Search results for: Paul Michael Petersen
161 Measurement of in-situ Horizontal Root Tensile Strength of Herbaceous Vegetation for Improved Evaluation of Slope Stability in the Alps
Authors: Michael T. Lobmann, Camilla Wellstein, Stefan Zerbe
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Vegetation plays an important role for the stabilization of slopes against erosion processes, such as shallow erosion and landslides. Plant roots reinforce the soil, increase soil cohesion and often cross possible shear planes. Hence, plant roots reduce the risk of slope failure. Generally, shrub and tree roots penetrate deeper into the soil vertically, while roots of forbs and grasses are concentrated horizontally in the topsoil and organic layer. Therefore, shrubs and trees have a higher potential for stabilization of slopes with deep soil layers than forbs and grasses. Consequently, research mainly focused on the vertical root effects of shrubs and trees. Nevertheless, a better understanding of the stabilizing effects of grasses and forbs is needed for better evaluation of the stability of natural and artificial slopes with herbaceous vegetation. Despite the importance of vertical root effects, field observations indicate that horizontal root effects also play an important role for slope stabilization. Not only forbs and grasses, but also some shrubs and trees form tight horizontal networks of fine and coarse roots and rhizomes in the topsoil. These root networks increase soil cohesion and horizontal tensile strength. Available methods for physical measurements, such as shear-box tests, pullout tests and singular root tensile strength measurement can only provide a detailed picture of vertical effects of roots on slope stabilization. However, the assessment of horizontal root effects is largely limited to computer modeling. Here, a method for measurement of in-situ cumulative horizontal root tensile strength is presented. A traction machine was developed that allows fixation of rectangular grass sods (max. 30x60cm) on the short ends with a 30x30cm measurement zone in the middle. On two alpine grass slopes in South Tyrol (northern Italy), 30x60cm grass sods were cut out (max. depth 20cm). Grass sods were pulled apart measuring the horizontal tensile strength over 30cm width over the time. The horizontal tensile strength of the sods was measured and compared for different soil depths, hydrological conditions, and root physiological properties. The results improve our understanding of horizontal root effects on slope stabilization and can be used for improved evaluation of grass slope stability.Keywords: grassland, horizontal root effect, landslide, mountain, pasture, shallow erosion
Procedia PDF Downloads 166160 New Derivatives 7-(diethylamino)quinolin-2-(1H)-one Based Chalcone Colorimetric Probes for Detection of Bisulfite Anion in Cationic Micellar Media
Authors: Guillermo E. Quintero, Edwin G. Perez, Oriel Sanchez, Christian Espinosa-Bustos, Denis Fuentealba, Margarita E. Aliaga
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Bisulfite ion (HSO3-) has been used as a preservative in food, drinks, and medication. However, it is well-known that HSO3- can cause health problems like asthma and allergic reactions in people. Due to the above, the development of analytical methods for detecting this ion has gained great interest. In line with the above, the current use of colorimetric and/or fluorescent probes as a detection technique has acquired great relevance due to their high sensitivity and accuracy. In this context, 2-quinolinone derivatives have been found to possess promising activity as antiviral agents, sensitizers in solar cells, antifungals, antioxidants, and sensors. In particular, 7-(diethylamino)-2-quinolinone derivatives have attracted attention in recent years since their suitable photophysical properties become promising fluorescent probes. In Addition, there is evidence that photophysical properties and reactivity can be affected by the study medium, such as micellar media. Based on the above background, 7-(diethylamino)-2-quinolinone derivatives based chalcone will be able to be incorporated into a cationic micellar environment (Cetyltrimethylammonium bromide, CTAB). Furthermore, the supramolecular control induced by the micellar environment will increase the reactivity of these derivatives towards nucleophilic analytes such as HSO3- (Michael-type addition reaction), leading to the generation of new colorimetric and/or fluorescent probes. In the present study, two derivatives of 7-(diethylamino)-2-quinolinone based chalcone DQD1-2 were synthesized according to the method reported by the literature. These derivatives were structurally characterized by 1H, 13C NMR, and HRMS-ESI. In addition, UV-VIS and fluorescence studies determined absorption bands near 450 nm, emission bands near 600 nm, fluorescence quantum yields near 0.01, and fluorescence lifetimes of 5 ps. In line with the foregoing, these photophysical properties aforementioned were improved in the presence of a cationic micellar medium using CTAB thanks to the formation of adducts presenting association constants of the order of 2,5x105 M-1, increasing the quantum yields to 0.12 and the fluorescence lifetimes corresponding to two lifetimes near to 120 and 400 ps for DQD1 and DQD2. Besides, thanks to the presence of the micellar medium, the reactivity of these derivatives with nucleophilic analytes, such as HSO3-, was increased. This was achieved through kinetic studies, which demonstrated an increase in the bimolecular rate constants in the presence of a micellar medium. Finally, probe DQD1 was chosen as the best sensor since it was assessed to detect HSO3- with excellent results.Keywords: bisulfite detection, cationic micelle, colorimetric probes, quinolinone derivatives
Procedia PDF Downloads 94159 School Refusal Behaviours: The Roles of Adolescent and Parental Factors
Authors: Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson
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School refusal behaviours refer to behaviours to avoid school attendance, chronic lateness in arriving at school, or regular early dismissal. Poor attendance in schools is highly correlated with anxiety, depression, suicide attempts, delinquency, violence, and substance use and abuse. Poor attendance is also a strong indicator of lower achievement in school, as well as problematic social-emotional development. Long-term consequences of school refusal behaviours include fewer opportunities for higher education, employment, and social difficulties, and high risks of later psychiatric illness. Given its negative impacts on youth educational outcomes and well-being, a thorough understanding of factors that are involved in the development of this phenomenon is warranted for developing effective management approaches. This study investigated parental and adolescent factors that may contribute to school refusal behaviours by specifically focusing on the role of parental and adolescents’ anxiety and depression, emotion dysregulation, and parental rearing style. Findings are expected to inform the identification of both parental and adolescents’ factors that may contribute to school refusal behaviours. This knowledge will enable novel and effective approaches that incorporate these factors to managing school refusal behaviours in adolescents, which in turn improve their school and daily functioning. Results are important for an integrative understanding of school refusal behaviours. Furthermore, findings will also provide information for policymakers to weigh the benefits of interventions targeting school refusal behaviours in adolescents. One-hundred-and-six adolescents aged 12-18 years (mean age = 14.79 years old, SD = 1.78, males = 44) and their parents (mean age = 47.49 years old, SD = 5.61, males = 27) completed an online questionnaire measuring both parental and adolescents’ anxiety, depression, emotion dysregulation, parental rearing styles, and adolescents’ school refusal behaviours. Adolescents with school refusal behaviours reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Parental emotion dysregulation and adolescents’ anxiety and depression predicted school refusal behaviours independently. To date, only limited studies have investigated the interplay between parental and youth factors in relation to youth school refusal behaviours. Although parental emotion dysregulation has been investigated in relation to youth emotion dysregulation, little is known about its role in the context of school refusal. This study is one of the very few that investigated both parental and adolescent factors in relation to school refusal behaviours in adolescents. The findings support the theoretical models that emphasise the role of youth and parental psychopathology in school refusal behaviours. Future management of school refusal behaviours should target adolescents’ anxiety and depression while incorporating training for parental emotion regulation skills.Keywords: adolescents, school refusal behaviors, parental factors, anxiety and depression, emotion dysregulation
Procedia PDF Downloads 127158 Monitoring of Wound Healing Through Structural and Functional Mechanisms Using Photoacoustic Imaging Modality
Authors: Souradip Paul, Arijit Paramanick, M. Suheshkumar Singh
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Traumatic injury is the leading worldwide health problem. Annually, millions of surgical wounds are created for the sake of routine medical care. The healing of these unintended injuries is always monitored based on visual inspection. The maximal restoration of tissue functionality remains a significant concern of clinical care. Although minor injuries heal well with proper care and medical treatment, large injuries negatively influence various factors (vasculature insufficiency, tissue coagulation) and cause poor healing. Demographically, the number of people suffering from severe wounds and impaired healing conditions is burdensome for both human health and the economy. An incomplete understanding of the functional and molecular mechanism of tissue healing often leads to a lack of proper therapies and treatment. Hence, strong and promising medical guidance is necessary for monitoring the tissue regeneration processes. Photoacoustic imaging (PAI), is a non-invasive, hybrid imaging modality that can provide a suitable solution in this regard. Light combined with sound offers structural, functional and molecular information from the higher penetration depth. Therefore, molecular and structural mechanisms of tissue repair will be readily observable in PAI from the superficial layer and in the deep tissue region. Blood vessel formation and its growth is an essential tissue-repairing components. These vessels supply nutrition and oxygen to the cell in the wound region. Angiogenesis (formation of new capillaries from existing blood vessels) contributes to new blood vessel formation during tissue repair. The betterment of tissue healing directly depends on angiogenesis. Other optical microscopy techniques can visualize angiogenesis in micron-scale penetration depth but are unable to provide deep tissue information. PAI overcomes this barrier due to its unique capability. It is ideally suited for deep tissue imaging and provides the rich optical contrast generated by hemoglobin in blood vessels. Hence, an early angiogenesis detection method provided by PAI leads to monitoring the medical treatment of the wound. Along with functional property, mechanical property also plays a key role in tissue regeneration. The wound heals through a dynamic series of physiological events like coagulation, granulation tissue formation, and extracellular matrix (ECM) remodeling. Therefore tissue elasticity changes, can be identified using non-contact photoacoustic elastography (PAE). In a nutshell, angiogenesis and biomechanical properties are both critical parameters for tissue healing and these can be characterized in a single imaging modality (PAI).Keywords: PAT, wound healing, tissue coagulation, angiogenesis
Procedia PDF Downloads 106157 Telemedicine Versus Face-to-Face Follow up in General Surgery: A Randomized Controlled Trial
Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles
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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.Keywords: general surgery, telemedicine, patient satisfaction, patient safety
Procedia PDF Downloads 118156 Ecosystem Approach in Aquaculture: From Experimental Recirculating Multi-Trophic Aquaculture to Operational System in Marsh Ponds
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Integrated multi-trophic aquaculture (IMTA) is used to reduce waste from aquaculture and increase productivity by co-cultured species. In this study, we designed a recirculating multi-trophic aquaculture system which requires low energy consumption, low water renewal and easy-care. European seabass (Dicentrarchus labrax) were raised with co-cultured sea urchin (Paracentrotus lividus), deteritivorous polychaete fed on settled particulate matter, mussels (Mytilus galloprovincialis) used to extract suspended matters, macroalgae (Ulva sp.) used to uptake dissolved nutrients and gastropod (Phorcus turbinatus) used to clean the series of 4 tanks from fouling. Experiment was performed in triplicate during one month in autumn under an experimental greenhouse at the Institute Océanographique Paul Ricard (IOPR). Thanks to the absence of a physical filter, any pomp was needed to pressure water and the water flow was carried out by a single air-lift followed by gravity flow.Total suspended solids (TSS), biochemical oxygen demand (BOD5), turbidity, phytoplankton estimation and dissolved nutrients (ammonium NH₄, nitrite NO₂⁻, nitrate NO₃⁻ and phosphorus PO₄³⁻) were measured weekly while dissolved oxygen and pH were continuously recorded. Dissolved nutrients stay under the detectable threshold during the experiment. BOD5 decreased between fish and macroalgae tanks. TSS highly increased after 2 weeks and then decreased at the end of the experiment. Those results show that bioremediation can be well used for aquaculture system to keep optimum growing conditions. Fish were the only feeding species by an external product (commercial fish pellet) in the system. The others species (extractive species) were fed from waste streams from the tank above or from Ulva produced by the system for the sea urchin. In this way, between the fish aquaculture only and the addition of the extractive species, the biomass productivity increase by 5.7. In other words, the food conversion ratio dropped from 1.08 with fish only to 0.189 including all species. This experimental recirculating multi-trophic aquaculture system was efficient enough to reduce waste and increase productivity. In a second time, this technology has been reproduced at a commercial scale. The IOPR in collaboration with Les 4 Marais company run for 6 month a recirculating IMTA in 8000 m² of water allocate between 4 marsh ponds. A similar air-lift and gravity recirculating system was design and only one feeding species of shrimp (Palaemon sp.) was growth for 3 extractive species. Thanks to this joint work at the laboratory and commercial scales we will be able to challenge IMTA system and discuss about this sustainable aquaculture technology.Keywords: bioremediation, integrated multi-trophic aquaculture (IMTA), laboratory and commercial scales, recirculating aquaculture, sustainable
Procedia PDF Downloads 152155 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center
Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar
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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate
Procedia PDF Downloads 96154 Metal Contaminants in River Water and Human Urine after an Episode of Major Pollution by Mining Wastes in the Kasai Province of DR Congo
Authors: Remy Mpulumba Badiambile, Paul Musa Obadia, Malick Useni Mutayo, Jeef Numbi Mukanya, Patient Nkulu Banza, Tony Kayembe Kitenge, Erik Smolders, Jean-François Picron, Vincent Haufroid, Célestin Banza Lubaba Nkulu, Benoit Nemery
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Background: In July 2021, the Tshikapa river became heavily polluted by mining wastes from a diamond mine in neighboring Angola, leading to massive killing of fish, as well as disease and even deaths among residents living along the Tshikapa and Kasai rivers, a major contributory of the Congo river. The exact nature of the pollutants was unknown. Methods: In a cross-sectional study conducted in the city of Tshikapa in August 2021, we enrolled by opportunistic sampling 65 residents (11 children < 16y) living alongside the polluted rivers and 65 control residents (5 children) living alongside a non-affected portion of the Kasai river (upstream from the Tshikapa-Kasai confluence). We administered a questionnaire and obtained spot urine samples for measurements of thiocyanate (a metabolite of cyanide) and 26 trace metals (by ICP-MS). Metals (and pH) were also measured in samples of river water. Results: Participants from both groups consumed river water. In the area affected by the pollution, most participants had eaten dead fish. Prevalences of reported health symptoms were higher in the exposed group than among controls: skin rashes (52% vs 0%), diarrhea (40% vs 8%), abdominal pain (8% vs 3%), nausea (3% vs 0%). In polluted water, concentrations [median (range)] were only higher for nickel [(2.2(1.4–3.5)µg/L] and uranium [78(71–91)ng/L] than in non-polluted water [0.8(0.6–1.9)µg/L; 9(7–19)ng/L]. In urine, concentrations [µg/g creatinine, median(IQR)] were significantly higher in the exposed group than in controls for lithium [19.5(12.4–27.3) vs 6.9(5.9–12.1)], thallium [0.41(0.31–0.57) vs 0.19(0.16–0.39)], and uranium [0.026(0.013–0.037)] vs 0.012(0.006–0.024)]. Other elements did not differ between the groups, but levels were higher than reference values for several metals (including manganese, cobalt, nickel, and lead). Urinary thiocyanate concentrations did not differ. Conclusion: This study, after an ecological disaster in the DRC, has documented contamination of river water by nickel and uranium and high urinary levels of some trace metals among affected riverine populations. However, the exact cause of the massive fish kill and disease among residents remains elusive. The capacity to rapidly investigate toxic pollution events must be increased in the area.Keywords: metal contaminants, river water and human urine, pollution by mining wastes, DR Congo
Procedia PDF Downloads 157153 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore
Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan
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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.Keywords: frailty elderly, emergency, laparotomy
Procedia PDF Downloads 145152 Efficacy and Safety of COVID-19 Vaccination in Patients with Multiple Sclerosis: Looking Forward to Post-COVID-19
Authors: Achiron Anat, Mathilda Mandel, Mayust Sue, Achiron Reuven, Gurevich Michael
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Introduction: As coronavirus disease 2019 (COVID-19) vaccination is currently spreading around the world, it is of importance to assess the ability of multiple sclerosis (MS) patients to mount an appropriate immune response to the vaccine in the context of disease-modifying treatments (DMT’s). Objectives: Evaluate immunity generated following COVID-19 vaccination in MS patients, and assess factors contributing to protective humoral and cellular immune responses in MS patients vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus infection. Methods: Review our recent data related to (1) the safety of PfizerBNT162b2 COVID-19 mRNA vaccine in adult MS patients; (2) the humoral post-vaccination SARS-CoV2 IgG response in MS vaccinees using anti-spike protein-based serology; and (3) the cellular immune response of memory B-cells specific for SARS-CoV-2 receptor-binding domain (RBD) and memory T-cells secreting IFN-g and/or IL-2 in response to SARS-CoV2 peptides using ELISpot/Fluorospot assays in MS patients either untreated or under treatment with fingolimod, cladribine, or ocrelizumab; (4) covariate parameters related to mounting protective immune responses. Results: COVID-19 vaccine proved safe in MS patients, and the adverse event profile was mainly characterised by pain at the injection site, fatigue, and headache. Not any increased risk of relapse activity was noted and the rate of patients with acute relapse was comparable to the relapse rate in non-vaccinated patients during the corresponding follow-up period. A mild increase in the rate of adverse events was noted in younger MS patients, among patients with lower disability, and in patients treated with DMTs. Following COVID-19 vaccination protective humoral immune response was significantly decreased in fingolimod- and ocrelizumab- treated MS patients. SARS-CoV2 specific B-cell and T-cell cellular responses were respectively decreased. Untreated MS patients and patients treated with cladribine demonstrated protective humoral and cellular immune responses, similar to healthy vaccinated subjects. Conclusions: COVID-19 BNT162b2 vaccine proved as safe for MS patients. No increased risk of relapse activity was noted post-vaccination. Although COVID-19 vaccination is new, accumulated data demonstrate differences in immune responses under various DMT’s. This knowledge can help to construct appropriate COVID-19 vaccine guidelines to ensure proper immune responses for MS patients.Keywords: covid-19, vaccination, multiple sclerosis, IgG
Procedia PDF Downloads 139151 Quantum Mechanics as A Limiting Case of Relativistic Mechanics
Authors: Ahmad Almajid
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The idea of unifying quantum mechanics with general relativity is still a dream for many researchers, as physics has only two paths, no more. Einstein's path, which is mainly based on particle mechanics, and the path of Paul Dirac and others, which is based on wave mechanics, the incompatibility of the two approaches is due to the radical difference in the initial assumptions and the mathematical nature of each approach. Logical thinking in modern physics leads us to two problems: - In quantum mechanics, despite its success, the problem of measurement and the problem of wave function interpretation is still obscure. - In special relativity, despite the success of the equivalence of rest-mass and energy, but at the speed of light, the fact that the energy becomes infinite is contrary to logic because the speed of light is not infinite, and the mass of the particle is not infinite too. These contradictions arise from the overlap of relativistic and quantum mechanics in the neighborhood of the speed of light, and in order to solve these problems, one must understand well how to move from relativistic mechanics to quantum mechanics, or rather, to unify them in a way different from Dirac's method, in order to go along with God or Nature, since, as Einstein said, "God doesn't play dice." From De Broglie's hypothesis about wave-particle duality, Léon Brillouin's definition of the new proper time was deduced, and thus the quantum Lorentz factor was obtained. Finally, using the Euler-Lagrange equation, we come up with new equations in quantum mechanics. In this paper, the two problems in modern physics mentioned above are solved; it can be said that this new approach to quantum mechanics will enable us to unify it with general relativity quite simply. If the experiments prove the validity of the results of this research, we will be able in the future to transport the matter at speed close to the speed of light. Finally, this research yielded three important results: 1- Lorentz quantum factor. 2- Planck energy is a limited case of Einstein energy. 3- Real quantum mechanics, in which new equations for quantum mechanics match and exceed Dirac's equations, these equations have been reached in a completely different way from Dirac's method. These equations show that quantum mechanics is a limited case of relativistic mechanics. At the Solvay Conference in 1927, the debate about quantum mechanics between Bohr, Einstein, and others reached its climax, while Bohr suggested that if particles are not observed, they are in a probabilistic state, then Einstein said his famous claim ("God does not play dice"). Thus, Einstein was right, especially when he didn't accept the principle of indeterminacy in quantum theory, although experiments support quantum mechanics. However, the results of our research indicate that God really does not play dice; when the electron disappears, it turns into amicable particles or an elastic medium, according to the above obvious equations. Likewise, Bohr was right also, when he indicated that there must be a science like quantum mechanics to monitor and study the motion of subatomic particles, but the picture in front of him was blurry and not clear, so he resorted to the probabilistic interpretation.Keywords: lorentz quantum factor, new, planck’s energy as a limiting case of einstein’s energy, real quantum mechanics, new equations for quantum mechanics
Procedia PDF Downloads 78150 A Cross-Cultural Validation of the Simple Measure of Impact of Lupus Erythematosus in Youngsters (Smiley) among Filipino Pediatric Lupus Patients
Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan
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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)
Procedia PDF Downloads 443149 How Virtualization, Decentralization, and Network-Building Change the Manufacturing Landscape: An Industry 4.0 Perspective
Authors: Malte Brettel, Niklas Friederichsen, Michael Keller, Marius Rosenberg
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The German manufacturing industry has to withstand an increasing global competition on product quality and production costs. As labor costs are high, several industries have suffered severely under the relocation of production facilities towards aspiring countries, which have managed to close the productivity and quality gap substantially. Established manufacturing companies have recognized that customers are not willing to pay large price premiums for incremental quality improvements. As a consequence, many companies from the German manufacturing industry adjust their production focusing on customized products and fast time to market. Leveraging the advantages of novel production strategies such as Agile Manufacturing and Mass Customization, manufacturing companies transform into integrated networks, in which companies unite their core competencies. Hereby, virtualization of the process- and supply-chain ensures smooth inter-company operations providing real-time access to relevant product and production information for all participating entities. Boundaries of companies deteriorate, as autonomous systems exchange data, gained by embedded systems throughout the entire value chain. By including Cyber-Physical-Systems, advanced communication between machines is tantamount to their dialogue with humans. The increasing utilization of information and communication technology allows digital engineering of products and production processes alike. Modular simulation and modeling techniques allow decentralized units to flexibly alter products and thereby enable rapid product innovation. The present article describes the developments of Industry 4.0 within the literature and reviews the associated research streams. Hereby, we analyze eight scientific journals with regards to the following research fields: Individualized production, end-to-end engineering in a virtual process chain and production networks. We employ cluster analysis to assign sub-topics into the respective research field. To assess the practical implications, we conducted face-to-face interviews with managers from the industry as well as from the consulting business using a structured interview guideline. The results reveal reasons for the adaption and refusal of Industry 4.0 practices from a managerial point of view. Our findings contribute to the upcoming research stream of Industry 4.0 and support decision-makers to assess their need for transformation towards Industry 4.0 practices.Keywords: Industry 4.0., mass customization, production networks, virtual process-chain
Procedia PDF Downloads 277148 Examining the Role of Farmer-Centered Participatory Action Learning in Building Sustainable Communities in Rural Haiti
Authors: Charles St. Geste, Michael Neumann, Catherine Twohig
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Our primary aim is to examine farmer-centered participatory action learning as a tool to improve agricultural production, build resilience to climate shocks and, more broadly, advance community-driven solutions for sustainable development in rural communities across Haiti. For over six years, sixty plus farmers from Deslandes, Haiti, organized in three traditional work groups called konbits, have designed and tested low-input agroecology techniques as part of the Konbit Vanyan Kapab Pwoje Agroekoloji. The project utilizes a participatory action learning approach, emphasizing social inclusion, building on local knowledge, experiential learning, active farmer participation in trial design and evaluation, and cross-community sharing. Mixed methods were used to evaluate changes in knowledge and adoption of agroecology techniques, confidence in advancing agroecology locally, and innovation among Konbit Vanyan Kapab farmers. While skill and knowledge in application of agroecology techniques varied among individual farmers, a majority of farmers successfully adopted techniques outside of the trial farms. The use of agroecology techniques on trial and individual farms has doubled crop production in many cases. Farm income has also increased, and farmers report less damage to crops and property caused by extreme weather events. Furthermore, participatory action strategies have led to greater local self-determination and greater capacity for sustainable community development. With increased self-confidence and the knowledge and skills acquired from participating in the project, farmers prioritized sharing their successful techniques with other farmers and have developed a farmer-to-farmer training program that incorporates participatory action learning. Using adult education methods, farmers, trained as agroecology educators, are currently providing training in sustainable farming practices to farmers from five villages in three departments across Haiti. Konbit Vanyan Kapab farmers have also begun testing production of value-added food products, including a dried soup mix and tea. Key factors for success include: opportunities for farmers to actively participate in all phases of the project, group diversity, resources for application of agroecology techniques, focus on group processes and overcoming local barriers to inclusive decision-making.Keywords: agroecology, participatory action learning, rural Haiti, sustainable community development
Procedia PDF Downloads 156147 Processing, Nutritional Assessment and Sensory Evaluation of Bakery Products Prepared from Orange Fleshed Sweet Potatoes (OFSP) and Wheat Composite Flours
Authors: Hategekimana Jean Paul, Irakoze Josiane, Ishimweyizerwe Valentin, Iradukunda Dieudonne, Uwanyirigira Jeannette
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Orange fleshed sweet potatoes (OFSP) are highly grown and are available plenty in rural and urban local markets and its contribution in reduction of food insecurity in Rwanda is considerable. But the postharvest loss of this commodity is a critical challenge due to its high perishability. Several research activities have been conducted on how fresh food commodities can be transformed into extended shelf life food products for prevention of post-harvest losses. However, such activity was not yet well studied in Rwanda. The aim of the present study was the processing of backed products from (OFSP)combined with wheat composite flour and assess the nutritional content and consumer acceptability of new developed products. The perishability of OFSP and their related lack during off season can be eradicated by producing cake, doughnut and bread with OFSP puree or flour. The processing for doughnut and bread were made by making OFSP puree and other ingredients then a dough was made followed by frying and baking while for cake OFSP was dried through solar dryer to have a flour together with wheat flour and other ingredients to make dough cake and baking. For each product, one control and three experimental samples, (three products in three different ratios (30,40 and50%) of OFSP and the remaining percentage of wheat flour) were prepared. All samples including the control were analyzed for the consumer acceptability (sensory attributes). Most preferred samples (One sample for each product with its control sample and for each OFSP variety) were analyzed for nutritional composition along with control sample. The Cake from Terimbere variety and Bread from Gihingumukungu supplemented with 50% OFSP flour or Puree respectively were most acceptable except Doughnut from Vita variety which was highly accepted at 50% of OFSP supplementation. The moisture, ash, protein, fat, fiber, Total carbohydrate, Vitamin C, reducing sugar and minerals (Sodium, Potassium and Phosphorus.) content was different among products. Cake was rich in fibers (14.71%), protein (6.590%), and vitamin c(19.988mg/100g) compared to other samples while bread found to be rich in reducing sugar with 12.71mg/100g compared to cake and doughnut. Also doughnut was found to be rich in fat content with 6.89% compared to other samples. For sensory analysis, doughnut was highly accepted in ratio of 60:40 compared to other products while cake was least accepted at ratio of 50:50. The Proximate composition and minerals content of all the OFSP products were significantly higher as compared to the control samples.Keywords: post-harvest loss, OFSP products, wheat flour, sensory evaluation, proximate composition
Procedia PDF Downloads 62146 Screening for Larvicidal Activity of Aqueous and Ethanolic Extracts of Fourteen Selected Plants and Formulation of a Larvicide against Aedes aegypti (Linn.) and Aedes albopictus (Skuse) Larvae
Authors: Michael Russelle S. Alvarez, Noel S. Quiming, Francisco M. Heralde
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This study aims to: a) obtain ethanolic (95% EtOH) and aqueous extracts of Selaginella elmeri, Christella dentata, Elatostema sinnatum, Curculigo capitulata, Euphorbia hirta, Murraya koenigii, Alpinia speciosa, Cymbopogon citratus, Eucalyptus globulus, Jatropha curcas, Psidium guajava, Gliricidia sepium, Ixora coccinea and Capsicum frutescens and screen them for larvicidal activities against Aedes aegypti (Linn.) and Aedes albopictus (Skuse) larvae; b) to fractionate the most active extract and determine the most active fraction; c) to determine the larvicidal properties of the most active extract and fraction against by computing their percentage mortality, LC50, and LC90 after 24 and 48 hours of exposure; and d) to determine the nature of the components of the active extracts and fractions using phytochemical screening. Ethanolic (95% EtOH) and aqueous extracts of the selected plants will be screened for potential larvicidal activity against Ae. aegypti and Ae. albopictus using standard procedures and 1% malathion and a Piper nigrum based ovicide-larvicide by the Department of Science and Technology as positive controls. The results were analyzed using One-Way ANOVA with Tukey’s and Dunnett’s test. The most active extract will be subjected to partial fractionation using normal-phase column chromatography, and the fractions subsequently screened to determine the most active fraction. The most active extract and fraction were subjected to dose-response assay and probit analysis to determine the LC50 and LC90 after 24 and 48 hours of exposure. The active extracts and fractions will be screened for phytochemical content. The ethanolic extracts of C. citratus, E. hirta, I. coccinea, G. sepium, M. koenigii, E globulus, J. curcas and C. frutescens exhibited significant larvicidal activity, with C. frutescens being the most active. After fractionation, the ethyl acetate fraction was found to be the most active. Phytochemical screening of the extracts revealed the presence of alkaloids, tannins, indoles and steroids. A formulation using talcum powder–300 mg fraction per 1 g talcum powder–was made and again tested for larvicidal activity. At 2 g/L, the formulation proved effective in killing all of the test larvae after 24 hours.Keywords: larvicidal activity screening, partial purification, dose-response assay, capsicum frutescens
Procedia PDF Downloads 329145 Development of Bilayer Coating System for Mitigating Corrosion of Offshore Wind Turbines
Authors: Adamantini Loukodimou, David Weston, Shiladitya Paul
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Offshore structures are subjected to harsh environments. It is documented that carbon steel needs protection from corrosion. The combined effect of UV radiation, seawater splash, and fluctuating temperatures diminish the integrity of these structures. In addition, the possibility of damage caused by floating ice, seaborne debris, and maintenance boats make them even more vulnerable. Their inspection and maintenance when far out in the sea are difficult, risky, and expensive. The most known method of mitigating corrosion of offshore structures is the use of cathodic protection. There are several zones in an offshore wind turbine. In the atmospheric zone, due to the lack of a continuous electrolyte (seawater) layer between the structure and the anode at all times, this method proves inefficient. Thus, the use of protective coatings becomes indispensable. This research focuses on the atmospheric zone. The conversion of commercially available and conventional paint (epoxy) system to an autonomous self-healing paint system via the addition of suitable encapsulated healing agents and catalyst is investigated in this work. These coating systems, which can self-heal when damaged, can provide a cost-effective engineering solution to corrosion and related problems. When the damage of the paint coating occurs, the microcapsules are designed to rupture and release the self-healing liquid (monomer), which then will react in the presence of the catalyst and solidify (polymerization), resulting in healing. The catalyst should be compatible with the system because otherwise, the self-healing process will not occur. The carbon steel substrate will be exposed to a corrosive environment, so the use of a sacrificial layer of Zn is also investigated. More specifically, the first layer of this new coating system will be TSZA (Thermally Sprayed Zn85/Al15) and will be applied on carbon steel samples with dimensions 100 x 150 mm after being blasted with alumina (size F24) as part of the surface preparation. Based on the literature, it corrodes readily, so one additional paint layer enriched with microcapsules will be added. Also, the reaction and the curing time are of high importance in order for this bilayer system of coating to work successfully. For the first experiments, polystyrene microcapsules loaded with 3-octanoyltio-1-propyltriethoxysilane were conducted. Electrochemical experiments such as Electrochemical Impedance Spectroscopy (EIS) confirmed the corrosion inhibiting properties of the silane. The diameter of the microcapsules was about 150-200 microns. Further experiments were conducted with different reagents and methods in order to obtain diameters of about 50 microns, and their self-healing properties were tested in synthetic seawater using electrochemical techniques. The use of combined paint/electrodeposited coatings allows for further novel development of composite coating systems. The potential for the application of these coatings in offshore structures will be discussed.Keywords: corrosion mitigation, microcapsules, offshore wind turbines, self-healing
Procedia PDF Downloads 115144 Phytochemistry and Alpha-Amylase Inhibitory Activities of Rauvolfia vomitoria (Afzel) Leaves and Picralima nitida (Stapf) Seeds
Authors: Oseyemi Omowunmi Olubomehin, Olufemi Michael Denton
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Diabetes mellitus is a disease that is related to the digestion of carbohydrates, proteins and fats and how this affects the blood glucose levels. Various synthetic drugs employed in the management of the disease work through different mechanisms. Keeping postprandial blood glucose levels within acceptable range is a major factor in the management of type 2 diabetes and its complications. Thus, the inhibition of carbohydrate-hydrolyzing enzymes such as α-amylase is an important strategy in lowering postprandial blood glucose levels, but synthetic inhibitors have undesirable side effects like flatulence, diarrhea, gastrointestinal disorders to mention a few. Therefore, it is necessary to identify and explore the α-amylase inhibitors from plants due to their availability, safety, and low costs. In the present study, extracts from the leaves of Rauvolfia vomitoria and seeds of Picralima nitida which are used in the Nigeria traditional system of medicine to treat diabetes were tested for their α-amylase inhibitory effect. The powdered plant samples were subjected to phytochemical screening using standard procedures. The leaves and seeds macerated successively using n-hexane, ethyl acetate and methanol resulted in the crude extracts which at different concentrations (0.1, 0.5 and 1 mg/mL) alongside the standard drug acarbose, were subjected to α-amylase inhibitory assay using the Benfield and Miller methods, with slight modification. Statistical analysis was done using ANOVA, SPSS version 2.0. The phytochemical screening results of the leaves of Rauvolfia vomitoria and the seeds of Picralima nitida showed the presence of alkaloids, tannins, saponins and cardiac glycosides while in addition Rauvolfia vomitoria had phenols and Picralima nitida had terpenoids. The α-amylase assay results revealed that at 1 mg/mL the methanol, hexane, and ethyl acetate extracts of the leaves of Rauvolfia vomitoria gave (15.74, 23.13 and 26.36 %) α-amylase inhibitions respectively, the seeds of Picralima nitida gave (15.50, 30.68, 36.72 %) inhibitions which were not significantly different from the control at p < 0.05, while acarbose gave a significant 56 % inhibition at p < 0.05. The presence of alkaloids, phenols, tannins, steroids, saponins, cardiac glycosides and terpenoids in these plants are responsible for the observed anti-diabetic activity. However, the low percentages of α-amylase inhibition by these plant samples shows that α-amylase inhibition is not the major way by which both plants exhibit their anti-diabetic effect.Keywords: alpha-amylase, Picralima nitida, postprandial hyperglycemia, Rauvolfia vomitoria
Procedia PDF Downloads 191143 Streamlining the Fuzzy Front-End and Improving the Usability of the Tools Involved
Authors: Michael N. O'Sullivan, Con Sheahan
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Researchers have spent decades developing tools and techniques to aid teams in the new product development (NPD) process. Despite this, it is evident that there is a huge gap between their academic prevalence and their industry adoption. For the fuzzy front-end, in particular, there is a wide range of tools to choose from, including the Kano Model, the House of Quality, and many others. In fact, there are so many tools that it can often be difficult for teams to know which ones to use and how they interact with one another. Moreover, while the benefits of using these tools are obvious to industrialists, they are rarely used as they carry a learning curve that is too steep and they become too complex to manage over time. In essence, it is commonly believed that they are simply not worth the effort required to learn and use them. This research explores a streamlined process for the fuzzy front-end, assembling the most effective tools and making them accessible to everyone. The process was developed iteratively over the course of 3 years, following over 80 final year NPD teams from engineering, design, technology, and construction as they carried a product from concept through to production specification. Questionnaires, focus groups, and observations were used to understand the usability issues with the tools involved, and a human-centred design approach was adopted to produce a solution to these issues. The solution takes the form of physical toolkit, similar to a board game, which allows the team to play through an example of a new product development in order to understand the process and the tools, before using it for their own product development efforts. A complimentary website is used to enhance the physical toolkit, and it provides more examples of the tools being used, as well as deeper discussions on each of the topics, allowing teams to adapt the process to their skills, preferences and product type. Teams found the solution very useful and intuitive and experienced significantly less confusion and mistakes with the process than teams who did not use it. Those with a design background found it especially useful for the engineering principles like Quality Function Deployment, while those with an engineering or technology background found it especially useful for design and customer requirements acquisition principles, like Voice of the Customer. Products developed using the toolkit are added to the website as more examples of how it can be used, creating a loop which helps future teams understand how the toolkit can be adapted to their project, whether it be a small consumer product or a large B2B service. The toolkit unlocks the potential of these beneficial tools to those in industry, both for large, experienced teams and for inexperienced start-ups. It allows users to assess the market potential of their product concept faster and more effectively, arriving at the product design stage with technical requirements prioritized according to their customers’ needs and wants.Keywords: new product development, fuzzy front-end, usability, Kano model, quality function deployment, voice of customer
Procedia PDF Downloads 108142 Prenatal Paraben Exposure Impacts Infant Overweight Development and in vitro Adipogenesis
Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge
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The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure
Procedia PDF Downloads 274141 Trends in All-Cause Mortality and Inpatient and Outpatient Visits for Ambulatory Care Sensitive Conditions during the First Year of the COVID-19 Pandemic: A Population-Based Study
Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon
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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical OrganizationKeywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy
Procedia PDF Downloads 92140 Deep Mill Level Zone (DMLZ) of Ertsberg East Skarn System, Papua; Correlation between Structure and Mineralization to Determined Characteristic Orebody of DMLZ Mine
Authors: Bambang Antoro, Lasito Soebari, Geoffrey de Jong, Fernandy Meiriyanto, Michael Siahaan, Eko Wibowo, Pormando Silalahi, Ruswanto, Adi Budirumantyo
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The Ertsberg East Skarn System (EESS) is located in the Ertsberg Mining District, Papua, Indonesia. EESS is a sub-vertical zone of copper-gold mineralization hosted in both diorite (vein-style mineralization) and skarn (disseminated and vein style mineralization). Deep Mill Level Zone (DMLZ) is a mining zone in the lower part of East Ertsberg Skarn System (EESS) that product copper and gold. The Deep Mill Level Zone deposit is located below the Deep Ore Zone deposit between the 3125m to 2590m elevation, measures roughly 1,200m in length and is between 350 and 500m in width. DMLZ planned start mined on Q2-2015, being mined at an ore extraction rate about 60,000 tpd by the block cave mine method (the block cave contain 516 Mt). Mineralization and associated hydrothermal alteration in the DMLZ is hosted and enclosed by a large stock (The Main Ertsberg Intrusion) that is barren on all sides and above the DMLZ. Late porphyry dikes that cut through the Main Ertsberg Intrusion are spatially associated with the center of the DMLZ hydrothermal system. DMLZ orebody hosted in diorite and skarn, both dominantly by vein style mineralization. Percentage Material Mined at DMLZ compare with current Reserves are diorite 46% (with 0.46% Cu; 0.56 ppm Au; and 0.83% EqCu); Skarn is 39% (with 1.4% Cu; 0.95 ppm Au; and 2.05% EqCu); Hornfels is 8% (with 0.84% Cu; 0.82 ppm Au; and 1.39% EqCu); and Marble 7 % possible mined waste. Correlation between Ertsberg intrusion, major structure, and vein style mineralization is important to determine characteristic orebody in DMLZ Mine. Generally Deep Mill Level Zone has 2 type of vein filling mineralization from both hosted (diorite and skarn), in diorite hosted the vein system filled by chalcopyrite-bornite-quartz and pyrite, in skarn hosted the vein filled by chalcopyrite-bornite-pyrite and magnetite without quartz. Based on orientation the stockwork vein at diorite hosted and shallow vein in skarn hosted was generally NW-SE trending and NE-SW trending with shallow-moderate dipping. Deep Mill Level Zone control by two main major faults, geologist founded and verified local structure between major structure with NW-SE trending and NE-SW trending with characteristics slickenside, shearing, gauge, water-gas channel, and some has been re-healed.Keywords: copper-gold, DMLZ, skarn, structure
Procedia PDF Downloads 501139 Risk and Emotion: Measuring the Effect of Emotion and Other Visceral Factors on Decision Making under Risk
Authors: Michael Mihalicz, Aziz Guergachi
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Background: The science of modelling choice preferences has evolved over centuries into an interdisciplinary field contributing to several branches of Microeconomics and Mathematical Psychology. Early theories in Decision Science rested on the logic of rationality, but as it and related fields matured, descriptive theories emerged capable of explaining systematic violations of rationality through cognitive mechanisms underlying the thought processes that guide human behaviour. Cognitive limitations are not, however, solely responsible for systematic deviations from rationality and many are now exploring the effect of visceral factors as the more dominant drivers. The current study builds on the existing literature by exploring sleep deprivation, thermal comfort, stress, hunger, fear, anger and sadness as moderators to three distinct elements that define individual risk preference under Cumulative Prospect Theory. Methodology: This study is designed to compare the risk preference of participants experiencing an elevated affective or visceral state to those in a neutral state using nonparametric elicitation methods across three domains. Two experiments will be conducted simultaneously using different methodologies. The first will determine visceral states and risk preferences randomly over a two-week period by prompting participants to complete an online survey remotely. In each round of questions, participants will be asked to self-assess their current state using Visual Analogue Scales before answering a series of lottery-style elicitation questions. The second experiment will be conducted in a laboratory setting using psychological primes to induce a desired state. In this experiment, emotional states will be recorded using emotion analytics and used a basis for comparison between the two methods. Significance: The expected results include a series of measurable and systematic effects on the subjective interpretations of gamble attributes and evidence supporting the proposition that a portion of the variability in human choice preferences unaccounted for by cognitive limitations can be explained by interacting visceral states. Significant results will promote awareness about the subconscious effect that emotions and other drive states have on the way people process and interpret information, and can guide more effective decision making by informing decision-makers of the sources and consequences of irrational behaviour.Keywords: decision making, emotions, prospect theory, visceral factors
Procedia PDF Downloads 149138 Data Refinement Enhances The Accuracy of Short-Term Traffic Latency Prediction
Authors: Man Fung Ho, Lap So, Jiaqi Zhang, Yuheng Zhao, Huiyang Lu, Tat Shing Choi, K. Y. Michael Wong
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Nowadays, a tremendous amount of data is available in the transportation system, enabling the development of various machine learning approaches to make short-term latency predictions. A natural question is then the choice of relevant information to enable accurate predictions. Using traffic data collected from the Taiwan Freeway System, we consider the prediction of short-term latency of a freeway segment with a length of 17 km covering 5 measurement points, each collecting vehicle-by-vehicle data through the electronic toll collection system. The processed data include the past latencies of the freeway segment with different time lags, the traffic conditions of the individual segments (the accumulations, the traffic fluxes, the entrance and exit rates), the total accumulations, and the weekday latency profiles obtained by Gaussian process regression of past data. We arrive at several important conclusions about how data should be refined to obtain accurate predictions, which have implications for future system-wide latency predictions. (1) We find that the prediction of median latency is much more accurate and meaningful than the prediction of average latency, as the latter is plagued by outliers. This is verified by machine-learning prediction using XGBoost that yields a 35% improvement in the mean square error of the 5-minute averaged latencies. (2) We find that the median latency of the segment 15 minutes ago is a very good baseline for performance comparison, and we have evidence that further improvement is achieved by machine learning approaches such as XGBoost and Long Short-Term Memory (LSTM). (3) By analyzing the feature importance score in XGBoost and calculating the mutual information between the inputs and the latencies to be predicted, we identify a sequence of inputs ranked in importance. It confirms that the past latencies are most informative of the predicted latencies, followed by the total accumulation, whereas inputs such as the entrance and exit rates are uninformative. It also confirms that the inputs are much less informative of the average latencies than the median latencies. (4) For predicting the latencies of segments composed of two or three sub-segments, summing up the predicted latencies of each sub-segment is more accurate than the one-step prediction of the whole segment, especially with the latency prediction of the downstream sub-segments trained to anticipate latencies several minutes ahead. The duration of the anticipation time is an increasing function of the traveling time of the upstream segment. The above findings have important implications to predicting the full set of latencies among the various locations in the freeway system.Keywords: data refinement, machine learning, mutual information, short-term latency prediction
Procedia PDF Downloads 169137 A Case of Bilateral Vulval Abscess with Pelvic Fistula in an Immunocompromised Patient with Colostomy: A Diagnostic Challenge
Authors: Paul Feyi Waboso
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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition
Procedia PDF Downloads 18136 Marketing in the Fashion Industry and Its Critical Success Factors: The Case of Fashion Dealers in Ghana
Authors: Kumalbeo Paul Kamani
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Marketing plays a very important role in the success of any firm since it represents the means through which a firm can reach its customers and also promotes its products and services. In fact, marketing aids the firm in identifying customers who the business can competitively serve, and tailoring product offerings, prices, distribution, promotional efforts, and services towards those customers. Unfortunately, in many firms, marketing has been reduced to merely advertisement. For effective marketing, firms must go beyond this often-limited function of advertisement. In the fashion industry in particular, marketing faces challenges due to its peculiar characteristics. Previous research for instance affirms the idiosyncrasy and peculiarities that differentiate the fashion industry from other industrial areas. It has been documented that the fashion industry is characterized seasonal intensity, short product life cycles, the difficulty of competitive differentiation, and long time for companies to reach financial stability. These factors are noted to pose obstacles to the fashion entrepreneur’s endeavours and can be the reasons that explain their low survival rates. In recent times, the fashion industry has been described as a market that is accessible market, has low entry barriers, both in terms of needed capital and skills which have all accounted for the burgeoning nature of startups. Yet as already stated, marketing is particularly challenging in the industry. In particular, areas such as marketing, branding, growth, project planning, financial and relationship management might represent challenges for the fashion entrepreneur but that have not been properly addressed by previous research. It is therefore important to assess marketing strategies of fashion firms and the factors influencing their success. This study generally sought to examine marketing strategies of fashion dealers in Ghana and their critical success factors. The study employed the quantitative survey research approach. A total of 120 fashion dealers were sampled. Questionnaires were used as instrument of data collection. Data collected was analysed using quantitative techniques including descriptive statistics and Relative Importance Index. The study revealed that the marketing strategies used by fashion apparels are text messages using mobile phones, referrals, social media marketing, and direct marketing. Results again show that the factors influencing fashion marketing effectiveness are strategic management, marketing mix (product, price, promotion etc), branding and business development. Policy implications are finally outlined. The study recommends among others that there is a need for the top management executive to craft and adopt marketing strategies that enable that are compatible with the fashion trends and the needs of the customers. This will improve customer satisfaction and hence boost market penetration. The study further recommends that the fashion industry in Ghana should seek to ensure that fashion apparels accommodate the diversity and the cultural setting of different customers to meet their unique needs.Keywords: marketing, fashion, industry, success factors
Procedia PDF Downloads 42135 The Invisible Planner: Unearthing the Informal Dynamics Shaping Mixed-Use and Compact Development in Ghanaian Cities
Authors: Muwaffaq Usman Adam, Isaac Quaye, Jim Anbazu, Yetimoni Kpeebi, Michael Osei-Assibey
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Urban informality, characterized by spontaneous and self-organized practices, plays a significant but often overlooked role in shaping the development of cities, particularly in the context of mixed-use and compact urban environments. This paper aims to explore the invisible planning processes inherent in informal practices and their influence on the urban form of Ghanaian cities. By examining the dynamic interplay between informality and formal planning, the study will discuss the ways in which informal actors shape and plan for mixed-use and compact development. Drawing on the synthesis of relevant secondary data, the research will begin by defining urban informality and identifying the factors that contribute to its prevalence in Ghanaian cities. It will delve into the concept of mixed-use and compact development, highlighting its benefits and importance in urban areas. Drawing on case studies, the paper will uncover the hidden planning processes that occur within informal settlements, showcasing their impact on the physical layout, land use, and spatial arrangements of Ghanaian cities. The study will also uncover the challenges and opportunities associated with informal planning. It examines the constraints faced by informal planners (actors) while also exploring the potential benefits and opportunities that emerge when informality is integrated into formal planning frameworks. By understanding the invisible planner, the research will offer valuable insights into how informal practices can contribute to sustainable and inclusive urban development. Based on the findings, the paper will present policy implications and recommendations. It highlights the need to bridge the policy gaps and calls for the recognition of informal planning practices within formal systems. Strategies are proposed to integrate informality into planning frameworks, fostering collaboration between formal and informal actors to achieve compact and mixed-use development in Ghanaian cities. This research underscores the importance of recognizing and leveraging the invisible planner in Ghanaian cities. By embracing informal planning practices, cities can achieve more sustainable, inclusive, and vibrant urban environments that meet the diverse needs of their residents. This research will also contribute to a deeper understanding of the complex dynamics between informality and planning, advocating for inclusive and collaborative approaches that harness the strengths of both formal and informal actors. The findings will likewise contribute to advancing our understanding of informality's role as an invisible yet influential planner, shedding light on its spatial planning implications on Ghanaian cities.Keywords: informality, mixed-uses, compact development, land use, ghana
Procedia PDF Downloads 125134 On implementing Sumak Kawsay in Post Bellum Principles: The Reconstruction of Natural Damage in the Aftermath of War
Authors: Lisa Tragbar
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In post-war scenarios, reconstruction is a principle towards creating a Just Peace in order to restore a stable post-war society. Just peace theorists explore normative behaviour after war, including the duties and responsibilities of different actors and peacebuilding strategies to achieve a lasting, positive peace. Environmental peace ethicists have argued for including the role of nature in the Ethics of War and Peace. This text explores the question of why and how to rethink the value of nature in post-war scenarios. The aim is to include the rights of nature within a maximalist account of reconstruction by highlighting sumak kawsay in the post-war period. Destruction of nature is usually considered collateral damage in war scenarios. Common universal standards for post-war reconstruction are restitution, compensation and reparation programmes, which is mostly anthropocentric approach. The problem of reconstruction in the aftermath of war is the instrumental value of nature. The responsibility to rebuild needs to be revisited within a non-anthropocentric context. There is an ongoing debate about a minimalist or maximalist approach to post-war reconstruction. While Michael Walzer argues for minimalist in-and-out interventions, Alex Bellamy argues for maximalist strategies such as the responsibility to protect, a UN-concept on how face mass atrocity crimes and how to reconstruct peace. While supporting the tradition of maximalist responsibility to rebuild, these normative post-Bellum concepts do not yet sufficiently consider the rights of nature in the aftermath of war. While reconstruction of infrastructures seems important and necessary, concepts that strengthen the intrinsic value of nature in post-bellum measures must also be included. Peace is not Just Peace without a thriving nature that provides the conditions and resources to live and guarantee human rights. Ecuador's indigenous philosophy of life can contribute to the restoration of nature after war by changing the perspective on the value of nature. The sumak kawsay includes the de-hierarchisation of humans and nature and the principle of reciprocity towards nature. Transferring this idea of life and interconnectedness to post-war reconstruction practices, post bellum perpetrators have restorative obligations not only to people but also to nature. This maximalist approach would include both a restitutive principle, by restoring the balance between humans and nature, and a retributive principle, by punishing the perpetrators through compensatory duties to nature. A maximalist approach to post-war reconstruction that takes into account the rights of nature expands the normative post-war questions to include a more complex field of responsibilities. After a war, Just Peace is restored once not only human rights but also the rights of nature are secured. A minimalist post-bellum approach to reconstruction does not locate future problems at their source and does not offer a solution for the inclusion of obligations to nature. There is a lack of obligations towards nature after a war, which can be changed through a different perspective: The indigenous philosophy of life provides the necessary principles for a comprehensive reconstruction of Just Peace.Keywords: normative ethics, peace, post-war, sumak kawsay, applied ethics
Procedia PDF Downloads 78133 Investigating Early Markers of Alzheimer’s Disease Using a Combination of Cognitive Tests and MRI to Probe Changes in Hippocampal Anatomy and Functionality
Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard
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Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus
Procedia PDF Downloads 573132 Experimental Investigation of Absorbent Regeneration Techniques to Lower the Cost of Combined CO₂ and SO₂ Capture Process
Authors: Bharti Garg, Ashleigh Cousins, Pauline Pearson, Vincent Verheyen, Paul Feron
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The presence of SO₂ in power plant flue gases makes flue gas desulfurization (FGD) an essential requirement prior to post combustion CO₂ (PCC) removal facilities. Although most of the power plants worldwide deploy FGD in order to comply with environmental regulations, generally the achieved SO₂ levels are not sufficiently low for the flue gases to enter the PCC unit. The SO₂ level in the flue gases needs to be less than 10 ppm to effectively operate the PCC installation. The existing FGD units alone cannot bring down the SO₂ levels to or below 10 ppm as required for CO₂ capture. It might require an additional scrubber along with the existing FGD unit to bring the SO₂ to the desired levels. The absence of FGD units in Australian power plants brings an additional challenge. SO₂ concentrations in Australian power station flue gas emissions are in the range of 100-600 ppm. This imposes a serious barrier on the implementation of standard PCC technologies in Australia. CSIRO’s developed CS-Cap process is a unique solution to capture SO₂ and CO₂ in a single column with single absorbent which can potentially bring cost-effectiveness to the commercial deployment of carbon capture in Australia, by removing the need for FGD. Estimated savings of removing SO₂ through a similar process as CS-Cap is around 200 MMUSD for a 500 MW Australian power plant. Pilot plant trials conducted to generate the proof of concept resulted in 100% removal of SO₂ from flue gas without utilising standard limestone-based FGD. In this work, removal of absorbed sulfur from aqueous amine absorbents generated in the pilot plant trials has been investigated by reactive crystallisation and thermal reclamation. More than 95% of the aqueous amines can be reclaimed back from the sulfur loaded absorbent via reactive crystallisation. However, the recovery of amines through thermal reclamation is limited and depends on the sulfur loading on the spent absorbent. The initial experimental work revealed that reactive crystallisation is a better fit for CS-Cap’s sulfur-rich absorbent especially when it is also capable of generating K₂SO₄ crystals of highly saleable quality ~ 99%. Initial cost estimation carried on both the technologies resulted in almost similar capital expenditure; however, the operating cost is considerably higher in thermal reclaimer than that in crystalliser. The experimental data generated in the laboratory from both the regeneration techniques have been used to generate the simulation model in Aspen Plus. The simulation model illustrates the economic benefits which could be gained by removing flue gas desulfurization prior to standard PCC unit and replacing it with a CS-Cap absorber column co-capturing CO₂ and SO₂, and it's absorbent regeneration system which would be either reactive crystallisation or thermal reclamation.Keywords: combined capture, cost analysis, crystallisation, CS-Cap, flue gas desulfurisation, regeneration, sulfur, thermal reclamation
Procedia PDF Downloads 127