominate this application due to their good- quality beam combined with high output power. It comes with a small scale and it has a limitation in cutting sizes of materials, therefore it is more appropriate for custom- made products. The same laser cutting machine is also capable in cutting fine material such as fine silk, cotton, leather, polyester, etc. Lack of explorations and knowledge besides being unaware about this technology had caused many of the designers not to use this laser cutting method in their collections. The objectives of this study are: 1) To identify the potential of laser cutting technique in Custom-Made Garments for men’s casual wear: 2) To experiment the laser cutting technique in custom made garments: 3) To offer guidelines and formula for men’s custom- made casualwear designs with aesthetic value. In order to achieve the objectives, this research has been conducted by using mixed methods which are interviews with two (2) local experts in the apparel manufacturing industries and interviews via telephone with five (5) local respondents who are local emerging fashion designers, the questionnaires were distributed to one hundred (100) respondents around Klang Valley, in order to gain the information about their understanding and awareness regarding laser cutting technology. The experiment was conducted by using natural and man- made fibers. As a conclusion, all of the objectives had been achieved in producing custom-made men’s casualwear and with the production of these attires it will help to educate and enhance the innovation in fine technology. Therefore, there will be a good linkage and collaboration between the design experts and the manufacturing companies.

Keywords: custom-made, fashion, laser cut, men’s wear

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3122 Transgressing Gender Norms in Addiction Treatment

Authors: Sara Matsuzaka

Abstract:

At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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3121 Examining Predictive Coding in the Hierarchy of Visual Perception in the Autism Spectrum Using Fast Periodic Visual Stimulation

Authors: Min L. Stewart, Patrick Johnston

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Predictive coding has been proposed as a general explanatory framework for understanding the neural mechanisms of perception. As such, an underweighting of perceptual priors has been hypothesised to underpin a range of differences in inferential and sensory processing in autism spectrum disorders. However, empirical evidence to support this has not been well established. The present study uses an electroencephalography paradigm involving changes of facial identity and person category (actors etc.) to explore how levels of autistic traits (AT) affect predictive coding at multiple stages in the visual processing hierarchy. The study uses a rapid serial presentation of faces, with hierarchically structured sequences involving both periodic and aperiodic repetitions of different stimulus attributes (i.e., person identity and person category) in order to induce contextual expectations relating to these attributes. It investigates two main predictions: (1) significantly larger and late neural responses to change of expected visual sequences in high-relative to low-AT, and (2) significantly reduced neural responses to violations of contextually induced expectation in high- relative to low-AT. Preliminary frequency analysis data comparing high and low-AT show greater and later event-related-potentials (ERPs) in occipitotemporal areas and prefrontal areas in high-AT than in low-AT for periodic changes of facial identity and person category but smaller ERPs over the same areas in response to aperiodic changes of identity and category. The research advances our understanding of how abnormalities in predictive coding might underpin aberrant perceptual experience in autism spectrum. This is the first stage of a research project that will inform clinical practitioners in developing better diagnostic tests and interventions for people with autism.

Keywords: hierarchical visual processing, face processing, perceptual hierarchy, prediction error, predictive coding

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3120 Prismatic Bifurcation Study of a Functionally Graded Dielectric Elastomeric Tube Using Linearized Incremental Theory of Deformations

Authors: Sanjeet Patra, Soham Roychowdhury

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In recent times, functionally graded dielectric elastomer (FGDE) has gained significant attention within the realm of soft actuation due to its dual capacity to exert highly localized stresses while maintaining its compliant characteristics on application of electro-mechanical loading. Nevertheless, the full potential of dielectric elastomer (DE) has not been fully explored due to their susceptibility to instabilities when subjected to electro-mechanical loads. As a result, study and analysis of such instabilities becomes crucial for the design and realization of dielectric actuators. Prismatic bifurcation is a type of instability that has been recognized in a DE tube. Though several studies have reported on the analysis for prismatic bifurcation in an isotropic DE tube, there is an insufficiency in studies related to prismatic bifurcation of FGDE tubes. Therefore, this paper aims to determine the onset of prismatic bifurcations on an incompressible FGDE tube when subjected to electrical loading across the thickness of the tube and internal pressurization. The analysis has been conducted by imposing two axial boundary conditions on the tube, specifically axially free ends and axially clamped ends. Additionally, the rigidity modulus of the tube has been linearly graded in the direction of thickness where the inner surface of the tube has a lower stiffness than the outer surface. The static equilibrium equations for deformation of the axisymmetric tube are derived and solved using numerical technique. The condition for prismatic bifurcation of the axisymmetric static equilibrium solutions has been obtained by using the linearized incremental constitutive equations. Two modes of bifurcations, corresponding to two different non-circular cross-sectional geometries, have been explored in this study. The outcomes reveal that the FGDE tubes experiences prismatic bifurcation before the Hessian criterion of failure is satisfied. It is observed that the lower mode of bifurcation can be triggered at a lower critical voltage as compared to the higher mode of bifurcation. Furthermore, the tubes with larger stiffness gradient require higher critical voltages for triggering the bifurcation. Moreover, with the increase in stiffness gradient, a linear variation of the critical voltage is observed with the thickness of the tube. It has been found that on applying internal pressure to a tube with low thickness, the tube becomes less susceptible to bifurcations. A thicker tube with axially free end is found to be more stable than the axially clamped end tube at higher mode of bifurcation.

Keywords: critical voltage, functionally graded dielectric elastomer, linearized incremental approach, modulus of rigidity, prismatic bifurcation

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3119 Photoelastic Analysis and Finite Elements Analysis of a Stress Field Developed in a Double Edge Notched Specimen

Authors: A. Bilek, M. Beldi, T. Cherfi, S. Djebali, S. Larbi

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Finite elements analysis and photoelasticity are used to determine the stress field developed in a double edge notched specimen loaded in tension. The specimen is cut in a birefringent plate. Experimental isochromatic fringes are obtained with circularly polarized light on the analyzer of a regular polariscope. The fringes represent the loci of points of equal maximum shear stress. In order to obtain the stress values corresponding to the fringe orders recorded in the notched specimen, particularly in the neighborhood of the notches, a calibrating disc made of the same material is loaded in compression along its diameter in order to determine the photoelastic fringe value. This fringe value is also used in the finite elements solution in order to obtain the simulated photoelastic fringes, the isochromatics as well as the isoclinics. A color scale is used by the software to represent the simulated fringes on the whole model. The stress concentration factor can be readily obtained at the notches. Good agreements are obtained between the experimental and the simulated fringe patterns and between the graphs of the shear stress particularly in the neighborhood of the notches. The purpose in this paper is to show that one can obtain rapidly and accurately, by the finite element analysis, the isochromatic and the isoclinic fringe patterns in a stressed model as the experimental procedure can be time consuming. Stress fields can therefore be analyzed in three dimensional models as long as the meshing and the limit conditions are properly set in the program.

Keywords: isochromatic fringe, isoclinic fringe, photoelasticity, stress concentration factor

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3118 A Question of Ethics and Faith

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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