Search results for: agile methods

Authors: J. K Adedeji, O. H Olowomofe, C. O Alo, S.T Ijatuyi

Abstract:

The issue of high blood sugar level, the effects of which might end up as diabetes mellitus, is now becoming a rampant cardiovascular disorder in our community. In recent times, a lack of awareness among most people makes this disease a silent killer. The situation calls for urgency, hence the need to design a device that serves as a monitoring tool such as a wrist watch to give an alert of the danger a head of time to those living with high blood glucose, as well as to introduce a mechanism for checks and balances. The neural network architecture assumed 8-15-10 configuration with eight neurons at the input stage including a bias, 15 neurons at the hidden layer at the processing stage, and 10 neurons at the output stage indicating likely symptoms cases. The inputs are formed using the exclusive OR (XOR), with the expectation of getting an XOR output as the threshold value for diabetic symptom cases. The neural algorithm is coded in Java language with 1000 epoch runs to bring the errors into the barest minimum. The internal circuitry of the device comprises the compatible hardware requirement that matches the nature of each of the input neurons. The light emitting diodes (LED) of red, green, and yellow colors are used as the output for the neural network to show pattern recognition for severe cases, pre-hypertensive cases and normal without the traces of diabetes mellitus. The research concluded that neural network is an efficient Accu-Chek design tool for the proper monitoring of high glucose levels than the conventional methods of carrying out blood test.

Keywords: Accu-Check, diabetes, neural network, pattern recognition

Procedia PDF Downloads 134

Authors: Swati Bajpai, S. P. K Jena

Abstract:

Background: There is dramatic increase in the prevalence and severity of overweight in adolescents, raising concerns about their psychosocial and cognitive consequences, thereby indicating the immediate need to understand the effects of increased weight on scholastic performance. Although the body of research is currently limited, available results have identified an inverse relationship between obesity and cognition in adolescents. Aim: to examine the association between increased Body Mass Index in adolescents and their neurocognitive functioning. Methods: A case –control study of 28 subjects in the age group of 11-17 years (14 Males and 14 females) was taken on the basis of main inclusion criteria (Body Mass Index). All of them were randomized to (experimental group: overweight) and (control group: normal weighted). A complete neurocognitive assessment was carried out using validated psychological scales namely, Color Progressive Matrices (to assess intelligence); Bender Visual Motor Gestalt Test (Perceptual motor functioning); PGI-Memory Scale for Children (memory functioning) and Malin’s Intelligence Scale Indian Children (verbal and performance ability). Results: statistical analysis of the results depicted that 57% of the experimental group lack in cognitive abilities, especially in general knowledge (99.1±12.0 vs. 102.8±6.7), working memory (91.5±8.4 vs. 93.1±8.7), concrete ability (82.3±11.5 vs. 92.6±1.7) and perceptual motor functioning (1.5±1.0 vs. 0.3±0.9) as compared to control group. Conclusion: Our investigations suggest that weight gain results, at least in part, from a neurological predisposition characterized by reduced executive function, and in turn obesity itself has a compounding negative impact on the brain. Though, larger sample is needed to make more affirmative claims.

Keywords: adolescents, body mass index, neurocognition, obesity

Procedia PDF Downloads 474

Authors: Sogol Zarafshan

Abstract:

The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA). The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods. The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ and ‘Group leadership’. Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively. The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible.

Keywords: Quality control circles, Fuzzy VIKOR, Grey Relational Analysis, Importance–Performance Analysis

Procedia PDF Downloads 119

Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

Abstract:

Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

Procedia PDF Downloads 106

Authors: Ipek Gunay, Efe B. Orman, Metin Ozer, Bekir Salih, Ali R. Ozkaya

Abstract:

Phthalocyanines with macrocyclic ring containing at least three heteroatoms have nine or more membered structures. Metal-free phthalocyanines react with metal salts to obtain chelate complexes. This is one of the most important features of metal-free phthalocyanine as ligand structure. Although phthalocyanines have very similar properties with porphyrins, they have some advantages such as lower cost, easy to prepare, and chemical and thermal stability. It’s known that Pc compounds have shown one-electron metal-and/or ligand-based reversible or quasi-reversible reduction and oxidation processes. The redox properties of phthalocyanines are critically related to the desirable properties of these compounds in their technological applications. Thus, Pc complexes have also been receiving increasing interest in the area of fuel cells due to their high electrocatalytic activity in dioxygen reduction and fuel cell applications. In this study, novel phthalocyanine complexes coordinated with Fe(II) and Co (II) to be used as catalyst were synthesized. Aiming this goal, a new nitrile ligand was synthesized starting from 4-hydroxy-3,5-dimethoxy benzyl alcohol and 4-nitrophthalonitrile in the presence of K2CO3 as catalyst. After the isolation of the new type of nitrile and metal complexes, the characterization of mentioned compounds was achieved by IR, H-NMR and UV-vis methods. In addition, the electrochemical behaviour of Pc complexes was identified by cyclic voltammetry, square wave voltammetry and in situ spectroelectrochemical measurements. Furthermore, the catalytic performances of Pc complexes for oxygen reduction were tested by dynamic voltammetry measurements, carried out by the combined system of rotating ring-disk electrode and potentiostat, in a medium similar to fuel-cell working conditions.

Keywords: phthalocyanine, electrocatalysis, electrochemistry, in-situ spectroelectrochemistry

Procedia PDF Downloads 300

Authors: Yao Song

Abstract:

Objectives: We aimed to explore the clinicodemographic characteristics and prognosis of grey zone squamous cell cancer (GZSCC) located in the overlapping or ambiguous area of the oral cavity and oropharynx and to identify valuable factors that would improve its differential diagnosis and prognosis. Methods: Information of GZSCC patients in the Surveillance, Epidemiology, and End Results (SEER) database was compared to patients with an oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinomas with corresponding HPV status, respectively. Kaplan-Meier method with log-rank test and multivariate Cox regression analysis were applied to assess associations between clinical characteristics and overall survival (OS). A predictive model integrating age, gender, marital status, HPV status, and staging variables was conducted to classify GZSCC patients into three risk groups and verified internally by 10-fold cross validation. Results: A total of 3318 GZSCC, 10792 OPSCC, and 6656 OCSCC patients were identified. HPV-positive GZSCC patients had the best 5-year OS as HPV-positive OPSCC (81% vs. 82%). However, the 5-year OS of HPV-negative/unknown GZSCC (43%/42%) was the worst among all groups, indicating that HPV status and the overlapping nature of tumors were valuable prognostic predictors in GZSCC patients. Compared with the strategy of dividing GZSCC into two groups by HPV status, the predictive model integrating more variables could additionally identify a unique high-risk GZSCC group with the lowest OS rate. Conclusions: GZSCC patients had distinct clinical characteristics and prognoses compared with OPSCC and OCSCC; integrating HPV status and other clinical factors could help distinguish GZSCC and predict their prognosis.

Keywords: GZSCC, OCSCC, OPSCC, HPV

Procedia PDF Downloads 65

Authors: Malik Abid Hussain Khokhar, Muhammad Adnan Tahir, Hisham Bin Hafeez Awan

Abstract:

Continuous environmental determinism and climatic change in the entire globe due to increasing land surface temperature (LST) has become a vital phenomenon nowadays. LST is accelerating because of increasing greenhouse gases in the environment which results of melting down ice caps, ice sheets and glaciers. It has not only worse effects on vegetation and water bodies of the region but has also severe impacts on monsoon areas in the form of capricious rainfall and monsoon failure extensive precipitation. Environment can be monitored with the help of various geographic information systems (GIS) based algorithms i.e. SC (Single), DA (Dual Angle), Mao, Sobrino and SW (Split Window). Estimation of LST is very much possible from digital image processing of satellite imagery. This paper will encompass extraction of LST of Abbottabad using SW technique of GIS and Remote Sensing over last ten years by means of Landsat 7 ETM+ (Environmental Thematic Mapper) and Landsat 8 vide their Thermal Infrared (TIR Sensor) and Optical Land Imager (OLI sensor less Landsat 7 ETM+) having 100 m TIR resolution and 30 m Spectral Resolutions. These sensors have two TIR bands each; their emissivity and spectral radiance will be used as input statistics in SW algorithm for LST extraction. Emissivity will be derived from Normalized Difference Vegetation Index (NDVI) threshold methods using 2-5 bands of OLI with the help of e-cognition software, and spectral radiance will be extracted TIR Bands (Band 10-11 and Band 6 of Landsat 7 ETM+). Accuracy of results will be evaluated by weather data as well. The successive research will have a significant role for all tires of governing bodies related to climate change departments.

Keywords: environment, Landsat 8, SW Algorithm, TIR

Procedia PDF Downloads 346

Authors: Nickolay Nosik, Dmitry Nosik, Marina Bochkova, Nina Kondrashina, Olga Lobach

Abstract:

The bactericidal effect of UV radiation is known for long time and widely used for inactivation of pathogens but for viruses it is not so uniform. Due to a wide variety of viruses their sensitivity to UV radiation is quite different and not quite predictable. The goal of the study was to determine the inactivation kinetics of UV radiation ( 254 nm) of the viruses of social importance (HIV), as well as test-viruses (poliovirus, adenovirus) used for the evaluation of the viral inactivation efficacy of germicides. Methods: DNA viruses- adenovirus, type 5; Herpes simplex virus (HSV), type 1, and RNA viruses–human immunodeficiency virus (HIV), type 1 and poliovirus, type 1 (Sabin strain) were obtained from State collection of viruses ( The D.I. Ivanovsky Institute of Virology). The source of UV radiation was a 15-watt low-pressure mercury vapor lamp (over 60% 254nm). The samples of 5cm2 were placed direct under the UV lamp flow (h-0.3m). Log reduction value was used as a marker for the rate of virus inactivation. Results: The data obtained indicate that poliovirus (one of the viruses most resistant to chemical germicides) and HSV are rather sensitive to UV radiation ( D90 =250-311 J/m2). Adenovirus is much more resistant to UV radiation (750 J/m2 ). The kinetics of adenovirus inactivation : 0 min- 5.0 lg TCID50, 10 min - 5,0, 15 min -4,0, 30 min – 3.5, 60 min – 1,0, 75 min -0,5 lg TCID50, 90 min –virus not detectable. HIV is most resistant to UV radiation among the studied viruses. It takes more than 4 hrs to inactivate the virus on the surface. D90 = 2000 J/m2 Conclusion: The results of the study show that there is no direct dependence between sensitivity to UV light and the size of the virion or presence\absence of the envelope of the virus. Poliovirus and adenovirus are small viruses (20-30nm poliovirus and 70-90nm adenovirus) and both are non-enveloped viruses but adenovirus 3-fold more resistant to UV radiation than poliovirus. It can be expected that viruses with more complicate structure, like Herpes virus (200nm) or HIV (80-100 nm), would be more sensitive to UV light. However, the very high resistance of HIV to UV radiation needs further investigation. The diverse resistance of the different viruses to UV radiation should be taken into the account when UV light is used to inactivate infectious viruses in hospitals and other public environments.

Keywords: HIV, HSV, inhibition of viruses, UV radiation

Procedia PDF Downloads 432

Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

Abstract:

Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

Procedia PDF Downloads 449

Authors: Irene M. Arora

Abstract:

Hypothesis: Attention Deficit Hyperactivity Disorder is the result of an underdeveloped prefrontal cortex which is the primary cause for the signs and symptoms seen as defining features of ADHD. Methods: Through ‘PubMed’, ‘Wiley’ and ‘Google Scholar’ studies published between 2011-2018 were evaluated, determining if a dysfunctional prefrontal cortex caused the characteristic symptoms associated with ADHD. The search terms "prefrontal cortex", "Attention-Deficit/Hyperactivity Disorder", "cognitive control", "frontostriatal tract" among others, were used to maximize the assortment of relevant studies. Excluded papers were systematic reviews, meta-analyses and publications published before 2010 to ensure clinical relevance. Results: Nine publications were analyzed in this review, all of which were non-randomized matched control studies. Three studies found a decrease in the functional integrity of the frontostriatal tract fibers in conjunction with four studies finding impaired frontal cortex stimulation. Prefrontal dysfunction, specifically medial and orbitofrontal areas, displayed abnormal functionality of reward processing in ADHD patients when compared to their normal counterparts. A total of 807 subjects were studied in this review, yielding that a little over half (54%) presented with remission of symptoms in adulthood. Conclusion: While the prefrontal cortex shows the highest consistency of impaired activity and thinner volumes in patients with ADHD, this is a heterogenous disorder implicating its pathophysiology to the dysfunction of other neural structures as well. However, remission of ADHD symptomatology in adulthood was found to be attributable to increased prefrontal functional connectivity and integration, suggesting a key role for the prefrontal cortex in the development of ADHD.

Keywords: prefrontal cortex, ADHD, inattentive, impulsivity, reward processing

Procedia PDF Downloads 105

Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

Abstract:

Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

Procedia PDF Downloads 134

Authors: C. Sridawruang

Abstract:

Young people today has sexual activities differing from those of earlier generations, in that teenagers are likely to have multiple partners, and are frequently in short-term relationships or with partners that are not well known to them. The proportion of teenage mothers in Thailand has increased. Young people were not specifically addressed during the overall very successful HIV-prevention campaigns. Because of this missed opportunity, they are still unaware of the risk of unsafe sexual behavior. Aims: To describe the reproductive health care services in perspectives of rural Thai teenagers Methods: This survey was one part of a mixed method approach taken using survey and focus groups with 439 teenagers aged 12-18 years in 5 villages, Udon Thani, Thailand. The standard questionnaire survey had been used for collecting data. The numeric data was checked and analyzed by using descriptive statistics. Results: Most teenager respondents stated that they do not know where sexual reproductive health services provided for them. Most teenagers felt difficult to access and talk with health staff about sexual related issues. They stated that discussing, or consulting with health providers might not be safe. Teenagers might lose opportunities to access and get advice from health care services. The mean knowledge score of contraception and condom reproductive was 6.34 from a total score 11. Most teenagers especially girls expressed a need for counseling services and reported a need for telephone services. Conclusions: The need of appropriate information focusing on sexual relationships and contraception should be designed to help young people make wise decisions and there should be set health care services for Thai teenagers to make sure that teenagers could access easily. Health care providers need to be trained to improve their knowledge, attitudes and skills in reproductive health care practices for Thai teenagers.

Keywords: youth friendly health services, rural, Thai, teenagers

Procedia PDF Downloads 326

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

Abstract:

Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

Procedia PDF Downloads 128

Authors: J. E. O. Hernandez

Abstract:

In the next 20 years, energy production by burning fuels will increase and so will the atmospheric concentration of CO2 and its well-known threats to life on Earth. The technologies available for capturing CO2 are still dubious and this keeps fostering an interest in bio-inspired approaches. The leading one is the application of carbonic anhydrase (CA) –a superfast biocatalyst able to convert up to one million molecules of CO2 into carbonates in water. However, natural CA underperforms when applied to real smoky CO2 in chimneys and, so far, the efforts to create superior CAs in the lab rely on screening methods running under pristine conditions at the micro level, which are far from resembling those in chimneys. For the evolution of man-made enzymes, selection rather than screening would be ideal but this is challenging because of the need for a suitable artificial environment that is also sustainable for our society. Herein we present the stepwise design and construction of a bioprocess (from bench-scale to semi-pilot) for evolutionary selection experiments. In this bioprocess, reaction and adsorption took place simultaneously at atmospheric pressure in a spray tower. The scrubbing solution was fed countercurrently by reusing municipal pressure and it was mainly prepared with water, carbonic anhydrase and calcium chloride. This bioprocess allowed for the enzymatic carbonation of smoky CO2; the reuse of process water and the recovery of solid carbonates without cooling of smoke, pretreatments, solvent amines and compression of CO2. The average yield of solid carbonates was 0.54 g min-1 or 12-fold the amount produced in serum bottles at lab bench scale. This bioprocess could be used as a tailor-made environment for driving the selection of superior CAs. The bioprocess and its match CA could be sustainably used to reduce global warming by CO2 emissions from exhausts.

Keywords: biological carbon capture and sequestration, carbonic anhydrase, directed evolution, global warming

Procedia PDF Downloads 182

Authors: Hao-Su Liu, Jun-Qing Lei

Abstract:

This study introduces the theory of modified particle swarm optimizer and its application in time-domain expressions for bridge self-excited aerodynamic forces. Based on the indicial function expression and the rational function expression in time-domain expression for bridge self-excited aerodynamic forces, the characteristics of the two methods, i.e. the modified particle swarm optimizer and conventional search method, are compared in flutter derivatives’ fitting process. Theoretical analysis and numerical results indicate that adopting whether the indicial function expression or the rational function expression, the fitting flutter derivatives obtained by modified particle swarm optimizer have better goodness of fit with ones obtained from experiment. As to the flutter derivatives which have higher nonlinearity, the self-excited aerodynamic forces, using the flutter derivatives obtained through modified particle swarm optimizer fitting process, are much closer to the ones simulated by the experimental. The modified particle swarm optimizer was used to recognize the parameters of time-domain expressions for flutter derivatives of an actual long-span highway-railway truss bridge with double decks at the wind attack angle of 0°, -3° and +3°. It was found that this method could solve the bounded problems of attenuation coefficient effectively in conventional search method, and had the ability of searching in unboundedly area. Accordingly, this study provides a method for engineering industry to frequently and efficiently obtain the time-domain expressions for bridge self-excited aerodynamic forces.

Keywords: time-domain expressions, bridge self-excited aerodynamic forces, modified particle swarm optimizer, long-span highway-railway truss bridge

Procedia PDF Downloads 303

Authors: Rithika Sriram, Kiran M. Bhojwani

Abstract:

Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

Procedia PDF Downloads 264

Authors: S. M. Javad Davoodi, Mojtaba Shourian

Abstract:

Groundwater table close to the ground surface causes major problems in construction and mining operation. One of the methods to control groundwater in such cases is using pumping wells. These pumping wells remove excess water from the site project and lower the water table to a desirable value. Although the efficiency of this method is acceptable, it needs high expenses to apply. It means even small improvement in a design of pumping wells can lead to substantial cost savings. In order to minimize the total cost in the method of pumping wells, a simulation-optimization approach is applied. The proposed model integrates MODFLOW as the simulation model with Firefly as the optimization algorithm. In fact, MODFLOW computes the drawdown due to pumping in an aquifer and the Firefly algorithm defines the optimum value of design parameters which are numbers, pumping rates and layout of the designing wells. The developed Firefly-MODFLOW model is applied to minimize the cost of the dewatering project for the ancient mosque of Kerman city in Iran. Repetitive runs of the Firefly-MODFLOW model indicates that drilling two wells with the total rate of pumping 5503 m3/day is the result of the minimization problem. Results show that implementing the proposed solution leads to at least 1.5 m drawdown in the aquifer beneath mosque region. Also, the subsidence due to groundwater depletion is less than 80 mm. Sensitivity analyses indicate that desirable groundwater depletion has an enormous impact on total cost of the project. Besides, in a hypothetical aquifer decreasing the hydraulic conductivity contributes to decrease in total water extraction for dewatering.

Keywords: groundwater dewatering, pumping wells, simulation-optimization, MODFLOW, firefly algorithm

Procedia PDF Downloads 282

Authors: Amina R. Issae, Godfrey C. Katusi, Beda J. Mwang’Onde, Ladslaus L. Mnyone, Allen L. Malisa

Abstract:

Background: The fluctuating composition of mosquito species over time, driven by ecological changes in specific regions, plays a pivotal role in the transmission of malaria. Grasping these dynamics is fundamental for establishing a baseline understanding and is crucial for identifying transmission patterns. This knowledge is essential in devising effective strategies for managing and controlling vector populations. Our study focused on examining the species composition and Plasmodium infection rates of malaria vectors, aiming to enhance the health and well-being of communities affected by malaria. Methods: Species composition was determined through a cross-sectional collection of mosquitoes, conducted once in the village, in four selected villages of Kilosa district, Tanzania. Mosquitoes were collected indoors and outdoors using CDC light traps. A sub-sample of all collected mosquitoes was subjected to PCR identification and assayed for Plasmodium porozoites. Results: A total of 6493 female Anophelines mosquitoes were collected, of which eight species were identified as Anopheles gambiaes.l., An. funestus group, An. coustani, An. pharoensis, An. squamosus, and An. rufipes. The abundance of the Anopheles gambiaes.s.and An. funestuss.s. varied with location and village. A total of 5 sporozoite-positive mosquitoes were found, of which 4 were An. funestuss.s. and 1 was An. gambiaes.s. Conclusions: Anopheles gambiaes.s.and An. funestuss.s. were identified as the most abundant malaria vectors, respectively. Sporozoite analysis indicated this for An. funestuss.s. contribute to most of the malaria transmission in the area. Further studies are required to assess the role of seasonal shifts in vector abundance, insecticide resistance and malaria transmission of the vectors.

Keywords: mosquito, composition, malaria, sporozoites

Procedia PDF Downloads 24

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

Abstract:

Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

Procedia PDF Downloads 53

Authors: Ehsan Pegah, Huabei Liu

Abstract:

Determination of the internal friction angle (φ) in natural soil deposits is an important issue in geotechnical engineering. The main objective of this study was to examine the evaluation of this parameter in overconsolidated granular soil deposits by using the P-wave velocity and the anisotropic components of S-wave velocity (i.e., both the vertical component (SV) and the horizontal component (SH) of S-wave). To this end, seventeen pairs of P-wave and S-wave seismic refraction profiles were carried out at three different granular sites in Iran using non-invasive seismic wave methods. The acquired shot gathers were processed, from which the P-wave, SV-wave and SH-wave velocities were derived. The reference values of φ and overconsolidation ratio (OCR) in the soil deposits were measured through laboratory tests. By assuming cross-anisotropy of the soils, the P-wave and S-wave velocities were utilized to develop an equation for calculating the coefficient of lateral earth pressure at-rest (K₀) based on the theory of elasticity for a cross-anisotropic medium. In addition, to develop an equation for OCR estimation in granular geomaterials in terms of SH/SV velocity ratios, a general regression analysis was performed on the resulting information from this research incorporated with the respective data published in the literature. The calculated K₀ values coupled with the estimated OCR values were finally employed in the Mayne and Kulhawy formula to evaluate φ in granular soil deposits. The results showed that reliable values of φ could be estimated based on the seismic wave velocities. The findings of this study may be used as the appropriate approaches for economic and non-invasive determination of in-situ φ in granular soil deposits using the surface seismic surveys.

Keywords: angle of internal friction, overconsolidation ratio, granular soils, P-wave velocity, SV-wave velocity, SH-wave velocity

Procedia PDF Downloads 142

Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert

Abstract:

Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.

Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running

Procedia PDF Downloads 112

Authors: Serges Mendomo Meye, Li Guowei, Shen Zhenzhong, Gan Lei, Xu Liqun

Abstract:

Due to the characteristics of high-heap and large-volume, the complex layers of waste and the high-water level of leachate, environmental pollution, and slope instability are easily produced. It is therefore of great significance to research the heterogeneous seepage field and stability of landfills. This paper focuses on the heterogeneous characteristics of the landfill piles and analyzes the seepage field and slope stability of the landfill using statistical and numerical analysis methods. The calculated results are compared with the field measurement and literature research data to verify the reliability of the model, which may provide the basis for the design, safe, and eco-friendly operation of the landfill. The main innovations are as follows: (1) The saturated-unsaturated seepage equation of heterogeneous soil is derived theoretically. The heterogeneous landfill is regarded as composed of infinite layers of homogeneous waste, and a method for establishing the heterogeneous seepage model is proposed. Then the formation law of the stagnant water level of heterogeneous landfills is studied. It is found that the maximum stagnant water level of landfills is higher when considering the heterogeneous seepage characteristics, which harms the stability of landfills. (2) Considering the heterogeneity weight and strength characteristics of waste, a method of establishing a heterogeneous stability model is proposed, and it is extended to the three-dimensional stability study. It is found that the distribution of heterogeneous characteristics has a great influence on the stability of landfill slope. During the operation and management of the landfill, the reservoir bank should also be considered while considering the capacity of the landfill.

Keywords: heterogeneous characteristics, leachate levels, saturated-unsaturated seepage, seepage field, slope stability

Procedia PDF Downloads 230

Authors: Habte Tadesse Likassa, Bacha Edosa

Abstract:

Customer’s satisfaction was very important thing that is required for the existence of banks to be more productive and success in any organization and business area. The main goal of the study is assessing and identifying factors that influence customer’s satisfaction in West Shoa Zone of Commercial Bank of Ethiopia (Holeta, Ginchi, Ambo, Gedo and Bako). Stratified random sampling procedure was used in the study and by using simple random sampling (lottery method) 520 customers were drawn from the target population. By using Probability Proportional Size Techniques sample size for each branch of banks were allocated. Both descriptive and inferential statistics methods were used in the study. A binary logistic regression model was fitted to see the significance of factors affecting customer’s satisfaction in this study. SPSS statistical package was used for data analysis. The result of the study reveals that the overall level of customer’s satisfaction in the study area is low (38.85%) as compared those who were not satisfied (61.15%). The result of study showed that all most all factors included in the study were significantly associated with customer’s satisfaction. Therefore, it can be concluded that based on the comparison of branches on their customers satisfaction by using odd ratio customers who were using Ambo and Bako are less satisfied as compared to customers who were in Holeta branch. Additionally, customers who were in Ginchi and Gedo were more satisfied than that of customers who were in Holeta. Since the level of customers satisfaction was low in the study area, it is more advisable and recommended for concerned body works cooperatively more in maximizing satisfaction of their customers.

Keywords: customers, satisfaction, binary logistic, complain handling process, waiting time

Procedia PDF Downloads 446

Authors: Indu Chauhan, Bhupendra S. Butola, Paritosh Mohanty

Abstract:

It is very well known that properties of material changes as their size approach to nanoscale level due to the high surface area to volume ratio. However, in last few decades, a tenet ‘structure dictates function’ is quickly being adopted by researchers working with nanomaterials. The design and exploitation of nanoparticles with tailored shape and size has become one of the primary goals of materials science researchers to expose the properties of nanostructures. To date, various methods, including soft/hard template/surfactant assisted route hydrothermal reaction, seed mediated growth method, capping molecule-assisted synthesis, polyol process, etc. have been adopted to synthesize the nanostructures with controlled size and shape and monodispersity. However controlling the shape and size of nanoparticles is an ultimate challenge of modern material research. In particular, many efforts have been devoted to rational and skillful control of hierarchical and complex nanostructures. Thus in our research work, role of cellulose in manipulating the nanostructures has been discussed. Nanoparticles of α-Fe₂O₃ (diameter ca. 15 to 130 nm) were immobilized on the cellulose fiber surface by a single step in situ hydrothermal method. However, nanoflakes of α-FeOOH having thickness ca. ~25 nm and length ca. ~250 nm were obtained by the same method in absence of cellulose fibers. A possible nucleation and growth mechanism of the formation of nanostructures on cellulose fibers have been proposed. The covalent bond formation between the cellulose fibers and nanostructures has been discussed with supporting evidence from the spectroscopic and other analytical studies such as Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The role of cellulose in manipulating the nanostructures has been discussed.

Keywords: cellulose fibers, α-Fe₂O₃, α-FeOOH, hydrothermal, nanoflakes, nanoparticles

Procedia PDF Downloads 134

Authors: Guncel Ozturk

Abstract:

Background: Rhinoplasty is the most commonly performed cosmetic operations in plastic surgery. Maneuvers used in rhinoplasty lead to a firm and stiff nasal tip in the early postoperative months. This unnatural stability of the nose may easily cause distortion in the reshaped nose after severe trauma. Moreover, a firm nasal tip may cause difficulties in performing activities such as touching, hugging, or kissing. Decreasing the stability and increasing the mobility of the nasal tip would help rhinoplasty patients to avoid these small but relatively important problems. Methods: We use delivery approach with closed rhinoplasty and changed positions of intranasal incisions to reach a dynamic and mobile nose. A total of 203 patients who had undergone primary closed rhinoplasty in private practice were inspected retrospectively. Posterior strut flap that was connected with connective tissues in the caudal of septum and the medial crurals were formed. Cartilage of the posterior strut graft was left 2 mm thick in the distal part of septum, it was cut vertically, and the connective tissue in the distal part was preserved. Results: The median patient age was 24 (range 17-42) years. The median follow-up period was15.2 (range12-26) months. Patient satisfaction was assessed with the 'Rhinoplasty Outcome Evaluation' (ROE) questionnaire. Twelve months after surgeries, 87.5% of patients reported excellent outcomes, according to ROE. Conclusion: The soft tissue connections between that segment and surrounding structures should be preserved to save the support of the tip while having a mobile tip at the same time with this method. These modifications would access to a mobile, non-stiff, and dynamic nasal tip in the early postoperative months. Further and prospective studies should be performed for supporting this method.

Keywords: closed rhinoplasty, dynamic, mobile, tip

Procedia PDF Downloads 118

Authors: Jerzy Banski

Abstract:

Small towns represent a key element of settlement structure and serve a number of important functions associated with the servicing of rural areas that surround them. It is in light of this that scientific studies have paid considerable attention to the functional structure of centers of this kind, as well as the relationships with both surrounding rural areas and other urban centers. But a preliminary to such research has typically involved attempts at classifying the urban centers themselves, with this also assisting with the planning and shaping of development policy on different spatial scales. The purpose of the work is to test out the methods underpinning three different classifications of small urban centers, as well as to offer a preliminary interpretation of the outcomes obtained. Research took in 722 settlement units in Poland, granted town rights and populated by fewer than 20,000 inhabitants. A morphologically-based classification making reference to the database of topographic objects as regards land cover within the administrative boundaries of towns and cities was carried out, and it proved possible to distinguish the categories of “housing-estate”, industrial and R&R towns, as well as towns characterized by dichotomy. Equally, a functional/morphological approach taken with the same database allowed for the identification – via an alternative method – of three main categories of small towns (i.e., the monofunctional, multifunctional or oligo functional), which could then be described in far greater detail. A third, multi-criterion classification made simultaneous reference to the conditioning of a structural, a location-related, and an administrative hierarchy-related nature, allowing for distinctions to be drawn between small towns in 9 different categories. The results obtained allow for multifaceted analysis and interpretation of the geographical differentiation characterizing the distribution of Poland’s urban centers across space in the country.

Keywords: small towns, classification, local planning, Poland

Procedia PDF Downloads 70

Authors: Boularas El Alia, H. Rezk-Allah, S. Chaoui, A. Chama, B. Rezk-Allah

Abstract:

Aims: To assess the current exposure to the PHA among various workers in the sector of asphalt and road paving. Methods: The assessment of the exposure to PHA has been performed on workers (n=14) belonging to two companies, allocated into several activities such as road paving, manufacturing of coated bituminous warm, manufacturing of asphalt cut-back, manufacturing of emulsion of asphalt. A group of control subjects (n=18) was associated. The internal exposure to PHA was investigated by measurement of the urinary excretion of 2-naphtol, urine metabolite of naphtalene, one of the biomarkers of total PHA exposure. Urine samples were collected from the exposed workers, at the beginning of the week, at the beginning of the work shift (BWBS) and at the end of the work shift, at the end of the week (ESEW). In the control subjects, single samples of urine were collected after the end of the work shift.Every subject was invited to answer a questionnaire for the collection of technical and medical data as well as smoking habits and food intake. The concentration of 2-naphtol in the hydrolysate of urine was determined spectrophotometrically, after its reaction with the Fast Blue BB salt (diazotized 4-benzoylamino-2,5-diethoxyaniline). Results: For all the workers included in the study, the 2-urinary naphtol concentrations were higher than those in the control subjects (Median=9,55 µg/g creatinine) whether it is at (BWBS) (Md=16,2 µg/g creatinine) or at (ESEW) (n=18,Median=32,22 µg/g creatinine). Considerable differences are observed according to the category of job. The concentrations are also higher among smokers. Conclusion:The results show a significant exposure, mainly during manual laying, reveals an important risk particularly for the respiratory system.Considering the current criteria, carcinogenic risk due to the PHA seems not insignificant.

Keywords: PHA, asphalt, assessment, occupational, exposure

Procedia PDF Downloads 462

Authors: Mostafa Fanaei, Shahram R. Sistani, Athare Nazri-Panjaki

Abstract:

Introduction: Critical thinking skills are increasingly recognized as vital for academic success, particularly in higher education. This study examines the influence of critical thinking on learning achievement among undergraduate and master's students enrolled in foreign language programs. By investigating this correlation, educators can gain valuable insights into optimizing teaching methodologies and enhancing academic outcomes. Methods: This cross-sectional study involved 150 students from the Shahid Bahonar University of Kerman, recruited via random sampling. Participants completed the Critical Thinking Questionnaire (CThQ), assessing dimensions such as analysis, evaluation, creation, remembering, understanding, and application. Academic performance was measured using the students' GPA (0-20). Results: The participants' mean age was 21.46 ± 5.2 years, with 62.15% being female. The mean scores for critical thinking subscales were as follows: Analyzing (13.2 ± 3.5), Evaluating (12.8 ± 3.4), Creating (18.6 ± 4.8), Remembering (9.4 ± 2.1), Understanding (12.9 ± 3.3), and Applying (12.5 ± 3.2). The overall critical thinking score was 79.4 ± 18.1, and the average GPA was 15.7 ± 2.4. Significant positive correlations were found between GPA and several critical thinking subscales: Analyzing (r = 0.45, p = 0.013), Creating (r = 0.52, p < 0.001), Remembering (r = 0.29, p = 0.021), Understanding (r = 0.41, p = 0.002), and the overall CThQ score (r = 0.54, p = 0.043). Conclusion: The study demonstrates a significant positive relationship between critical thinking skills and learning achievement in foreign language programs. Enhancing critical thinking skills through educational interventions could potentially improve academic performance. Further research is recommended to explore the underlying mechanisms and long-term impacts of critical thinking on academic success.

Keywords: critical thinking, learning achievement, higher education, foreign language programs, student success

Procedia PDF Downloads 16

Authors: Usha Loganathan, Haresh Pandya

Abstract:

Analysis and correlation of soil properties represent an important outset for precision agriculture and is currently promoted and implemented in the developed world. Establishing relationships among indices of soil salinity has always been a challenging task in salt affected soils necessitating unique approaches for their reclamation and management to sustain long term productivity of Soil. Soil salinity indices like Electrical Conductivity (EC) and Sodium Adsorption Ratio (SAR) are normally used to characterize soils as either sodic or saline sodic. Currently, Determination of Soil sodium adsorption ratio is a more accepted and reliable measure of soil salinity. However, it involves arduous and protracted laboratory investigations which demand evolving new and economical methods to determine SAR based on simple soil salinity index. A linear regression model to predict soil SAR from soil electrical conductivity has been developed and presented in this paper as per which, soil SAR could very well be worked out as a pedotransfer function of soil EC. The present study was carried out in Orathupalayam (11.09-11.11 N latitude and 74.54-77.59 E longitude) in the vicinity of Orathupalayam Reservoir of Noyyal River Basin, India, over a period of 3 consecutive years from September 2013 through February 2016 in different locations chosen randomly through different seasons. The research findings are discussed in the light of micro level farming practices in India and recommend determination of SAR as a low cost technology aiding in the effective management of salt affected agricultural land.

Keywords: electrical conductivity, orathupalayam, pedotranfer function, sodium adsorption ratio

Procedia PDF Downloads 243

Authors: S. Łęgowik-Świącik

Abstract:

This article is a contribution to the research into the determinants of value creation via digital platforms in variable operating conditions. The dynamics of the market environment caused by the COVID-19 pandemic have made enterprises built on digital platforms financially successful. While many classic companies are struggling with the uncertainty of conducting a business and difficulties in the process of value creation, digital platforms create value by modifying the existing business model to meet the changing needs of customers. Therefore, the objective of this publication is to understand and explain the relationship between value creation and the conversion of the business model built on digital platforms under pandemic conditions. The considerations relating to the conceptual framework and determining the research objective allowed for adopting the hypothesis, assuming that the processes of value creation are evolving, and the measurement of these processes allows for the protection of value created and enables its growth in changing circumstances. The research methods, such as critical literature analysis and case study, were applied to accomplish the objective pursued and verify the hypothesis formulated. The empirical research was carried out based on the data from enterprises listed on the Nasdaq Stock Exchange: Amazon, Alibaba, and Facebook. The research period was the years 2018-2021. The surveyed enterprises were chosen based on the targeted selection. The problem discussed is important and current since the lack of in-depth theoretical research results in few attempts to identify the determinants of value creation via digital platforms. The above arguments led to an attempt at theoretical analysis and empirical research to fill in the gap perceived by deepening the understanding of the process of value creation through network effects via digital platforms under pandemic conditions.

Keywords: business model, digital platforms, enterprise management, pandemic conditions, value creation process

Procedia PDF Downloads 111