Search results for: discharge rating

Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Laiba Amin, Rashna H. Sukhia, Mubassar Fida

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Introduction: This study evaluates the accuracy of responses from ChatGPT, Google Bard, and Microsoft Copilot regarding dentofacial orthopedic appliances. As artificial intelligence (AI) increasingly enhances various fields, including healthcare, understanding its reliability in specialized domains like orthodontics becomes crucial. By comparing the accuracy of different AI models, this study aims to shed light on their effectiveness and potential limitations in providing technical insights. Materials and Methods: A total of 110 questions focused on dentofacial orthopedic appliances were posed to each AI model. The responses were then evaluated by five experienced orthodontists using a modified 5-point Likert scale to ensure a thorough assessment of accuracy. This structured approach allowed for consistent and objective rating, facilitating a meaningful comparison between the AI systems. Results: The results revealed that Google Bard demonstrated the highest accuracy at 74%, followed by Microsoft Copilot, with an accuracy of 72.2%. In contrast, ChatGPT was found to be the least accurate, achieving only 52.2%. These results highlight significant differences in the performance of the AI models when addressing orthodontic queries. Conclusions: Our study highlights the need for caution in relying on AI for orthodontic insights. The overall accuracy of the three chatbots was 66%, with Google Bard performing best for removable Class II appliances. Microsoft Copilot was more accurate than ChatGPT, which, despite its popularity, was the least accurate. This variability emphasizes the importance of human expertise in interpreting AI-generated information. Further research is necessary to improve the reliability of AI models in specialized healthcare settings.

Keywords: artificial intelligence, large language models, orthodontics, dentofacial orthopaedic appliances, accuracy assessment.

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Authors: Leila Zarei

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The primary objective of the 2014 Survey of The Capacity Assessment of Kish Island in Visa Exchange and its Effect of Tourism Development was to obtain more comprehensive statistical information relating to foreign tourists who aimed to renew their visa in Kish Island. Kish Island the pearl of Persian Gulf is well known as a destination for visa exchange to many alien who work and live in the country located around Persian Gulf. Foreign visitors fly to Kish with aim of visa exchange and after passing through official procedures they return back to their country of resident. The present thesis studied the subject of capacity and potential of Kish Island in visa exchange. In accordance with it a survey had been conducted in English written form of a questionnaire which was researcher's made composed of 120 questions which covers diverse aspects of the field of this study (airport, public transportation, accommodate and medical centers and travel agencies). The data collected were obtained at the airport, hotels and other places from the international tourists and covered the following items: a) the profile of the tourists (sex, age, occupation, purpose of visit, etc.) b) The Rating of services and Prices. The target population was all international tourists who master English and non Iranian. Main findings: 56% of tourists interviewed were males and 44% were females. The age of arrived tourist was 30 – 39 years with the highest percentage of 47%. The highest percentage frequencies of income belong to the 1000- 2500 Dhrs. (26%). In addition, that 50 percentage of the population was married and rest was single. Concerning the religion, 26 percent of the travelers were Muslim and 65% Christian and the rest from the other branches which all these populations reach Kish via air. The majority (56%) of visa exchangers hold diploma.

Keywords: Kish Island, tourism development, visa exchange, Iran

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Authors: Zviad Ghadua, Biswa Bhattacharya

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The Flash Flood Guidance (FFG) provides the rainfall amount of a given duration necessary to cause flooding. The approach is based on the development of rainfall-runoff curves, which helps us to find out the rainfall amount that would cause flooding. An alternative approach, mostly experimented with Italian Alpine catchments, is based on determining threshold discharges from past events and on finding whether or not an oncoming flood has its magnitude more than some critical discharge thresholds found beforehand. Both approaches suffer from large uncertainties in forecasting flash floods as, due to the simplistic approach followed, the same rainfall amount may or may not cause flooding. This uncertainty leads to the question whether a probabilistic model is preferable over a deterministic one in forecasting flash floods. We propose the use of a Bayesian probabilistic approach in flash flood forecasting. A prior probability of flooding is derived based on historical data. Additional information, such as antecedent moisture condition (AMC) and rainfall amount over any rainfall thresholds are used in computing the likelihood of observing these conditions given a flash flood has occurred. Finally, the posterior probability of flooding is computed using the prior probability and the likelihood. The variation of the computed posterior probability with rainfall amount and AMC presents the suitability of the approach in decision making in an uncertain environment. The methodology has been applied to the Posina basin in Italy. From the promising results obtained, we can conclude that the Bayesian approach in flash flood forecasting provides more realistic forecasting over the FFG.

Keywords: flash flood, Bayesian, flash flood guidance, FFG, forecasting, Posina

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Authors: Ningning Liu, Gaoding Jia, Yinshan Wang, Haimei Li, Xinian Zuo, Yufeng Wang, Lu Liu, Qiujin Qian

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Background: There has been speculation that a high IQ may not necessarily provide protection against attention deficit hyperactivity disorder (ADHD), and there may be a U-shaped correlation between IQ and ADHD symptoms. However, this speculation has not been validated in the ADHD population in any study so far. Method: We conducted a study with 5,138 children who have been professionally diagnosed with ADHD and have a wide range of IQ levels. General Linear Models were used to determine the optimal model between IQ and ADHD core symptoms with sex and age as covariates. The ADHD symptoms we looked at included the total scores (TO), inattention (IA) and hyperactivity/impulsivity (HI). Wechsler Intelligence scale were used to assess IQ [Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ)]. Furthermore, we examined the correlation between IQ and the execution function [Behavior Rating Inventory of Executive Function (BRIEF)], as well as between IQ and brain surface area, to determine if the associations between IQ and ADHD symptoms are reflected in executive functions and brain structure. Results: Consistent with previous research, the results indicated that FSIQ and VIQ both showed a linear negative correlation with the TO and IA scores of ADHD. However, PIQ showed an inverted U-shaped relationship with the TO and HI scores of ADHD, with 103 as the peak point. These findings were also partially reflected in the relationship between IQ and executive functions, as well as IQ and brain surface area. Conclusion: To sum up, the relationship between IQ and ADHD symptoms is not straightforward. Our study confirms long-standing academic hypotheses and finds that PIQ exhibits an inverted U-shaped relationship with ADHD symptoms. This study enhances our understanding of symptoms and behaviors of ADHD with varying IQ characteristics and provides some evidence for targeted clinical intervention.

Keywords: ADHD, IQ, execution function, brain imaging

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Authors: Muhammad Hassan, Kemal Celebi

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Developing a highly efficient electrochromic energy storage device with sufficient color fluctuation and significant electrochemical performance is highly desirable for practical energy-saving applications. Here, to achieve a highly stable material with a large electrochemical storage capacity, a W₁₈O₄₉ NW/Ti₃C₂Tₓ composite has been fabricated and deposited on a pre-assembled Ag and W₁₈O₄₉ NW conductive network by Langmuir-Blodgett technique. The resulting hybrid electrode composed of 15 layers of W₁₈O₄₉ NW/Ti₃C₂Tₓ exhibits an areal capacitance of 125 mF/cm², with a fast and reversible switching response. An optical modulation of 98.2% can be maintained at a current density of 5 mAcm⁻². Using this electrode, we fabricated a bifunctional symmetric electrochromic supercapacitor device having an energy density of 10.26 μWh/cm² and a power density of 0.605 mW/cm², with high capacity retention and full columbic efficiency over 4000 charge-discharge cycles. Meanwhile, the device displays remarkable electrochromic characteristics, including fast switching time (5 s for coloring and 7 s for bleaching) and a significant coloration efficiency of 116 cm²/C with good optical modulation stability. In addition, the device exhibits remarkable mechanical flexibility and fast switching while being stable over 100 bending cycles, which is promising for real-world applications.

Keywords: MXene, nanowires, supercapacitor, ion diffusion, electrochromic, coloration efficiency

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Authors: Mouna Hamed, Ammar B. Brahim

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The objective of this work was to develop a theoretical model to study the dynamic thermal behavior of a flat plate solar collector integrated with a phase change material (PCM). The PCM acted as a heat source for the solar system during low intensity solar radiation and night. The energy balance equations for the various components of the collector as well as for the PCM were formulated and numerically solved using MATLAB computational program. The effect of natural convection on heat during the melting process was taken into account by using an effective thermal conductivity. The model was used to investigate the effect of inlet water temperature, water mass flow rate, and PCM thickness on the outlet water temperature and the melt fraction during charging and discharging modes. A comparison with a collector without PCM was made. Results showed that charging and discharging processes of PCM have six stages. The adding of PCM caused a decrease in temperature during charge and an increase during discharge. The rise was most enhanced for higher inlet water temperature, PCM thickness and for lower mass flow rate. Analysis indicated that the complete melting time was shorter than the solidification time due to the high heat transfer coefficient during melting. The increases in PCM height and mass flow rate were not linear with the melting and solidification times.

Keywords: thermal energy storage, phase change material, melting, solidification

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Authors: Mahmoud Zakeri Niri, Saber Moazami, Arman Abdollahipour, Hossein Ghalkhani

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The objective of this research is to hydrological evaluation of four widely-used satellite precipitation products named PERSIANN, TMPA-3B42V7, TMPA-3B42RT, and CMORPH over Zarinehrood basin in Iran. For this aim, at first, daily streamflow of Sarough-cahy river of Zarinehrood basin was simulated using IHACRES rainfall-runoff model with daily rain gauge and temperature as input data from 1988 to 2008. Then, the model was calibrated in two different periods through comparison the simulated discharge with the observed one at hydrometric stations. Moreover, in order to evaluate the performance of satellite precipitation products in streamflow simulation, the calibrated model was validated using daily satellite rainfall estimates from the period of 2003 to 2008. The obtained results indicated that TMPA-3B42V7 with CC of 0.69, RMSE of 5.93 mm/day, MAE of 4.76 mm/day, and RBias of -5.39% performs better simulation of streamflow than those PERSIANN and CMORPH over the study area. It is noteworthy that in Iran, the availability of ground measuring station data is very limited because of the sparse density of hydro-meteorological networks. On the other hand, large spatial and temporal variability of precipitations and lack of a reliable and extensive observing system are the most important challenges to rainfall analysis, flood prediction, and other hydrological applications in this country.

Keywords: hydrological evaluation, IHACRES, satellite precipitation product, streamflow simulation

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Authors: Meghan Biallas, Amanda Hoffman, Tamara Miller, Kimmy Schnibben, Janaina Siegler

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This paper assesses Walmart’s supply chain resiliency amidst continuous supply chain disruptions. It aims to evaluate how Walmart can use supply chain resiliency theory to retain its status as a global supply chain leader. The Bloomberg terminal was used to organize Walmart’s 754 Tier-1 suppliers by the size of their relationship to Walmart. Additional data from IBISWorld and Statista was also used in the analysis. This research focused on the top ten Tier-1 suppliers, with the greatest percentage of their revenue attributed to Walmart. This paper also applied the firm’s information to the Supply Chain Resilience Assessment and Management (SCRAM) framework for supply chain resiliency to evaluate the firm’s capabilities, vulnerabilities, and gaps. A rubric was created to quantify Walmart’s risks using four pillars: flexibility, velocity, visibility, and collaboration. Information and examples were reported from Walmart’s 10k filing. For each example, a rating of 1 indicated “high” resiliency, 0 indicated “medium” resiliency, and -1 indicated “low” resiliency. Findings from this study include the following: (1) Walmart has maintained its leadership through its ability to remain resilient with regard to visibility, efficiency, capacity, and collaboration. (2) Walmart is experiencing increases in supply chain costs due to internal factors affecting the company and external factors affecting its suppliers. (3) There are a number of emerging supply chain risks with Walmart’s suppliers, which could cause issues for Walmart to remain a supply chain leader in the future. Using the SCRAM framework, this paper assesses how Walmart measures up to the Supply Chain Resiliency Theory, identifying areas of strength as well as areas where Walmart can improve in order to remain a global supply chain leader.

Keywords: supply chain resiliency, zone of balanced resilience, supply chain resilience assessment and management, supply chain theory.

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Authors: Pál Iván Szontagh

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We suppose that today, the motivation for the career of a pedagogue (including its existential, organizational and infrastructural conditions) is different from the level of commitment to the profession of an educator (which can be experienced informally, or outside of the public education system). In our research, we made efforts to address the widest possible range of student elementary teachers, and to interpret their responses using different filters. In the first phase of our study, we analyzed first-year kindergarten teacher students’ career motivation and commitment to the profession, and in the second phase, that of final-year kindergarten teacher candidates. In the third phase, we conducted surveys to explore students’ motivation for the profession and the career path of a pedagogue in four countries of the Carpathian Basin (Hungary, Slovakia, Romania and Serbia). The surveys were conducted in 17 campuses of 11 Hungarian teacher’s training colleges and universities. Finally, we extended the survey to practicing graduates preparing for their on-the-job rating examination. Based on our results, in all breakdowns, regardless of age group, training institute or - in part - geographical location and nationality, it is proven that lack of social- and financial esteem of the profession poses serious risks for recruitment and retention of teachers. As a summary, we searched for significant differences between the professional- and career motivations of the three respondent groups (kindergarten teacher students, elementary teacher students and practicing teachers), i.e. the motivation factors that change the most with education and/or with the time spent on the job. Based on our results, in all breakdowns, regardless of age group, training institute or - in part - geographical location and nationality, it is proven that lack of social- and financial esteem of the profession poses serious risks for recruitment and retention of teachers.

Keywords: career motivation, career socialization, professional motivation, teacher training

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Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

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Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

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Authors: Amna I. Shibeika, Batoul Y. Hittini, Tasneem B. Abd Bakri

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Regulation and integration of public policy, economy, insurance industry, education, and construction stakeholders are the main contributors to achieve sustainable development. Building environmental assessment methods were introduced in the field to address issues such as global warming and conservation of natural resources. In the UAE, Estidama framework with its associated Pearl Building Rating System (PBRS) has been introduced in 2010 to address and spread sustainability practices within the country’s fast-growing built environment. Based on literature review of relevant studies investigating different project characteristics that influence sustainability outcomes, this paper presents a conceptual framework for understanding the adoption of PBRS in UAE projects. The framework also draws on Diffusion of Innovations theory to address the questions of how the assessment method is chosen in the first place and what is the impact of PBRS on the multi-disciplinary design and construction processes. The study highlights the mandatory nature of the adoption of PBRS for government buildings as well as imbedding Estidama principles within Abu Dhabi building codes as key factors for raising awareness about sustainable practices. Moreover, several project-related elements are addressed to understand their relationship with the adoption process, including project team collaboration; communication and coordination; levels of commitment and engagement; and the involvement of key actors as sustainability champions. This conceptualization of the adoption of PBRS in UAE projects contributes to the growing literature on the adoption of energy assessment tools and addresses the UAE vision is to be at the forefront of innovative sustainable development by 2021.

Keywords: adoption, building assessment, design management, innovation, sustainability

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Authors: Tomas O. Ortega, Cecilia T. Reyes, Cecile O. Legaspi, Cylde G. Abayon, Anna Mae C. Relingo, Mary Eden M. Teruel

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A study was conducted to evaluate the performance in the delivery of environmental management programs of the local government of Malay, Aklan, Philippines. The samples were determined by adopting the Multi-Stage Random Probability Sampling technique. The 150 respondents were drawn from barangays with larger shares of the population based on the Philippine Statistical Authority’s Data on Census Population and Housing for the year 2015. The qualified sample respondents were selected using the Kish Grid. Female respondents were targeted for even numbered questionnaires while male respondents were targeted for odd numbers. The four major core concepts namely awareness, availment, satisfaction and need for action were used in measuring the rating of the respondents and presented in frequency and percentage distributions. The reasons for their response were likewise gathered. The study inferred that a large portion of the respondents was profoundly aware of the environmental management programs implemented by their local government unit especially the solid waste management and the clean-up programs/projects. Programs to control air pollution and waste water management obtained the least awareness ratings from the respondents. A high percentage of respondents had availed of environmental management programs, particularly solid waste management. Overall, majority of the respondents were satisfied with the environmental management programs rendered by the local government unit and therefore needs less action. It is recommended that the local government unit must strengthen air pollution control program. Appropriate action must be taken to support the people’s interest in this program most particularly to the individuals who burn their garbage. Seminars and training-workshops about appropriate waste disposal will most likely help settle this issue.

Keywords: availment, awareness, environmental management, need for action, satisfaction

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Authors: Wassima El Mofid, Svetlozar Ivanov, Andreas Bund

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The increasing requirements for high power and energy lithium ion batteries have led to the development of several classes of positive electrode materials. Among those one promising material is LiNixMnyCo1−x−yO2 due to its high reversible capacity and remarkable cycling performance. Further structural stabilization and improved electrochemical performance of this class of cathode materials can be achieved by cationic substitution to a transition metal such as Al, Mg, Cr, etc. The current study discusses a novel NMC type material obtained by simultaneous cationic substitution of the cobalt which is a toxic element, with aluminum and iron. A compound with the composition LiNi0.6Mn0.2Co0.15Al0.025Fe0.025O2 (NMCAF) was synthesized by the self-combustion method using sucrose as fuel. The material has a layered α-NaFeO2 type structure with a good hexagonal ordering. Rietveld refinement analysis of the XRD patterns revealed a very low cationic mixing compared to the non-substituted material LiNi0.6Mn0,2Co0.2O2 suggesting a structural stabilization. Galvanostatic cycling measurements indicate improved electrochemical performance after the metal substitution. An initial discharge capacity of about 190 mAh.g−1 at slow rate (C/20), and a good cycling stability even at moderately faster rates (C/5 and C) have been observed. The long term cycling displayed a capacity retention of about 90% after 10 cycles.

Keywords: cationic substitution, lithium ion batteries, positive electrode material, self-combustion synthesis method

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Authors: Odeh Regina Comfort, Angelina Okewu Ogwuche

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The study investigated transformational leadership style of principal and conflict management in secondary schools in North Central Nigeria. A descriptive survey design was adopted. The population of the study comprised 34,473 teachers in 1949 public secondary schools in the study area. Proportionate stratified random sampling and simple random sampling techniques were used to select 39 public secondary schools and 689 respondents, respectively, for the study. The researcher utilized a self-structured questionnaire titled 'Influence of Transformational Leadership Style Questionnaire (ITLSQ)'. Face and content validity were ensured. The reliability index of 0.86 was obtained through Cronbach alpha statistics. The instrument was a modified Likert rating scale of Very High Extent (4), High Extent (3), Low Extent (2) and Very Low Extent (1). Mean, and standard deviation were used to answer 2 research questions, while chi-square goodness of fit was used to test the 2 hypotheses at 0.05 level of significance. The results among others indicate: that intellectual stimulation and individualized components of transformational leadership style of principal in public secondary schools in the study area have significant influence on conflict management in secondary schools. Based on the results, it was recommended that principals of secondary schools should be encouraged to practice the intellectual stimulation component of transformational leadership style that would help to consider teachers' levels of knowledge to decide what suits them to reach high levels of attainment thereby minimizing conflict in school settings; also transformational leadership should be taught to all people at all levels of secondary school especially that which pertains to individualized consideration to have a positive impact on the overall performance of teachers and this would help to minimize conflict in schools.

Keywords: conflict management, individualized consideration, intellectual stimulation, transformational leadership style

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Authors: Abdulrazaq Yahaya, Omobola Okoh, Anthony Okoh

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Polychlorinated biphenyls (PCBs) are generated from short emission or leakage from capacitors and electrical transformers, industrial chemicals wastewater discharge and careless disposal of wastes. They are toxic, semi-volatile compounds which can persist in the environment, hence classified as persistent organic pollutants. Their presence in the environmental matrices has become a global concern. In this study, we assessed the concentrations and distribution patterns of 19 polychlorinated biphenyls congeners (PCB 1, 5, 18, 31, 44, 52, 66, 87, 101, 110, 138, 141, 151, 153, 170, 180, 183, 187, and 206) at six sampling points in water along the course of Buffalo River, Eastern Cape, South Africa. Solvent extraction followed by sulphuric acid, potassium permanganate and silica gel cleanup were used in this study. The analysis was done with gas chromatography electron capture detector (GC-ECD). The results of the analysis of all the 19 PCBs congeners ranged from not detectable to 0.52 ppb and 2.5 ppb during summer and autumn periods respectively. These values are generally higher than the World Health Organization (WHO) maximum permissible limit. Their presence in the waterbody suggests an increase in anthropogenic activities over the seasons. In view of their volatility, the compounds are transportable over long distances by air currents away from their point of origin putting the health of the communities at risk, thus suggesting the need for strict regulations on the use as well as save disposal of this group of compounds in the communities.

Keywords: organic pollutants, polychlorinated biphenyls, pollution, solvent extraction

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Authors: Sabo Elizabeth

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Electronic learning is increasingly popular learning approach in higher educational institutions due to vast growth of internet technology. This approach is important in human capital development. An investigation of open distance and e-learning facilities and information need by open and distance learning students was carried out in Jalingo, Nigeria. Structured questionnaires were administered to 70 registered ODL students of the NOUN. Information sourced from the respondents covered demographic, economic and institutional variables. Data collected for demographic variables were computed as frequency count and percentages. Assessment of the effectiveness of ODL facilities and information need among open and distance learning students was computed on a three or four point Likert Rating Scale. Findings indicated that there are more men compared to women. A large proportion of the respondents are married and there are more matured students in ODL compared to the youth. A high proportion of the ODL students obtained qualifications higher than the secondary school certificate. The proportion of computer literate ODL students was high, and large number of the students does not own a laptop computer. Inadequate e -books and reference materials, internet gadgets and inadequate books (hard copies) and reference material are factors that limit utilization of e-learning facilities in the study areas. Inadequate computer facilities and power back up caused inconveniences and delay in administering and use of e learning facilities. To a high extent, open and distance learning students needed information on university time table and schedule of activities, availability and access to books (hard and e-books) and reference materials. The respondents emphasized that contact with course coordinators via internet will provide a better learning and academic performance.

Keywords: open and distance learning, information required, electronic books, internet gadgets, Likert scale test

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Authors: Jinsong Zhao, Lin Zhao

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Shenzhen, one of the fastest growing cities in the world, has been building a global ocean central city since 2017, facing many challenges, especially how to innovate new legal regimes to meet the future demands of the development of global shipping. First, the current legal regime of bills of lading as a document of title was established by English law in the 18th century but limited to the period of marine transportation from port of loading to port of discharge (namely, port to port). The e-commerce era is asking for such a function to be extended from port to port to door to door. Secondly, the function of the port has also been upgraded from the traditional loading and unloading of goods to a much wider area, such as being custody of warehousing goods for its mortgage bank, and therefore its legal status is changing, so it is necessary to amend the law of ports and harbours and innovate the rights and responsibilities of the port under its new role as the custody. Thirdly, the development of new marine energy has made more and more offshore floating wind power and floating photovoltaic devices face new legal issues such as legal status, nationality and ownership registration, mortgage, maritime lien, and possessory lien. Fourthly, the jurisdiction of the above issues, as well as conflicts of law and the applicable law, are also questions pending answers. This paper will discuss these issues of private international law, especially the innovation of new legal regimes with an aim to solve the above problems.

Keywords: maritime law, bills of lading, e-commerce, port law, marine clean energy

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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Authors: Wern Lin Yeo, Choo Kim Tan, Sook Ling Lew

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Mathematics anxiety refers to the feeling of anxious when one having difficulties in solving mathematical problem. Mathematics anxiety is the most common type of anxiety among other types of anxiety which occurs among the students. However, level of anxiety among males and females are different. There were few past study were conducted to determine the relationship of anxiety and gender but there were still did not have an exact results. Hence, the purpose of this study is to determine the relationship of anxiety level between male and female undergraduates at a private university in Malaysia. Convenient sampling method used in this study in which the students were selected based on the grouping assigned by the faculty. There were 214 undergraduates who registered the probability courses had participated in this study. Mathematics Anxiety Rating Scale (MARS) was the instrument used in study which used to determine students’ anxiety level towards probability. Reliability and validity of instrument was done before the major study was conducted. In the major study, students were given briefing about the study conducted. Participation of this study were voluntary. Students were given consent form to determine whether they agree to participate in the study. Duration of two weeks were given for students to complete the given online questionnaire. The data collected will be analyzed using Statistical Package for the Social Sciences (SPSS) to determine the level of anxiety. There were three anxiety level, i.e., low, average and high. Students’ anxiety level were determined based on their scores obtained compared with the mean and standard deviation. If the scores obtained were below mean and standard deviation, the anxiety level was low. If the scores were at below and above the mean and between one standard deviation, the anxiety level was average. If the scores were above the mean and greater than one standard deviation, the anxiety level was high. Results showed that both of the gender were having average anxiety level. Males having high frequency of three anxiety level which were low, average and high anxiety level as compared to females. Hence, the mean values obtained for males (M = 3.62) was higher than females (M = 3.42). In order to be significant of anxiety level among the gender, the p-value should be less than .05. The p-value obtained in this study was .117. However, this value was greater than .05. Thus, there was no significant difference of anxiety level among the gender. In other words, there was no relationship of anxiety level with the gender.

Keywords: anxiety level, gender, mathematics anxiety, probability and statistics

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Authors: A. Sreedevi, G. Anantaramu

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The present space research organizations are striving towards the development of lighter, smaller, more efficient, low cost, and highly reliable power supply. Switch mode power supplies (SMPS) overcome the demerits of linear power supplies such as low efficiency, difficulties in thermal management, and in boosting the output voltage. Space applications require a constant DC voltage to supply its load. As the load varies, the battery terminal voltage tends to vary accordingly. To avoid this variation in the load terminal voltage, a DC-DC regulator is required. The conventional regulator for space applications is isolated boost topology. The proposed topology uses an interleaved push-pull converter with a current doubler secondary to reduce the EMI issues and increase efficiency. The proposed topology uses a floating technique where the converter derives power from the battery and generates only the voltage that is required to fill the gap between the bus and the battery voltage. The direct voltage sense and current loop provide tight regulation of output and better stability. Converter is designed with 50 kHz switching frequency using UC 1825 PWM controller employing both voltage and peak current mode control. Experimental tests have been carried out on the converter under different input and load conditions to validate the design. The experimental results showed that the efficiency was greater than 91%. Stability analysis is done using venable stability analyzer.

Keywords: push pull converter, current doubler, converter, PWM control

Procedia PDF Downloads 101

Authors: Mitchell T. Grothaus, Cory Grigsby, Timothy S. Hare

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This study aims to determine if there is a relationship between elevated cancer risks in eastern Kentucky and the environmental effects of black shale. Previous research shows that black shale formations, such as those in eastern Kentucky contain high levels of toxic elements including arsenic and radon compared to average rocks and sediment. Similarly, the population of eastern Kentucky has higher rates of many health conditions, including lung cancer and cardiovascular disease, than surrounding regions. These poor health outcomes are typically explained in relation to social, economic, behavioral, and healthcare factors. The rates of many conditions, however, have not decreased as these factors improve with regional development. Black shale is known to affect environmental conditions such as by increasing radiation levels and heavy metal toxicity. We are mapping the effects of black shale through monitoring radiation, microbes, and chemical standards of water sources. In this presentation, we report on our measuring pH, dissolved oxygen, total dissolved solids, conductivity, temperature, and discharge and comparison with water quality standards from the Kentucky Department for Environmental Protection. The conditions of water sources combined with an environmental survey of the surrounding areas provide a greater understanding of why the people in eastern Kentucky face the current health issues.

Keywords: black shale, eastern Kentucky, environmental impact, water quality

Procedia PDF Downloads 162

Authors: Bahareh Yazdanparast Chaharmahali

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The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

Procedia PDF Downloads 245

Authors: Abubakar Muhammad Umar, Nur Adeela Yasid, Hassan Mohd Daud, Mohd Yunus Abd Shukor

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Glyphosate [N-(phosphonomethyl) glycine] is among the most broadly and generally recognised broad-spectrum herbicides used in agriculture due to its low cost and effectiveness in weed management. The pollution of glyphosate in the aquatic environment can be via water run-off from agricultural lands, or by spray drift, aerial spraying or due to industrial discharge, which may be seen as a threat to aquatic biota. Fish is one of the best organisms to study the toxicological aspects of glyphosate. A 49 days experiment was conducted under laboratory conditions to ascertain the effects of technical grade glyphosate on behaviour and histopathological conditions in the gills of red hybrid tilapia using a light inverted microscope. Air gasping, erratic swimming, fin movement, mucus secretion, hemorrhages, and loss of scales were observed as behavioural changes in the exposed fish. There was no histopathological complication observed in the gill of the control fish, but various levels of alterations were seen in the gills of the fish exposed to glyphosate herbicide. These include lifting of primary lamella, congestion of secondary lamella, as well as hyperplasia in both primary and secondary gill lamella, and hypertrophy of secondary gill lamella. Based on the findings of this study, glyphosate herbicide exerts behavioural and histopathological changes in the gill of red hybrid tilapia, and therefore, the fish is considered a good bioindicator in aquatic environment monitoring. Excessive usage of glyphosate herbicide near aquatic habitats should be discouraged.

Keywords: behavioural, histopathological, Oreochromis niloticus, glyphosate

Procedia PDF Downloads 47

Authors: Abimbola M. Enitan, J. Adeyemo

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Anaerobic modeling is a useful tool to describe and simulate the condition and behaviour of anaerobic treatment units for better effluent quality and biogas generation. The present investigation deals with the anaerobic treatment of brewery wastewater with varying organic loads. The chemical oxygen demand (COD) and total suspended solids (TSS) of the influent and effluent of the bioreactor were determined at various retention times to generate data for kinetic coefficients. The bio-kinetic coefficients in the modified Stover–Kincannon kinetic and methane generation models were determined to study the performance of anaerobic digestion process. At steady-state, the determination of the kinetic coefficient (K), the endogenous decay coefficient (Kd), the maximum growth rate of microorganisms (µmax), the growth yield coefficient (Y), ultimate methane yield (Bo), maximum utilization rate constant Umax and the saturation constant (KB) in the model were calculated to be 0.046 g/g COD, 0.083 (dˉ¹), 0.117 (d-¹), 0.357 g/g, 0.516 (L CH4/gCODadded), 18.51 (g/L/day) and 13.64 (g/L/day) respectively. The outcome of this study will help in simulation of anaerobic model to predict usable methane and good effluent quality during the treatment of industrial wastewater. Thus, this will protect the environment, conserve natural resources, saves time and reduce cost incur by the industries for the discharge of untreated or partially treated wastewater. It will also contribute to a sustainable long-term clean development mechanism for the optimization of the methane produced from anaerobic degradation of waste in a close system.

Keywords: brewery wastewater, methane generation model, environment, anaerobic modeling

Procedia PDF Downloads 268

Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

Procedia PDF Downloads 87

Authors: Amgad A. Farghal, Dina I. El Desouki

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Energy consumption and users’ satisfaction were compared in three LEED certified office buildings in turkey and an office building in Egypt. The field studies were conducted in summer 2012. The measured environmental parameters in the four buildings were indoor air temperature, relative humidity, CO2 percentage and light intensity. The traditional building is located in Smart Village in Abu Rawash, Cairo, Egypt. The building was studied for 7 days resulting in 84 responds. The three rated buildings are in Istanbul; Turkey. A Platinum LEED certified office building is owned by BASF and gained a platinum certificate for new construction and major renovation. The building was studied for 3 days resulting in 13 responds. A Gold LEED certified office building is owned by BASF and gained a gold certificate for new construction and major renovation. The building was studied for 2 days resulting in 10 responds. A silver LEED certified office building is owned by Unilever and gained a silver certificate for commercial interiors. The building was studied for 7 days resulting in 84 responds. The results showed that all buildings had no significant difference regarding occupants’ satisfaction with the amount of lighting, noise level, odor and access to the outdoor view. There was significant difference between occupants’ satisfaction in LEED certified buildings and the traditional building regarding the thermal environment and the perception of the general environment (colors, carpet and decoration. The findings suggest that careful design could lead to a certified building that enhances the thermal environment and the perception of the indoor environment leading to energy consumption without scarifying occupants’ satisfaction.

Keywords: energy consumption, occupants’ satisfaction, rating systems, office buildings

Procedia PDF Downloads 418

Authors: Praveenkumar Natarajan

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A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

Procedia PDF Downloads 134

Authors: Kuladeep Kumar Sadevi

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The shift towards raising global urban population has intense implications on the sustainability of the urban livelihoods. Rapid urbanization has made governments, companies and civil societies recognize that they are barely equipped to deal with growing urban demands, especially water, waste and energy management. Effective management of land, water, energy and waste at a community level should be addressed well to attain greener cities. In pursuit of Green livelihoods; various norms, codes, and green rating programmes have been followed by stakeholders at various levels. While the sustainability is being adapted at smaller scale developments, greening the urban environment at community/city level is still finding its path to reality. This is due to lack of the sense of ownership in the citizens for their immediate neighborhoods and city as a whole. This phenomenon can be well connected to the theory of 'tragedy of commons' with respect to the community engagement to manage the common pool resources. The common pool resource management has been well addressed by Elinor Ostrom, who shared the Nobel Prize in Economics in 2009 for her lifetime of scholarly work investigating how communities succeed or fail at managing common pool (finite) resources. This paper examines the applicability of Elinor Ostrom's 8 Principles for Managing a Commons, to meet urban sustainability. The key objective of this paper is to come up with a model for effective urban common pool resource management, which ultimately leads to sustainability as a whole. The paper brings out a methodology to understand various parameters involved in urban sustainability, examine the synergies of all such parameters, and application of Ostrom’s principles to correlate these parameters in order to attain effective urban resource management.

Keywords: common pool resources, green cities, green communities, participatory management, sustainable development, urban resource management, urban sustainability

Procedia PDF Downloads 355