Search results for: ultrasound guidance

Authors: Ji Jiazheng, Wang Jingrao, Jin Xin, Zhang Hong

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Diabetes mellitus is a metabolic disease characterized by high blood sugar. A long-standing hyperglycemic state can lead to various tissue damage. Diabetic retinopathy is the most common and widely studied ocular complication and has become the leading cause of blindness in my country. At the same time, diabetes has profound clinically relevant effects on the cornea, leading to keratopathy and vision-threatening. The cornea is an avascular tissue and is sensitive to hyperglycemia, Keratopathy caused by diabetes is usually chronic, they are called diabetic keratopathy or diabetic neurotrophic keratopathy, leading to several diabetic corneal complications including delayed epithelial wound healing, recurrent erosions, neuropathy, loss of sensitivity. Corneal stem cell dysfunction in diabetic patients as an important influencing factor of diabetic keratopathy. The consequences of this condition are often underestimated. The limbus is located between the cornea and the sclera tissue. The limbal stroma consists of a series of radial elevations with fibrovascular centers known as palisades of Vogt (POV). Previous studies have shown that palisades of Vogt (POV), as the main site of limbal stem cells, plays an important role in the homeostasis of the corneal epithelium. Therefore, POV plays a vital role in the healing of corneal epithelial surgery and postoperative evaluation. IVCM can observe the condition of the corneal epithelium at the cellular level. It has profound significance and guidance for the evaluation of limbal and limbal stem cells. We have previously observed structural changes in POV in HSK and HZO patients on IVCM. At present, there have been reports involving limbal stem cell dysfunction in diabetic patients, but the specific pathogenesis is still unclear. However, there are no studies on POV morphological changes in patients with DM. Therefore, we performed statistics and compared the correlation between POV morphological changes and corneal epithelial basal cell density, corneal nerves, and length of disease in DM patients and normal humans using IVCM studies. At the same time, fundoscopy was used to observe the correlation between the thickness of RNFL and the thickness of GCC and POV in diabetic patients. And to observe the correlation between SVD, DVD and POV for research.

Keywords: confocal microscopy, fundus, limbal stem cells, diabetes

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Authors: Mine Koyaz, M. Cem Altun

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Selection of the materials satisfying the expected performances is significantly important for any design. Today, with the constantly evolving and developing technologies, the material options are so wide that the necessity of the use of some support tools in the selection process is arising. Therefore, as a sub process of building element design, a systematic material selection tool is developed, that defines four main steps of the material selection; definition, research, comparison and decision. The main purpose of the tool is being an educational instrument that would show a methodic way of material selection in architectural detailing for the use of architecture students. The tool predefines the possible uses of various material databases and other sources of information on material properties. Hence, it is to be used as a guidance for designers, especially with a limited material knowledge and experience. The material selection tool not only embraces technical properties of materials related with building elements’ functional requirements, but also its sensual properties related with the identity of design and its environmental impacts with respect to the sustainability of the design. The method followed in the development of the tool has two main sections; first the examination and application of the existing methods and second the development of trial versions and their applications. Within the scope of the existing methods; design support tools, methodic approaches for the building element design and material selection process, material properties, material databases, methodic approaches for the decision making process are examined. The existing methods are applied by architecture students and newly graduate architects through different design problems. With respect to the results of these applications, strong and weak sides of the existing material selection tools are presented. A main flow chart of the material selection tool has been developed with the objective to apply the strong aspects of the existing methods and develop their weak sides. Through different stages, a different aspect of the material selection process is investigated and the tool took its final form. Systematic material selection tool, within the building element design process, guides the users with a minimum background information, to practically and accurately determine the ideal material that is to be chosen, satisfying the needs of their design. The tool has a flexible structure that answers different needs of different designs and designers. The trial version issued in this paper shows one of the paths that could be followed and illustrates its application over a design problem.

Keywords: architectural education, building element design, material selection tool, systematic approach

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Authors: Mohamad Shamsuri Juhari

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Fathers who positively involve themselves in their children’s lives will have had a constructive influence on the latter’s social, behavioural, and psychological development. This paper will share the preliminary findings of an ongoing research project which investigates Singaporean fathers from the nation’s minority Malay-Muslim community who commit the reverse, that is, it intends to study the reasons behind these fathers’ non-involvement during the period of their children’s developing years be it through absence, disinterest or ignorance. For instance, children from homes with absentee fathers are more likely to develop deficiencies in attitude and conduct. A father’s negative show of parental skills can also cause setbacks in the child’s education, economic instability in the latter’s future family life, as well as the likelihood of an ensuing intergenerational transmission of criminal behaviour. In the context of the minority Singaporean Malay-Muslim community, the need to investigate the challenges faced by fathers from the ethnic group in carrying out their parental roles arose due to the perceptible rise in statistics reflecting delinquency among its youths. This has resulted in other associated issues such as teenage pregnancies (and the subsequent cyclical patterns of divorce and single motherhood), over-representation in the data for drug offences, and under-representation in statistics reflecting academic achievement. While other factors are known to be involved, these negative outcomes have also been attributed to the lack of fatherly guidance in the affected Malay families. This still-ongoing research project is being carried out in two phases: The first by means of secondary research as well as exploratory data collection via roundtable and focus group discussions with fathers from diverse socio-economic backgrounds. This sets the way for the second phase in which a survey will be undertaken, followed by a series of in-depth face-to-face interviews. The research findings will then be translated into intervention initiatives to overcome the identified challenges. Based on the results collated from Phase 1 of the research, this paper will share a ‘first look’ on the challenges to effective parenting faced by Malay-Muslim fathers in Singapore specifically those relating to the socio-cultural domains of attitude, knowledge, and practice.

Keywords: Malay fathers, socio-cultural domains, attitude, knowledge, practice

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Authors: Huidan Yu, Anurag Deb, Rou Chen, I-Wen Wang

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The use of left ventricle assist devices (LVADs) in patients with heart failure has been a proven and effective therapy for patients with severe end-stage heart failure. Due to the limited availability of suitable donor hearts, LVADs will probably become the alternative solution for patient with heart failure in the near future. While the LVAD is being continuously improved toward enhanced performance, increased device durability, reduced size, a better understanding of implantation management becomes critical in order to achieve better long-term blood supplies and less post-surgical complications such as thrombi generation. Important issues related to the LVAD implantation include the location of outflow grafting (OG), the angle of the OG, the combination between LVAD and native heart pumping, uniform or pulsatile flow at OG, etc. We have hypothesized that an optimal implantation of LVAD is patient specific. To test this hypothesis, we employ a novel in-house computational modeling technique, named InVascular, to conduct a systematic evaluation of cardiac output at aortic arch together with other pertinent hemodynamic quantities for each patient under various implantation scenarios aiming to get an optimal implantation strategy. InVacular is a powerful computational modeling technique that integrates unified mesoscale modeling for both image segmentation and fluid dynamics with the cutting-edge GPU parallel computing. It first segments the aortic artery from patient’s CT image, then seamlessly feeds extracted morphology, together with the velocity wave from Echo Ultrasound image of the same patient, to the computation model to quantify 4-D (time+space) velocity and pressure fields. Using one NVIDIA Tesla K40 GPU card, InVascular completes a computation from CT image to 4-D hemodynamics within 30 minutes. Thus it has the great potential to conduct massive numerical simulation and analysis. The systematic evaluation for one patient includes three OG anastomosis (ascending aorta, descending thoracic aorta, and subclavian artery), three combinations of LVAD and native heart pumping (1:1, 1:2, and 1:3), three angles of OG anastomosis (inclined upward, perpendicular, and inclined downward), and two LVAD inflow conditions (uniform and pulsatile). The optimal LVAD implantation is suggested through a comprehensive analysis of the cardiac output and related hemodynamics from the simulations over the fifty-four scenarios. To confirm the hypothesis, 5 random patient cases will be evaluated.

Keywords: graphic processing unit (GPU) parallel computing, left ventricle assist device (LVAD), lumped-parameter model, patient-specific computational hemodynamics

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Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite

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This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.

Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care

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Authors: Ujunma Nnenna Egbuawa

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Rape or sexual assault is a hideous crime of violence done predominantly to women and occasionally to men. In institutions of higher learning, it’s mostly experienced within or outside the campus environment due to students who are from different backgrounds socially. These students also have been imbibed with conflicting ethical standards, thus act both morally and amoral with respect to their sexual urges. The most affected among these are the female students who live outside the campus environment that is suitable for any immoral activity. These female students that are victims of rape hardly would want to be identified and this has left them as habitual prey to the unsuspecting predators. The socio-cultural setting has also been a contributory factor to the psychological and physical damage these victims face throughout their time of study as female rape victims. This is an empirical study designed to elicit information from students of Federal Polytechnic Nekede Owerri Imo State Nigeria on whether they have been sexually assaulted or raped and how they handled it thereafter. This institution was used as a case study because the provost of this tertiary institution is a woman whose name is Dr( Mrs ) C.U Njoku who has made consented efforts to ensure these rape victims rise above the social stigma associated with it. This rector has also put in some measures to bring about a decline in cases of rape within and outside the campus environment. She also granted the researcher an oral interview on how she has been able to achieve these and the challenges she hitherto faced in the process. Three research questions and a hypothesis guided the study. Samples of 119 students were used and stratification was done for sex, age and the academic level of the students. 14 item questionnaires were used and data generated from the survey were analyzed using percentages. This workshop would engage the participants by investigating some courses that may help in declining the rate of rape cases within a campus. Also, necessary measures that would be taken to help in sensitizing the tertiary institutions in areas that can aid the healing procedures of these victims. The need also for guidance and counseling unit is also a necessity for the psychological survival of these rape victims. As a result, the participants would gain an increased awareness of the influence of rape and sexual assault on campus. There ought to be a paradigm shift in institutions of higher learning in policies, administrative decisions and introduction of courses that will uplift ethical standards in order to bring about a change both locally and globally.

Keywords: institutions, psychological, sexual assault, socio-cultural

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Authors: Cui Li, Xu Yuping

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Based on the question of, "Are short video creators who are digital workers controlled by platform rules?" this study discusses the specific ways of platform rules control and the impact on short video creators. Based on the theory of digital labor, this paper adopts the method of in-depth interview and participant observation and chooses 24 producers of short video content of Tiktok to conduct in-depth interview. At the same time, through entering the short video creation field, the author carries on the four-month field investigation, obtains the creation process related data, and analyzes how the short video creator, as the digital labor, is controlled by the platform rule, as well as the creator in this process of compromise and resistance, a more comprehensive presentation of the short video creators of the labor process. It is found that the short video creators are controlled by the platform rules, mainly in the control of traffic rules, and the creators create content, compromise and resist under the guidance of traffic. First, while the platform seems to offer a flexible and autonomous way for creators to monetize, the threshold for participating in the event is actually very high for creators, and the rules for monetizing the event are vague. Under the influence of the flow rule, the creator is faced unstable incomes and high costs. Therefore, creators have to follow the rules of traffic to guide their own creation, began to flow-oriented content production, mainly reflected in the need to keep up-to-date, the pursuit of traffic to ride on the hot spots, in order to flow regardless, set up people "Born for the show", by the label solidified content creation. Secondly, the irregular working hours lead to the extension and overwork of the working hours, which leads to the internal friction of the short video creators at the spiritual level, and finally leads to the Rat Race of video creation. Thirdly, the video creator has completed the internalization and compromise of the platform rules in practice, which promotes the creator to continue to create independently, and forms the intrinsic motive force of the creator. Finally, the rule-controlled short video creators resist and fight in flexible ways, make use of the mechanism and rules of the platform to carry on the second creation, carry on the routine production, purchase the false flow, transfer the creation position to maintain own creation autonomy.

Keywords: short videos, tiktok, production, digital labors

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Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Inigo Beckett

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In forensic investigations, it is often the case that the most potentially useful recorded evidence derives from coincidental imagery, recorded immediately before or during an incident, and that during the incident (e.g. a ‘failure’ or fire event), the evidence is changed or destroyed. To an image analysis expert involved in photogrammetric analysis for Civil or Criminal Proceedings, traditional computer vision methods involving calibrated cameras is often not appropriate because image metadata cannot be relied upon. This paper presents an approach for resolving this problem, considering in particular and by way of a case study, the angle of a simple ladder shown in a photograph. The UK Health and Safety Executive (HSE) guidance document published in 2014 (INDG455) advises that a leaning ladder should be erected at 75 degrees to the horizontal axis. Personal injury cases can arise in the construction industry because a ladder is too steep or too shallow. Ad-hoc photographs of such ladders in their incident position provide a basis for analysis of their angle. This paper presents a direct approach for ascertaining the position of the camera and the angle of the ladder simultaneously from the photograph(s) by way of a workflow that encompasses a novel application of projective geometry and matrix analysis. Mathematical analysis shows that for a given pixel ratio of directly measured collinear points (i.e. features that lie on the same line segment) from the 2D digital photograph with respect to a given viewing point, we can constrain the 3D camera position to a surface of a sphere in the scene. Depending on what we know about the ladder, we can enforce another independent constraint on the possible camera positions which enables us to constrain the possible positions even further. Experiments were conducted using synthetic and real-world data. The synthetic data modeled a vertical plane with a ladder on a horizontally flat plane resting against a vertical wall. The real-world data was captured using an Apple iPhone 13 Pro and 3D laser scan survey data whereby a ladder was placed in a known location and angle to the vertical axis. For each case, we calculated camera positions and the ladder angles using this method and cross-compared them against their respective ‘true’ values.

Keywords: image analysis, projective geometry, homography, photogrammetry, ladders, Forensics, Mathematical modeling, planar geometry, matrix analysis, collinear, cameras, photographs

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Authors: Xinghui Wu, Chun Yang

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Inertial microfluidics is a competitive fluidic method with applications in separation of particles, cells and bacteria. In contrast to traditional microfluidic devices with low Reynolds number, inertial microfluidics works in the intermediate Re number range which brings about several intriguing inertial effects on particle separation/focusing to meet the throughput requirement in the real-world. Geometric modifications to make channels become irregular shapes can leverage fluid inertia to create complex secondary flow for adjusting the particle equilibrium positions and thus enhance the separation resolution and throughput. Although inertial microfluidics has been extensively studied by experiments, our current understanding of its mechanisms is poor, making it extremely difficult to build rational-design guidelines for the particle focusing locations, especially for irregularly shaped microfluidic channels. Inertial particle microfluidics in irregularly shaped channels were investigated in our group. There are several fundamental issues that require us to address. One of them is about the balance between the inertial lift forces and the secondary drag forces. Also, it is critical to quantitatively describe the dependence of the life forces on particle-particle interactions in irregularly shaped channels, such as a rectangular one. To provide physical insights into the inertial microfluidics in channels of irregular shapes, in this work the immersed boundary-lattice Boltzmann method (IB-LBM) was introduced and validated to explore the transport characteristics and the underlying mechanisms of an inertial focusing single particle in a rectangular microchannel. The transport dynamics of a finitesized particle were investigated over wide ranges of Reynolds number (20 < Re < 500) and particle size. The results show that the inner equilibrium positions are more difficult to occur in the rectangular channel, which can be explained by the secondary flow caused by the presence of a finite-sized particle. Furthermore, force decoupling analysis was utilized to study the effect of each type of lift force on the inertia migration, and a theoretical model for the lateral lift force of a finite-sized particle in the rectangular channel was established. Such theoretical model can be used to provide theoretical guidance for the design and operation of inertial microfluidics.

Keywords: inertial microfluidics, particle focuse, life force, IB-LBM

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Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

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Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

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Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

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Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: ash, farmers, household, peri-urban, refuse, sewage, sludge, urban

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

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Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

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Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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Authors: Gyorgy Folk

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A finite set of cardinal needs define the human core of living well shaped on the evolutionary time scale as attested by social and life sciences of the last decades. Well-being is the purported state of living well. Living of humans akin any other living beings involves the exchange of vital substance with nature, maintaining a supportive symbiosis with an array of other living beings, living up to bonds to kin and exerting efforts to sustain living. A supportive natural environment, access to material resources, the nearness to fellow beings, and life sustaining activity are prerequisites of well-being. Well-living is prone to misinterpretation as an individual achievement, one lives well only and only if bonded to human relationships, related to a place, incorporated in nature. Akin all other forms of it, human life is a self-sustaining arrangement. One may say that the substance of life is life, and not materials, products, and services converted into life. The human being remains shaped on an evolutionary time scale and is enabled within the non-altering core of human being, invariant of cultural differences in earthly space and time. Present paper proposes the introduction of weal, the missing link in the causal chain of societal performance and the goodness of life. Interpreted differently over the ages, cultures and disciplines, instead of well-being, the construct in general use, weal is proposed as the underlying foundation of well-being. Weal stands for the totality of socialised reality as framing well-being for the individual beyond the possibility of deliberate choice. The descriptive approach to weal, mapping it under the guidance of discrete scientific disciplines reveals a limited set of cardinal aspects, labeled here the cardinal needs. Cardinal expresses the fundamental reorientation weal can bring about, needs deliver the sense of sine qua non. Weal is conceived as a oneness mapped along eight cardinal needs. The needs, approached as aspects instead of analytically isolated factors do not require mutually exclusive definitions. To serve the purpose of reorientation, weal is operationalised as a domain in multidimensional space, each dimension encompassing an optimal level of availability of the fundamental satisfiers between the extremes of drastic insufficiency and harmful excess, ensured by actual human effort. Weal seeks balance among the material and social aspects of human being while allows for cultural and individual uniqueness in attaining human flourishing.

Keywords: human well-being, development, economic theory, human needs

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Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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Authors: Yen-Mei Lee

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The concept of a knowledge-behavior gap has been discussed for several years. It is addressed that an individual’s knowledge does not sufficiently transfer to his or her actual actions. This concept is mostly focused on fields related to medicine or applied to health care issues to explain how people or patients connect their personal knowledge to actual health care behaviors. To our knowledge, seldomly has this research been applied to discuss people’s online information seeking behavior. In the current study, the main purpose is to investigate the relationship between web users’ personal values and their actual performances when seeking information on the Internet. The total number of twenty-eight participants, divided into one experienced group (n=14) and one novice group (n=14), were recruited and asked to complete a self-report questionnaire of fifty items related to information seeking actions and behaviors. During the execution, participants needed to rate the importance level (how important each item is) and the performance level (how often they actually do each item) from 1 to 10 points on each item. In this paper, the mean scores of the importance and the performance level are analyzed and discussed. The results show that there is a gap between web user’s knowledge and their actual online seeking behaviors. Both experienced group and novice group have higher average scores of the importance level (experienced group = 7.57, novice group = 6.01) than the actual performance level (experienced group = 6.89, novice group = 5.00) in terms of the fifty online information seeking actions. On the other hand, the experienced group perceives more importance of the fifty online seeking actions and performs actual behaviors better than the novice group. Moreover, experienced participants express a consistent result between their concept knowledge and actual behaviors. For instance, they feel extending a seeking strategy is important and frequently perform this action when seeking online. However, novice participants do not have a consistency between their knowledge and behaviors. For example, though they perceive browsing and judging information are less important than they get lost in the online information seeking process. However, in the actual behavior rating, the scores show that novices do browsing and judge information more often than they get lost when seeking information online. These results, therefore, help scholars and educators have a better understanding of the difference between experienced and novice web users regarding their concept knowledge and actual behaviors. In future study, figuring out how to narrow down the knowledge-behavior gap and create practical guidance for novice users to increase their online seeking efficiency is crucial. Not only could it help experienced users be aware of their actual information seeking behaviors, but also help the novice become mastery to concisely obtain information on the Internet.

Keywords: experienced web user, information seeking behavior, knowledge-behavior gap, novice, online seeking efficiency

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Authors: Yawen Dai, Ping Cheng, Jian Ru Gong

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Photoelctrochemical (PEC) water splitting using semiconductors (SCs) provides a convenient way to convert sustainable but intermittent solar energy into clean hydrogen energy, and it has been regarded as one of most promising technology to solve the energy crisis and environmental pollution in modern society. However, the record energy conversion efficiency of a PEC cell (~3%) is still far lower than the commercialization requirement (~10%). The sluggish kinetics of oxygen evolution reaction (OER) half reaction on photoanodes is a significant limiting factor of the PEC device efficiency, and electrocatalysts (ECs) are always deposited on SCs to accelerate the hole injection for OER. However, an active EC cannot guarantee enhanced PEC performance, since the newly emerged SC-EC interface complicates the interfacial charge behavior. Herein, α-Fe2O3 photoanodes coated with Co3O4 and CoO ECs are taken as the model system to glean fundamental understanding on the EC-dependent interfacial charge behavior. Intensity modulated photocurrent spectroscopy and electrochemical impedance spectroscopy were used to investigate the competition between interfacial charge transfer and recombination, which was found to be dominated by the charge storage capacities of ECs. The combined results indicate that both ECs can store holes and increase the hole density on photoanode surface. It is like a double-edged sword that benefit the multi-hole participated OER, as well as aggravate the SC-EC interfacial charge recombination due to the Coulomb attraction, thus leading to a nonmonotonic PEC performance variation trend with the increasing surface hole density. Co3O4 has low hole storage capacity which brings limited interfacial charge recombination, and thus the increased surface holes can be efficiently utilized for OER to generate enhanced photocurrent. In contrast, CoO has overlarge hole storage capacity that causes severe interfacial charge recombination, which hinders hole transfer to electrolyte for OER. Therefore, the PEC performance of α-Fe2O3 is improved by Co3O4 but decreased by CoO despite the similar electrocatalytic activity of the two ECs. First-principle calculation was conducted to further reveal how the charge storage capacity depends on the EC’s intrinsic property, demonstrating that the larger hole storage capacity of CoO than that of Co3O4 is determined by their Co valence states and original Fermi levels. This study raises up a new strategy to manipulate interfacial charge behavior and the resultant PEC performance by the charge storage capacity of ECs, providing insightful guidance for the interface design in PEC devices.

Keywords: charge storage capacity, electrocatalyst, interfacial charge behavior, photoelectrochemistry, water-splitting

Procedia PDF Downloads 111

Authors: Shiva Naidoo, Kristena Yossef, Grimm Jimm, Mirza Wasique, Eric Kemmerer, Joshua Obuch, Anand Mahadevan

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Background: Fiducial markers effectively enhance tumor target visibility prior to Stereotactic Body Radiation Therapy or Proton therapy. To streamline clinical practice, fiducial placement guidelines from a robotic radiosurgery vendor were examined with the goals of optimizing and standardizing feasible geometries for each treatment indication. Clinical examples of prostate, renal, and pancreatic cases are presented. Methods: Vendor guidelines (Accuray, Sunnyvale, Ca) suggest implantation of 4–6 fiducials at least 20 mm apart, with at least a 15-degree angular difference between fiducials, within 50 mm or less from the target centroid, to ensure that any potential fiducial motion (e.g., from respiration or abdominal/pelvic pressures) will mimic target motion. Also recommended is that all fiducials can be seen in 45-degree oblique views with no overlap to coincide with the robotic radiosurgery imaging planes. For the prostate, a standardized geometry that meets all these objectives is a 2 cm-by-2 cm square in the coronal plane. The transperineal implant of two pairs of preloaded tandem fiducials makes the 2 cm-by-2 cm square geometry clinically feasible. This technique may be applied for renal cancer, except repositioned in a sagittal plane, with the retroperitoneal placement of the fiducials into the tumor. Pancreatic fiducial placement via endoscopic ultrasound (EUS) is technically more challenging, as fiducial placement is operator-dependent, and lesion access may be limited by adjacent vasculature, tumor location, or restricted mobility of the EUS probe in the duodenum. Fluoroscopically assisted fiducial placement during EUS can help ensure fiducial markers are deployed with optimal geometry and visualization. Results: Among the first 22 fiducial cases on a newly installed robotic radiosurgery system, live x-ray images for all nine prostatic cases had excellent fiducial visualization at the treatment console. Renal and pancreatic fiducials were not as clearly visible due to difficult target access and smaller caliber insertion needle/fiducial usage. The geometry of the first prostate case was used to ensure accurate geometric marker placement for the remaining 8 cases. Initially, some of the renal and pancreatic fiducials were closer than the 20 mm recommendation, and interactive feedback with the proceduralists led to subsequent fiducials being too far to the edge of the tumor. Further feedback and discussion of all cases are being used to help guide standardized geometries and achieve ideal fiducial placement. Conclusion: The ideal tradeoffs of fiducial visibility versus the thinnest possible gauge needle to avoid complications needs to be systematically optimized among all patients, particularly in regards to body habitus. Multidisciplinary collaboration among proceduralists and radiation oncologists can lead to improved outcomes.

Keywords: fiducial, prostate cancer, renal cancer, pancreatic cancer, radiotherapy

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Authors: Kai Zhang, Xi Jiang

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Effect of fuel variabilities on premixed combustion of bio-syngas mixtures is of great importance in bio-syngas utilisation. The uncertainties of concentrations of fuel constituents such as H2, CO and CH4 may lead to unpredictable combustion performances, combustion instabilities and hot spots which may deteriorate and damage the combustion hardware. Numerical modelling and simulations can assist in understanding the behaviour of bio-syngas combustion with pre-defined species concentrations, while the evaluation of variabilities of concentrations is expensive. To be more specific, questions such as ‘what is the burning velocity of bio-syngas at specific equivalence ratio?’ have been answered either experimentally or numerically, while questions such as ‘what is the likelihood of burning velocity when precise concentrations of bio-syngas compositions are unknown, but the concentration ranges are pre-described?’ have not yet been answered. Uncertainty quantification (UQ) methods can be used to tackle such questions and assess the effects of fuel compositions. An efficient probabilistic UQ method based on Polynomial Chaos Expansion (PCE) techniques is employed in this study. The method relies on representing random variables (combustion performances) with orthogonal polynomials such as Legendre or Gaussian polynomials. The constructed PCE via Galerkin Projection provides easy access to global sensitivities such as main, joint and total Sobol indices. In this study, impacts of fuel compositions on combustion (adiabatic flame temperature and laminar flame speed) of bio-syngas fuel mixtures are presented invoking this PCE technique at several equivalence ratios. High-pressure effects on bio-syngas combustion instability are obtained using detailed chemical mechanism - the San Diego Mechanism. Guidance on reducing combustion instability from upstream biomass gasification process is provided by quantifying the significant contributions of composition variations to variance of physicochemical properties of bio-syngas combustion. It was found that flame speed is very sensitive to hydrogen variability in bio-syngas, and reducing hydrogen uncertainty from upstream biomass gasification processes can greatly reduce bio-syngas combustion instability. Variation of methane concentration, although thought to be important, has limited impacts on laminar flame instabilities especially for lean combustion. Further studies on the UQ of percentage concentration of hydrogen in bio-syngas can be conducted to guide the safer use of bio-syngas.

Keywords: bio-syngas combustion, clean energy utilisation, fuel variability, PCE, targeted uncertainty reduction, uncertainty quantification

Procedia PDF Downloads 252

Authors: Scott Hollier, Ruchi Permvattana

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The purpose of this abstract is to share the findings of a recently completed disability-related Internet of Things (IoT) project undertaken at Curtin University in Australia. The project focused on identifying how IoT could support people with disabilities with their educational outcomes. To achieve this, the research consisted of an analysis of current literature and interviews conducted with students with vision, hearing, mobility and print disabilities. While the research acknowledged the ability to collect data with IoT is now a fairly common occurrence, its benefits and applicability still need to be grounded back into real-world applications. Furthermore, it is important to consider if there are sections of our society that may benefit from these developments and if those benefits are being fully realised in a rush by large companies to achieve IoT dominance for their particular product or digital ecosystem. In this context, it is important to consider a group which, to our knowledge, has had little specific mainstream focus in the IoT area –people with disabilities. For people with disabilities, the ability for every device to interact with us and with each other has the potential to yield significant benefits. In terms of engagement, the arrival of smart appliances is already offering benefits such as the ability for a person in a wheelchair to give verbal commands to an IoT-enabled washing machine if the buttons are out of reach, or for a blind person to receive a notification on a smartphone when dinner has finished cooking in an IoT-enabled microwave. With clear benefits of IoT being identified for people with disabilities, it is important to also identify what implications there are for education. With higher education being a critical pathway for many people with disabilities in finding employment, the question as to whether such technologies can support the educational outcomes of people with disabilities was what ultimately led to this research project. This research will discuss several significant findings that have emerged from the research in relation to how consumer-based IoT can be used in the classroom to support the learning needs of students with disabilities, how industrial-based IoT sensors and actuators can be used to monitor and improve the real-time learning outcomes for the delivery of lectures and student engagement, and a proposed method for students to gain more control over their learning environment. The findings shared in this presentation are likely to have significant implications for the use of IoT in the classroom through the implementation of affordable and accessible IoT solutions and will provide guidance as to how policies can be developed as the implications of both benefits and risks continue to be considered by educators.

Keywords: disability, higher education, internet of things, students

Procedia PDF Downloads 92

Authors: Mawong R., Bussracumpakorn C.

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Millions of young people around the world have been affected by COVID-19 to their psychological and social effects. Millennials’ stresses have been shaped by a few global issues, including climate change, political instability, and financial crisis. In particular, the spread of COVID-19 has become laying psychological and socioeconomic scars on them. When end-of-life planning turns into more widely discussed, the stigma and taboos around this issue are greatly lessened. End-of-life planning is defined as a future life plan, such as financial, legacy, funeral, and memorial planning. This plan would help millennials to discover the value and meaning of life. This study explores the attitudes of Thai Millennials toward end-of-life planning as a new normal awareness of life in order to initiate an innovative service concept to fit with their value and meaning. The study conducts an in-depth interview with 12 potential participants who have awareness or action on the plan. The framework of the customer journey map is used to analyze the responses to examine trigger points, barriers, beliefs, and expectations. The findings pointed to a service concept that is suggested for a new end-of-life planning service that is suited to Thai Millennials in 4 different groups, which are 1. Social -Conscious as a socially aware who to donate time and riches to make the world and society a better place, their end-of-life planning value is inspired by the social impact of giving something or some action that they will be able to do after life or during life which provides a variety of choice based on their preference to give to society, 2. Life Fulfillment who make a life goal for themselves and attempt to achieve it before the time comes to their value will be to inspire life value with a customized plan and provide guidance to suggest, 3. Prevention of the After-Death Effect who want to plan to avoid the effects of their death as patriarch, head of the family, and anchor of someone, so they want to have a plan that brings confidence and feel relief while they are still alive and they want to find some reliable service that they can leave the death will or asset, and 4. No Guilty Planning who plan for when they wish to be worry-free as a self-responsible they want to have the plan which is easy to understand and easy to access. The overall finding of the study is to understand the new service concept of end-of-life planning which to improve knowledge of significant life worth rather than death planning, encouraging people to reassess their lives in a positive way, leading to higher self-esteem and intrinsic motivation for this generation in this time of global crisis.

Keywords: design management, end-of-life planning, millennial generation, service design solution

Procedia PDF Downloads 167

Authors: Jiaxin Shi, Kaifeng Hao, Qingfan An, Zeng Peng

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Due to a lack of data sources and data processing techniques, it has always been difficult to quantify public space quality, which includes urban construction quality and how it is perceived by people, especially in large urban areas. This study proposes a quantitative research method based on the consideration of emotional health and physical health of the built environment. It highlights the low quality of public areas in Tianjin, China, where there are many negative elements. Deep learning technology is then used to measure how effectively people perceive urban areas. First, this work suggests a deep learning model that might simulate how people can perceive the quality of urban construction. Second, we perform semantic segmentation on street images to identify visual elements influencing scene perception. Finally, this study correlated the scene perception score with the proportion of visual elements to determine the surrounding environmental elements that influence scene perception. Using a small-scale labeled Tianjin street view data set based on transfer learning, this study trains five negative spatial discriminant models in order to explore the negative space distribution and quality improvement of urban streets. Then it uses all Tianjin street-level imagery to make predictions and calculate the proportion of negative space. Visualizing the spatial distribution of negative space along the Tianjin Inner Ring Road reveals that the negative elements are mainly found close to the five key districts. The map of Tianjin was combined with the experimental data to perform the visual analysis. Based on the emotional assessment, the distribution of negative materials, and the direction of street guidelines, we suggest guidance content and design strategy points of the negative phenomena in Tianjin street space in the two dimensions of perception and substance. This work demonstrates the utilization of deep learning techniques to understand how people appreciate high-quality urban construction, and it complements both theory and practice in urban planning. It illustrates the connection between human perception and the actual physical public space environment, allowing researchers to make urban interventions.

Keywords: human perception, public space quality, deep learning, negative elements, street images

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Authors: Sadhana Deshmukh

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Objective: Men represent only a fraction of the medical aesthetic practice. They are increasingly becoming more cosmetically-inclined. The primary objective is to harmonize facial proportion by prioritizing and focusing on forehead nose, cheek and chin complex. Introduction: Despite tremendous variability, diverse population of the Indian subcontinent, the male skull is unique in its overall larger size, and shape. Men tend to have a large forehead with prominent supraorbital ridges, wide glabella, square orbit, and a prominent protruding mandible. Men have increased skeletal muscle mass, with less facial subcutaneous fat. Facial aesthetics is evolving rapidly. Commonly published canons of facial proportions usually represent feminine standards and are not applicable to males. Strict adherence to these norms is therefore not necessary to obtain satisfying results in male patients. Materials and Methods: Male patients age group 30-60 years have been enrolled. Botulinum toxin and hyaluronic acid fillers were used to update consensus recommendations for facial rejuvenation using these two types of products alone and in combination. Results: There are specific recommendations by facial area, focusing on relaxing musculature, restoring volume, recontouring using toxin and dermal fillers alone and in combination. For upper face, though botulinum toxin remains the cornerstone of treatment, temples and forehead fillers are recommended for optimal results. In Mid face, these fillers are placed more laterally to maintain the masculine look. Botulinum toxin and fillers in combination can improve outcomes in the lower face. Chin augmentation remains the center point for lower face. Conclusions: Males are more likely to have shorter doctor visits, less likely to ask questions, have a lower attention to bodily changes. The physician must patiently gauge male patients’ aging and cosmetic goals. Clinicians can also benefit from ongoing guidance on products, tailoring treatments, treating multiple facial areas, and using combinations of products. An appreciation that rejuvenation is 3-dimensional process involving muscle control, volume restoration and recontouring helps.

Keywords: male aesthetics, botulinum toxin, hyaluronic acid dermal fillers, Asian patients

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Authors: Qi En Han, Si En Wai, Eugene Quek

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As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

Procedia PDF Downloads 192

Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

Procedia PDF Downloads 79

Authors: Pandurang Balwant, Ashutosh Mishra, Jyothi V., Abhay Soni, Padmakar C., Rafat Quamar, Ramesh J.

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The sea water intrusion in the coastal aquifers has become one of the major environmental concerns. Although, it is a natural phenomenon but, it can be induced with anthropogenic activities like excessive exploitation of groundwater, seacoast mining, etc. The geological and hydrogeological conditions including groundwater heads and groundwater pumping pattern in the coastal areas also influence the magnitude of seawater intrusion. However, this problem can be remediated by taking some preventive measures like rainwater harvesting and artificial recharge. The present study is an attempt to identify suitable sites for rainwater harvesting in salt intrusion affected area near coastal aquifer of Jafrabad town, Amreli district, Gujrat, India. The physico-chemical water quality results show that out of 25 groundwater samples collected from the study area most of samples were found to contain high concentration of Total Dissolved Solids (TDS) with major fractions of Na and Cl ions. The Cl/HCO3 ratio was also found greater than 1 which indicates the salt water contamination in the study area. The geophysical survey was conducted at nine sites within the study area to explore the extent of contamination of sea water. From the inverted resistivity sections, low resistivity zone (<3 Ohm m) associated with seawater contamination were demarcated in North block pit and south block pit of NCJW mines, Mitiyala village Lotpur and Lunsapur village at the depth of 33 m, 12 m, 40 m, 37 m, 24 m respectively. Geospatial techniques in combination of Analytical Hierarchy Process (AHP) considering hydrogeological factors, geographical features, drainage pattern, water quality and geophysical results for the study area were exploited to identify potential zones for the Rainwater Harvesting. Rainwater harvesting suitability model was developed in ArcGIS 10.1 software and Rainwater harvesting suitability map for the study area was generated. AHP in combination of the weighted overlay analysis is an appropriate method to identify rainwater harvesting potential zones. The suitability map can be further utilized as a guidance map for the development of rainwater harvesting infrastructures in the study area for either artificial groundwater recharge facilities or for direct use of harvested rainwater.

Keywords: analytical hierarchy process, groundwater quality, rainwater harvesting, seawater intrusion

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Authors: Ross J. Maestas

Abstract:

Biofuels are derived from multiple renewable bioenergy feedstocks including animal fats, wood, starchy grains, and oil seeds. Transportation agencies have considered growing the latter two on underutilized and nontraditional lands that they manage, such as in the Right of Way (ROW), abandoned weigh stations, and at maintenance yards. These crops provide the opportunity to generate revenue or supplement fuel once converted and offer a solution to increasing fuel costs and instability by creating a ‘home-grown’ alternative. Biofuels are non-toxic, biodegradable, and emit less Green House Gasses (GHG) than fossil fuels, therefore allowing agencies to meet sustainability goals and regulations. Furthermore, they enable land managers to achieve soil erosion and roadside aesthetic strategies. The research sought to understand if the cultivation of a biofuel feedstock within the Arkansas State Highway Transportation Department’s (AHTD) managed and marginalized lands is feasible by identifying potential land areas and crops. To determine potential plots the parcel data was downloaded from Arkansas’s GIS office. ArcGIS was used to query the data for all variations of the names of property owned by AHTD and a KML file was created that identifies the queried parcel data in Google Earth. Furthermore, biofuel refineries in the state were identified to optimize the harvest to transesterification process. Agricultural data was collected from federal and state agencies and universities to assess various oil seed crops suitable for conversion and suited to grow in Arkansas’s climate and ROW conditions. Research data determined that soybean is the best adapted biofuel feedstock for Arkansas with camelina and canola showing possibilities as well. Agriculture is Arkansas’s largest industry and soybean is grown in over half of the state’s counties. Successful cultivation of a feedstock in the aforementioned areas could potentially offer significant employment opportunity for which the skilled farmers already exist. Based on compiled data, AHTD manages 21,489 acres of marginalized land. The result of the feasibility assessment offer suggestions and guidance should AHTD decide to further investigate this type of initiative.

Keywords: Arkansas highways, biofuels, renewable energy initiative, marginalized lands

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