Search results for: multiple cranial nerve impairment

Authors: Oluwatosin M. A. Jesuyon

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In order to propose a simpler tool that eliminates the age-long problems associated with the traditional index method for selection of multiple traits in broilers, the Barttlet factor regression equation is being proposed as an alternative selection tool. 100 day-old chicks each of Arbor Acres (AA) and Annak (AN) broiler strains were obtained from two rival hatcheries in Ibadan Nigeria. These were raised in deep litter system in a 56-day feeding trial at the University of Ibadan Teaching and Research Farm, located in South-west Tropical Nigeria. The body weight and body dimensions were measured and recorded during the trial period. Eight (8) zoometric measurements namely live weight (g), abdominal circumference, abdominal length, breast width, leg length, height, wing length and thigh circumference (all in cm) were recorded randomly from 20 birds within strain, at a fixed time on the first day of the new week respectively with a 5-kg capacity Camry scale. These records were analyzed and compared using completely randomized design (CRD) of SPSS analytical software, with the means procedure, Factor Scores (FS) in stepwise Multiple Linear Regression (MLR) procedure for initial live weight equations. Bartlett Factor Score (BFS) analysis extracted 2 factors for each strain, termed Body-length and Thigh-meatiness Factors for AA, and; Breast Size and Height Factors for AN. These derived orthogonal factors assisted in deducing and comparing trait-combinations that best describe body conformation and Meatiness in experimental broilers. BFS procedure yielded different body conformational traits for the two strains, thus indicating the different economic traits and advantages of strains. These factors could be useful as selection criteria for improving desired economic traits. The final Bartlett Factor Regression equations for prediction of body weight were highly significant with P < 0.0001, R2 of 0.92 and above, VIF of 1.00, and DW of 1.90 and 1.47 for Arbor Acres and Annak respectively. These FSR equations could be used as a simple and potent tool for selection during poultry flock improvement, it could also be used to estimate selection index of flocks in order to discriminate between strains, and evaluate consumer preference traits in broilers.

Keywords: alternative selection tool, Bartlet factor regression model, consumer preference trait, linear and body measurements, live body weight

Procedia PDF Downloads 192

Authors: Donatien Niragira

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The progress of technology creates new expectations for patients. The world of deafness is no exception. In recent years, there have been considerable advances in the field of technologies aimed at assisting failing hearing. According to the usual medical vocabulary, hearing aids are actually orthotics. They do not replace an organ but compensate for a functional impairment. The Amplifier Hearing amplification is useful for a large number of people with hearing loss. Hearing aids restore speech audibility. However, their benefits vary depending on the quality of residual hearing. The hearing aid is not a "cure" for deafness. It cannot correct all affected hearing abilities. It should be considered as an aid to communication. The urge to judge from the audiogram alone should be resisted here, as audiometry only indicates the ability to detect non-verbal sounds. To prevent hearing aids from ending up in the drawer, it is important to ensure that the patient's disability situations justify the use of this type of orthosis. If the problems of receptive Pre-fitting counseling are crucial: the person with hearing loss must be informed of the advantages and disadvantages of amplification in his or her case. Their expectations must be realistic. They also need to be aware that the adaptation process requires a good deal of patience and perseverance. They should be informed about the various models and types of hearing aids, including all the aesthetic, functional and financial considerations. If the person's motivation "survives" pre-fitting counseling, we are in the presence of a good candidate for amplification. In addition to its relevance, it shows that the results found in this study significantly improve the quality of audibility in the patient, from where this technology must be made accessible everywhere in the world.

Keywords: auditives protheses, hearing, aids, no medicaly treatable deafnes

Procedia PDF Downloads 43

Authors: Vishwanath Pethri Kamath, Jayantha Gowda Sarapanahalli, Vishal Mishra, Siddhesh Balwant Bandgar

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Recognition of emotional information is essential in any form of communication. Growing HCI (Human-Computer Interaction) in recent times indicates the importance of understanding of emotions expressed and becomes crucial for improving the system or the interaction itself. In this research work, textual data for emotion recognition is used. The text being the least expressive amongst the multimodal resources poses various challenges such as contextual information and also sequential nature of the language construction. In this research work, the proposal is made for a neural architecture to resolve not less than 8 emotions from textual data sources derived from multiple datasets using google pre-trained word2vec word embeddings and a Multi-head attention-based bidirectional LSTM model with a one-vs-all Multi-Level Classification. The emotions targeted in this research are Anger, Disgust, Fear, Guilt, Joy, Sadness, Shame, and Surprise. Textual data from multiple datasets were used for this research work such as ISEAR, Go Emotions, Affect datasets for creating the emotions’ dataset. Data samples overlap or conflicts were considered with careful preprocessing. Our results show a significant improvement with the modeling architecture and as good as 10 points improvement in recognizing some emotions.

Keywords: text emotion recognition, bidirectional LSTM, multi-head attention, multi-level classification, google word2vec word embeddings

Procedia PDF Downloads 161

Authors: David Chao, John Lai, Alvin Wu, Carl Wang

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For lithium-ion batteries with multiple cell configurations, some use scenarios can cause uneven aging effects to each cell within the battery because of uneven current distribution. Hence the focus of the study is to explore the aging effect(s) on batteries with different construction designs. In order to systematically study the influence of various factors in some key battery configurations, a detailed analysis of three key battery construction factors is conducted. And those key factors are (1) terminal position; (2) cell alignment matrix; and (3) interconnect resistance between cells. In this study, the 2S2P circuitry has been set as a model multi-cell battery to set up different battery samples, and the aging behavior is studied by a cycling test to analyze the current distribution and recoverable capacity. According to the outcome of aging tests, some key findings are: (I) different cells alignment matrices can have an impact on the cycle life of the battery; (II) symmetrical structure has been identified as a critical factor that can influence the battery cycle life, and unbalanced resistance can lead to inconsistent cell aging status; (III) the terminal position has been found to contribute to the uneven current distribution, that can cause an accelerated battery aging effect; and (IV) the internal connection resistance increase can actually result in cycle life increase; however, it is noteworthy that such increase in cycle life is accompanied by a decline in battery performance. In summary, the key findings from the study can help to identify the key aging factor of multi-cell batteries, and it can be useful to effectively improve the accuracy of battery capacity predictions.

Keywords: multiple cells battery, current distribution, battery aging, cell connection

Procedia PDF Downloads 63

Authors: Aparna Datta, Mahabub Alam

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Animal welfare is comparatively new area of research in Bangladesh and welfare concern for animal is increasing day by day. The study was conducted to investigate the animal welfare violations during treatment at different level of hospitals in Bangladesh and India. This study was conducted between January and May, 2017. The recorded data (N=180) were categorized into eight major types of violation like - delay in starting treatment, non-specific treatment, surgery without anesthesia, use of unsterilized needle, rough and painful handling, fearful approach, multiple pricking during injection and use of blunt needle. Categorized groups were analyzed according to different hospitals like Upazila Veterinary Hospitals, Bangladesh (UVHs), SAQ-Teaching Veterinary Hospital, Bangladesh (SAQTVH) and Veterinary College and Research Institute, India (VCRI). Among all hospitals, violation during treatment more frequently occurred in UVH. Among all violations, surgery without anesthesia was only found in UVH (80%) and it was belong to considerable number of cases (80%). In the view of other major violations like - non-specific treatment was 69% in UVHs, 13% in SAQTVH and 5% in VCRI. Use of unsterilized instruments during treatment was also higher in UVHs (65%) than SAQTVH (5%) and VCRI (1%). But delay in starting treatment varied insignificantly and it was 26-42% across the different levels of hospitals. Although multiple pricking during injection was found 30% cases in UVH, but statistical variations with other level of hospitals were unnoticed (p>0.05). The findings of this study will help to take necessary steps to control violation against animal welfare during treatment. A comprehensive study considering all levels of hospitals including field treatment is also recommended to find out the welfare violations during treatment.

Keywords: animal welfare, treatment, veterinary hospitals, violations

Procedia PDF Downloads 140

Authors: Rahul Thakur, Onkar Chandel

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Red Hat is the world leader in providing open source software and solutions. A global enterprise, like Red Hat, has unique issues of connecting employees with content because of distributed offices, multiple teams spread across geographies, multiple languages, and different cultures. Employees, of a global company, create content that is distributed across departments, teams, regions, and countries. This makes finding the best content difficult since owners keep iterating on the existing content. When employees are unable to find the content, they end up creating it once again and in the process duplicating existing material and effort. Also, employees may not find the relevant content and spend time reviewing obsolete duplicate, or irrelevant content. On an average, a person spends 15 minutes/day in failed searches that might result in missed business opportunities, employee frustration, and substandard deliverables. Red Hat Knowledge Management Office (KMO) applied 'open source strategy' to solve the above problems. Under the Open Source Strategy, decisions are taken collectively. The strategy aims at accomplishing common goals with the help of communities. The objectives of this initiative were to save employees' time, get them authentic content, improve their content search experience, avoid duplicate content creation, provide context based search, improve analytics, improve content management workflows, automate content classification, and automate content upload. This session will describe open source strategy, its applicability in content management, challenges, recommended solutions, and outcome.

Keywords: content classification, content management, knowledge management, open source

Procedia PDF Downloads 195

Authors: C. Paglia, C. Mosca

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Synthetic resin floorsare often used in sport infrastructure. These organic materials are often in contact with a bituminous substrate, which in turn is placed on the ground. In this work, the damage of a basket resin field surface was characterized by means of visual inspection, optical microscopy, resin thickness measurements, adhesion strength, water vapor transmission capacity, capillary water adsorption, granulometry of the bituminous conglomerate, the surface properties, and the water ground infiltration speed. The infiltration speed indicates water pemeability. This was due to its composition: clean sand mixed with gravel. Relatively good adhesion was present between the synthetic resin and the bituminous layer. The adhesion resistance of the bituminous layer was relatively low. According to the required bitumoniousasphalt-concrete mixes AC 11 S, the placed material was more porous. Insufficient constipation was present. The spaces values were above the standard limits, while the apparent densities were lower compared to the conventional AC 11 mixtures. The microstructure outlines the high permeability and porosity of the bituminous layer. The synthetic resin wasvapourproof and did not exhibit capillary adsorption. It exhibited a lower thickness as required, and no multiple placing steps were observed. Multiple cavities were detected along with the interface between the bituminous layer and the resin coating with no intermediate layers. The layer for the pore filling in the bituminous surface was not properly applied. The swelling bubbles on the synthetic pavement were caused by the humidity in the bituminous layer. Water or humidity were present prior to the application of the resin, and the effect was worsened by the upward movement of the water from the ground.

Keywords: resin, floor, damage, durability

Procedia PDF Downloads 148

Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek

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Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.

Keywords: guillain barre syndrome, emergency, children, medical

Procedia PDF Downloads 55

Authors: Yeaeun Jang

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Shamanism, in general, has been steadily reinterpreted as research and art from cult, superstition, mysticism, and historical perspectives. Shamanism has existed throughout the five-thousand-year-old history of Korea, and it still actively is ongoing. It is interesting to observe how this tradition has had a profound impact on its current high-technology society. Many still ask Shamans for pieces of advice rituals for their problems to be solved. Historically, Korean shamanism has a strong connection and many similarities with Mongolian and Eastern Siberian Shamanism. 'God' is 'Nature'. 'Shaman' is a 'Mediator of communication chosen by God' and is a divine being who has entered the mysterious realm by challenging human limitations through harsh training. A shaman in ancient society used to be a leader of a group and entertainer who played various roles; king, counsellor, doctor, singer, dancer, painter, and performer. This artistic research focuses on the Shaman role as an artist with multiple mediums and reconstructing their ancient ritual into multimedia performing art that attempts to deal with traumatic memories in one’s life. This fusion style of contemporary ritual is mainly inspired by ‘Gut(굿)’, Korean Shamanism ritual. This comprehensive art needs several important elements; a shaman, a client, musicians, helpers, and the audience. It is a feast to gather people in a big circle. Nowadays, art has been divided into separate fields and developed, but before, there existed art of Synesthesia, whose boundaries were unclear that were not determined through which medium to express that abstract ideas. Multiple disciplines coexist and harmonise with each other. Studying shamanism ritual as an ancient form of performing art can create a warm, spiritual feast for everyone and remind us about ‘togetherness’.

Keywords: healing, multimedia art, performance art, shamanism, spirituality

Procedia PDF Downloads 88

Authors: Akash Soogumbur

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Tourniquets are commonly used in orthopaedic surgery to provide hemostasis during procedures on the upper and lower limbs. However, there is a risk of complications associated with tourniquet use, such as nerve damage, skin necrosis, and compartment syndrome. The British Orthopaedic Association (BOAST) guidelines recommend the use of tourniquets at a pressure of 300 mmHg or less for a maximum of 2 hours. Research Aim: The aim of this study was to evaluate the effectiveness of a tourniquet checklist in improving compliance with the BOAST guidelines. Methodology: This was a retrospective study of all orthopaedic procedures performed at a single institution over a 12-month period. The study population included patients who had a tourniquet applied during surgery. Data were collected from the patients' medical records, including the duration of tourniquet use, the pressure used, and the method of exsanguination. Findings: The results showed that the use of the tourniquet checklist significantly improved compliance with the BOAST guidelines. Prior to the introduction of the checklist, compliance with the guidelines was 83% for the duration of tourniquet use and 73% for pressure used. After the introduction of the checklist, compliance increased to 100% for both duration of tourniquet use and pressure used. Theoretical Importance: The findings of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use. Data Collection: Data were collected from the patients' medical records. The data included the following information: Patient demographics, procedure performed, duration of tourniquet use, pressure used, method of exsanguination. Analysis Procedures: The data were analyzed using descriptive statistics. The compliance with the BOAST guidelines was calculated as the percentage of patients who met the guidelines for the duration of tourniquet use and pressure used. Question Addressed: The question addressed by this study was whether the use of a tourniquet checklist could improve compliance with the BOAST guidelines. Conclusion: The results of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use.

Keywords: tourniquet, pressure, duration, complications, surgery

Procedia PDF Downloads 52

Authors: Fariza Yunus, Jasmee Jaafar, Zamalia Mahmud, Nurul Nisa’ Khairul Azmi, Nursalleh K. Chang, Nursalleh K. Chang

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Variation of air temperature from one place to another is cause by air temperature controls. In general, the most important control of air temperature is elevation. Another significant independent variable in estimating air temperature is the location of meteorological stations. Distances to coastline and land use type are also contributed to significant variations in the air temperature. On the other hand, in homogeneous terrain direct interpolation of discrete points of air temperature work well to estimate air temperature values in un-sampled area. In this process the estimation is solely based on discrete points of air temperature. However, this study presents that air temperature controls also play significant roles in estimating air temperature over homogenous terrain of Peninsular Malaysia. An Inverse Distance Weighting (IDW) interpolation technique was adopted to generate continuous data of air temperature. This study compared two different datasets, observed mean monthly data of T, and estimation error of T–T’, where T’ estimated value from a multiple regression model. The multiple regression model considered eight independent variables of elevation, latitude, longitude, coastline, and four land use types of water bodies, forest, agriculture and build up areas, to represent the role of air temperature controls. Cross validation analysis was conducted to review accuracy of the estimation values. Final results show, estimation values of T–T’ produced lower errors for mean monthly mean air temperature over homogeneous terrain in Peninsular Malaysia.

Keywords: air temperature control, interpolation analysis, peninsular Malaysia, regression model, air temperature

Procedia PDF Downloads 363

Authors: K. Yuki, R. Tsuji, K. Takai, S. Aramaki, R. Kibushi, N. Unno, K. Suzuki

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A small cold plate with uni-directional porous copper is proposed for cooling power electronics such as an on-vehicle inverter with the heat generation of approximately 500 W/cm2. The uni-directional porous copper with the pore perpendicularly orienting the heat transfer surface is soldered to a grooved heat transfer surface. This structure enables the cooling liquid to evaporate in the pore of the porous copper and then the vapor to discharge through the grooves. In order to minimize the cold plate, a double flow channel concept is introduced for the design of the cold plate. The cold plate consists of a base plate, a spacer, and a vapor discharging plate, totally 12 mm in thickness. The base plate has multiple nozzles of 1.0 mm in diameter for the liquid supply and 4 slits of 2.0 mm in width for vapor discharging, and is attached onto the top surface of the porous copper plate of 20 mm in diameter and 5.0 mm in thickness. The pore size is 0.36 mm and the porosity is 36 %. The cooling liquid flows into the porous copper as an impinging jet flow from the multiple nozzles, and then the vapor, which is generated in the pore, is discharged through the grooves and the vapor slits outside the cold plate. A heated test section consists of the cold plate, which was explained above, and a heat transfer copper block with 6 cartridge heaters. The cross section of the heat transfer block is reduced in order to increase the heat flux. The top surface of the block is the grooved heat transfer surface of 10 mm in diameter at which the porous copper is soldered. The grooves are fabricated like latticework, and the width and depth are 1.0 mm and 0.5 mm, respectively. By embedding three thermocouples in the cylindrical part of the heat transfer block, the temperature of the heat transfer surface ant the heat flux are extrapolated in a steady state. In this experiment, the flow rate is 0.5 L/min and the flow velocity at each nozzle is 0.27 m/s. The liquid inlet temperature is 60 °C. The experimental results prove that, in a single-phase heat transfer regime, the heat transfer performance of the cold plate with the uni-directional porous copper is 2.1 times higher than that without the porous copper, though the pressure loss with the porous copper also becomes higher than that without the porous copper. As to the two-phase heat transfer regime, the critical heat flux increases by approximately 35% by introducing the uni-directional porous copper, compared with the CHF of the multiple impinging jet flow. In addition, we confirmed that these heat transfer data was much higher than that of the ordinary single impinging jet flow. These heat transfer data prove high potential of the cold plate with the uni-directional porous copper from the view point of not only the heat transfer performance but also energy saving.

Keywords: cooling, cold plate, uni-porous media, heat transfer

Procedia PDF Downloads 284

Authors: Akankunda Veronicah Karuhanga

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Dementia is an age mental disorder that makes victims lose normal functionality that needs delicate attention. It has been technically defined as a clinical syndrome that presents a number of difficulties in speech and other cognitive functions that change someone’s behaviors and can also cause impairments in activities of daily living, not forgetting a range of neurological disorders that bring memory loss and cognitive impairment. Family members are the primary healthcare givers and therefore, the way how they handle the situation in its early stages determines future deterioration syndromes like total memory loss. Unfortunately, most family members are ignorant about this condition and in most cases, the patients are brought to our facilities when their condition was already mismanaged by family members and we thus cannot do much. For example, incontinence can be managed at early stages through potty training or toilet scheduling before resorting to 24/7 diapers which are also not good. Professional Elderly care should be understood and practiced as an extension of homes, not a dumping place for people considered “abnormal” on account of ignorance. Immediate relatives should therefore be sensitized concerning the normalcy of dementia in the context of old age so that they can be understanding and supportive of dementia patients rather than discriminating against them as present-day lepers. There is a need to skill home-based caregivers on how to handle dementia in its early stages. Unless this is done, many of our elderly homes shall be filled with patients who should have been treated and supported from their homes. This skilling of home-based caregivers is a vital intervention because until elderly care is appreciated as a human moral obligation, many transactional rehabilitation centers will crop up and this shall be one of the worst moral decadences of our times.

Keywords: dementia, family, Alzheimers, relevancy

Procedia PDF Downloads 66

Authors: Kai-Yao Huang, Tzong-Yi Lee, Pin-Hao Ho, Tzu-Hao Chang, Cheng-Wei Chang

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Background: Human cytomegalovirus (HCMV) infects much people around the world, and there were many researches mention that many diseases were caused by HCMV. To understand the mechanism of HCMV lead to diseases during infection. We observe a microRNA (miRNA) – miRNA interaction between HCMV and host during infection. We found HCMV miRNA sequence component complementary with host miRNA precursors, and we also found that the host miRNA abundances were decrease in HCMV infection. Hence, we focus on the host miRNA which may target by the other HCMV miRNA to find theirs target mRNAs expression and analysis these mRNAs affect what kind of signaling pathway. Interestingly, we found the affected mRNA play an important role in some diseases related pathways, and these diseases had been annotated by HCMV infection. Results: From our analysis procedure, we found 464 human miRNAs might be targeted by 26 HCMV miRNAs and there were 291 human miRNAs shows the concordant decrease trend during HCMV infection. For case study, we found hcmv-miR-US22-5p may regulate hsa-mir-877 and we analysis the KEGG pathway which built by hsa-mir-877 validate target mRNA. Additionally, through survey KEGG Disease database found that these mRNA co-regulate some disease related pathway for instance cancer, nerve disease. However, there were studies annotated that HCMV infection casuse cancer and Alzheimer. Conclusions: This work supply a different scenario of miRNA target interactions(MTIs). In previous study assume miRNA only target to other mRNA. Here we wonder there is possibility that miRNAs might regulate non-mRNA targets, like other miRNAs. In this study, we not only consider the sequence similarity with HCMV miRNAs and human miRNA precursors but also the expression trend of these miRNAs. Then we analysis the human miRNAs validate target mRNAs and its associated KEGG pathway. Finally, we survey related works to validate our investigation.

Keywords: human cytomegalovirus, HCMV, microRNA, miRNA

Procedia PDF Downloads 416

Authors: M. Bolacali

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This study was conducted to determine the effects of and sex on the carcass characteristics in Japanese quails. A total of 320 (160 for each sex groups) one-day-old quail chicks were randomly allocated to the sex groups, each containing 160 chicks according to a completely randomized design. Each gender was then divided into five replicate groups of 32 chicks. According to sex groups, the chicks of all replicate groups were housed in cages. The normality of distribution for all data was tested with the Shapiro-Wilk test at 95% confidence interval. A P value of ≤ 0.05 was interpreted as different. The statistical analysis for normal distribution data of the dietary groups was carried out with the general linear model procedure of SPSS software. The results are expressed as mean ± standard deviation of five replications. Duncan’s multiple range test was used for multiple comparisons in important groups. Data points bearing different letters are significantly different P ≤ 0.05. For the distribution of data that was different from normal, Kruskal Wallis H-Test was applied as a nonparametric test, and the results were expressed as median, minimum and maximum values. Pairwise comparisons of groups were made when Kruskal Wallis H-Test was significant. The study period lasted 42 days. Hot carcass, cold carcass, heart, and leg percentages in male quails was higher than female quails (P < 0.05), but liver, and breast percentages in female quails was higher than male quails (P > 0.05). The highest slaughter and carcass weight values were determined in the female quails in the cage. As a conclusion, it may be recommended to quail meat producers, who would like to obtain higher carcass weight to make more economic profit, to raise female quails in cage.

Keywords: carcass yield, chick, gender, management

Procedia PDF Downloads 171

Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill

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Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.

Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer

Procedia PDF Downloads 92

Authors: Qing Zhang, Janak L. Pathak, Macro N. Helder, Richard T. Jaspers, Yin Xiao

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Introduction: Nanomaterial-based bone regeneration is greatly influenced by the immune microenvironment. Tissue-engineered nanomaterials mediate the inflammatory response of macrophages to regulate bone regeneration. Silica nanoparticles have been widely used in tissue engineering-related preclinical studies. However, the effect of topological features on the surface of silica nanoparticles on the immune response of macrophages remains unknown. Purposes: The aims of this research are to compare the influences of normal and pollen-like silica nano-surface topography on macrophage immune responses and to obtain insight into their potential regulatory mechanisms. Method: Macrophages (RAW 264.7 cells) were exposed to mesoporous silica nanoparticles with normal morphology (MSNs) and pollen-like morphology (PMSNs). RNA-seq, RT-qPCR, and LSCM were used to assess the changes in expression levels of immune response-related genes and proteins. SEM and TEM were executed to evaluate the contact and adherence of silica nanoparticles by macrophages. For the assessment of the immunomodulation-mediated osteogenic potential, BMSCs were cultured with conditioned medium (CM) from LPS pre-stimulated macrophage cultures treated with MSNs or PMSNs. Osteoimmunomodulatory potential of MSNs and PMSNs in vivo was tested in a mouse cranial bone osteolysis model. Results: The results of the RNA-seq, RT-qPCR, and LSCM assays showed that PMSNs inhibited the expression of pro-inflammatory genes and proteins in macrophages. SEM images showed distinct macrophage membrane surface binding patterns of MSNs and PMSNs. MSNs were more evenly dispersed across the macrophage cell membrane, while PMSNs were aggregated. PMSNs-induced macrophage anti-inflammatory response was associated with upregulation of the cell surface receptor CD28 and inhibition of ERK phosphorylation. TEM images showed that both MSNs and PMSNs could be phagocytosed by macrophages, and inhibiting nanoparticle phagocytosis did not affect the expression of anti-inflammatory genes and proteins. Moreover, PMSNs-induced conditioned medium from macrophages enhanced BMP-2 expression and osteogenic differentiation mBMSCs. Similarly, PMSNs prevented LPS-induced bone resorption via downregulation of inflammatory reaction. Conclusions: PMSNs can promote bone regeneration by modulating osteoimmunological processes through surface topography. The study offers insights into how surface physical contact cues can modulate the regulation of osteoimmunology and provides a basis for the application of nanoparticles with pollen-like morphology to affect immunomodulation in bone tissue engineering and regeneration.

Keywords: physical contact, osteoimmunology, macrophages, silica nanoparticles, surface morphology, membrane receptor, osteogenesis, inflammation

Procedia PDF Downloads 44

Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

Procedia PDF Downloads 76

Authors: Cyrillus Prabandana

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Supply chain optimisation requires multiple factors as consideration or constraints. These factors are including but not limited to demand forecasting, raw material fulfilment, production capacity, inventory level, facilities locations, transportation means, and manpower availability. By knowing all manageable factors involved and assuming the uncertainty with pre-defined percentage factors, an integrated supply chain model could be developed to manage various business scenarios. This paper analyse the utilisation of geographical point of view to develop an integrated supply chain network model to optimise the distribution of finished product appropriately according to forecasted demand and available supply. The supply chain optimisation model shows that small change in one supply chain constraint is possible to largely impact other constraints, and the new information from the model should be able to support the decision making process. The model was focused on three areas, i.e. raw material fulfilment, production capacity and finished products transportation. To validate the model suitability, it was implemented in a project aimed to optimise the concrete supply chain in a mining location. The high level of operations complexity and involvement of multiple stakeholders in the concrete supply chain is believed to be sufficient to give the illustration of the larger scope. The implementation of this geographical supply chain network modeling resulted an optimised concrete supply chain from raw material fulfilment until finished products distribution to each customer, which indicated by lower percentage of missed concrete order fulfilment to customer.

Keywords: decision making, geographical supply chain modeling, supply chain optimisation, supply chain

Procedia PDF Downloads 337

Authors: Chua Si Wen Alicia, Marcus Goh Tian Xi, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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In a world full of rapid changes, people often need a set of skills to help them navigate an ever-changing workscape. These skills, often known as “future-oriented skills,” include learning to learn, critical thinking, understanding multiple perspectives, and knowledge creation. Future-oriented skills are typically assumed to be domain-general, applicable to multiple domains, and can be cultivated through a learning approach called Dialogical Inquiry. Dialogical Inquiry is known for its benefits of making sense of multiple perspectives, encouraging critical thinking, and developing learner’s capability to learn. However, it currently exists as a quantitative tool, which makes it hard to track and compare learning processes over time. With these concerns, the present research aimed to develop and validate a quantitative tool for the Map of Dialogical Inquiry, focusing Imagining aspect of learning. The Imagining aspect four dimensions: 1) speculative/ look for alternatives, 2) risk taking/ break rules, 3) create/ design, and 4) vision/ imagine. To do so, an exploratory literature review was conducted to better understand the dimensions of Imagining. This included deep-diving into the history of the creation of the Map of Dialogical Inquiry and a review on how “Imagining” has been conceptually defined in the field of social psychology, education, and beyond. Then, we synthesised and validated scales. These scales measured the dimension of Imagination and related concepts like creativity, divergent thinking regulatory focus, and instrumental risk. Thereafter, items were adapted from the aforementioned procured scales to form items that would contribute to the preliminary version of the Imagining Scale. For scale validation, 250 participants were recruited. A Confirmatory Factor Analysis (CFA) sought to establish dimensionality of the Imagining Scale with an iterative procedure in item removal. Reliability and validity of the scale’s dimensions were sought through measurements of Cronbach’s alpha, convergent validity, and discriminant validity. While CFA found that the distinction of Imagining’s four dimensions could not be validated, the scale was able to establish high reliability with a Cronbach alpha of .96. In addition, the convergent validity of the Imagining scale was established. A lack of strong discriminant validity may point to overlaps with other components of the Dialogical Map as a measure of learning. Thus, a holistic approach to forming the tool – encompassing all eight different components may be preferable.

Keywords: learning, education, imagining, pedagogy, dialogical teaching

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Authors: Hong Yu, Ion Matei

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Carbon fiber reinforced composites (CFRP) used as aircraft structure are subject to lightning strike, putting structural integrity under risk. Indirect damage may occur after a lightning strike where the internal structure can be damaged due to excessive heat induced by lightning current, while the surface of the structures remains intact. Three damage modes may be observed after a lightning strike: fiber breakage, inter-ply delamination and intra-ply cracks. The assessment of internal damage states in composite is challenging due to complicated microstructure, inherent uncertainties, and existence of multiple damage modes. In this work, a model based approach is adopted to diagnose faults in carbon composites after lighting strikes. A resistor network model is implemented to relate the overall electrical and thermal conduction behavior under simulated lightning current waveform to the intrinsic temperature dependent material properties, microstructure and degradation of materials. A fault detection and identification (FDI) module utilizes the physics based model and a particle filtering algorithm to identify damage mode as well as calculate the probability of structural failure. Extensive simulation results are provided to substantiate the proposed fault diagnosis methodology with both single fault and multiple faults cases. The approach is also demonstrated on transient resistance data collected from a IM7/Epoxy laminate under simulated lightning strike.

Keywords: carbon composite, fault detection, fault identification, particle filter

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Authors: A. Guezane-Lakoud, S. Bensebaa

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In this paper, we study a boundary value problem of nonlinear fractional differential equation. Existence and positivity results of solutions are obtained.

Keywords: positive solution, fractional caputo derivative, Banach contraction principle, Avery and Peterson fixed point theorem

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Authors: Boris Djartov, Sanaz Mostaghim

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This paper presents a number-based dominance method. The main idea is how to fragment the many attributes of the problem into subsets suitable for the well-established concept of Pareto dominance. Although other similar methods can be found in the literature, they focus on comparing the solutions one objective at a time, while the focus of this method is to compare entire subsets of the objective vector. Given the nature of the method, it is computationally costlier than other methods and thus, it is geared more towards selecting an option from a finite set of alternatives, where each solution is defined by multiple objectives. The need for this method was motivated by dynamic alternate airport selection (DAAS). In DAAS, pilots, while en route to their destination, can find themselves in a situation where they need to select a new landing airport. In such a predicament, they need to consider multiple alternatives with many different characteristics, such as wind conditions, available landing distance, the fuel needed to reach it, etc. Hence, this method is primarily aimed at human decision-makers. Many methods within the field of multi-objective and many-objective decision-making rely on the decision maker to initially provide the algorithm with preference points and weight vectors; however, this method aims to omit this very difficult step, especially when the number of objectives is so large. The proposed method will be compared to Favour (1 − k)-Dom and L-dominance (LD) methods. The test will be conducted using well-established test problems from the literature, such as the DTLZ problems. The proposed method is expected to outperform the currently available methods in the literature and hopefully provide future decision-makers and pilots with support when dealing with many-objective optimization problems.

Keywords: multi-objective decision-making, many-objective decision-making, multi-objective optimization, many-objective optimization

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: Yusuf Hesham Mohamed

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Introduction: Three-dimensional printing technology includes multiple procedures that fabricate three-dimensional objects through consecutively layering two-dimensional cross-sections on top of each other. 3D bioprinting is a promising field of 3D printing, which fabricates tissues and organs by accurately controlling the proper arrangement of diverse biological components. 3D bioprinting uses software and prints biological materials and their supporting components layer-by-layer on a substrate or in a tissue culture plate to produce complex live tissues and organs. 3D food printing is an emerging field of 3D bioprinting in which the 3D printed products are food products that are cheap, require less effort to produce, and have more desirable traits. The Aim of the Study is the development of an affordable 3D bioprinter by altering a locally made CNC instrument with an open-source platform to suit the 3D bio-printer purposes. Later, we went through applying the prototype in several applications regarding food technology and drug testing, including the organ-On-Chip. Materials and Methods: An off-the-shelf 3D printer was modified by designing and fabricating the syringe unit, which was designed on the basis of the Milli-fluidics system. Sodium alginate and gelatin hydrogels were prepared, followed by leaf cell suspension preparation from narrow sections of Fragaria’s viable leaves. The desired 3D structure was modeled, and 3D printing preparations took place. Cell-free and cell-laden hydrogels were printed at room temperature under sterile conditions. Post printing curing process was performed. The printed structure was further studied. Results: Positive results have been achieved using the altered 3D bioprinter where a 3D hydrogel construct of two layers made of the combination of sodium alginate to gelatin (15%: 0.5%) has been printed. DLP 3D printer was used to design the syringe component with a transparent PLA-Pro resin for the creation of a microfluidics system having two channels altered to the double extruder. The hydrogel extruder’s design was based on peristaltic pumps, which utilized a stepper motor. The design and fabrication were made using DIY-3D printed parts. Hard plastic PLA was the material utilized for printing. SEM was used to carry out the porous 3D construct imaging. Multiple physical and chemical tests were performed in order to ensure that the cell line was suitable for hosting. Fragaria plant was developed by suspending Fragaria’s cells from its leaves using the 3D bioprinter. Conclusion: 3D bioprinting is considered to be an emerging scientific field that can facilitate and improve many scientific tests and studies. Thus, having a 3D bioprinter in labs is considered to be an essential requirement. 3D bioprinters are very expensive; however, the fabrication of a 3D printer into a 3D bioprinter can lower the cost of the bioprinter. The 3D bioprinter implemented made use of peristaltic pumps instead of syringe-based pumps in order to extend the ability to print multiple types of materials and cells.

Keywords: scaffold, eco on chip, 3D bioprinter, DLP printer

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Kang-Hyun Leem, Myung-Gyou Kim, Hye Kyung Kim

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Eggs have long been an important contributor to the nutritional quality of the human, and recognized as a very valuable source of proteins for human nutrition. Egg yolk is composed of various important chemical substances for human health. Growth means not only the increase of body weight but also the elongation of height and the enlargement of each organ's anatomical and morphological size. A calcium shortage causes the growth retardation on the body growth. In this study, we examined the therapeutic effects of egg yolk peptide (EYP) on the retardation of the longitudinal bone growth induced by low-calcium diet (0.05%) in adolescent rats. Low calcium diets were administrated for 15 days. During the last five days, calcium and/or vitamin D and/or EYP were administrated. The body weights, longitudinal bone growth rates, the heights of growth plates, and bone morphogenetic protein (BMP)-2 and insulin-like growth factor (IGF)-1 expressions were measured using histochemical analysis. Low calcium diets caused the significant reduction in body weight gains and the longitudinal bone growth. The heights of growth plates and the expressions of BMP-2 and IGF-1 showed the impairment of body growth as well. Calcium and/or vitamin D administration could not significantly increase the longitudinal bone growth. However, calcium, vitamin D, and EYP administration significantly increased the bone growth, the growth plate height, and BMP-2 and IGF-1 expressions. These results suggest that EYP enhances the longitudinal bone growth in the calcium and/or vitamin D deficiency and it could be a promising agent for the treatment of children suffering from malnutrition.

Keywords: egg yolk peptide, low-calcium diet, longitudinal bone growth, morphogenetic protein-2, insulin-like growth factor-1, vitamin D

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: Saidou Hassidou, Laminou Ary Mahaman Moustapha

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Uncontrolled urbanization of African cities, plus the lack of municipal waste management services in these cities, generate landscapes become places of multiple and varied interactions between health and environment. In this sense, under strong urban growth in a context of sub-equipment sanitation, the city of Maradi doesn’t escape to this situation which results in the spread of pollution (release of unpleasant odors, proliferation of mosquitoes) and many diseases posing multiple health problems. Our study focuses only on liquid waste especially domestic wastewater. To study the different domestic wastewater management options in the town of Maradi, a survey was conducted among 340 households in 17 districts. We note in most cases a crucial of waste management infrastructure (drainage and wastewater treatment) at the city. Thus, only the individual sanitation facilities are used. In the town of Maradi, in addition to the storm drains, there are, in old districts, ditches that discharge wastewater and unfortunately end up in rivers without treatment. Domestic wastewater total production is estimated at 86,761.28 m3 per day. This water is mostly from laundry activities, bathing, dishes, and is discharged in large part through the streets, by more than 60% of households. Also, pit emptying is performed at 39.11% by the vehicle Peugeot tank. The quality of service rendered by an actor is very important to encourage households to join. Existing autonomous sanitation facilities are poorly designed and poorly maintained. Fecal sludge is dumped in a hole near saturated latrines; this work is mainly done by manual scavengers or dumped in fields or on nearby vacant land concessions.

Keywords: management, urban wastewater, domestic wastewater, Maradi, Niger

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Authors: Shin-Pin Tseng

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Nowadays, numerous spectral amplitude coding (SAC) fiber-optic code-division-multiple-access (FO-CDMA) techniques were appealing due to their capable of providing moderate security and relieving the effects of multiuser interference (MUI). Nonetheless, the performance of the previous network is degraded due to fixed in-phase cross-correlation (IPCC) value. Based on the above problems, a new SAC FO-CDMA network using partial M-sequence (PMS) code is presented in this study. Because the proposed PMS code is originated from M-sequence code, the system using the PMS code could effectively suppress the effects of MUI. In addition, two-code keying (TCK) scheme can applied in the proposed SAC FO-CDMA network and enhance the whole network performance. According to the consideration of system flexibility, simple optical encoders/decoders (codecs) using fiber Bragg gratings (FBGs) were also developed. First, we constructed a diagram of the SAC FO-CDMA network, including (N/2-1) optical transmitters, (N/2-1) optical receivers, and one N×N star coupler for broadcasting transmitted optical signals to arrive at the input port of each optical receiver. Note that the parameter N for the PMS code was the code length. In addition, the proposed SAC network was using superluminescent diodes (SLDs) as light sources, which then can save a lot of system cost compared with the other FO-CDMA methods. For the design of each optical transmitter, it is composed of an SLD, one optical switch, and two optical encoders according to assigned PMS codewords. On the other hand, each optical receivers includes a 1 × 2 splitter, two optical decoders, and one balanced photodiode for mitigating the effect of MUI. In order to simplify the next analysis, the some assumptions were used. First, the unipolarized SLD has flat power spectral density (PSD). Second, the received optical power at the input port of each optical receiver is the same. Third, all photodiodes in the proposed network have the same electrical properties. Fourth, transmitting '1' and '0' has an equal probability. Subsequently, by taking the factors of phase‐induced intensity noise (PIIN) and thermal noise, the corresponding performance was displayed and compared with the performance of the previous SAC FO-CDMA networks. From the numerical result, it shows that the proposed network improved about 25% performance than that using other codes at BER=10-9. This is because the effect of PIIN was effectively mitigated and the received power was enhanced by two times. As a result, the SAC FO-CDMA network using PMS codes has an opportunity to apply in applications of the next-generation optical network.

Keywords: spectral amplitude coding, SAC, fiber-optic code-division multiple-access, FO-CDMA, partial M-sequence, PMS code, fiber Bragg grating, FBG

Procedia PDF Downloads 375