Search results for: median opening

Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

Procedia PDF Downloads 310

Authors: Maciej Szeląg

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The changing nature of environmental impacts, in which cement composites are operating, are causing in the structure of the material a number of phenomena, which result in volume deformation of the composite. These strains can cause composite cracking. Cracks are merging by propagation or intersect to form a characteristic structure of cracks known as the cluster cracks. This characteristic mesh of cracks is crucial to almost all building materials, which are working in service loads conditions. Particularly dangerous for a cement matrix is a sudden load of elevated temperature – the thermal shock. Resulting in a relatively short period of time a large value of a temperature gradient between the outer surface and the material’s interior can result in cracks formation on the surface and in the volume of the material. In the paper, in order to analyze the geometry of the cluster cracks of the cement pastes, the image analysis tools were used. Tested were 4 series of specimens made of two different Portland cement. In addition, two series include microsilica as a substitute for the 10% of the cement. Within each series, specimens were performed in three w/b indicators (water/binder): 0.4; 0.5; 0.6. The cluster cracks were created by sudden loading the samples by elevated temperature of 250°C. Images of the cracked surfaces were obtained via scanning at 2400 DPI. Digital processing and measurements were performed using ImageJ v. 1.46r software. To describe the structure of the cluster cracks three stereological parameters were proposed: the average cluster area - A ̅, the average length of cluster perimeter - L ̅, and the average opening width of a crack between clusters - I ̅. The aim of the study was to identify and evaluate the relationships between measured stereological parameters, and the compressive strength and the bulk density of the modified cement pastes. The tests of the mechanical and physical feature have been carried out in accordance with EN standards. The curves describing the relationships have been developed using the least squares method, and the quality of the curve fitting to the empirical data was evaluated using three diagnostic statistics: the coefficient of determination – R2, the standard error of estimation - Se, and the coefficient of random variation – W. The use of image analysis allowed for a quantitative description of the cluster cracks’ geometry. Based on the obtained results, it was found a strong correlation between the A ̅ and L ̅ – reflecting the fractal nature of the cluster cracks formation process. It was noted that the compressive strength and the bulk density of cement pastes decrease with an increase in the values of the stereological parameters. It was also found that the main factors, which impact on the cluster cracks’ geometry are the cement particles’ size and the general content of the binder in a volume of the material. The microsilica caused the reduction in the A ̅, L ̅ and I ̅ values compared to the values obtained by the classical cement paste’s samples, which is caused by the pozzolanic properties of the microsilica.

Keywords: cement paste, cluster cracks, elevated temperature, image analysis, microsilica, stereological parameters

Procedia PDF Downloads 246

Authors: Pawel Magryta, Tytus Tulwin, Paweł Karpiński

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The ASz62IR engine is a radial aircraft engine with 9 cylinders. This object is produced by the Polish company WSK "PZL-KALISZ" S.A. This is engine is currently being developed by the above company and Lublin University of Technology. In order to provide an effective work of the technological development of this unit it was decided to made the simulation model. The model of ASz-62IR was developed with AVL BOOST software which is a tool dedicated to the one-dimensional modeling of internal combustion engines. This model can be used to calculate parameters of an air and fuel flow in an intake system including charging devices as well as combustion and exhaust flow to the environment. The main purpose of this model is the analysis of the charge exchange and mixture formation in this engine. For this purpose, the model consists of elements such: as air inlet, throttle system, compressor connector, charging compressor, inlet pipes and injectors, outlet pipes, fuel injection and model of fuel mixing and evaporation. The model of charge exchange and mixture formation was based on the model of mass flow rate in intake and exhaust pipes, and also on the calculation of gas properties values like gas constant or thermal capacity. This model was based on the equations to describe isentropic flow. The energy equation to describe flow under steady conditions was transformed into the mass flow equation. In the model the flow coefficient μσ was used, that varies with the stroke/valve opening and was determined in a steady flow state. The geometry of the inlet channels and other key components was mapped with reference to the technical documentation of the engine and empirical measurements of the structure elements. The volume of elements on the charge flow path between the air inlet and the exhaust outlet was measured by the CAD mapping of the structure. Taken from the technical documentation, the original characteristics of the compressor engine was entered into the model. Additionally, the model uses a general model for the transport of chemical compounds of the mixture. There are 7 compounds used, i.e. fuel, O2, N2, CO2, H2O, CO, H2. A gasoline fuel of a calorific value of 43.5 MJ/kg and an air mass fraction for stoichiometric mixture of 14.5 were used. Indirect injection into the intake manifold is used in this model. The model assumes the following simplifications: the mixture is homogenous at the beginning of combustion, accordingly, mixture stoichiometric coefficient A/F remains constant during combustion, combusted and non-combusted charges show identical pressures and temperatures although their compositions change. As a result of the simulation studies based on the model described above, the basic parameters of combustion process, charge exchange, mixture formation in cylinders were obtained. The AVL Boost software is very useful for the piston engine performance simulations. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: aviation propulsion, AVL Boost, engine model, charge exchange, mixture formation

Procedia PDF Downloads 338

Authors: Kristine Demilou D. Santiago

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An access to a high-quality health care system is what sets apart industrialized nations, such as the United States from other developing countries, which in this case is specifically pertaining to their older population. But what was the underrated factor in the sphere of quality healthcare rendered to elderly people in the Western context? Will this salient factor could push conviction to prorogue the existing gaps between self-denial patient-client and cheek by jowl medications? Are the natural socio-environmental approaches of caregiving the protracted remedy to healthcare disparities for aging population considering their day to day living? The conceptual framework of this model is primarily associated with addressing health and illness of human beings considering the biological, psychological and socio-environmental factors around them. The relevance of biopsychosocial formulation advancing each of the characteristics in the Biopsychosocial (BPS) model in a balance contemplation is the tumult of this study in an attempt to respond to prevailing disparities in caregiving services for old-aged patients on a day to day living. Caregiving services have been the medium path connecting between the patient and its prescribed medications. Moreover, caregivers serve as positive reinforcers in a patient’s environment. Therefore, caregivers play an important role in healthcare delivery to patients. They are considered significant people whom their acts will give an impact to a patient’s view in life. This research study intends to present the supreme importance of biopsychosocial assessment to old-aged patients with mental health illness and conditions. Biopsychosocial assessment will secure the quality of full medication to an old-aged adult suffering from a mental illness. This is because it offers a recognizably wholesome approach to medical healing of old-aged adult patients. The principle of biopsychosocial supersedes the biomedicine being offered to old-aged adults having mental illness, but it does not take away the high relevance of scientific biomedicine in healing patients. The framework presented an overlapping participation of each of its factors in its BPS model that affects in general a person’s health. The correlation between the biological (physiological), psychological (mental) and social (environment) in a person’s health condition requires equal attention according to BPS, and it always coexist with each other. Indisputably said, bio-medicine has been and is being in its unceasing endeavor to provide scientifically proven health care medications for every individual seeking medical treatments. As we grow older and eventually reach the other side of the median population, not only our physiological aspects change, our psychological and socio-environmental changes happen too. Caregiving is a salient responsibility taking place on these inevitable changes.

Keywords: biopsychosocial formulation, caregiving through natural approaches, US health care, BPS in caregiving, caregiving for aging population

Procedia PDF Downloads 98

Authors: Panagiotis Svarnas, Polykarpos Papadopoulos

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Atmospheric-pressure cold plasmas continue to gain increasing interest for various applications due to their unique properties, like cost-efficient production, high chemical reactivity, low gas temperature, adaptability, etc. Numerous designs have been proposed for these plasmas production in terms of electrode configuration, driving voltage waveform and working gas(es). However, in order to exploit most of the advantages of these systems, the majority of the designs are based on dielectric-barrier discharges (DBDs) either in filamentary or glow regimes. A special category of the DBD-based atmospheric-pressure cold plasmas refers to the so-called plasma jets, where a carrier noble gas is guided by the dielectric barrier (usually a hollow cylinder) and left to flow up to the atmospheric air where a complicated hydrodynamic interplay takes place. Although it is now well established that these plasmas are generated due to ionizing waves reminding in many ways streamer propagation, they exhibit discrete characteristics which are better mirrored on the terms 'guided streamers' or 'plasma bullets'. These 'bullets' travel with supersonic velocities both inside the dielectric barrier and the channel formed by the noble gas during its penetration into the air. The present work is devoted to the interpretation of the electro-hydrodynamic effects that take place downstream of the dielectric barrier opening, i.e., in the noble gas-air mixing area where plasma bullet propagate under the influence of local electric fields in regions of variable noble gas concentration. Herein, we focus on the role of the local space charge and the residual ionic charge left behind after the bullet propagation in the gas flow field modification. The study communicates both experimental and numerical results, coupled in a comprehensive manner. The plasma bullets are here produced by a custom device having a quartz tube as a dielectric barrier and two external ring-type electrodes driven by sinusoidal high voltage at 10 kHz. Helium gas is fed to the tube and schlieren photography is employed for mapping the flow field downstream of the tube orifice. Mixture mass conservation equation, momentum conservation equation, energy conservation equation in terms of temperature and helium transfer equation are simultaneously solved, leading to the physical mechanisms that govern the experimental results. Namely, we deal with electro-hydrodynamic effects mainly due to momentum transfer from atomic ions to neutrals. The atomic ions are left behind as residual charge after the bullet propagation and gain energy from the locally created electric field. The electro-hydrodynamic force is eventually evaluated.

Keywords: atmospheric-pressure plasmas, dielectric-barrier discharges, schlieren photography, electro-hydrodynamic force

Procedia PDF Downloads 139

Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

Procedia PDF Downloads 96

Authors: M. Zasada, A. Markiewicz, A. Erkiert-Polguj, E. Budzisz

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The epidermis is a keratinized stratified squamous epithelium covered by the hydro-lipid barrier. Therefore, active substances should be able to penetrate through this hydro-lipid coating. L-ascorbic acid is one of the vitamins which plays an important role in stimulation fibroblast to produce collagen type I and in hyperpigmentation lightening. Vitamin C is a water-soluble antioxidant, which protects skin from oxidation damage and rejuvenates photoaged skin. No-needle mesotherapy is a non-invasive rejuvenation technique depending on electric pulses, electroporation, and ultrasounds. These physicals factors result in deeper penetration of cosmetics. It is important to increase the penetration of L-ascorbic acid, thereby increasing the spectrum of its activity. The aim of the work was to assess the effectiveness of pure L-ascorbic acid activity in anti-aging therapy using a needle-free and micro-needling mesotherapy. The study was performed on a group of 35 healthy volunteers in accordance with the Declaration of Helsinki of 1964 and agreement of the Ethics Commissions no RNN/281/16/KE 2017. Women were randomized to mesotherapy or control group. Control group applied topically 2,5 ml serum containing 20% L-ascorbic acid with hydrate from strawberries, every 10 days for a period of 9 weeks. No-needle mesotherapy, on the left half of the face and micro-needling on the right with the same serum, was done in mesotherapy group. The pH of serum was 3.5-4, and the serum was prepared directly prior to the facial treatment. The skin parameters were measured at the beginning and before each treatment. The measurement of the forehead skin was done using Cutometer® (measurement of skin elasticity and firmness), Corneometer® (skin hydration measurement), Mexameter® (skin tone measurement). Also, the photographs were taken by Fotomedicus system. Additionally, the volunteers fulfilled the questionnaire. Serum was tested for microbiological purity and stability after the opening of the cosmetic. During the study, all of the volunteers were taken care of a dermatologist. The regular application of the serum has caused improvement of the skin parameters. Respectively, after 4 and 8 weeks improvement in hydration and elasticity has been seen (Corneometer®, Cutometer® results). Moreover, the number of hyper-pigmentated spots has decreased (Mexameter®). After 8 weeks the volunteers has claimed that the tested product has smoothing and moisturizing features. Subjective opinions indicted significant improvement of skin color and elasticity. The product containing the L-ascorbic acid used with intercellular penetration promoters demonstrates higher anti-aging efficiency than control. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. Mesotherapy with pure L-ascorbic acid provides better diffusion of active substances through the skin.

Keywords: anti-aging, l-ascorbic acid, mesotherapy, promoters

Procedia PDF Downloads 265

Authors: Emmanuel A. David, Rebecca O. Soremekun, Roseline I. Aderemi-Williams

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Background: The complexities involved in the management of diabetes mellitus require a multi-dimensional, multi-professional collaborative and continuous care by health care providers and a substantial self-care by the patients in order to achieve desired treatment outcomes. The effect of pharmacists’ care in the management of diabetes in resource-endowed nations is well documented in literature, but randomised-controlled assessment of the impact of pharmacist-led care among patients with diabetes in resource-limited settings like Nigeria and sub-Saharan Africa countries is scarce. Objective: To evaluate the impact of Pharmacist-led care on glycaemic control in patients with uncontrolled type 2 diabetes, using a randomised-controlled study design Methods: This study employed a prospective randomised controlled design, to assess the impact of pharmacist-led care on glycaemic control of 108 poorly controlled type 2 diabetic patients. A total of 200 clinically diagnosed type 2 diabetes patients were purposively selected using fasting blood glucose ≥ 7mmol/L and tested for long term glucose control using Glycated haemoglobin measure. One hundred and eight (108) patients with ≥ 7% Glycated haemoglobin were recruited for the study and assigned unique identification numbers. They were further randomly allocated to intervention and usual care groups using computer generated random numbers, with each group containing 54 subjects. Patients in the intervention group received pharmacist-structured intervention, including education, periodic phone calls, adherence counselling, referral and 6 months follow-up, while patients in usual care group only kept clinic appointments with their physicians. Data collected at baseline and six months included socio-demographic characteristics, fasting blood glucose, Glycated haemoglobin, blood pressure, lipid profile. With an intention to treat analysis, Mann-Whitney U test was used to compared median change from baseline in the primary outcome (Glycated haemoglobin) and secondary outcomes measure, effect size was computed and proportion of patients that reached target laboratory parameter were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each study. Mean age was 51±11.75 and majority were female (68.5%). Intervention patients had significant reduction in Glycated haemoglobin (-0.75%; P<0.001; η2 = 0.144), with greater proportion attaining target laboratory parameter after 6 months of care compared to usual care group (Glycated haemoglobin: 42.6% vs 20.8%; P=0.02). Furthermore, patients who received pharmacist-led care were about 3 times more likely to have better glucose control (AOR 2.718, 95%CI: 1.143-6.461) compared to usual care group. Conclusion: Pharmacist-led care significantly improved glucose control in patients with uncontrolled type 2 diabetes mellitus and should be integrated in the routine management of diabetes patients, especially in resource-limited settings.

Keywords: glycaemic control , pharmacist-led care, randomised-controlled trial , type 2 diabetes mellitus

Procedia PDF Downloads 120

Authors: Austin P. Hopkins, R. Daren Harmel, Jim A Ippolito, P. J. A. Kleinman, D. Sahoo

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Field-scale runoff and water quality data are critical to understanding the fate and transport of nutrients applied to agricultural lands and minimizing their off-site transport because it is at that scale that agricultural management decisions are typically made based on hydrologic, soil, and land use factors. However, regional influences such as precipitation, temperature, and prevailing cropping systems and land use patterns also impact nutrient runoff. In the present study, the recently-updated MANAGE (Measured Annual Nutrient loads from Agricultural Environments) database was used to conduct an ecoregion-level analysis of nitrogen and phosphorus runoff from agricultural lands in the North America. Specifically, annual N and P runoff loads for cropland and grasslands in North American Level II EPA ecoregions were presented, and the impact of factors such as land use, tillage, and fertilizer timing and placement on N and P runoff were analyzed. Specifically we compiled annual N and P runoff load data (i.e., dissolved, particulate, and total N and P, kg/ha/yr) for each Level 2 EPA ecoregion and for various agricultural management practices (i.e., land use, tillage, fertilizer timing, fertilizer placement) within each ecoregion to showcase the analyses possible with the data in MANAGE. Potential differences in N and P runoff loads were evaluated between and within ecoregions with statistical and graphical approaches. Non-parametric analyses, mainly Mann-Whitney tests were conducted on median values weighted by the site years of data utilizing R because the data were not normally distributed, and we used Dunn tests and box and whisker plots to visually and statistically evaluate significant differences. Out of the 50 total North American Ecoregions, 11 were found that had significant data and site years to be utilized in the analysis. When examining ecoregions alone, it was observed that ER 9.2 temperate prairies had a significantly higher total N at 11.7 kg/ha/yr than ER 9.4 South Central Semi Arid Prairies with a total N of 2.4. When examining total P it was observed that ER 8.5 Mississippi Alluvial and Southeast USA Coastal Plains had a higher load at 3.0 kg/ha/yr than ER 8.2 Southeastern USA Plains with a load of 0.25 kg/ha/yr. Tillage and Land Use had severe impacts on nutrient loads. In ER 9.2 Temperate Prairies, conventional tillage had a total N load of 36.0 kg/ha/yr while conservation tillage had a total N load of 4.8 kg/ha/yr. In all relevant ecoregions, when corn was the predominant land use, total N levels significantly increased compared to grassland or other grains. In ER 8.4 Ozark-Ouachita, Corn had a total N of 22.1 kg/ha/yr while grazed grassland had a total N of 2.9 kg/ha/yr. There are further intricacies of the interactions that agricultural management practices have on one another combined with ecological conditions and their impacts on the continental aquatic nutrient loads that still need to be explored. This research provides a stepping stone to further understanding of land and resource stewardship and best management practices.

Keywords: water quality, ecoregions, nitrogen, phosphorus, agriculture, best management practices, land use

Procedia PDF Downloads 79

Authors: Juan C. Pérez-Mesa, Emilio Galdeano-Gómez, Jerónimo De Burgos-Jiménez, José F. Bienvenido-Bárcena, José F. Jiménez-Guerrero

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Environmental cost and transport congestion on roads resulting from product distribution in Europe have to lead to the creation of various programs and studies seeking to reduce these negative impacts. In this regard, apart from other institutions, the European Commission (EC) has designed plans in recent years promoting a more sustainable transportation model in an attempt to ultimately shift traffic from the road to the sea by using intermodality to achieve a model rebalancing. This issue proves especially relevant in supply chains from peripheral areas of the continent, where the supply of certain agrifood products is high. In such cases, the most difficult challenge is managing perishable goods. This study focuses on new approaches that strengthen the modal shift, as well as the reduction of externalities. This problem is analyzed by attempting to promote intermodal system (truck and short sea shipping) for transport, taking as point of reference highly perishable products (vegetables) exported from southeast Spain, which is the leading supplier to Europe. Methodologically, this paper seeks to contribute to the literature by proposing a different and complementary approach to establish a comparison between intermodal and the “only road” alternative. For this purpose, the multicriteria decision is utilized in a p-median model (P-M) adapted to the transport of perishables and to a means of shipping selection problem, which must consider different variables: transit cost, including externalities, time, and frequency (including agile response time). This scheme avoids bias in decision-making processes. By observing the results, it can be seen that the influence of the externalities as drivers of the modal shift is reduced when transit time is introduced as a decision variable. These findings confirm that the general strategies, those of the EC, based on environmental benefits lose their capacity for implementation when they are applied to complex circumstances. In general, the different estimations reveal that, in the case of perishables, intermodality would be a secondary and viable option only for very specific destinations (for example, Hamburg and nearby locations, the area of influence of London, Paris, and the Netherlands). Based on this framework, the general outlook on this subject should be modified. Perhaps the government should promote specific business strategies based on new trends in the supply chain, not only on the reduction of externalities, and find new approaches that strengthen the modal shift. A possible option is to redefine ports, conceptualizing them as digitalized redistribution and coordination centers and not only as areas of cargo exchange.

Keywords: environmental externalities, intermodal transport, perishable food, transit time

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

Procedia PDF Downloads 134

Authors: O. F. Elkommos

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Teaching and learning EFL speaking modules is one of the most challenging productive modules for both instructors and learners. In a student-centered interactive communicative language teaching approach, learners and instructors should be aware of the fact that the target language must be taught as/for communication. The student must be empowered by tools that will work on more than one level of their communicative competence. Communicative learning will need a teaching and learning methodology that will address the goal. Teaching turn-taking rules, pragmatic principles and speech acts will enhance students' sociolinguistic competence, strategic competence together with discourse competence. Sociolinguistic competence entails the mastering of speech act conventions and illocutionary acts of refusing, agreeing/disagreeing; emotive acts like, thanking, apologizing, inviting, offering; directives like, ordering, requesting, advising, and hinting, among others. Strategic competence includes enlightening students’ consciousness of the various particular turn-taking systemic rules of organizing techniques of opening and closing conversation, adjacency pairs, interrupting, back-channeling, asking for/giving opinion, agreeing/disagreeing, using natural fillers for pauses, gaps, speaker select, self-select, and silence among others. Students will have the tools to manage a conversation. Students are engaged in opportunities of experiencing the natural language not as a mere extra student talking time but rather an empowerment of knowing and using the strategies. They will have the component items they need to use as well as the opportunity to communicate in the target language using topics of their interest and choice. This enhances students' communicative abilities. Available websites and textbooks now use one or more of these tools of turn-taking or pragmatics. These will be students' support in self-study in their independent learning study hours. This will be their reinforcement practice on e-Learning interactive activities. The students' target is to be able to communicate the intended meaning to an addressee that is in turn able to infer that intended meaning. The combination of these tools will be assertive and encouraging to the student to beat the struggle with what to say, how to say it, and when to say it. Teaching the rules, principles and techniques is an act of awareness raising method engaging students in activities that will lead to their pragmatic discourse competence. The aim of the paper is to show how the suggested pragmatic model will empower students with tools and systems that would support their learning. Supporting students with turn taking rules, speech act theory, applying both to texts and practical analysis and using it in speaking classes empowers students’ pragmatic discourse competence and assists them to understand language and its context. They become more spontaneous and ready to learn the discourse pragmatic dimension of the speaking techniques and suitable content. Students showed a better performance and a good motivation to learn. The model is therefore suggested for speaking modules in EFL classes.

Keywords: communicative competence, EFL, empowering learners, enhance learning, speech acts, teaching speaking, turn taking, learner centred, pragmatics

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Authors: Bastien Sanglard, Simon Cayez, Guillaume Viau, Thomas Blon, Julian Carrey, Sébastien Lachaize

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The need to develop clean production processes is a key challenge of any industry. Steel and iron industries are particularly concerned since they emit 6.8% of global anthropogenic greenhouse gas emissions. One key step of the process is the high-temperature reduction of iron ore using coke, leading to large amounts of CO2 emissions. One route to decrease impacts is to get rid of fossil fuels by changing both the heat source and the reducer. The present work aims at investigating experimentally the possibility to use concentrated solar energy and carbon-free reducing agents. Two sets of experimentations were realized. First, in situ X-ray diffraction on pure and industrial powder of hematite was realized to study the phase evolution as a function of temperature during reduction under hydrogen and ammonia. Secondly, experiments were performed on industrial iron ore pellets, which were reduced by NH3 or H2 into a “solar furnace” composed of a controllable 1600W Xenon lamp to simulate and control the solar concentrated irradiation of a glass reactor and of a diaphragm to control light flux. Temperature and pressure were recorded during each experiment via thermocouples and pressure sensors. The percentage of iron oxide converted to iron (called thereafter “reduction ratio”) was found through Rietveld refinement. The power of the light source and the reduction time were varied. Results obtained in the diffractometer reaction chamber show that iron begins to form at 300°C with pure Fe2O3 powder and 400°C with industrial iron ore when maintained at this temperature for 60 minutes and 80 minutes, respectively. Magnetite and wuestite are detected on both powders during the reduction under hydrogen; under ammonia, iron nitride is also detected for temperatures between400°C and 600°C. All the iron oxide was converted to iron for a reaction of 60 min at 500°C, whereas a conversion ratio of 96% was reached with industrial powder for a reaction of 240 min at 600°C under hydrogen. Under ammonia, full conversion was also reached after 240 min of reduction at 600 °C. For experimentations into the solar furnace with iron ore pellets, the lamp power and the shutter opening were varied. An 83.2% conversion ratio was obtained with a light power of 67 W/cm2 without turning over the pellets. Nevertheless, under the same conditions, turning over the pellets in the middle of the experiment permits to reach a conversion ratio of 86.4%. A reduction ratio of 95% was reached with an exposure of 16 min by turning over pellets at half time with a flux of 169W/cm2. Similar or slightly better results were obtained under an ammonia reducing atmosphere. Under the same flux, the highest reduction yield of 97.3% was obtained under ammonia after 28 minutes of exposure. The chemical reaction itself, including the solar heat source, does not produce any greenhouse gases, so solar metallurgy represents a serious way to reduce greenhouse gas emission of metallurgy industry. Nevertheless, the ecological impact of the reducers must be investigated, which will be done in future work.

Keywords: solar concentration, metallurgy, ammonia, hydrogen, sustainability

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Authors: Harpal Singh, Sakshi Batra

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The widespread and easy accesses to multimedia contents and possibility to make numerous copies without loss of significant fidelity have roused the requirement of digital rights management. Thus this problem can be effectively solved by Digital watermarking technology. This is a concept of embedding some sort of data or special pattern (watermark) in the multimedia content; this information will later prove ownership in case of a dispute, trace the marked document’s dissemination, identify a misappropriating person or simply inform user about the rights-holder. The primary motive of digital watermarking is to embed the data imperceptibly and robustly in the host information. Extensive counts of watermarking techniques have been developed to embed copyright marks or data in digital images, video, audio and other multimedia objects. With the development of digital video-based innovations, copyright dilemma for the multimedia industry increases. Video watermarking had been proposed in recent years to serve the issue of illicit copying and allocation of videos. It is the process of embedding copyright information in video bit streams. Practically video watermarking schemes have to address some serious challenges as compared to image watermarking schemes like real-time requirements in the video broadcasting, large volume of inherently redundant data between frames, the unbalance between the motion and motionless regions etc. and they are particularly vulnerable to attacks, for example, frame swapping, statistical analysis, rotation, noise, median and crop attacks. In this paper, an effective, robust and imperceptible video watermarking algorithm is proposed based on hybridization of powerful mathematical transforms; Fractional Fourier Transform (FrFT), Discrete Wavelet transforms (DWT) and Singular Value Decomposition (SVD) using redundant wavelet. This scheme utilizes various transforms for embedding watermarks on different layers by using Hybrid systems. For this purpose, the video frames are portioned into layers (RGB) and the watermark is being embedded in two forms in the video frames using SVD portioning of the watermark, and DWT sub-band decomposition of host video, to facilitate copyright safeguard as well as reliability. The FrFT orders are used as the encryption key that allows the watermarking method to be more robust against various attacks. The fidelity of the scheme is enhanced by introducing key generation and wavelet based key embedding watermarking scheme. Thus, for watermark embedding and extraction, same key is required. Therefore the key must be shared between the owner and the verifier via some safe network. This paper demonstrates the performance by considering different qualitative metrics namely Peak Signal to Noise ratio, Structure similarity index and correlation values and also apply some attacks to prove the robustness. The Experimental results are presented to demonstrate that the proposed scheme can withstand a variety of video processing attacks as well as imperceptibility.

Keywords: discrete wavelet transform, robustness, video watermarking, watermark

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Authors: Ch. Sridevi, S. P. Shailender Kumar, B. Gurudayal, A. Chalapathi Rao, K. Koteswara Rao, P. Srinivasulu

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System reliability and system availability evaluation plays a crucial role in ensuring the seamless operation of complex satellite data reception system with consistent performance for longer periods. This paper presents a novel approach for the same using a case study on one of the antenna systems at satellite data reception ground station in India. The methodology involves analyzing system's components, their failure rates, system's architecture, generation of logical reliability block diagram model and estimating the reliability of the system using the component level mean time between failures considering exponential distribution to derive a baseline estimate of the system's reliability. The model is then validated with collected system level field failure data from the operational satellite data reception systems that includes failure occurred, failure time, criticality of the failure and repair times by using statistical techniques like median rank, regression and Weibull analysis to extract meaningful insights regarding failure patterns and practical reliability of the system and to assess the accuracy of the developed reliability model. The study mainly focused on identification of critical units within the system, which are prone to failures and have a significant impact on overall performance and brought out a reliability model of the identified critical unit. This model takes into account the interdependencies among system components and their impact on overall system reliability and provides valuable insights into the performance of the system to understand the Improvement or degradation of the system over a period of time and will be the vital input to arrive at the optimized design for future development. It also provides a plug and play framework to understand the effect on performance of the system in case of any up gradations or new designs of the unit. It helps in effective planning and formulating contingency plans to address potential system failures, ensuring the continuity of operations. Furthermore, to instill confidence in system users, the duration for which the system can operate continuously with the desired level of 3 sigma reliability was estimated that turned out to be a vital input to maintenance plan. System availability and station availability was also assessed by considering scenarios of clash and non-clash to determine the overall system performance and potential bottlenecks. Overall, this paper establishes a comprehensive methodology for reliability and availability analysis of complex satellite data reception systems. The results derived from this approach facilitate effective planning contingency measures, and provide users with confidence in system performance and enables decision-makers to make informed choices about system maintenance, upgrades and replacements. It also aids in identifying critical units and assessing system availability in various scenarios and helps in minimizing downtime and optimizing resource allocation.

Keywords: exponential distribution, reliability modeling, reliability block diagram, satellite data reception system, system availability, weibull analysis

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Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

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Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: Beth Jacobs

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The landmark movement of Western clinical psychology in the 20th century was the development of psychotherapy. The landmark movement of clinical psychology in the 21st century will be the absorption of meditation practices from Buddhist psychology. While millions of people explore meditation and related philosophy, very few people are exposed to the materials of original Buddhism on this topic, especially to the Theravadan Abhidharma. The Abhidharma is an intricate system of lists and matrixes that were used to understand and remember Buddha’s teaching. The Abhidharma delineates the first psychological system of Buddhism, how the mind works in the universe of reality and why meditation training strengthens and purifies the experience of life. Its lists outline the psychology of mental constructions, perception, emotion and cosmological causation. While the Abhidharma is technical, elaborate and complex, its essential purpose relates to the central purpose of clinical psychology: to relieve human suffering. Like Western depth psychology, the methodology rests on understanding underlying processes of consciousness and perception. What clinical psychologists might describe as therapeutic improvement, the Abhidharma delineates as a specific pathway of purified actions of consciousness. This paper discusses the concept of 'path' as presented in aspects of the Theravadan Abhidharma and relates this to current clinical psychological views of therapy outcomes and gains. The core path in Buddhism is the Eight-Fold Path, which is the fourth noble truth and the launching of activity toward liberation. The path is not composed of eight ordinal steps; it’s eight-fold and is described as opening the way, not funneling choices. The specific path in the Abhidharma is described in many steps of development of consciousness activities. The path is not something a human moves on, but something that moments of consciousness develop within. 'Cittas' are extensively described in the Abhidharma as the atomic-level unit of a raw action of consciousness touching upon an object in a field, and there are 121 types of cittas categorized. The cittas are embedded in the mental factors, which could be described as the psychological packaging elements of our experiences of consciousness. Based on these constellations of infinitesimal, linked occurrences of consciousness, citta are categorized by dimensions of purification. A path is a chain of citta developing through causes and conditions. There are no selves, no pronouns in the Abhidharma. Instead of me walking a path, this is about a person working with conditions to cultivate a stream of consciousness that is pure, immediate, direct and generous. The same effort, in very different terms, informs the work of most psychotherapies. Depth psychology seeks to release the bound, unconscious elements of mental process into the clarity of realization. Cognitive and behavioral psychologies work on breaking down automatic thought valuations and actions, changing schemas and interpersonal dynamics. Understanding how the original Buddhist concept of positive human development relates to the clinical psychological concept of therapy weaves together two brilliant systems of thought on the development of human well being.

Keywords: Abhidharma, Buddhist path, clinical psychology, psychotherapeutic outcome

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Authors: Hadi S. Hosseini, Larry A. Taber

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In the embryo, heart is initially a simple tubular structure that undergoes complex morphological changes as it transforms into a four-chambered pump. This work focuses on mechanisms that create heart tube (HT). The early embryo is composed of three relatively flat primary germ layers called endoderm, mesoderm, and ectoderm. Precardiac cells located within bilateral regions of the mesoderm called heart fields (HFs) fold and fuse along the embryonic midline to create the HT. The right and left halves of this plate fold symmetrically to bring their upper edges into contact along the midline, where they fuse. In a region near the fusion line, these layers then separate to generate the primitive HT and foregut, which then extend vertically. The anterior intestinal portal (AIP) is the opening at the caudal end of the foregut, which descends as the HT lengthens. The biomechanical mechanisms that drive this folding are poorly understood. Our central hypothesis is that folding is caused by differences in growth between the endoderm and mesoderm while subsequent extension is driven by contraction along the AIP. The feasibility of this hypothesis is examined using experiments with chick embryos and finite-element modeling (FEM). Fertilized white Leghorn chicken eggs were incubated for approximately 22-33 hours until appropriate Hamburger and Hamilton stage (HH5 to HH9) was reached. To inhibit contraction, embryos were cultured in media containing blebbistatin (myosin II inhibitor) for 18h. Three-dimensional models were created using ABAQUS (D. S. Simulia). The initial geometry consists of a flat plate including two layers representing the mesoderm and endoderm. Tissue was considered as a nonlinear elastic material with growth and contraction (negative growth) simulated using a theory, in which the total deformation gradient is given by F=F^*.G, where G is growth tensor and F* is the elastic deformation gradient tensor. In embryos exposed to blebbistatin, initial folding and AIP descension occurred normally. However, after HFs partially fused to create the upper part of the HT, fusion, and AIP descension stopped, and the HT failed to grow longer. These results suggest that cytoskeletal contraction is required only for the later stages of HT formation. In the model, a larger biaxial growth rate in the mesoderm compared to the endoderm causes the bilayered plate to bend ventrally, as the upper edge moves toward the midline, where it 'fuses' with the other half . This folding creates the upper section of the HT, as well as the foregut pocket bordered by the AIP. After this phase completes by stage HH7, contraction along the arch-shaped AIP pulls the lower edge of the plate downward, stretching the two layers. Results given by model are in reasonable agreement with experimental data for the shape of HT, as well as patterns of stress and strain. In conclusion, results of our study support our hypothesis for the creation of the heart tube.

Keywords: heart tube formation, FEM, chick embryo, biomechanics

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Authors: Mansoureh Zangiabadi, Shamil Velji, Rajendra Kelkar, Neal Wade, Volker Pickert

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The EU has set itself a long-term goal of reducing greenhouse gas emissions by 80-95% of the 1990 levels by 2050 as set in the Energy Roadmap 2050. This paper reports on the European Union H2020 funded E-Lobster project which demonstrates tools and technologies, software and hardware in integrating the grid distribution, and the railway power systems with power electronics technologies (Smart Soft Open Point - sSOP) and local energy storage. In this context this paper describes the existing policies and regulatory frameworks of the energy market at European level with a special focus then at National level, on the countries where the members of the consortium are located, and where the demonstration activities will be implemented. By taking into account the disciplinary approach of E-Lobster, the main policy areas investigated includes electricity, energy market, energy efficiency, transport and smart cities. Energy storage will play a key role in enabling the EU to develop a low-carbon electricity system. In recent years, Energy Storage System (ESSs) are gaining importance due to emerging applications, especially electrification of the transportation sector and grid integration of volatile renewables. The need for storage systems led to ESS technologies performance improvements and significant price decline. This allows for opening a new market where ESSs can be a reliable and economical solution. One such emerging market for ESS is R+G management which will be investigated and demonstrated within E-Lobster project. The surplus of energy in one type of power system (e.g., due to metro braking) might be directly transferred to the other power system (or vice versa). However, it would usually happen at unfavourable instances when the recipient does not need additional power. Thus, the role of ESS is to enhance advantages coming from interconnection of the railway power systems and distribution grids by offering additional energy buffer. Consequently, the surplus/deficit of energy in, e.g. railway power systems, is not to be immediately transferred to/from the distribution grid but it could be stored and used when it is really needed. This will assure better energy management exchange between the railway power systems and distribution grids and lead to more efficient loss reduction. In this framework, to identify the existing policies and regulatory frameworks is crucial for the project activities and for the future development of business models for the E-Lobster solutions. The projections carried out by the European Commission, the Member States and stakeholders and their analysis indicated some trends, challenges, opportunities and structural changes needed to design the policy measures to provide the appropriate framework for investors. This study will be used as reference for the discussion in the envisaged workshops with stakeholders (DSOs and Transport Managers) in the E-Lobster project.

Keywords: light railway, electrical distribution network, Electrical Energy Storage, policy

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Authors: Brigitte Mischler, Marget Hund, Hilfiker Roger, Clare Maguire

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Background: Brain injury is one of the main causes of permanent physical disability, and improving walking ability is one of the most important goals for patients. After inpatient rehabilitation, most do not receive long-term rehabilitation services. Physical activity is important for the health prevention of the musculoskeletal system, circulatory system and the psyche. Objective: This follow-up study measured physical activity in subacute patients after traumatic brain injury and stroke. The difference in the number of steps in the inpatient setting was compared to the number of steps 1 year after the event in the outpatient setting. Methods: This follow-up study is a cross-sectional observational study with 29 participants. The measurement of daily step count over a seven-day period one year after the event was evaluated with the StepWatch™ ankle sensor. The number of steps taken one year after the event in the outpatient setting was compared with the number of steps taken during the inpatient stay and evaluated if they reached the recommended target value. Correlations between steps-count and exit domain, FAC level, walking speed, light touch, joint position sense, cognition, and fear of falling were calculated. Results: The median (IQR) daily step count of all patients was 2512 (568.5, 4070.5). During follow-up, the number of steps improved to 3656(1710,5900). The average difference was 1159(-2825, 6840) steps per day. Participants who were unable to walk independently (FAC 1) improved from 336(5-705) to 1808(92, 5354) steps per day. Participants able to walk with assistance (FAC 2-3) walked 700(31-3080) and at follow-up 3528(243,6871). Independent walkers (FAC 4-5) walked 4093(2327-5868) and achieved 3878(777,7418) daily steps at follow-up. This value is significantly below the recommended guideline. Step-count at follow-up showed moderate to high and statistically significant correlations: positive for FAC score, positive for FIM total score, positive for walking speed, and negative for fear of falling. Conclusions: Only 17% of all participants achieved the recommended daily step count one year after the event. We need better inpatient and outpatient strategies to improve physical activity. In everyday clinical practice, pedometers and diaries with objectives should be used. A concrete weekly schedule should be drawn up together with the patient, relatives, or nursing staff after discharge. This should include daily self-training, which was instructed during the inpatient stay. A good connection to social life (professional connection or a daily task/activity) can be an important part of improving daily activity. Further research should evaluate strategies to increase daily step counts in inpatient settings as well as in outpatient settings.

Keywords: neurorehabilitation, stroke, traumatic brain injury, steps, stepcount

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Authors: Kathryn Ewing

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Safe and accessible public spaces are vital elements of our South African cities. Public spaces hold the potential to act as important, vibrant places for learning, exchange, and practice. Public walkways, however, are some of the most neglected and extremely dangerous public spaces experienced in the local neighborhood of Gugulethu in Cape Town. Walkways feel insignificant, being recognized as informal and undetermined or retain complex fragments of formal erven. They are generally out of sight connecting minor streets and informal settlements. Community residents refer to the walkways as unsafe and dirty spaces. Local authorities allocate minimal to no municipal budgets nor maintenance plans resulting in a lack of basic services, particularly lighting and green infrastructure. ‘The Walkway Project’ presents a series of urban stories collected from co-design workshops, emotional mapping exercises, and fieldwork, including urban walks and urban talks. The narrative interprets the socio-spatial practice and complexity of informal public space in Gugulethu, Cape Town. The Walkway Project research, interrelated to the Master of Urban Design teaching and design-research studio, has a strong focus on participatory and engaged learning and action research methodology within a deliberate pedagogy. A consolidated urban design implementation plan exposes the impact and challenges of waste and water, opening the debate on relevant local solutions for resilience and safety in Cape Town. A small and neglected passage connecting two streets, commonly referred to as iThemba Walkway, is presented as a case study to show-case strategic urban design intervention strategies for urban upgrading. The iThemba walkway is a community-driven project that demonstrates active and responsible co-design and participatory development opportunities. In March 2021, when visited on an urban walk, the public space was covered by rubble and solid waste. By April 2021, the community cleaned the walkway and created an accessible passage for the school children to pass. Numerous co-design workshops have taken place over the past year. The walkway has emerged as a public space upgrading project facilitated, motivated, and implemented by multiple local partners and residents. Social maps from urban walks and talks illustrate the transformation of iThemba Walkway into an inclusive, safe, resilient, and sustainable urban space, linked to Sustainable Development Goal number 11, sustainable cities and communities. The outcomes of the upgrading project facilitate a deeper understanding of co-design methods, urban upgrading processes, and monitoring of public space and informal urbanism.

Keywords: informal, public space, resilience, safety, upgrade, walkways

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Authors: Shuyi Xie

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As the vital city in south China since the ancient time, Guangzhou has been losing its leading role among the rising neighboring cities, especially, Hong Kong and Shenzhen, since the late 1980s, with the overloaded infrastructure and deteriorating urban environment in its old inner city. Fortunately, with the new expansion of its administrative area in 2000, the local municipality considered it as a great opportunity to solve a series of alarming urban problems. Thus, for the first time, strategic planning was introduced to China for providing more convincing and scientific basis towards better urban future. Differed from traditional Chinese planning practices, which rigidly and dogmatically focused on future blueprints, the strategic planning of Guangzhou proceeded from analyzing practical challenges and opportunities towards establishing reasonable developing objectives and proposing corresponding strategies. Moreover, it was pioneering that the municipality invited five planning institutions for proposals, among which, the paper focuses on the one proposed by China Academy of Urban Planning & Design from its theoretical basis to problems’ defining and analyzing the process, as well as planning results. Since it was closer to the following municipal decisions and had a more far-reaching influence for other Chinese cities' following practices. In particular, it demonstrated an innovative exploration on the role played by urban developing rate on deciding urban growth patterns (‘Spillover-reverberation’ or ‘Leapfrog’). That ultimately established an unprecedented paradigm on deciding an appropriate urban spatial structure in future, including its specific location, function and scale. Besides the proposal itself, this article highlights the role of interactions, among actors, as well as proposals, subsequent discussions, summaries and municipal decisions, especially the establishment of the rolling dynamic evaluation system for periodical reviews on implementation situations, as the first attempt in China. Undoubtedly, strategic planning of Guangzhou has brought out considerable benefits, especially opening the strategic mind for plentiful Chinese cities in the following years through establishing a flexible and dynamic planning mechanism highlighted the interactions among multiple actors with innovative and effective tools, methodologies and perspectives on regional, objective-approach and comparative analysis. However, compared with some developed countries, the strategic planning in China just started and has been greatly relied on empirical studies rather than scientific analysis. Moreover, it still faced a bit of controversy, for instance, the certain gap among institutional proposals, final municipal decisions and implemented results, due to the lacking legal constraint. Also, how to improve the public involvement in China with an absolute up-down administrative system is another urgent task. In future, despite of irresistible and irretrievable weakness, some experiences and lessons from previous international practices, with the combination of specific Chinese situations and domestic practices, would enable to promote the further advance on strategic planning in China.

Keywords: evaluation system, global perspective, Guangzhou, interactions, strategic planning, urban growth patterns

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Authors: Jens Hagman, Jenny Janhager Stier, Ellen Olausson, Anne Y. Faxer, Ana Magazinius

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Sweden has the second highest electric vehicle (plug-in hybrid and battery electric vehicle) sales per capita in Europe but in relation to sales of internal combustion engine electric vehicles sales are still minuscular (< 4%). Much research effort has been placed on various technical and user focused barriers and enablers for adoption of electric vehicles. Less effort has been placed on investigating the retail (dealership-customer) sales process of vehicles in general and electric vehicles in particular. Arguably, no one ought to be better informed about needs and desires of potential electric vehicle buyers than car salesmen, originating from their daily encounters with customers at the dealership. The aim of this paper is to explore the conditions of selling electric vehicle from a car salesmen’s perspective. This includes identifying barriers and enablers for electric vehicle sales originating from internal (dealership and brand) and external (customer, government) sources. In this interview study five car brands (manufacturers) that sell both electric and internal combustion engine vehicles have been investigated. A total of 15 semi-structured interviews have been conducted (three per brand, in rural and urban settings and at different dealerships). Initial analysis reveals several barriers and enablers, experienced by car salesmen, which influence electric vehicle sales. Examples of as reported by car salesmen identified barriers are: -Electric vehicles earn car salesmen less commission on average compared to internal combustion engine vehicles. -It takes more time to sell and deliver an electric vehicle than an internal combustion engine vehicle. -Current leasing contracts entails relatively low second-hand value estimations for electric vehicles and thus a high leasing fee, which negatively affects the attractiveness of electric vehicles for private consumers in particular. -High purchasing price discourages many consumers from considering electric vehicles. -The education and knowledge level of electric vehicles differs between car salesmen, which could affect their self-confidence in meeting well prepared and question prone electric vehicle buyers. Examples of identified enablers are: -Company car tax regulation promotes sales of electric vehicles; in particular, plug-in hybrid electric vehicles are sold extensively to companies (up to 95 % of sales). -Low operating cost of electric vehicles such as fuel and service is an advantage when understood by consumers. -The drive performance of electric vehicles (quick, silent and fun to drive) is attractive to consumers. -Environmental aspects are considered important for certain consumer groups. -Fast technological improvements, such as increased range are opening up a wider market for electric vehicles. -For one of the brands; attractive private lease campaigns have proved effective to promote sales. This paper gives insights of an important but often overlooked aspect for the diffusion of electric vehicles (and durable products in general); the interaction between car salesmen and customers at the critical acquiring moment. Extracted through interviews with multiple car salesmen. The results illuminate untapped potential for sellers (salesmen, dealerships and brands) to mitigating sales barriers and strengthening sales enablers and thus becoming a more important actor in the electric vehicle diffusion process.

Keywords: customer barriers, electric vehicle promotion, sales of electric vehicles, interviews with car salesmen

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Authors: Ilaria Coppola, Davide Lacqua, Nadia Ranìa

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Over the past two decades, migration has gained central importance in the global landscape. Europe hosts the largest number of migrants, totaling 92.9 million people, approximately 37.4 million of whom are regular residents within the European Union's borders. Reception services and different modes of management have received increasing attention precisely because of the complexity of the phenomenon, which necessarily impacts the wider community. Indeed, opening a reception center in an area entails major challenges for that context, for the community that inhabits it, and for the people who use that service. Questioning the strategies needed to offer a functional reception service means listening to the different actors involved who daily face the difficulties involved in working in the field. Recognizing the importance of the professional figures who work closely with migrant people, each with their own specific experiences has led researchers to study and analyze the different types of reception centers and their management. This has led to the development of intervention models and best practices in various countries. However, research from this perspective is still limited, especially in Italy. From this theoretical framework, this study aims to bring out an innovative qualitative tool, such as the world café, the work experiences of 29 social workers working in shelters in the Italian context. Most of the participants were female and lived in the Northwest regions of Italy. Through this tool, the aim was to bring out and share reflections on the critical issues encountered in working in reception centers, with a view to identifying possible solutions for better management of services. The World café represents a tool used in participatory action research that promotes dialogue among participants through the sharing of reflections and ideas. In fact, from critical reflections, participants are invited to identify and share possible solutions to provide a more functional service with benefits to the entire community. Therefore, this research, through the innovative technique of the World café, aims to promote critical thinking processes that can help participants find solutions that can be introduced into their work contexts or proposed to decision-makers. Specifically, the findings shed light on several issues, including complex bureaucratic procedures, insufficient project planning, and inefficiencies in the services provided to migrants. These concerns collectively contribute to what participants perceive as a disorganized and uncoordinated system. In addition, the study explores potential solutions that promote more efficient networking practices, coordinated project management, and a more positive approach to cultural diversity. The main results obtained will be discussed with a focus on critical reflections and possible solutions identified.

Keywords: participatory action research, world café method, reception services, migration contexts, social workers, Italy

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Authors: Aline Woine, Moïra Mikolajczak, Virginie Dardier, Isabelle Roskam

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Background information: Becoming a parent is said to be the happiest event one can ever experience in one’s life. This popular (and almost absolute) truth–which no reasonable and decent human being would ever dare question on pain of being singled out as a bad parent–contrasts with the nuances that reality offers. Indeed, while many parents do thrive in their parenting role, some others falter and become progressively overwhelmed by their parenting role, ineluctably caught in a spiral of exhaustion. Parental burnout (henceforth PB) sets in when parental demands (stressors) exceed parental resources. While it is now generally acknowledged that PB affects the parent’s behavior in terms of neglect and violence toward their offspring, little is known about the impact that the syndrome might have on the children’s internalized (anxious and depressive symptoms, somatic complaints, etc.) and/or externalized (irritability, violence, aggressiveness, conduct disorder, oppositional disorder, etc.) behaviors. Furthermore, at the time of writing, to our best knowledge, no research has yet tested the reverse effect, namely, that of the child's internalized and/or externalized behaviors on the onset and/or maintenance of parental burnout symptoms. Goals and hypotheses: The present pioneering research proposes to fill an important gap in the existing literature related to PB by investigating the bidirectional effect between PB and the child’s internalized and/or externalized behaviors. Relying on a cross-lagged longitudinal study with three waves of data collection (4 months apart), our study tests a transactional model with bidirectional and recursive relations between observed variables and at the three waves, as well as autoregressive paths and cross-sectional correlations. Methods: As we write this, wave-two data are being collected via Qualtrics, and we expect a final sample of about 600 participants composed of French-speaking (snowball sample) and English-speaking (Prolific sample) parents. Structural equation modeling is employed using Stata version 17. In order to retain as much statistical power as possible, we use all available data and therefore apply the maximum likelihood with a missing value (mlmv) as the method of estimation to compute the parameter estimates. To limit (in so far is possible) the shared method variance bias in the evaluation of the child’s behavior, the study relies on a multi-informant evaluation approach. Expected results: We expect our three-wave longitudinal study to show that PB symptoms (measured at T1) raise the occurrence/intensity of the child’s externalized and/or internalized behaviors (measured at T2 and T3). We further expect the child’s occurrence/intensity of externalized and/or internalized behaviors (measured at T1) to augment the risk for PB (measured at T2 and T3). Conclusion: Should our hypotheses be confirmed, our results will make an important contribution to the understanding of both PB and children’s behavioral issues, thereby opening interesting theoretical and clinical avenues.

Keywords: exhaustion, structural equation modeling, cross-lagged longitudinal study, violence and neglect, child-parent relationship

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Authors: Monika Patel, Kazuaki Matsumura

Abstract:

Synthetic hydrogels, with their unique properties such as porosity, strength, and swelling in aqueous environment, are being used in many fields from food additives to regenerative medicines, from diagnostic and pharmaceuticals to drug delivery systems (DDS). But, hydrogels also have some limitations in terms of homogeneity of drug distribution and quantity of loaded drugs. As an alternate, polymeric micelles are extensively used as DDS. With the ease of self-assembly, and distinct stability they remarkably improve the solubility of hydrophobic drugs. However, presently, combinational therapy is the need of time and so are systems which are capable of releasing more than one drug. And it is one of the major challenges towards DDS to control the release of each drug independently, which simple DDS cannot meet. In this work, we present an amphiphilic polypeptide based micelle hydrogel composite to study the dual drug release for wound healing purposes using Amphotericin B (AmpB) and Curcumin as model drugs. Firstly, two differently charged amphiphilic polypeptide chains were prepared namely, poly L-Lysine-b-poly phenyl alanine (PLL-PPA) and poly Glutamic acid-b-poly phenyl alanine (PGA-PPA) through ring opening polymerization of amino acid N-carboxyanhydride. These polymers readily self-assemble to form micelles with hydrophobic PPA block as core and hydrophilic PLL/PGA as shell with an average diameter of about 280nm. The thus formed micelles were loaded with the model drugs. The PLL-PPA micelle was loaded with curcumin and PGA-PPA was loaded with AmpB by dialysis method. Drug loaded micelles showed a slight increase in the mean diameter and were fairly stable in solution and lyophilized forms. For forming the micelles hydrogel composite, the drug loaded micelles were dissolved and were cross linked using genipin. Genipin uses the free –NH2 groups in the PLL-PPA micelles to form a hydrogel network with free PGA-PPA micelles trapped in between the 3D scaffold formed. Different composites were tested by changing the weight ratios of the both micelles and were seen to alter its resulting surface charge from positive to negative with increase in PGA-PPA ratio. The composites with high surface charge showed a burst release of drug in initial phase, were as the composites with relatively low net charge showed a sustained release. Thus the resultant surface charge of the composite can be tuned to tune its drug release profile. Also, while studying the degree of cross linking among the PLL-PPA particles for effect on dual drug release, it was seen that as the degree of crosslinking increases, an increase in the tendency to burst release the drug (AmpB) is seen in PGA-PPA particle, were as on the contrary the PLL-PPA particles showed a slower release of Curcumin with increasing the cross linking density. Thus, two different pharmacokinetic profile of drugs were seen by changing the cross linking degree. In conclusion, a unique charged amphiphilic polypeptide based micelle hydrogel composite for dual drug delivery. This composite can be finely tuned on the basis of need of drug release profiles by changing simple parameters such as composition, cross linking and pH.

Keywords: amphiphilic polypeptide, dual drug release, micelle hydrogel composite, tunable DDS

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Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

Abstract:

Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

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Authors: Shatakshi Garg

Abstract:

As the world continues to grapple with the COVID-19 pandemic, India, one of the most populous democratic federal developing nation, continues to report the highest active cases and deaths, as well as struggle to let its health infrastructure not succumb to the exponentially growing requirements of hospital beds, ventilators, oxygen to save thousands of lives daily at risk. In this context, the paper outlines the handling of the COVID-19 pandemic since it first hit India in January 2020 – the policy decisions taken by the Union and the State governments from the larger perspective of its federal structure. The Constitution of India adopted in 1950 enshrined the federal relations between the Union and the State governments by way of the constitutional division of revenue-raising and expenditure responsibilities. By way of the 72nd and 73rd Amendments in the Constitution, powers and functions were devolved further to the third tier, namely the local governments, with the intention of further strengthening the federal structure of the country. However, with time, several constitutional amendments have shifted the scales in favour of the union government. The paper briefly traces some of these major amendments as well as some policy decisions which made the federal relations asymmetrical. As a result, data on key fiscal parameters helps establish how the union government gained upper hand at the expense of weak state governments, reducing the local governments to mere constitutional bodies without adequate funds and fiscal autonomy to carry out the assigned functions. This quasi-federal structure of India with the union government amassing the majority of power in terms of ‘funds, functions and functionaries’ exposed the perils of weakening sub-national governments post COVID-19 pandemic. With a complex quasi-federal structure and a heterogeneous population of over 1.3 billion, the announcement of a sudden nationwide lockdown by the union government was followed by a plight of migrants struggling to reach homes safely in the absence of adequate arrangements for travel and safety-net made by the union government. With limited autonomy enjoyed by the states, they were mostly dictated by the union government on most aspects of handling the pandemic, including protocols for lockdown, re-opening post lockdown, and vaccination drive. The paper suggests that certain policy decisions like demonetization, the introduction of GST, etc., taken by the incumbent government since 2014 when they first came to power, have further weakened the states and local governments, which have amounted to catastrophic losses, both economic and human. The role of the executive, legislature and judiciary are explored to establish how all these three arms of the government have worked simultaneously to further weaken and expose the fault-lines of the federal structure of India, which has lent the nation incapacitated to handle this pandemic. The paper then suggests the urgency of re-looking at the federal structure of the country and undertaking measures that strengthen the sub-national governments and restore the federal spirit as was enshrined in the constitution to avoid mammoth human and economic losses from a pandemic of this sort.

Keywords: COVID-19 pandemic, India, federal structure, economic losses

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Authors: Z. Yousefniayejahr, S. Bolognini, A. Bonini, C. Campobasso, N. Poma, F. Vivaldi, M. Di Luca, A. Tavanti, F. Di Francesco

Abstract:

Pathogenic bacteria represent a threat to healthcare systems and the food industry because their rapid detection remains challenging. Electrochemical biosensors are gaining prominence as a novel technology for the detection of pathogens due to intrinsic features such as low cost, rapid response time, and portability, which make them a valuable alternative to traditional methodologies. These sensors use biorecognition elements that are crucial for the identification of specific bacteria. In this context, bacteriophages are promising tools for their inherent high selectivity towards bacterial hosts, which is of fundamental importance when detecting bacterial pathogens in complex biological samples. In this study, we present the development of a low-cost and portable sensor based on the Zeno phage for the rapid detection of Staphylococcus aureus. Screen-printed gold electrodes functionalized with the Zeno phage were used, and electrochemical impedance spectroscopy was applied to evaluate the change of the charge transfer resistance (Rct) as a result of the interaction with S. aureus MRSA ATCC 43300. The phage-based biosensor showed a linear range from 101 to 104 CFU/mL with a 20-minute response time and a limit of detection (LOD) of 1.2 CFU/mL under physiological conditions. The biosensor’s ability to recognize various strains of staphylococci was also successfully demonstrated in the presence of clinical isolates collected from different geographic areas. Assays using S. epidermidis were also carried out to verify the species-specificity of the phage sensor. We only observed a remarkable change of the Rct in the presence of the target S. aureus bacteria, while no substantial binding to S. epidermidis occurred. This confirmed that the Zeno phage sensor only targets S. aureus species within the genus Staphylococcus. In addition, the biosensor's specificity with respect to other bacterial species, including gram-positive bacteria like Enterococcus faecium and the gram-negative bacterium Pseudomonas aeruginosa, was evaluated, and a non-significant impedimetric signal was observed. Notably, the biosensor successfully identified S. aureus bacterial cells in a complex matrix such as a nasal swab, opening the possibility of its use in a real-case scenario. We diluted different concentrations of S. aureus from 108 to 100 CFU/mL with a ratio of 1:10 in the nasal swap matrices collected from healthy donors. Three different sensors were applied to measure various concentrations of bacteria. Our sensor indicated high selectivity to detect S. aureus in biological matrices compared to time-consuming traditional methods, such as enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), and radioimmunoassay (RIA), etc. With the aim to study the possibility to use this biosensor to address the challenge associated to pathogen detection, ongoing research is focused on the assessment of the biosensor’s analytical performances in different biological samples and the discovery of new phage bioreceptors.

Keywords: electrochemical impedance spectroscopy, bacteriophage, biosensor, Staphylococcus aureus

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