Search results for: invasive procedure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2811

Search results for: invasive procedure

1821 The Effects of Various Curing Compounds on the Mechanical Characteristics of Roller Compacted Concrete Pavements (RCCP)

Authors: Azadeh Askarinejad, Parmida Hayati, Parham Hayati, Reza Parchami

Abstract:

Curing is a very important factor in the ultimate strength and durability of roller compacted concrete pavements (RCCP). Curing involves keeping the concrete is saturated or close to saturation point. Since maintaining concrete moisture has a significant impact on its mechanical properties, permeability and durability, curing is important. The most common procedure for curing of roller compacted concrete is using a white pigmented curing compound. This method is effective, economical and fast. In the present study, different curing compounds were applied on concrete specimens and the results of their effects on the mechanical properties were compared with each other and usual methods of curing in order to select appropriate materials and methods of curing for RCCP construction.

Keywords: curing compounds, roller compacted concrete pavements, mechanical properties, durability

Procedia PDF Downloads 622
1820 Linac Quality Controls Using An Electronic Portal Imaging Device

Authors: Domingo Planes Meseguer, Raffaele Danilo Esposito, Maria Del Pilar Dorado Rodriguez

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Monthly quality control checks for a Radiation Therapy Linac may be performed is a simple and efficient way once they have been standardized and protocolized. On the other hand this checks, in spite of being imperatives, require a not negligible execution times in terms of machine time and operators time. Besides it must be taken into account the amount of disposable material which may be needed together with the use of commercial software for their performing. With the aim of optimizing and standardizing mechanical-geometric checks and multi leaves collimator checks, we decided to implement a protocol which makes use of the Electronic Portal Imaging Device (EPID) available on our Linacs. The user is step by step guided by the software during the whole procedure. Acquired images are automatically analyzed by our programs all of them written using only free software.

Keywords: quality control checks, linac, radiation oncology, medical physics, free software

Procedia PDF Downloads 199
1819 The Effect of a Three-Month Training Program on the Back Kyphosis of Former Male Addicts

Authors: M. J. Pourvaghar, Sh. Khoshemehry

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Adopting inappropriate body posture during addiction can cause muscular and skeletal deformities. This study is aimed at investigating the effects of a program of the selected corrective exercises on the kyphosis of addicted male patients. Materials and methods: This was a quasi-experimental study. This study has been carried out using the semi-experimental method. The subjects of the present study included 104 addicted men between 25 to 45 years of age. In 2014, these men were referred to one of the NA (Narcotic Anonymous) centres in Kashan in 2015. A total of 24 people suffering from drug withdrawal, who had abnormal kyphosis, were purposefully selected as a sample. The sample was randomly divided into two groups, experimental and control; each group consisted of 12 people. The experimental group participated in a training program for 12 weeks consisting of three 60 minute sessions per week. That includes strengthening, stretching and PNF exercises (deep stretching of the muscle). The control group did no exercise or corrective activity. The Kolmogorov-Smirnov test was used to assess normal distribution of data; and a paired t-test and covariance analysis test were used to assess the effectiveness of the exercises, with a significance level of P≤0.05 by using SPSS18. The results showed that three months of the selected corrective exercises had a significant effect (P≤ 0.005) on the correction of the kyphosis of the addicted male patients after three months of rehabilitation (drug withdrawal) in the experimental group, while there was no significant difference recorded in the control group (P≥0.05). The results show that exercise and corrective activities can be used as non-invasive and non-pharmacological methods to rehabilitate kyphosis abnormalities after drug withdrawal and treatment for addiction.

Keywords: kyphosis, exercise-rehabilitation, addict, addiction

Procedia PDF Downloads 280
1818 Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population: A Five Years Retrospective Study

Authors: Syed Dawood M. Taimur

Abstract:

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

Procedia PDF Downloads 426
1817 Experimental Procedure of Identifying Ground Type by Downhole Test: A Case Study

Authors: Seyed Abolhassan Naeini, Maedeh Akhavan Tavakkoli

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Evaluating the shear wave velocity (V_s) and primary wave velocity (Vₚ) is necessary to identify the ground type of the site. Identifying the soil type based on different codes can affect the dynamic analysis of geotechnical properties. This study aims to separate the underground layers at the project site based on the shear wave and primary wave velocity (Sₚ) in different depths and determine dynamic elastic modulus based on the shear wave velocity. Bandar Anzali is located in a tectonically very active area. Several active faults surround the study site. In this case, a field investigation of downhole testing is conducted as a geophysics method to identify the ground type.

Keywords: downhole, geophysics, shear wave velocity, case-study

Procedia PDF Downloads 138
1816 The Role of Executive Functions and Emotional Intelligence in Leadership: A Neuropsychological Perspective

Authors: Chrysovalanto Sofia Karatosidi, Dimitra Iordanoglou

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The overlap of leadership skills with personality traits, beliefs, values, and the integration of cognitive abilities, analytical and critical thinking skills into leadership competencies raises the need to segregate further and investigate them. Hence, the domains of cognitive functions that contribute to leadership effectiveness should also be identified. Organizational cognitive neuroscience and neuroleadership can shed light on the study of these critical leadership skills. As the first part of our research, this pilot study aims to explore the relationships between higher-order cognitive functions (executive functions), trait emotional intelligence (EI), personality, and general cognitive ability in leadership. Twenty-six graduate and postgraduate students were assessed on neuropsychological tests that measure important aspects of executive functions (EF) and completed self-reported questionnaires about trait EI, personality, leadership styles, and leadership effectiveness. Specifically, we examined four core EF—fluency (phonemic and semantic), information updating and monitoring, working memory, and inhibition of prepotent responses. Leadership effectiveness was positively associated with phonemic fluency (PF), which involves mental flexibility, in turn, an increasingly important ability for future leaders in this rapidly changing world. Transformational leadership was positively associated with trait EI, extraversion, and openness to experience, a result that is following previous findings. The relationship between specific EF constructs and leadership effectiveness emphasizes the role of higher-order cognitive functions in the field of leadership as an individual difference. EF brings a new perspective into leadership literature by providing a direct, non-invasive, scientifically-valid connection between brain function and leadership behavior.

Keywords: cognitive neuroscience, emotional intelligence, executive functions, leadership

Procedia PDF Downloads 157
1815 Dermatological Study on Risk Factors for Pruritic Skin: Skin Properties of Elderly

Authors: Dianis Wulan Sari, Takeo Minematsu, Mikako Yoshida, Hiromi Sanada

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Introduction: Pruritus is diagnosed as itching without macroscopic abnormalities on skin. It is the most skin complaint of elderly people. In the present study, we conducted a dermatological study to examine the risk factors of pruritic skin and predicted how to prevent pruritus especially in the elderly population. Pruritus is caused several types of inflammation, including epidermal innate immunity based on keratinocyte responses and acquired immunity regulated by type 1 or 2 helper T (Th) cells. The triggers of pruritus differ among inflammation types, therefore we did separately assess the pruritus-associated factors of each inflammation type in an effort to contribute to the identification of intervention targets for preventing pruritus. Therefore, this study aimed to investigate the factors related with actual condition of pruritic skin by examine the skin properties. Method: This study was conducted in elderly population of Indonesian nursing home. Basic characteristics and behaviors were obtained by interview. The properties of pruritic skin were collected by examination of skin biomarker using skin blotting as novel method of non-invasive skin assessment method and examination of skin barrier function using stratum corneum hydration and skin pH. Result: The average age of participants was 74 years with independent status was 66.8%. Age (β = -0.130, p = 0.044), cumulative lifetime sun exposure (β = 0.145, p = 0.026), bathing duration (β = 0.151, p = 0.022), clothing change frequency (β = 0.135, p = 0.029), and clothing type (β = -0.139, p = 0.021) were risk factors of pruritic skin in multivariate analysis. Conclusion: Risk factors of pruritic skin in elderly population were caused by internal factors such as skin senescence and external factors such as sun exposure, hygiene care and skin care behavior.

Keywords: aging, hygiene care, pruritus, skin care, sun exposure

Procedia PDF Downloads 225
1814 Dry Relaxation Shrinkage Prediction of Bordeaux Fiber Using a Feed Forward Neural

Authors: Baeza S. Roberto

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The knitted fabric suffers a deformation in its dimensions due to stretching and tension factors, transverse and longitudinal respectively, during the process in rectilinear knitting machines so it performs a dry relaxation shrinkage procedure and thermal action of prefixed to obtain stable conditions in the knitting. This paper presents a dry relaxation shrinkage prediction of Bordeaux fiber using a feed forward neural network and linear regression models. Six operational alternatives of shrinkage were predicted. A comparison of the results was performed finding neural network models with higher levels of explanation of the variability and prediction. The presence of different reposes are included. The models were obtained through a neural toolbox of Matlab and Minitab software with real data in a knitting company of Southern Guanajuato. The results allow predicting dry relaxation shrinkage of each alternative operation.

Keywords: neural network, dry relaxation, knitting, linear regression

Procedia PDF Downloads 584
1813 A Kolmogorov-Smirnov Type Goodness-Of-Fit Test of Multinomial Logistic Regression Model in Case-Control Studies

Authors: Chen Li-Ching

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The multinomial logistic regression model is used popularly for inferring the relationship of risk factors and disease with multiple categories. This study based on the discrepancy between the nonparametric maximum likelihood estimator and semiparametric maximum likelihood estimator of the cumulative distribution function to propose a Kolmogorov-Smirnov type test statistic to assess adequacy of the multinomial logistic regression model for case-control data. A bootstrap procedure is presented to calculate the critical value of the proposed test statistic. Empirical type I error rates and powers of the test are performed by simulation studies. Some examples will be illustrated the implementation of the test.

Keywords: case-control studies, goodness-of-fit test, Kolmogorov-Smirnov test, multinomial logistic regression

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1812 Numerical Investigation of Improved Aerodynamic Performance of a NACA 0015 Airfoil Using Synthetic Jet

Authors: K. Boualem, T. Yahiaoui, A. Azzi

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Numerical investigations are performed to analyze the flow behavior over NACA0015 and to evaluate the efficiency of synthetic jet as active control device. The second objective of this work is to investigate the influence of momentum coefficient of synthetic jet on the flow behaviour. The unsteady Reynolds-averaged Navier-Stokes equations of the turbulent flow are solved using, k-ω SST provided by ANSYS CFX-CFD code. The model presented in this paper is a comprehensive representation of the information found in the literature. Comparison of obtained numerical flow parameters with the experimental ones shows that the adopted computational procedure reflects nearly the real flow nature. Also, numerical results state that use of synthetic jets devices has positive effects on the flow separation, and thus, aerodynamic performance improvement of NACA0015 airfoil. It can also be observed that the use of synthetic jet increases the lift coefficient about 13.3% and reduces the drag coefficient about 52.7%.

Keywords: active control, synthetic jet, NACA airfoil, CFD

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1811 A Review of Accuracy Optical Surface Imaging Systems for Setup Verification During Breast Radiotherapy Treatment

Authors: Auwal Abubakar, Ahmed Ahidjo, Shazril Imran Shaukat, Noor Khairiah A. Karim, Gokula Kumar Appalanaido, Hafiz Mohd Zin

Abstract:

Background: The use of optical surface imaging systems (OSISs) is increasingly becoming popular in radiotherapy practice, especially during breast cancer treatment. This study reviews the accuracy of the available commercial OSISs for breast radiotherapy. Method: A literature search was conducted and identified the available commercial OSISs from different manufacturers that are integrated into radiotherapy practice for setup verification during breast radiotherapy. Studies that evaluated the accuracy of the OSISs during breast radiotherapy using cone beam computed tomography (CBCT) as a reference were retrieved and analyzed. The physics and working principles of the systems from each manufacturer were discussed together with their respective strength and limitations. Results: A total of five (5) different commercially available OSISs from four (4) manufacturers were identified, each with a different working principle. Six (6) studies were found to evaluate the accuracy of the systems during breast radiotherapy in conjunction with CBCT as a goal standard. The studies revealed that the accuracy of the system in terms of mean difference ranges from 0.1 to 2.1 mm. The correlation between CBCT and OSIS ranges between 0.4 and 0.9. The limit of agreements obtained using bland Altman analysis in the studies was also within an acceptable range. Conclusion: The OSISs have an acceptable level of accuracy and could be used safely during breast radiotherapy. The systems are non-invasive, ionizing radiation-free, and provide real-time imaging of the target surface at no extra concomitant imaging dose. However, the system should only be used to complement rather than replace x-ray-based image guidance techniques such as CBCT.

Keywords: optical surface imaging system, Cone beam computed tomography (CBCT), surface guided radiotherapy, Breast radiotherapy

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1810 A Fuzzy Programming Approach for Solving Intuitionistic Fuzzy Linear Fractional Programming Problem

Authors: Sujeet Kumar Singh, Shiv Prasad Yadav

Abstract:

This paper develops an approach for solving intuitionistic fuzzy linear fractional programming (IFLFP) problem where the cost of the objective function, the resources, and the technological coefficients are triangular intuitionistic fuzzy numbers. Here, the IFLFP problem is transformed into an equivalent crisp multi-objective linear fractional programming (MOLFP) problem. By using fuzzy mathematical programming approach the transformed MOLFP problem is reduced into a single objective linear programming (LP) problem. The proposed procedure is illustrated through a numerical example.

Keywords: triangular intuitionistic fuzzy number, linear programming problem, multi objective linear programming problem, fuzzy mathematical programming, membership function

Procedia PDF Downloads 566
1809 Automatic Extraction of Water Bodies Using Whole-R Method

Authors: Nikhat Nawaz, S. Srinivasulu, P. Kesava Rao

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Feature extraction plays an important role in many remote sensing applications. Automatic extraction of water bodies is of great significance in many remote sensing applications like change detection, image retrieval etc. This paper presents a procedure for automatic extraction of water information from remote sensing images. The algorithm uses the relative location of R-colour component of the chromaticity diagram. This method is then integrated with the effectiveness of the spatial scale transformation of whole method. The whole method is based on water index fitted from spectral library. Experimental results demonstrate the improved accuracy and effectiveness of the integrated method for automatic extraction of water bodies.

Keywords: feature extraction, remote sensing, image retrieval, chromaticity, water index, spectral library, integrated method

Procedia PDF Downloads 384
1808 Energy Management System Based on Voltage Fluctuations Minimization for Droop-Controlled Islanded Microgrid

Authors: Zahra Majd, Mohsen Kalantar

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Power management and voltage regulation is one of the most important issues in microgrid (MG) control and scheduling. This paper proposes a multiobjective scheduling formulation that consists of active power costs, voltage fluctuations summation, and technical constraints of MG. Furthermore, load flow and reserve constraints are considered to achieve proper voltage regulation. A modified Jacobian matrix is presented for calculating voltage variations and Mont Carlo simulation is used for generating and reducing scenarios. To convert the problem to a mixed integer linear program, a linearization procedure for nonlinear equations is presented. The proposed model is applied to a typical low-voltage MG and two different cases are investigated. The results show the effectiveness of the proposed model.

Keywords: microgrid, energy management system, voltage fluctuations, modified Jacobian matrix

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1807 Rapid Green Synthesis and Characterization of Silver Nanoparticles Using Eclipta prostrata Leaf Extract

Authors: Siva Prasad Peddi

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Silver nanoparticles were successfully synthesized from silver nitrate through a rapid green synthesis method using Eclipta prostrata leaf extract as a reducing cum stabilizing agent. The experimental procedure was readily conducted at room temperature and pressure, and could be easily scaled up. The silver nanoparticles thus obtained were characterized using UV-Visible Spectroscopy (UV-VIS) which yielded an absorption peak at 416 nm. The biomolecules responsible for capping of the bio-reduced silver nanoparticles synthesized using plant extract were successfully identified through FTIR analysis. It was evinced through Scanning Electron Microscope (SEM), and X-ray diffraction (XRD) analysis that the silver nanoparticles were crystalline in nature and spherical in shape. The average size of the particles obtained using Scherrer’s formula was 27.4 nm. The adopted technique for silver nanoparticle synthesis is suitable for large-scale production.

Keywords: silver nanoparticles, green synthesis, characterization, Eclipta prostrata

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1806 Assessing the Structure of Non-Verbal Semantic Knowledge: The Evaluation and First Results of the Hungarian Semantic Association Test

Authors: Alinka Molnár-Tóth, Tímea Tánczos, Regina Barna, Katalin Jakab, Péter Klivényi

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Supported by neuroscientific findings, the so-called Hub-and-Spoke model of the human semantic system is based on two subcomponents of semantic cognition, namely the semantic control process and semantic representation. Our semantic knowledge is multimodal in nature, as the knowledge system stored in relation to a conception is extensive and broad, while different aspects of the conception may be relevant depending on the purpose. The motivation of our research is to develop a new diagnostic measurement procedure based on the preservation of semantic representation, which is appropriate to the specificities of the Hungarian language and which can be used to compare the non-verbal semantic knowledge of healthy and aphasic persons. The development of the test will broaden the Hungarian clinical diagnostic toolkit, which will allow for more specific therapy planning. The sample of healthy persons (n=480) was determined by the last census data for the representativeness of the sample. Based on the concept of the Pyramids and Palm Tree Test, and according to the characteristics of the Hungarian language, we have elaborated a test based on different types of semantic information, in which the subjects are presented with three pictures: they have to choose the one that best fits the target word above from the two lower options, based on the semantic relation defined. We have measured 5 types of semantic knowledge representations: associative relations, taxonomy, motional representations, concrete as well as abstract verbs. As the first step in our data analysis, we examined the normal distribution of our results, and since it was not normally distributed (p < 0.05), we used nonparametric statistics further into the analysis. Using descriptive statistics, we could determine the frequency of the correct and incorrect responses, and with this knowledge, we could later adjust and remove the items of questionable reliability. The reliability was tested using Cronbach’s α, and it can be safely said that all the results were in an acceptable range of reliability (α = 0.6-0.8). We then tested for the potential gender differences using the Mann Whitney-U test, however, we found no difference between the two (p < 0.05). Likewise, we didn’t see that the age had any effect on the results using one-way ANOVA (p < 0.05), however, the level of education did influence the results (p > 0.05). The relationships between the subtests were observed by the nonparametric Spearman’s rho correlation matrix, showing statistically significant correlation between the subtests (p > 0.05), signifying a linear relationship between the measured semantic functions. A margin of error of 5% was used in all cases. The research will contribute to the expansion of the clinical diagnostic toolkit and will be relevant for the individualised therapeutic design of treatment procedures. The use of a non-verbal test procedure will allow an early assessment of the most severe language conditions, which is a priority in the differential diagnosis. The measurement of reaction time is expected to advance prodrome research, as the tests can be easily conducted in the subclinical phase.

Keywords: communication disorders, diagnostic toolkit, neurorehabilitation, semantic knowlegde

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1805 Calculation of Stress Intensity Factors in Rotating Disks Containing 3D Semi-Elliptical Cracks

Authors: Mahdi Fakoor, Seyed Mohammad Navid Ghoreishi

Abstract:

Initiation and propagation of cracks may cause catastrophic failures in rotating disks, and hence determination of fracture parameter in rotating disks under the different working condition is very important issue. In this paper, a comprehensive study of stress intensity factors in rotating disks containing 3D semi-elliptical cracks under the different working condition is investigated. In this regard, after verification of modeling and analytical procedure, the effects of mechanical properties, rotational velocity, and orientation of cracks on Stress Intensity Factors (SIF) in rotating disks under centrifugal loading are investigated. Also, the effects of using composite patch in reduction of SIF in rotating disks are studied. By that way, the effects of patching design variables like mechanical properties, thickness, and ply angle are investigated individually.

Keywords: stress intensity factor, semi-elliptical crack, rotating disk, finite element analysis (FEA)

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1804 Human Vibrotactile Discrimination Thresholds for Simultaneous and Sequential Stimuli

Authors: Joanna Maj

Abstract:

Body machine interfaces (BMIs) afford users a non-invasive way coordinate movement. Vibrotactile stimulation has been incorporated into BMIs to allow feedback in real-time and guide movement control to benefit patients with cognitive deficits, such as stroke survivors. To advance research in this area, we examined vibrational discrimination thresholds at four body locations to determine suitable application sites for future multi-channel BMIs using vibration cues to guide movement planning and control. Twelve healthy adults had a pair of small vibrators (tactors) affixed to the skin at each location: forearm, shoulders, torso, and knee. A "standard" stimulus (186 Hz; 750 ms) and "probe" stimuli (11 levels ranging from 100 Hz to 235 Hz; 750 ms) were delivered. Probe and test stimulus pairs could occur sequentially or simultaneously (timing). Participants verbally indicated which stimulus felt more intense. Stimulus order was counterbalanced across tactors and body locations. Probabilities that probe stimuli felt more intense than the standard stimulus were computed and fit with a cumulative Gaussian function; the discrimination threshold was defined as one standard deviation of the underlying distribution. Threshold magnitudes depended on stimulus timing and location. Discrimination thresholds were better for stimuli applied sequentially vs. simultaneously at the torso as well as the knee. Thresholds were small (better) and relatively insensitive to timing differences for vibrations applied at the shoulder. BMI applications requiring multiple channels of simultaneous vibrotactile stimulation should therefore consider the shoulder as a deployment site for a vibrotactile BMI interface.

Keywords: electromyography, electromyogram, neuromuscular disorders, biomedical instrumentation, controls engineering

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1803 An Approach for Modeling CMOS Gates

Authors: Spyridon Nikolaidis

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A modeling approach for CMOS gates is presented based on the use of the equivalent inverter. A new model for the inverter has been developed using a simplified transistor current model which incorporates the nanoscale effects for the planar technology. Parametric expressions for the output voltage are provided as well as the values of the output and supply current to be compatible with the CCS technology. The model is parametric according the input signal slew, output load, transistor widths, supply voltage, temperature and process. The transistor widths of the equivalent inverter are determined by HSPICE simulations and parametric expressions are developed for that using a fitting procedure. Results for the NAND gate shows that the proposed approach offers sufficient accuracy with an average error in propagation delay about 5%.

Keywords: CMOS gate modeling, inverter modeling, transistor current mode, timing model

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1802 Shiva's Dance: Crisis, Local Institutions, and Private Firms

Authors: João Pereira Dos Santos

Abstract:

The uneven spatial distribution of start-ups and their respective survival may reflect comparative advantages resulting from the local institutional background. For the first time, we explore this idea using Data Envelopment Analysis (DEA) to assess relative efficiency of Portuguese municipalities in this specific context. We depart from the related literature where expenditure is perceived as a desirable input by choosing a measure of fiscal responsibility and infrastructural variables in the first stage. Comparing results for 2006 and 2010, we find that mean performance decreased substantially with 1) the effects of the Global Financial Crisis; 2) as municipal population increases and 3) as financial independence decreases. A second stage is then computed employing a double-bootstrap procedure to evaluate how the regional context outside the control of local authorities (e.g. demographic characteristics and political preferences) impacts on efficiency.

Keywords: entrepreneurship, political economy, public finance, accountability, crisis, efficiency, Portuguese municipalities

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1801 Analytical Formulae for Parameters Involved in Side Slopes of Embankments Stability

Authors: Abdulrahman Abdulrahman, Abir Abdulrahman

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The stability of slopes of earthen embankments is usually examined by Swedish slip circle method or the slices method. The factor of safety against sliding using Fellenius procedure depends upon the angle formed by the arc of sliding at the center ψ and the radius of the slip circle r. The values of both mentioned parameters ψ and r aren't precisely predicted because they are measured from the drawing. In this paper, analytical formulae were derived for finding the exact values of both ψ and r. Also this paper presents the different conditions of intersections the slip circle with the body of an earthen dam and the coordinate of intersection points. Numerical examples are chosen for demonstration the proposed solution

Keywords: earthen dams stability, , earthen embankments stability, , Fellenius method, hydraulic structures, , side slopes stability, , slices method, Swedish slip circle

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1800 Does Clinical Guidelines Affect Healthcare Quality and Populational Health: Quebec Colorectal Cancer Screening Program

Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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1799 Antifeedant Activity of Plant Extracts on the Spongy Moth (Lymantria dispar) Larvae

Authors: Jovana M. Ćirković, Aleksandar M. Radojković, Sanja Z. Perać, Jelena N. Jovanović, Zorica M. Branković, Slobodan D. Milanović, Ivan Lj. Milenković, Jovan N. Dobrosavljević, Nemanja V. Simović, Vanja M. Tadić, Ana R. Žugić, Goran O. Branković

Abstract:

The protection of forests is a national interest and of strategic importance in every country. The spongy moth (Lymantria dispar) is a damaging invasive pest that can weaken and destroy trees by defoliating them. Chemical pesticides commonly used to protect forests against spongy moths not only have a negative impact on terrestrial and aquatic organisms/ecosystems but also often fail to provide significant protection. Therefore, many eco-friendly alternatives have been considered. Within this research, a new biopesticide was developed based on the method of nanoencapsulation of plant extracts in a biopolymer matrix, which provides a slow release of the active components during a substantial time period. The antifeedant activity of plant extracts of common (Fraxinus excelsior L.), manna (F. ornus L.) ash tree, and the tree of heaven Ailanthus altissima (Mill.) was tested on the spongy moth (Lymantria dispar L, 1758) larvae. To test the antifeedant activity of these compounds, the choice and non-choice tests in laboratory conditions for different plant extract concentrations (0.01, 0.1, 0.5, and 1 % v/v) were carried out. In both cases, the best results showed formulations based on the tree of heaven and common ash for the concentration of 1%, with deterioration indices of 163 and 132, respectively. The main benefit of these formulations is their versatility, effectiveness, prolonged effect, and because they are completely environmentally acceptable. Therefore, they can be considered for suppression of the spongy moth in forest ecosystems.

Keywords: Ailanthus altissima (Mill.), Fraxinus excelsior L., encapsulation, Lymantria dispar

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1798 Bacteremia Caused by Nontoxigenic Vibrio cholerae in an Immunocompromised Patient in Istanbul, Turkey

Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

Abstract:

Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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1797 Studying Second Language Development from a Complex Dynamic Systems Perspective

Authors: L. Freeborn

Abstract:

This paper discusses the application of complex dynamic system theory (DST) to the study of individual differences in second language development. This transdisciplinary framework allows researchers to view the trajectory of language development as a dynamic, non-linear process. A DST approach views language as multi-componential, consisting of multiple complex systems and nested layers. These multiple components and systems continuously interact and influence each other at both the macro- and micro-level. Dynamic systems theory aims to explain and describe the development of the language system, rather than make predictions about its trajectory. Such a holistic and ecological approach to second language development allows researchers to include various research methods from neurological, cognitive, and social perspectives. A DST perspective would involve in-depth analyses as well as mixed methods research. To illustrate, a neurobiological approach to second language development could include non-invasive neuroimaging techniques such as electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) to investigate areas of brain activation during language-related tasks. A cognitive framework would further include behavioural research methods to assess the influence of intelligence and personality traits, as well as individual differences in foreign language aptitude, such as phonetic coding ability and working memory capacity. Exploring second language development from a DST approach would also benefit from including perspectives from the field of applied linguistics, regarding the teaching context, second language input, and the role of affective factors such as motivation. In this way, applying mixed research methods from neurobiological, cognitive, and social approaches would enable researchers to have a more holistic view of the dynamic and complex processes of second language development.

Keywords: dynamic systems theory, mixed methods, research design, second language development

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1796 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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1795 Prediction and Reduction of Cracking Issue in Precision Forging of Engine Valves Using Finite Element Method

Authors: Xi Yang, Bulent Chavdar, Alan Vonseggern, Taylan Altan

Abstract:

Fracture in hot precision forging of engine valves was investigated in this paper. The entire valve forging procedure was described and the possible cause of the fracture was proposed. Finite Element simulation was conducted for the forging process, with commercial Finite Element code DEFORMTM. The effects of material properties, the effect of strain rate and temperature were considered in the FE simulation. Two fracture criteria were discussed and compared, based on the accuracy and reliability of the FE simulation results. The selected criterion predicted the fracture location and shows the trend of damage increasing with good accuracy, which matches the experimental observation. Additional modification of the punch shapes was proposed to further reduce the tendency of fracture in forging. Finite Element comparison shows a great potential of such application in the mass production.

Keywords: hotforging, engine valve, fracture, tooling

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1794 Effects of IPPC Permits on Ambient Air Quality

Authors: C. Cafaro, P. Ceci, L. De Giorgi

Abstract:

The aim of this paper is to give an assessment of environmental effects of IPPC permit conditions of installations that are in the specific territory with a high concentration of industrial activities. The IPPC permit is the permit that each operator should hold to operate the installation as stated by the directive 2010/75/UE on industrial emissions (integrated pollution prevention and control), known as IED (Industrial Emissions Directive). The IPPC permit includes all the measures necessary to achieve a high level of protection of the environment as a whole, also defining the monitoring requirements as measurement methodology, frequency, and evaluation procedure. The emissions monitoring of a specific plant may also give indications of the contribution of these emissions on the air quality of a definite area. So, it is clear that the IPPC permits are important tools both to improve the environmental framework and to achieve the air quality standards, assisting in assessing the possible industrial sources contributions to air pollution.

Keywords: IPPC, IED, emissions, permits, air quality, large combustion plants

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1793 The Effect of Manual Acupuncture-induced Injury as a Mechanism Contributing to Muscle Regeneration

Authors: Kamal Ameis

Abstract:

This study aims to further improve our understanding of the underlying mechanism of local injury that occurs after manual acupuncture needle manipulation, and that initiates the muscle regeneration process, which is essential for muscle maintenance and adaptation. Skeletal muscle is maintained by resident stem cells called muscle satellite cells. These cells are normally in quiescent state, but following muscle injury, they re-enter the cell cycle and execute a myogenic program resulting in muscle fiber regeneration. Our previous work in young rats demonstrated that acupuncture treatment induced injury that activated resident satellite (stem) cells, which leads to muscle regeneration. Skeletal muscle regeneration is an adaptive response to injury that requires a tightly orchestrated event between signaling pathways activated by growth factor and intrinsic regulatory program controlled by myogenic transcription factor. We identified several gene expressions uniquely important for muscle regeneration in response to acupuncture treatment at different time course using different biological techniques, including Immunocytochemistry, western blotting, and Real Time PCR. This study uses a novel but non-invasive model of injury induced by manual acupuncture to further our current understanding of regenerative mechanism of muscle stem cells. From a clinical perspective, this model of injury induced by manual acupuncture may be easily translatable into a clinical tool that can be used as an alternative to physical exercise for patients challenged by bed rest or forced inactivity. Finally, the knowledge gained from this research could be useful for studies of the local effects of various modalities of induced injury, such as the traditional method of healing by cupping (hijamah), which may enhanced muscle stem cells and muscle fiber regeneration.

Keywords: acupuncture, injury, regeneration, muscle stem cells

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1792 Bariatric Surgery Referral as an Alternative to Fundoplication in Obese Patients Presenting with GORD: A Retrospective Hospital-Based Cohort Study

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

Abstract:

Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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