Search results for: lower and higher risk category

Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

Procedia PDF Downloads 408

Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Basma Hamdi, Lakdar Kairouani, Ezzedine Nahdi

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The objective of this work is to present a thermodynamic analysis of low temperature solar Rankine cycle with ejector for power generation using zeotropic mixtures. Based on theoretical calculation, effects of zeotropic mixtures compositions on the performance of solar Rankine cycle with ejector are discussed and compared with corresponding pure fluids. Variations of net power output, thermal efficiency were calculating with changing evaporation temperature. The ejector coefficient had analyzed as independent variable. The result show that (R245fa/R152a) has a higher thermal efficiency than using pure fluids.

Keywords: zeotropic mixture, thermodynamic analysis, ejector, low-temperature solar rankine cycle

Procedia PDF Downloads 281

Authors: Ms Azam Najafkouchak, David Todem, Dorothy Pathak, Pramod Pathak, Joseph Gardiner

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Propensity score (PS) methods have recently become the standard analysis as a tool for the causal inference in the observational studies where exposure is not randomly assigned, thus, confounding can impact the estimation of treatment effect on the outcome. For the binary outcome, the effect of treatment on the outcome can be estimated by odds ratios, relative risks, and risk differences. However, using the different PS methods may give you a different estimation of the treatment effect on the outcome. Several methods of PS analyses have been used mainly, include matching, inverse probability of weighting, stratification, and covariate adjusted on PS. Due to the dangers of discretizing continuous variables (exposure, covariates), the focus of this paper will be on how the variation in cut-points or boundaries will affect the average treatment effect (ATE) utilizing the stratification of PS method. Therefore, we are trying to avoid choosing arbitrary cut-points, instead, we continuously discretize the PS and accumulate information across all cut-points for inferences. We will use Monte Carlo simulation to evaluate ATE, focusing on two PS methods, stratification and covariate adjusted on PS. We will then show how this can be observed based on the analyses of the data from a case-control study of breast cancer, the Polish Women’s Health Study.

Keywords: average treatment effect, propensity score, stratification, covariate adjusted, monte Calro estimation, breast cancer, case_control study

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Authors: Saidia Houari

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The game of football is one of the global sports activities that have witnessed a remarkable development in recent years in the physical, technical, rhetorical and psychological aspects, so the modern play in different teams and international teams quickly and forcefully in the exact technical performance, and this is due to the interest of international coaches. The good training of the players during the youth stage at the level of various aspects to develop all the techniques that have a great effectiveness in competitions according to scientific methods studied. The muscle strength plays a very important role achieving the performance player during the game and it is clear the need for the player in many situations, especially when jumping to hit the ball head or the goal on the goal or long passes of different types and in the performance of various skills by force and speed appropriate to the possession of the ball or the control of the court of the court while overcoming the body weight during the game it is known that the stronger the muscles of the athlete and the reduced joints injuries, and the strength increases energy saving such as Latin phosphate and glycogen, and develop the player for a game football volitional qualities of the most important of courage, determination And self-confidence. There are also some skill movements that can not be performed without a certain level of strength, so the development of power may affect the effectiveness of the long-term training system.

Keywords: trainning program, maximum force and expolosive force, lowers limbs, under 17 years

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Authors: Mokali Veeresham

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The microstructure and texture evolution of cryo rolled and annealed ductile TaHfNbZrTi refractory high entropy alloy was investigated. To obtain that, the alloy is severely cryo rolled and subsequently annealed for the recrystallization process. The cryo rolled – 90% shows the presence of very fine grains and microstructural heterogeneity. The cryo rolled samples are annealed at a temperature ranging from 800°C to 1400°C, the partial recrystallization is observed at 800°C annealed condition, and at higher annealing temperatures the complete recrystallization process is noticed. The development of ND fiber texture is observed after the annealing.

Keywords: refractory high entropy alloy, cryo-rolling, annealing, microstructure, texture

Procedia PDF Downloads 176

Authors: Ana Maria De Azevedo

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We are living a remarkable period, responsible for the thriving of the human population to unprecedented levels. Still, it is empirically obvious that sustaining such a huge population puts a tremendous pressure on our planet. Once Land resources grow scarcer, there is a mounting pressure to find alternatives to support basic human needs elsewhere. Occupying most of our planet, it’s therefore natural that, is not a so distant future, humankind look for such basic subsistence means at the Ocean. Thus, once the Ocean becomes essential to Human subsistence, it is predictable it's moving to the foreground of Geopolitics. Both future technologies and uses of the Ocean, as bidding for the exploration of its resources away from the natural territory of influence of a Country, are susceptible of raising the risk of conflict between traditional political adversaries and/or the dilemma of having to balance economic interests, with various security and defense concerns. Those empirical observations suggest the need to further research on this perspective shift of the main Geopolitical axis to the Ocean, the new sources of conflict that can result thereon, and how to address them. The author suggests a systematic analysis of this problematic, to attain a political and legal international consensus, namely on what concerns updating of the 'United Nations Convention on the Law of the Sea' of 10 December 1982, and/or its annexes. To proceed with the present research, the primary analysis was based on a quantitative observation, but reasoning thereon relied essentially on a qualitative process of prospective scenarios assessment.

Keywords: marine resources, ocean geopolitics, security and defense, sustainable development

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Authors: Hebberly Ahatlan

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The process of digitizing energy systems involves transforming traditional energy infrastructure into interconnected, data-driven systems that enhance efficiency, sustainability, and responsiveness. As smart grids become increasingly integral to the efficient distribution and management of electricity from both fossil and renewable energy sources, the energy industry faces strategic challenges associated with digitalization and interoperability — particularly in the context of modern energy business models, such as virtual power plants (VPPs). The critical challenge in modern smart grids is to seamlessly integrate diverse technologies and systems, including virtualization, grid computing and service-oriented architecture (SOA), across the entire energy ecosystem. Achieving this requires addressing issues like semantic interoperability, IT/OT convergence, and digital asset scalability, all while ensuring security and risk management. This paper proposes a four-layer digitalization framework to tackle these challenges, encompassing persistent data protection, trusted key management, secure messaging, and authentication of IoT resources. Data assets generated through this framework enable AI systems to derive insights for improving smart grid operations, security, and revenue generation. Furthermore, this paper also proposes a Trusted Energy Interoperability Alliance as a universal guiding standard in the development of this digitalization framework to support more dynamic and interoperable energy markets.

Keywords: digitalization, IT/OT convergence, semantic interoperability, VPP, energy blockchain

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Authors: M. M. Alhaji, M. Alhassan, A. M. Yahaya

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Soil engineers pay very little or no attention to variation in the mineralogical and consequently, the geotechnical properties of overburden with depth on basement complexes, a situation which can lead to sudden failure of civil engineering structures. Soil samples collected at depths ranging from 0.5m to 4.0m at 0.5m intervals, from a trial pit dogged manually to depth of 4.0m on an overburden over gneiss basement complex, was evaluated for physico-chemical, mineralogical and physical properties. This is to determine the variation of these properties with depth within the profile of the strata. Results showed that sodium amphibolite and feldspar, which are both primary minerals dominate the overall profile of the overburden. Carbon which dominates the lower profile of the strata was observed to alter to gregorite at upper section of the profile. Organic matter contents and cation exchange capacity reduces with increase in depth while lost on ignition and pH were relatively constant with depth. The index properties, as well as natural moisture contents, increases from 0.5m to between 1.0m to 1.5m depth after which the values reduced to constant values at 3.0m depth. The grain size analysis shows high composition of sand sized particles with silts of low to non-plasticity. The maximum dry density (MDD) values are generally relatively high and increases from 2.262g/cm³ at 0.5m depth to 2.410g/cm³ at 4.0m depth while the optimum moisture content (OMC) reduced from 9.8% at 0.5m depth to 6.7% at 4.0m depth.

Keywords: Gneiss basement complex, mineralogical properties, North Central Nigeria, physico-chemical properties, physical properties, overburden soil

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Authors: Syed Islam, Yiyun Huang, Sebastian Magierowski, Ebrahim Ghafar-Zadeh

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This paper presents system level CMOS solid-state nanopore techniques enhancement for speedup next generation molecular recording and high throughput channels. This discussion also considers optimum number of base-pair (bp) measurements through channel as an important role to enhance potential read accuracy. Effective power consumption estimation offered suitable rangeof multi-channel configuration. Nanopore bp extraction model in statistical method could contribute higher read accuracy with longer read-length (200 < read-length). Nanopore ionic current switching with Time Multiplexing (TM) based multichannel readout system contributed hardware savings.

Keywords: DNA, nanopore, amplifier, ADC, multichannel

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Authors: Adam Musa Adam Eissa

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Environmental and weather changes especially rainfall affects the distribution and densities of mosquitoes. This work was carried out to study the distribution and densities of mosquitoes adults and larvae in a total of five selected stations in El Obied Town. A cross-sectional survey of Anopheline mosquito larval habitats was conducted. The survey was conducted during the dry season (January 2013). Larvae were collected by using the standard dipping technique, while adult stages were collected by rearing larvae in cage, because the density of adults Anopheles mosquito per room was zero by using spray sheet method by using Permethrin pesticide 25%E.C, during the study period. The results revealed that (2347) Anopheline mosquito larvae were found and collected from only one station. All of which (2347) larvae (100%) were classified as probably Anopheles Squamosus. The study also showed that, a number of 81 adults (100%) Anopheline mosquito were classified as probably Anopheles Squamosus. Anopheles Squamosus were found only in the shallow pond water habitat in Alrahma west area of El Obied, the mean Anopheline density in the study area for larvae was 0.313 per dip while the mean density of adult was 0 per room. The high mosquito larval density in Alrahma west area indicated that, this part of El Obied Town is at risk of mosquito-borne diseases including malaria. This study recommended to apply the control program against mosquito at this part of the Town.

Keywords: anopheles, squamosus, Alrahma, distribution

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

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Background: E-interventions as a universal approach to prevent a high-risk behavior, such as alcohol drinking. This study was conducted to evaluate web-based alcohol drinking preventative intervention efficiency among medical university students in Iran. Methods: Overall, 150 freshman and sophomore male student’s college students participated in this study as intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to alcohol drinking prevention among college students. Cross-tabulation, t-test, repeated measures, and GEE by using SPSS statistical package, version 21 was used for the statistical analysis. The participants were followed up for 6 months with data collection scheduled at baseline, 3 and 6 months. The primary outcomes are attitude, self-control, and sensation seeking. Furthermore, the secondary outcome is comparing alcohol drinking among the study groups. Results: It was found significant reduce in average response for an attitude towards alcohol drinking and sensation seeking among intervention group (P < 0.05). But after intervention not significant difference between intervention and control group of improve self-control and reduce alcohol drinking (P > 0.05). Conclusion: Our intervention has been accompanied with reducing alcohol use rate. These findings indicate that e-intervention may be effectiveness approach to address the alcohol prevention among college students.

Keywords: e-interventions, alcohol drinking, students, Iran

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Authors: Behnaz Moradijamei, Michael Higgins

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Identifying community structure is a critical task in analyzing social media data sets often modeled by networks. Statistical models such as the stochastic block model have proven to explain the structure of communities in real-world network data. In this work, we develop a goodness-of-fit test to examine community structure's existence by using a distinguishing property in networks: cyclic structures are more prevalent within communities than across them. To better understand how communities are shaped by the cyclic structure of the network rather than just the number of edges, we introduce a novel method for deciding on the existence of communities. We utilize these structures by using renewal non-backtracking random walk (RNBRW) to the existing goodness-of-fit test. RNBRW is an important variant of random walk in which the walk is prohibited from returning back to a node in exactly two steps and terminates and restarts once it completes a cycle. We investigate the use of RNBRW to improve the performance of existing goodness-of-fit tests for community detection algorithms based on the spectral properties of the adjacency matrix. Our proposed test on community structure is based on the probability distribution of eigenvalues of the normalized retracing probability matrix derived by RNBRW. We attempt to make the best use of asymptotic results on such a distribution when there is no community structure, i.e., asymptotic distribution under the null hypothesis. Moreover, we provide a theoretical foundation for our statistic by obtaining the true mean and a tight lower bound for RNBRW edge weights variance.

Keywords: hypothesis testing, RNBRW, network inference, community structure

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Authors: Bernhard Widhalm, Cornelia Rieder-Gradinger, Ewald Srebotnik

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Pine wood (Pinus sylvestris L.) is the basic raw material for the production of Oriented Strand Boards (OSB) and the major source of volatile organic compounds, especially terpenes (like α- and β-pinene). To lower the total emission level of OSB, terpene metabolising microorganisms were therefore applied onto pine wood strands for the production of emission-reduced boards. Suitable microorganisms were identified during preliminary tests under laboratory conditions. At first, their terpene degrading potential was investigated in liquid culture, followed by laboratory tests using unsterile pine wood particles and strands. The main focus was laid on an adoptable terpene reduction in a short incubation time. An optimised bacterial mixture of Pseudomonas putida and Pseudomonas fluorescens showed the best results and was therefore used for further experiments on a larger scale. In an industry-compatible testing procedure, pine wood strands were incubated with the bacterial mixture for a period of 2 to 4 days. Incubation time was stopped by drying the strands. OSB were then manufactured from the pre-treated strands and emissions were measured by means of SPME/GC-MS analysis. Bacterial pre-treatment of strands resulted in a reduction of α-pinene- and β-pinene-emissions from OSB by 40% and 70%, respectively, even after only 2 days of incubation. The results of the investigation provide a basis for the application of microbial treatment within the industrial OSB production line, where shortest possible incubation times are required. For this purpose, the performance of the bacterial mixture will have to be further optimised.

Keywords: GC-MS, OSB, Pseudomonas sp., terpene degradation

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Authors: Ahuva Even-Zohar, Shoshi Werner

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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.

Keywords: men, older adults, quality of life, sexuality, women

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Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

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Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

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Authors: Radah Yousuf, Ashraf Shebl

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Suicide is a tragic event with strong emotional repercussions for its survivors and for families of its victims. There were thousands of cases all over the world. There are many risk factors include mental disorders such as depression, and substance abuse, including alcoholism and use of benzodiazepines. Other suicides are impulsive acts due to stress such as from financial difficulties, troubles with relationships, or from bullying. The aim of work in this study is making a survey from archives of the suicidal cases, which had a medicolegal examination, in forensic medicine center in Al Madinah Almunawarah-KSA, for ten years in the period between 1428-1438h. In each case, some data are collected such as age, sex, time and place of an act, method of suicide, the presence of the witness, medical history. This study demonstrates that suicide is more common in male than female, and the 4th decade was the most period of age. The most common method of suicide was hanging followed by falling from the height. These results indicated that cultural and religious beliefs that discourage suicide and support self-preservation instinct, and suicide education programs provide information to students in high school, builds awareness, one of the most important issues in solving that problem. From the forensic view, circumstantial evidence of every forensic case must take and record, full history about the social, medical and psychological problems, attend the scene of death is a very important, complete medicolegal investigation for every case, and full autopsy with very skilled techniques and facilities can help in diagnosing what type of crimes.

Keywords: suicide, age, sex, hanging

Procedia PDF Downloads 148

Authors: Kgomotso Matobole, Natania De Wet, Tefo Mbambo, Hilary Rutto, Tumisang Seodigeng

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Nitrogen and phosphorus are nutrients which are required in the ecosystem, however, at high levels, these nutrients contribute to the process of eutrophication in the receiving water bodies, which threatens aquatic organisms. Hence it is vital that they are removed before the water is discharged. This phenomenon increases the cost related to wastewater treatment. This raises the need for the development of processes that are cheaper. Activated biocarbon was used in batch and filtration system to remove nitrates and phosphates. The batch system has higher nutrients removal capabilities than the filtration system. For phosphate removal, 93 % removal is achieved at the adsorbent of 300 g while for nitrates, 84 % removal is achieved when 200 g of activated carbon is loaded.

Keywords: waste water treatment, phosphates, nitrates, activated carbon, agricultural waste

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Authors: Ricardo Andrés Márquez Ortiz

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Objective. The objective of this literature review is to compile updated information from studies that have addressed the association between dental pathologies and diet in prehistoric populations of the equatorial Pacific coast. Materials and method. The research carried out corresponds to a documentary study of ex post facto retrospective, historiographic and bibliometric design. A bibliographic review search was carried out in the libraries of the Colombian Institute of Anthropology and History (ICANH) and the National University of Colombia for books and articles on the archeology of the region. In addition, a search was carried out in databases and the Internet for books and articles on dental anthropology, archeology and dentistry on the relationship between dental pathologies and diet in prehistoric and current populations from different parts of the world. Conclusions. The complex societies (500 BC - 300 AD) of the equatorial Pacific coast used an agricultural system of intensive monoculture of corn (Zea mays). This form of subsistence was reflected in an intensification of dental pathologies such as dental caries, dental abscesses generated by cavities, and enamel hypoplasia associated with a lower frequency of wear. The Upper Formative period (800 A.D. -16th century A.D.) is characterized by the development of polyculture, slash-and-burn agriculture, as an adaptive agricultural strategy to the ecological damage generated by the intensive economic activity of complex societies. This process leads to a more varied diet, which generates better dental health.

Keywords: dental pathologies, nutritional diet, equatorial pacific coast, dental anthropology

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Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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Authors: Özgür Cavbozar, Rasih Hakan Demirkol

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In many industries, it is occasionally essential to mount heavy modules to stationary racks or constructions in correct position in minimum time. With the rapid advancement in technology, consumption has increased. Therefore, to meet the higher demands, manufacturers should develope innovative methods to produce and store rapidly manufactured products faster. It is usually very tough to fix the heavy modules in two axes in correct position with fasteners like bolts. This paper represents a design solution for fixing the heavy modules to their racks of stationary shelves exactly with minimum effort. The design solution for a particular study has been proposed. Regarding quick mounting and easily adjustable operations for heavy modules, design and production suggestions have been carried out.

Keywords: exact mounting, mounting of heavy modules, quick mounting, two axial fixturing

Procedia PDF Downloads 78

Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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Authors: Mehari Kahsay, Krishna Murthy Kyathegowda, Temesgen Berhanu

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Aluminum matrix composites have gained focus on research and industrial use, especially those not requiring extreme loading or thermal conditions, for the last few decades. Their relatively low cost, simple processing and attractive properties are the reasons for the widespread use of aluminum matrix composites in the manufacturing of automobiles, aircraft, military, and sports goods. In this article, the microstructure, mechanical, and corrosion behaviors of the aluminum metal matrix were reviewed, focusing on the stir casting fabrication process and usage of agro/industrial waste reinforcement particles. The results portrayed that mechanical properties like tensile strength, ultimate tensile strength, hardness, percentage of elongation, impact, and fracture toughness are highly dependent on the amount, kind, and size of reinforcing particles. Additionally, uniform distribution, wettability of reinforcement particles, and the porosity level of the resulting composite also affect the mechanical and corrosion behaviors of aluminum matrix composites. The two-step stir-casting process resulted in better wetting characteristics, a lower porosity level, and a uniform distribution of particles with proper handling of process parameters. On the other hand, the inconsistent and contradicting results on corrosion behavior regarding monolithic and hybrid aluminum matrix composites need further study.

Keywords: microstructure, mechanical behavior, corrosion, aluminum matrix composite

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Authors: Tianyou Wang

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Students' own intrinsic motivation is the main source of energy for learning activities, and their self-efficacy becomes a key factor affecting the learning effect. In today's increasingly common situation of online vocal music teaching, virtualized teaching scenarios have brought a considerable impact on students' personal efficacy. Since personal efficacy is the result of the interaction between environmental factors and subject characteristics, an empirical study was conducted to investigate the changes in students' self-efficacy, influencing factors, and characteristics in online vocal teaching scenarios based on the three dimensions of teachers, students, and technology. One hundred valid questionnaires were studied through a quantitative survey. The results showed that students' personal efficacy was significantly lower in online learning environments compared to offline vocal teaching and showed significant differences due to factors such as gender and class type; students' self-efficacy in online vocal teaching was significantly affected by factors such as technological environment, teaching style, and information technology ability. Based on the results of the study, it is recommended to pay attention to inquiry and practice in the teaching design, use singing projects as the teaching organization, grasp the learning process with the orientation of problem-solving, push the applicable vocal music teaching resources in time, lead students to explore and refine the problems and push students to learn independently according to the goals and plans.

Keywords: vocal pedagogy, self-efficacy, online learning, intrinsic motivation, information technology

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Authors: Mara Balestrieri

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Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

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Authors: Uhde Serenay Sunay, Alev Yalçınkaya

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Emotional abuse is one of the most challenging forms of violence to define, and many individuals often unknowingly experience emotional abuse. Existing literature has found that individuals who have experienced psychological abuse tend to suffer from depression, low self-esteem, a decreased sense of autonomy, fear, and an increased risk of suicide. Current research indicates that physical abuse in romantic relationships is often accompanied by emotional abuse, supporting the idea that identifying emotional abuse is an essential factor in romantic relationships. On the other hand, studies on emotional abuse between partners in romantic relationships are limited. This study investigated attitudes towards emotional abuse among Turkish university students. Gender differences were investigated.Additionally, the study examined whether the degree of emotional abuse was related to attitudes towards emotional abuse. A total of 243 university students participated in the research, with 156 female and 87 male participants. Participants' attitudes toward emotional abuse were measured using the Turkish adaptation of Follingstad Psychological Aggression Scale and hypothetical scenarios created by the researchers. The results revealed that attitudes of women and men vary significantly in attack looks/sexuality, fidelity, gender roles, and jealousy subscales of Follingstad Psychological Aggression Scale. Furthermore, attitudes towards moderate-level and severe-level emotional abuse exhibit statistically significant variability by gender, while attitudes towards mild-level emotional abuse do not.

Keywords: emotional abuse, gender differences, Turkish culture, university students

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Authors: Bree Wiles

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Self-harm is still a topic that is not talked about enough, especially with the growing concern for the safety of LGBTQIA+ youth. LGBTQIA+ youth are coming out at earlier ages, thus bringing to attention the added risks for this population. Many LGBTQIA+ youth end up engaging in some form of self-destructive behavior from dealing with the stigma and negative socialization around them. Within the LGBTQIA+ youth population, self-harm alongside depression and suicide is especially common. This disparity shows the importance of providing LGBTQIA+ youth with resources that affirm their identities. As professionals and parents, it is important to understand the types of self-harm, the average age range when it can occur, causes, populations, risk factors, and self-harm in connection with mental health and suicide. It is imperative to provide protective factors for LGBTQIA+ youth in helping to replace self-harming behaviors with positive coping strategies. Helping LGBTQIA+ youth in different contexts, including from a professional, parent, and educator perspective, allows unique ways in which each can assist an LGBTQIA+ youth who is self-harming. The stigma, shame, and many misconceptions about self-harming behaviors are discussed in depth including from the lived experience of this author and professional experiences working with queer youth. Most importantly, it is imperative to know how to approach LGBTQIA+ youth who are self-harming, including how to speak in a compassionate and empathy-based framework. Clear interventions and therapeutic techniques based on evidence-based practices on alternatives to self-harm, lived experience, and previous practices with queer youth who are self-harming are provided and discussed.

Keywords: LGBTQ+, mental health, self-harm, depression

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Authors: Bualak Naksongkaew

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The purposes of this study were to compare pre- and post-test achievement of Thai language skills. The samples consisted of 40 tenth grader of Secondary Demonstration School of Suan Sunandha Rajabhat University in the first semester of the academic year 2010. The researcher prepared the Thai lesson plans, the pre- and post-achievement test at the end program. Data analyses were carried out using means, standard deviations and descriptive statistics, independent samples t-test analysis for comparison pre- and post-test. The study showed that there were a statistically significant difference at α= 0.05; therefore the use multiple intelligences theory can develop Thai languages skills. The results after using the multiple intelligences theory for Thai lessons had higher level than standard.

Keywords: multiple intelligences theory, Thai language skills, development, pre- and post-test achievement

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Authors: Elaine Marta Pereira Aaltonen

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Effective school leadership materialised in educational settings through the high standard professional performance of senior and middle leaders, has increasingly become an education policy priority around the world due to a wide recognition that schools need knowledgeable, skilled, and committed leaders, along with great teachers, in order to ensure outstanding education at all levels of schooling. The scope of this paper is the work of middle leaders, whose direct influence on teachers and classroom teaching, thus, on student learning outcomes, is a key component for successful school systems. It particularly aims at sharing some of the findings obtained through an academic study recently carried out by the same researcher, which was focused on enhancing understanding about aspects related to the professional performance of educational middle leaders, applied to the context of the lower elementary school division of a private mainstream school located in Brazil. The master´s dissertation findings included identifying the roles performed by a team of educational middle leaders throughout the year of 2021, as well as gaining insights on their perceptions about the roles performed, both through an electronic questionnaire and individual face-to-face interviews. Not only the roles of the middle leaders who participated in the research have been identified through the qualitative case study undertaken, but additional research finding lying within the sphere of the categorisation of such roles, based upon coherent domains of practice, has possibly been made. Hence, the main purpose of this paper is to outline the findings concerning the current roles played by educational middle leaders.

Keywords: roles, middle leaders, educational leadership, school leadership, and management

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Authors: Shahid Mahboob, Hafiz Muhammad Ashraf, Salma Sultana, Tayyaba Sultana, Khalid Al-Ghanim, Fahid Al-Misned, Zubair Ahmedd

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There is an increasing need for an effective tool to estimate the risks derived from the large number of pollutants released to the environment by human activities. Typical screening procedures are highly invasive or lethal to the fish. Recent studies show that fish scales biochemically respond to a range of contaminants, including toxic metals, organic compounds, and endocrine disruptors. The present study evaluated the effects of the surface water contaminants on Cyprinus carpio in the Ravi River by comparing DNA extracted non-lethally from their scales to DNA extracted from the scales of fish collected from a controlled fish farm. A single, random sampling was conducted. Fish were broadly categorised into three weight categories (W1, W2 and W3). The experimental samples in the W1, W2 and W3 categories had an average DNA concentration (µg/µl) that was lower than the control samples. All control samples had a single DNA band; whereas the experimental samples in W1 fish had 1 to 2 bands, the experimental samples in W2 fish had two bands and the experimental samples in W3 fish had fragmentation in the form of three bands. These bands exhibit the effects of pollution on fish in the Ravi River. On the basis findings of this study, we propose that fish scales can be successfully employed as a new non-lethal tool for the evaluation of the effect of surface water contaminants.

Keywords: fish scales, Cyprinus carpio, heavy metals, non-invasive, DNA fragmentation

Procedia PDF Downloads 414