Search results for: real-time safety risk assessment

Authors: Bharti Verma, Chandrajit Balomajumder

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Water pollution is escalated owing to industrialization and random ejection of one or more toxic heavy metal ions from the semiconductor industry, electroplating, metallurgical, mining, chemical manufacturing, tannery industries, etc., In semiconductor industry various kinds of chemicals in wafers preparation are used . Fluoride, toxic solvent, heavy metals, dyes and salts, suspended solids and chelating agents may be found in wastewater effluent of semiconductor manufacturing industry. Also in the chrome plating, in the electroplating industry, the effluent contains heavy amounts of Chromium. Since Cr(VI) is highly toxic, its exposure poses an acute risk of health. Also, its chronic exposure can even lead to mutagenesis and carcinogenesis. On the contrary, Cr (III) which is naturally occurring, is much less toxic than Cr(VI). Discharge limit of hexavalent chromium and trivalent chromium are 0.05 mg/L and 5 mg/L, respectively. There are numerous methods such as adsorption, chemical precipitation, membrane filtration, ion exchange, and electrochemical methods for the heavy metal removal. The present study focuses on the removal of Chromium ions by using flat sheet UF5kDa membrane. The Ultra filtration membrane process is operated above micro filtration membrane process. Thus separation achieved may be influenced due to the effect of Sieving and Donnan effect. Ultrafiltration is a promising method for the rejection of heavy metals like chromium, fluoride, cadmium, nickel, arsenic, etc. from effluent water. Benefits behind ultrafiltration process are that the operation is quite simple, the removal efficiency is high as compared to some other methods of removal and it is reliable. Polyamide membranes have been selected for the present study on rejection of Cr(VI) from feed solution. The objective of the current work is to examine the rejection of Cr(VI) from aqueous feed solutions by flat sheet UF5kDa membranes with different parameters such as pressure, feed concentration and pH of the feed. The experiments revealed that with increasing pressure, the removal efficiency of Cr(VI) is increased. Also, the effect of pH of feed solution, the initial dosage of chromium in the feed solution has been studied. The membrane has been characterized by FTIR, SEM and AFM before and after the run. The mass transfer coefficients have been estimated. Membrane transport parameters have been calculated and have been found to be in a good correlation with the applied model.

Keywords: heavy metal removal, membrane process, waste water treatment, ultrafiltration

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Authors: Volker Landersheim, Daria Manushyna, Thinh Pham, Dai-Duong Tran, Thomas Geury, Omar Hegazy, Steven Wilkins

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Air pollution is one of the emerging problems in our society. Targets of reduction of CO₂ emissions address low-carbon and resource-efficient transport. (Plug-in) hybrid electric propulsion concepts offer the possibility to reduce total cost of ownership (TCO) and emissions for public transport vehicles (e.g., bus application). In this context, typically, diesel engines are used to form the hybrid propulsion system of the vehicle. Though the technological development of diesel engines experience major advantages, some challenges such as the high amount of particle emissions remain relevant. Gaseous fuels (i.e., compressed natural gases (CNGs) or liquefied petroleum gases (LPGs) represent an attractive alternative to diesel because of their composition. In the framework of the research project 'Optimised Real-world Cost-Competitive Modular Hybrid Architecture' (ORCA), which was funded by the EU, two different hybrid-electric propulsion concepts have been investigated: one using a diesel engine as internal combustion engine and one using CNG as fuel. The aim of the current study is to analyze specific benefits for the aforementioned hybrid propulsion systems for predefined driving scenarios with regard to emissions and total cost of ownership in bus application. Engine models based on experimental data for diesel and CNG were developed. For the purpose of designing optimal energy management strategies for each propulsion system, maps-driven or quasi-static models for specific engine types are used in the simulation framework. An analogous modelling approach has been chosen to represent emissions. This paper compares the two concepts regarding their CO₂ and NOx emissions. This comparison is performed for relevant bus missions (urban, suburban, with and without zero-emission zone) and with different energy management strategies. In addition to the emissions, also the downsizing potential of the combustion engine has been analysed to minimize the powertrain TCO (pTCO) for plug-in hybrid electric buses. The results of the performed analyses show that the hybrid vehicle concept using the CNG engine shows advantages both with respect to emissions as well as to pTCO. The pTCO is 10% lower, CO₂ emissions are 13% lower, and the NOx emissions are more than 50% lower than with the diesel combustion engine. These results are consistent across all usage profiles under investigation.

Keywords: bus transport, emissions, hybrid propulsion, pTCO, CNG

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Authors: K. Rajarajeswaran, Krishna Prasad

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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.

Keywords: norepinephrine, methylene blue, shock, vasopressor

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Authors: Imelda Albert Gisip, Tarsiah T. Z. Taman

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In Asia, particularly in Malaysia women entrepreneurs contribute substantially to economic growth. This paper presents a review of the women entrepreneurs’ program, focusing on the Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia, which aims to accelerate entrepreneurship among young women in Sabah Malaysia. Entrepreneurs are seen as essential for growth, job creation and social progress and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner to achieve targets and goals that coincide with the development needs of the state. One of the government’s agenda is to put its efforts more strongly to ensure that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to producing competitive young women entrepreneurs in Sabah and achieving ‘millionaire’ status. CreaM@YWE Program is an innovation process specifically developed to accelerate the entrepreneurship sector, particularly for women entrepreneurs in Sabah, by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, this project is providing a supportive ecosystem, including six months of intensive courses guided through ‘hands-holding’, collaborations with strategic partners and easy access to government assistance. Since its inception, the program has significantly impacted society’s wellbeing, particularly in empowering young women entrepreneurs in Sabah for the past six years and has produced many successful women entrepreneurs with ‘millionaire’ status. Generally, improving women’s enterprise sector in Malaysia needs an overall enabling environment that allows development opportunities for women entrepreneurs including access to resources and support services. Since achieving the goal of women's entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach and long-term commitment. Thus, this paper presents how Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women, while addressing the few existing gender-specific hurdles.

Keywords: entrepreneurship programs, women, sabah, Malaysia

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Authors: Temple Probyne Abali

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Port Harcourt, Rivers State in the Niger Delta region of Nigeria is bedeviled by the phenomenon of climatechange, posing threat to food security and livelihood. This study examined a 4 decadel (1980-2020) trend of climate change as well as its socio-economic impact on food security in the region. Furthermore, to achieve sustainable food security and livelihood amidst the phenomenon, the study adopted the World Bank Assisted Third National Fadama Development Programme approach. The data source for climate change involved secondary data from Nigeria Meteorological Agency (NIMET). Consequently, the results for climate change over the 4decade period were displayed in tables, charts and maps for the expected changes. Data sources on socio-economic impact of food security and livelihood were acquired through questionnairedesign. A purposive random sampling technique was used in selecting 5 coastal communities inthe region known for viable economic potentials for agricultural development and the resultswere analyzed using Analysis of Variance (ANOVA). The Participatory Rural Appraisal (PRA) technique of the World Bank for needs assessment wasadopted in selecting 5 agricultural sub-project proposals/activities based on groups’ commoneconomic interest from a total of 1,000 farmers each drawn from the 5 communities of differentage groups including men, women, youths and the vulnerable. Based on the farmers’ sub-projectinterests, the various groups’ Strength, Weakness, Opportunities and Threats (SWOT), Problem Listing Matrix, Skill Gap Analysis as well as EIAson their sub-project proposals/activities were analyzed with substantialMonitoring and Evaluation (M & E), using the Specific, Measurable, Attribute, Reliable and Time bound (SMART)approach. Based on the findings from the PRA technique, the farmers recorded considerableincreaseinincomeofover200%withinthe5yearprojectplan(2008-2013).Thestudyrecommends capacity building and advisory services on this PRA innovation. By so doing, there would be a sustainable increase in agricultural production and assured food security in an environmental friendly manner, in line with the United Nation’s Sustainable Development Goals(SDGs).

Keywords: climate change, food security, fadama, world bank, agriculture, sdgs

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Authors: Tahamina Begum, Wan Nor Azlen Wan Mohamad, Faruque Reza, Wan Rosilawati Wan Rosli

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To assess auditory perception and cognitive function during pregnancy is necessary as the pregnant women need extra effort for attention mainly for their executive function to maintain their quality of life. This study aimed to investigate neural correlates of cognitive and behavioral processing during mid trimester pregnancy. Event-Related Potentials (ERPs) were studied by using 128-sensor net and PAS or COWA (controlled Oral Word Association), WCST (Wisconsin Card Sorting Test), RAVLTIM (Rey Auditory Verbal and Learning Test: immediate or interference recall, delayed recall (RAVLT DR) and total score (RAVLT TS) were tested for neuropsychology assessment. In total 18 subjects were recruited (n= 9 in each group; control and pregnant group). All participants of the pregnant group were within 16-27 (mid trimester) weeks gestation. Age and education matched control healthy subjects were recruited in the control group. Participants were given a standardized test of auditory cognitive function as auditory oddball paradigm during ERP study. In this paradigm, two different auditory stimuli (standard and target stimuli) were used where subjects counted silently only target stimuli with giving attention by ignoring standard stimuli. Mean differences between target and standard stimuli were compared across groups. N100 (auditory sensory ERP component) and P300 (auditory cognitive ERP component) were recorded at T3, T4, T5, T6, Cz and Pz electrode sites. An equal number of electrodes showed non-significantly shorter amplitude of N100 component (except significantly shorter at T3, P= 0.05) and non-significant longer latencies (except significantly longer latency at T5, P= 0.008) of N100 component in pregnant group comparing control. In case of P300 component, maximum electrode sites showed non-significantly higher amplitudes and equal number of sites showed non-significant shorter latencies in pregnant group comparing control. Neuropsychology results revealed the non-significant higher score of PAS, lower score of WCST, lower score of RAVLTIM and RAVLTDR in pregnant group comparing control. The results of N100 component and RAVLT scores concluded that auditory perception is mildly impaired and P300 component proved very mild cognitive dysfunction with good executive functions in second trimester of pregnancy.

Keywords: auditory perception, pregnancy, stimuli, trimester

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Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

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Authors: M. De Iuliis, O. Kammouh, G. P. Cimellaro, S. Tesfamariam

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Community Resilience has gained a significant attention due to the recent unexpected natural and man-made disasters. Resilience is the process of maintaining livable conditions in the event of interruptions in normally available services. Estimating the resilience of systems, ranging from individuals to communities, is a formidable task due to the complexity involved in the process. The most challenging parameter involved in the resilience assessment is the 'downtime'. Downtime is the time needed for a system to recover its services following a disaster event. Estimating the exact downtime of a system requires a lot of inputs and resources that are not always obtainable. The uncertainties in the downtime estimation are usually handled using probabilistic methods, which necessitates acquiring large historical data. The estimation process also involves ignorance, imprecision, vagueness, and subjective judgment. In this paper, a fuzzy-based approach to estimate the downtime of building structures following earthquake events is proposed. Fuzzy logic can integrate descriptive (linguistic) knowledge and numerical data into the fuzzy system. This ability allows the use of walk down surveys, which collect data in a linguistic or a numerical form. The use of fuzzy logic permits a fast and economical estimation of parameters that involve uncertainties. The first step of the method is to determine the building’s vulnerability. A rapid visual screening is designed to acquire information about the analyzed building (e.g. year of construction, structural system, site seismicity, etc.). Then, a fuzzy logic is implemented using a hierarchical scheme to determine the building damageability, which is the main ingredient to estimate the downtime. Generally, the downtime can be divided into three main components: downtime due to the actual damage (DT1); downtime caused by rational and irrational delays (DT2); and downtime due to utilities disruption (DT3). In this work, DT1 is computed by relating the building damageability results obtained from the visual screening to some already-defined components repair times available in the literature. DT2 and DT3 are estimated using the REDITM Guidelines. The Downtime of the building is finally obtained by combining the three components. The proposed method also allows identifying the downtime corresponding to each of the three recovery states: re-occupancy; functional recovery; and full recovery. Future work is aimed at improving the current methodology to pass from the downtime to the resilience of buildings. This will provide a simple tool that can be used by the authorities for decision making.

Keywords: resilience, restoration, downtime, community resilience, fuzzy logic, recovery, damage, built environment

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Authors: Katarzyna Neffe-Skocinska, Marzena Tomaszewska, Beata Bilska, Dorota Zielinska, Monika Trzaskowska, Anna Lepecka, Danuta Kolozyn-Krajewska

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The aim of the study was to assess Polish consumer behavior towards food waste, including knowledge of information on food labels. The survey was carried out using the CAPI (computer assisted personal interview) method, which involves interviewing the respondent using mobile devices. The research group was a representative sample for Poland due to demographic variables: gender, age, place of residence. A total of 1.115 respondents participated in the study (51.1% were women and 48.9% were men). The questionnaire included questions on five thematic aspects: 1. General knowledge and sources of information on the phenomenon of food waste; 2. Consumption of food after the date of minimum durability; 3. The meanings of the phrase 'best before ...'; 4. Indication of the difference between the meaning of the words 'best before ...' and 'use by'; 5. Indications products marked with the phrase 'best before ...'. It was found that every second surveyed Pole met with the topic of food waste (54.8%). Among the respondents, the most popular source of information related to the research topic was television (89.4%), radio (26%) and the Internet (24%). Over a third of respondents declared that they consume food after the date of minimum durability. Only every tenth (9.8%) respondent does not pay attention to the expiry date and type of consumed products (durable and perishable products). Correctly 39.8% of respondents answered the question: How do you understand the phrase 'best before ...'? In the opinion of 42.8% of respondents, the statements 'best before ...' and 'use by' mean the same thing, while 36% of them think differently. In addition, more than one-fifth of respondents could not respond to the questions. In the case of products of the indication information 'best before ...', more than 40% of the respondents chosen perishable products, e.g., yoghurts and durable, e.g., groats. A slightly lower percentage of indications was recorded for flour (35.1%), sausage (32.8%), canned corn (31.8%), and eggs (25.0%). Based on the assessment of the behavior of Polish consumers towards the phenomenon of food waste, it can be concluded that respondents have elementary knowledge of the study subject. Noteworthy is the good conduct of most respondents in terms of compliance with shelf life and dates of minimum durability of food products. The publication was financed on the basis of an agreement with the National Center for Research and Development No. Gospostrateg 1/385753/1/NCBR/2018 for the implementation and financing of the project under the strategic research and development program social and economic development of Poland in the conditions of globalizing markets – GOSPOSTRATEG - acronym PROM.

Keywords: food waste, shelf life, dates of durability, consumer knowledge and behavior

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Authors: Arto Grasten

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Given the rising trend in obesity in children and youth, age-related decline in moderate- to- vigorous-intensity physical activity (MVPA) in several Western, African, and Asian countries in addition to limited evidence of behavioral, affective, cognitive outcomes in physical education, it is important to clarify the motivational processes in physical education classes behind total MVPA engagement. The present study examined the full sequence of the Hierarchical Model of Motivation in physical education including motivational climate, basic psychological needs, intrinsic motivation, contextual behavior, affect, cognition, total MVPA, and associated links to body mass index (BMI) and gender differences. A cross-sectional data comprised self-reports and objective assessments of 770 middle school students (Mage = 13.99 ± .81 years, 52% of girls) in North-East Finland. In order to test the associations between motivational climate, psychological needs, intrinsic motivation, cognition, behavior, affect, and total MVPA, a path model was implemented. Indirect effects between motivational climate and cognition, behavior, affect and total MVPA were tested by setting basic needs and intrinsic motivation as mediators into the model. The findings showed that direct and indirect paths for girls and boys associated with different contextual outcomes and girls’ indirect paths were not related with total MVPA. Precisely, task-involving climate-mediated by physical competence and intrinsic motivation related to enjoyment, importance, and graded assessments within girls, whereas task-involving climate associated with enjoyment and importance via competence and autonomy, and total MVPA via autonomy, intrinsic motivation, and importance within boys. Physical education assessments appeared to be essential in motivating students to participate in greater total MVPA. BMI was negatively linked with competence and relatedness only among girls. Although, the current and previous empirical findings supported task-involving teaching methods in physical education, in some cases, ego-involving climate should not be totally avoided. This may indicate that girls and boys perceive physical education classes in a different way. Therefore, both task- and ego-involving teaching practices can be useful ways of driving behavior in physical education classes.

Keywords: achievement goal theory, assessment, enjoyment, hierarchical model of motivation, physical activity, self-determination theory

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Authors: Khairani Omar, Shalinawati Ramli, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

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Choosing a career which matches a student’s personality traits is one of the key factors for future work satisfaction. This is because career satisfaction is at the highest when it is in line with one’s personality strength, values and attitudes. Personality traits play a major role in determining the success of a student in the medical course. In the pre-clinical years, medical theories are being emphasized, thus, conscientious students would perform better than those with lower level of this trait. As the emphasis changes in the clinical years during which patient interaction is important, personality traits which involved interpersonal values become more essential for success. The aim of this study was to determine the personality traits of students who had chosen medicine as their career. It was a cross-sectional study conducted at the Islamic Science University of Malaysia. The respondents consisted of 81 students whose age ranged between 20-21 years old. A set of personality assessment inventory index which has been validated for the local context was used to determine the students’ personality traits. The instrument assessed 15 personality traits namely: aggressive, analytical, autonomy, creativity, extrovert, intellectual, motivation, diversity, resiliency, self-criticism, control, helpful, support, structured and achievement. The scores ranged between 1-100%, and they were categorized into low (1-30%), moderate (40-60%) and high scores (70-100%). The respondents were Year 3 pre-clinical medical students and there were more female students (69%) compared to male students (31%). Majority of them were from middle-income families. Approximately 70% of both parents of the respondents had tertiary education. Majority of the students had high scores in autonomy, creativity, diversity, helpful, structured and achievement. In other words, more than 50% of them scored high (70-100%) in these traits. Scoring high in these traits was beneficial for the medical course. For aggressive trait, 54% of them had moderate scores which is compatible for medicine as this indicated an inclination to being assertive. In the analytical and intellectual components, only 40% and 25% had high scores respectively. These results contradicted the usual expectation of medical students whereby they are expected to be highly analytical and intellectual. It would be an added value if the students had high scores in being extrovert as this reflects on good interpersonal values, however, the students had approximately similar scores in all categories of this trait. Being resilient in the medical school is important as the course is difficult and demanding. The students had good scores in this component in which 46% had high scores while 39% had moderate scores. In conclusion, by understanding their personality traits, strengths and weaknesses, the students will have an opportunity to improve themselves in the areas they lack. This will help them to become better doctors in future.

Keywords: career, medical students, medicine, personality traits

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Authors: Morgan Dombroski, Alexis Hartman

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Purpose: The present study aimed to explore factors related to overtraining within a female collegiate sample by analyzing the aftereffects of overtraining on athletes' physical and emotional well-being. Methods: 51 female collegiate athletes participated in a de-identified survey to assess factors related to overtraining. All survey questions were derived from the Recovery-Stress Questionnaire. Descriptive and bivariate correlations were conducted to test for significant factors related to the athletes' physical and emotional well-being relating to sports engagement. Results: Descriptive statistics indicated: 80.4% of athletes reported feeling tired from sport-related work, 72.5% reported parts of their body were aching, 47.1% reported feeling emotionally drained, and 37.3% reported feeling burnt out by sport. These findings were consistent with bivariate correlations, which yielded statistically significant findings between physical fatigue and emotional distress. Discussion: In a general sense, athletes increase their training to maximize their performance. The current study aimed to analyze how this training process can result in overtraining of female collegiate athletes, which in turn may negatively impact their physical and emotional functioning. Overtraining syndrome can occur as a maladaptive response to excessive exercise and inappropriate rest caused by systemic inflammation, which negatively affects the central nervous system. The physical manifestations of overtraining can then lead to depressed mood, fatigue, and neurohormonal changes in athletes. To remain competitive and high performing in sports, athletes partaking in excessive training can result in overtraining syndrome, athlete burnout, and compulsive exercise. Additionally, overtrained athletes were defined by displaying high levels of perfectionism, maladaptive coping, and training distress. The current study supported these findings, which yielded a strong correlation between physical and emotional functioning in the context of overtraining in sports. All in all, the environment revolving around sports and the intensity of training can be extremely stressful for athletes. There is a need to monitor athletes’ subjective responses to training, which will allow for early identification of at-risk athletes giving clinicians various opportunities to reduce the negative consequences of overtraining. By better understanding symptoms of emotional and physical fatigue, collegiate sports can become more aware of overtraining symptoms to prevent further detriment to female athletes' overall well-being.

Keywords: burnout, emotionally drained, overtraining, performance, well-being

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Authors: Shao-Huang Wu, Ai-Yun Wu, Meng-Chen Wu, Chun-Liang Wu, Kai-Ping Shaw, Hsiao-Ting Chen

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Objective: To analyze the forensic autopsy data of known passengers and compare it with the National database of the autopsy report in 2017, and obtain the special patterned injuries, which can be used as the reference for the reconstruction of hit-and-run motor vehicle accidents. Methods: Analyze the items of the Motor Vehicle Accident Report, including Date of accident, Time occurred, Day, Acc. severity, Acc. Location, Acc. Class, Collision with Vehicle, Motorcyclists Codes, Safety equipment use, etc. Analyzed the items of the Autopsy Report included, including General Description, Clothing and Valuables, External Examination, Head and Neck Trauma, Trunk Trauma, Other Injuries, Internal Examination, Associated Items, Autopsy Determinations, etc. Materials: Case 1. The process of injury formation: the car was chased forward and collided with the scooter. The passenger wearing the helmet fell to the ground. The helmet crashed under the bottom of the sedan, and the bottom of the sedan was raised. Additionally, the sedan was hit on the left by the other sedan behind, resulting in the front sedan turning 180 degrees on the spot. The passenger’s head was rotated, and the cervical spine was fractured. Injuries: 1. Fracture of atlantoaxial joint 2. Fracture of the left clavicle, scapula, and proximal humerus 3. Fracture of the 1-10 left ribs and 2-7 right ribs with lung contusion and hemothorax 4. Fracture of the transverse process of 2-5 lumbar vertebras 5. Comminuted fracture of the right femur 6. Suspected subarachnoid space and subdural hemorrhage 7. Laceration of the spleen. Case 2. The process of injury formation: The motorcyclist wearing the helmet fell to the left by himself, and his chest was crushed by the car going straight. Only his upper body was under the car and the helmet finally fell off. Injuries: 1. Dislocation of atlantoaxial joint 2. Laceration on the left posterior occipital 3. Laceration on the left frontal 4. Laceration on the left side of the chin 5. Strip bruising on the anterior neck 6. Open rib fracture of the right chest wall 7. Comminuted fracture of both 1-12 ribs 8. Fracture of the sternum 9. Rupture of the left lung 10. Rupture of the left and right atria, heart tip and several large vessels 11. The aortic root is nearly transected 12. Severe rupture of the liver. Results: The common features of the two cases were the fracture or dislocation of the atlantoaxial joint and both helmets that were crashed. There were no atlantoaxial fractures or dislocations in 27 pedestrians (without wearing a helmet) versus motor vehicle accidents in 2017 the National database of an autopsy report, but there were two atlantoaxial fracture or dislocation cases in the database, both of which were cases of falling from height. Conclusion: The cervical spine fracture injury of the motorcyclist, who was wearing a helmet, is very likely to be a patterned injury caused by his/her fall and rollover under the sedan. It could provide a reference for forensic peers.

Keywords: patterned injuries, atlantoaxial fracture or dislocation, accident reconstruction, motorcycle accident with helmet, forensic autopsy data

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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Authors: Jaime E. Salazar Lagos

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Chongqing is located in southwest China and is becoming one of the most significant cities in the world. Its urban territories and metropolitan-related areas have one of the largest urban populations in China and are partitioned and shaped by two of the biggest and longest rivers on Earth, the Yangtze and Jialing Rivers, making Chongqing a megalopolis intersected by rivers. Historically, Chongqing City enjoyed fundamental connections with its rivers; however, current urban development of Chongqing City has lost effective integration of the riverbanks within the urban space and structural dynamics of the city. Therefore, there exists a critical lack of physical and urban space conjoined with the rivers, which diminishes the economic, tourist, and environmental development of Chongqing. Using multi-scale satellite-map site verification the study confirmed the hypothesis and urban-waterside disconnect. Collected data demonstrated that the Chongqing urban zone, an area of 5292 square-kilometers and a water front of 203.4 kilometers, has only 23.49 kilometers of extension (just 11.5%) with high-quality physical and spatial urban-waterside connection. Compared with other metropolises around the world, this figure represents a significant lack of spatial development along the rivers, an issue that has not been successfully addressed in the last 10 years of urban development. On a macro scale, the study categorized the different kinds of relationships between the city and its riverbanks. This data was then utilized in the creation of an urban-waterfront relationship map that can be a tool for future city planning decisions and real estate development. On a micro scale, we discovered there are three primary elements that are causing the urban-waterside disconnect: extensive highways along the most dense areas and city center, large private real estate developments that do not provide adequate riverside access, and large industrial complexes that almost completely lack riverside utilization. Finally, as part of the suggested strategies, the study concludes that the most efficient and practical way to improve this situation is to follow the historic master-planning of Chongqing and create connective nodes in critical urban locations along the river, a strategy that has been used for centuries to handle the same urban-waterside relationship. Reviewing and implementing this strategy will allow the city to better connect with the rivers, reducing the various impacts of disconnect and urban transformation.

Keywords: Chongqing City, megalopolis, nodes, riverbanks disconnection, urban

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Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

Procedia PDF Downloads 182

Authors: J. Yan, B. Pieper, B. Bucsky, H. H. Sievers, B. Nasseri, S. A. Mohamed

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In order to optimize the efficacy of medications, the regular follow-up with long-term continuous monitoring of heart rhythmic patterns has been facilitated since clinical introduction of cardiac implantable electronic monitoring devices (CIMD). Extensive analysis of rhythmic circadian properties is capable to disclose the distributions of arrhythmic events, which may support appropriate medication according rate-/rhythm-control strategy and minimize consequent afflictions. 348 patients (69 ± 0.5ys, male 61.8%) with predisposed atrial fibrillation (AF), undergoing primary ablating therapies combined to coronary or valve operations and secondary implantation of CIMDs, were involved and divided into 3 groups such as PAAF (paroxysmal AF) (n=99, male 68.7%), PEAF (persistent AF) (n=94, male 62.8%), and LSPEAF (long-standing persistent AF) (n=155, male 56.8%). All patients participated in three-year ambulant follow-up (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation recurrence were assessed using cardiac monitor devices, whereby attacks frequencies and their circadian patterns were systemically analyzed. Anticoagulants and regular anti-arrhythmic medications were evaluated and the last were listed in terms of anti-rate and anti-rhythm regimens. Patients in the PEAF-group showed the least AF-burden after surgical ablating procedures compared to both of the other subtypes (p < 0.05). The AF-recurrences predominantly performed such attacks’ property as shorter than one hour, namely within 10 minutes (p < 0.05), regardless of AF-subtypes. Concerning circadian distribution of the recurrence attacks, frequent AF-attacks were mostly recorded in the morning in the PAAF-group (p < 0.05), while the patients with predisposed PEAF complained less attack-induced discomforts in the latter half of the night and the ones with LSPEAF only if they were not physically active after primary surgical ablations. Different AF-subtypes presented distinct therapeutic efficacies after appropriate surgical ablating procedures and recurrence properties in sense of circadian distribution. An optimization of medical regimen and drug dosages to maintain the therapeutic success needs more attention to detailed assessment of the long-term follow-up. Rate-control strategy plays a much more important role than rhythm-control in the ongoing follow-up examinations.

Keywords: atrial fibrillation, CIMD, MAZE, rate-control, rhythm-control, rhythm patterns

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Authors: Tsegaw Abebe, Temesgen Abebe

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Land degradation is one of a serious environmental challenge in Ethiopia and is one of the major underlying causes for declining agricultural productivity. The Ethiopia government realized the significance of environmental restoration specifically on deforested and degraded land after the 1973 and 1984/85 major famines that struck the country. Among the various conservation strategies, the establishment of area exclosures have been regarded as an effective response to halt and reverse the problems of land degradation. There are limited studies in Ethiopia dealing how the conversion of free grazing lands and degraded lands by closures increase biomass accumulation. However, these studies are not sufficient to conclude about the strength of area closures to restore degraded vegetations at the diverse agro-ecological condition. The overall objective of this study was, therefore, to assess and evaluate the usefulness of area closure technique in enhancing rehabilitation of degraded ecosystem and thereby increase the natural capital in the study site (southern Ethiopia). Woody plant species were collected from area exclosure for eight year and adjacent degraded land with similar landscape positions using systematic sampling plot design technique. Woody species diversity was determined by Shannon diversity. Comparative assessment result of woody plant species analysis showed that the density of woody species in the exclosure and degraded site were 778 and 222 individuals per hectare, respectively. A total of 16 woody species, representing 12 families were recorded in the study site. Out of the 12 families, all were recorded in the exclosure while 5 were recorded in the degraded site. Out of the 16 species, 15 were recorded in the exclosure while six were in the degraded site. A total of 10 species were recorded in the exclosure, which were absent in the degraded site. Similarly, one species was recorded in the degraded site which was not present in the exclosure. The results showed that protecting of degraded site from human and animal disturbances promotes woody plant species regenerations and productivity Apart from increasing woody plant species, the local communities have benefited from the exclosure in the form of both products (grass harvesting) and services (ecological). Due to this reason the local communities have positive attitudes and contribute a lot for the success of enclosures in the study site. The present study clearly showed that area closure interventions should be oriented towards managing and improving the productivity of the degraded land, in such a way that both the need for conservation of biodiversity and environmental sustainability, and the demands of the local people for biomass resources can be achieved.

Keywords: degraded land, exclosure, land restoration, woody vegetation

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Authors: Yu-Chen Wei

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The relationship between organizational human capital and organizational effectiveness have been a common topic of interest to organization researchers. Much of this research has concluded that higher human capital can predict greater organizational outcomes. Whereas human capital research has traditionally focused on organizations, the current study turns to the team level human capital. In addition, there are no known empirical studies assessing the effect of human capital divergence on team performance. Team human capital refers to the sum of knowledge, ability, and experience embedded in team members. Team human capital divergence is defined as the variation of human capital within a team. This study is among the first to assess the role of human capital divergence as a moderator of the effect of team human capital on team performance. From the traditional perspective, team human capital represents the collective ability to solve problems and reducing operational risk of all team members. Hence, the higher team human capital, the higher the team performance. This study further employs social learning theory to explain the relationship between team human capital and team performance. According to this theory, the individuals will look for progress by way of learning from teammates in their teams. They expect to have upper human capital, in turn, to achieve high productivity, obtain great rewards and career success eventually. Therefore, the individual can have more chances to improve his or her capability by learning from peers of the team if the team members have higher average human capital. As a consequence, all team members can develop a quick and effective learning path in their work environment, and in turn enhance their knowledge, skill, and experience, leads to higher team performance. This is the first argument of this study. Furthermore, the current study argues that human capital divergence is negative to a team development. For the individuals with lower human capital in the team, they always feel the pressure from their outstanding colleagues. Under the pressure, they cannot give full play to their own jobs and lose more and more confidence. For the smart guys in the team, they are reluctant to be colleagues with the teammates who are not as intelligent as them. Besides, they may have lower motivation to move forward because they are prominent enough compared with their teammates. Therefore, human capital divergence will moderate the relationship between team human capital and team performance. These two arguments were tested in 510 team-seasons drawn from major league baseball (1998–2014). Results demonstrate that there is a positive relationship between team human capital and team performance which is consistent with previous research. In addition, the variation of human capital within a team weakens the above relationships. That is to say, an individual working with teammates who are comparable to them can produce better performance than working with people who are either too smart or too stupid to them.

Keywords: human capital divergence, team human capital, team performance, team level research

Procedia PDF Downloads 237

Authors: Nazia Muhsin, Tofael Ahamed, Ryozo Noguchi, Tomohiro Takigawa

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One of the most challenging issues to achieve sustainable development on food security is land use changes. The crisis of lands for agricultural production mainly arises from the unplanned transformation of agricultural lands to infrastructure development i.e. urbanization and industrialization. Land use without sustainability assessment could have impact on the food security and environmental protections. Bangladesh, as the densely populated country with limited arable lands is now facing challenges to meet sustainable food security. Agricultural lands are using for economic growth by establishing industries. The industries are spreading from urban areas to the suburban areas and using the agricultural lands. To minimize the agricultural land losses for unplanned industrialization, compact economic zones should be find out in a scientific approach. Therefore, the purpose of the study was to find out suitable sites for industrial growth by land suitability analysis (LSA) by using Geographical Information System (GIS) and multi-criteria analysis (MCA). The goal of the study was to emphases both agricultural lands and industries for sustainable development in land use. The study also attempted to analysis the agricultural land use changes in a suburban area by statistical data of agricultural lands and primary data of the existing industries of the study place. The criteria were selected as proximity to major roads, and proximity to local roads, distant to rivers, waterbodies, settlements, flood-flow zones, agricultural lands for the LSA. The spatial dataset for the criteria were collected from the respective departments of Bangladesh. In addition, the elevation spatial dataset were used from the SRTM (Shuttle Radar Topography Mission) data source. The criteria were further analyzed with factors and constraints in ArcGIS®. Expert’s opinion were applied for weighting the criteria according to the analytical hierarchy process (AHP), a multi-criteria technique. The decision rule was set by using ‘weighted overlay’ tool to aggregate the factors and constraints with the weights of the criteria. The LSA found only 5% of land was most suitable for industrial sites and few compact lands for industrial zones. The developed LSA are expected to help policy makers of land use and urban developers to ensure the sustainability of land uses and agricultural production.

Keywords: AHP (analytical hierarchy process), GIS (geographic information system), LSA (land suitability analysis), MCA (multi-criteria analysis)

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Authors: Seungsik Yu, Minho Kang

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As the threat of terrorism to nuclear facilities is increasing globally after the attacks of September 11, we are striving to recognize the physical protection system and strengthen the emergency response system. Since 2015, Korea has implemented physical protection security exercise for nuclear facilities. The exercise should be carried out with full cooperation between the operator and response forces. Performance testing of the physical protection system should include appropriate exercises, for example, force-on-force exercises, to determine if the response forces can provide an effective and timely response to prevent sabotage. Significant deficiencies and actions taken should be reported as stipulated by the competent authority. The IAEA(International Atomic Energy Agency) is also preparing force-on-force exercise program documents to support exercise of member states. Currently, ROK(Republic of Korea) is implementing exercise on the force-on-force exercise evaluation system which is developed by itself for the nuclear power plant, and it is necessary to establish the exercise procedure considering the use of the force-on-force exercise evaluation system. The purpose of this study is to establish the work procedures of the three major organizations related to the force-on-force exercise of nuclear power plants in ROK, which conduct exercise using force-on-force exercise evaluation system. The three major organizations are composed of licensee, KINAC (Korea Institute of Nuclear Nonproliferation and Control), and the NSSC(Nuclear Safety and Security Commission). Major activities are as follows. First, the licensee establishes and conducts an exercise plan, and when recommendations are derived from the result of the exercise, it prepares and carries out a force-on-force result report including a plan for implementation of the recommendations. Other detailed tasks include consultation with surrounding units for adversary, interviews with exercise participants, support for document evaluation, and self-training to improve the familiarity of the MILES (Multiple Integrated Laser Engagement System). Second, KINAC establishes a force-on-force exercise plan review report and reviews the force-on-force exercise plan report established by licensee. KINAC evaluate force-on-force exercise using exercise evaluation system and prepare training evaluation report. Other detailed tasks include MILES training, adversary consultation, management of exercise evaluation systems, and analysis of exercise evaluation results. Finally, the NSSC decides whether or not to approve the force-on-force exercise and makes a correction request to the nuclear facility based on the exercise results. The most important part of ROK's force-on-force exercise system is the analysis through the exercise evaluation system implemented by KINAC after the exercise. The analytical method proceeds in the order of collecting data from the exercise evaluation system and analyzing the collected data. The exercise application process of the exercise evaluation system introduced in ROK in 2016 will be concretely set up, and a system will be established to provide objective and consistent conclusions between exercise sessions. Based on the conclusions drawn up, the ultimate goal is to complement the physical protection system of licensee so that the system makes licensee respond effectively and timely against sabotage or unauthorized removal of nuclear materials.

Keywords: Force-on-Force exercise, nuclear power plant, physical protection, sabotage, unauthorized removal

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Authors: N. D'Amico, E. Grossi, B. Colombo, F. Rigiroli, M. Buscema, D. Fazzini, G. Cornalba, S. Papa

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Purpose: To characterize, through a radiomic approach, the nature of nodules considered non-specific by expert radiologists, recognized in magnetic resonance mammography (MRm) with T1-weighted (T1w) sequences with paramagnetic contrast. Material and Methods: 47 cases out of 1200 undergoing MRm, in which the MRm assessment gave uncertain classification (non-specific nodules), were admitted to the study. The clinical outcome of the non-specific nodules was later found through follow-up or further exams (biopsy), finding 35 benign and 12 malignant. All MR Images were acquired at 1.5T, a first basal T1w sequence and then four T1w acquisitions after the paramagnetic contrast injection. After a manual segmentation of the lesions, done by a radiologist, and the extraction of 150 radiomic features (30 features per 5 subsequent times) a machine learning (ML) approach was used. An evolutionary algorithm (TWIST system based on KNN algorithm) was used to subdivide the dataset into training and validation test and to select features yielding the maximal amount of information. After this pre-processing, different machine learning systems were applied to develop a predictive model based on a training-testing crossover procedure. 10 cases with a benign nodule (follow-up older than 5 years) and 18 with an evident malignant tumor (clear malignant histological exam) were added to the dataset in order to allow the ML system to better learn from data. Results: NaiveBayes algorithm working on 79 features selected by a TWIST system, resulted to be the best performing ML system with a sensitivity of 96% and a specificity of 78% and a global accuracy of 87% (average values of two training-testing procedures ab-ba). The results showed that in the subset of 47 non-specific nodules, the algorithm predicted the outcome of 45 nodules which an expert radiologist could not identify. Conclusion: In this pilot study we identified a radiomic approach allowing ML systems to perform well in the diagnosis of a non-specific nodule at MR mammography. This algorithm could be a great support for the early diagnosis of malignant breast tumor, in the event the radiologist is not able to identify the kind of lesion and reduces the necessity for long follow-up. Clinical Relevance: This machine learning algorithm could be essential to support the radiologist in early diagnosis of non-specific nodules, in order to avoid strenuous follow-up and painful biopsy for the patient.

Keywords: breast, machine learning, MRI, radiomics

Procedia PDF Downloads 263

Authors: Nor Hidayah Reduwan, Jira Chindasombatjaroen, Suchaya Pornprasersuk-Damrongsri, Sopee Pomsawat

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INTRODUCTION: Odontogenic keratocyst (OKC) remain as a controversial pathologic entity under the scrutiny of many researchers and maxillofacial surgeons alike. The high recurrence rate and relatively aggressive nature of this lesion demand a meticulous analysis of the radiographic characteristic of OKC leading to the formulation of an accurate diagnosis. OBJECTIVE: This study aims to determine the radiographic characteristic of odontogenic keratocyst (OKC) using conventional radiographs and cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: Patients histopathologically diagnosed as OKC from 2003 to 2016 by Oral and Maxillofacial Pathology Department were retrospectively reviewed. Radiographs of these cases from the archives of the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Mahidol University were retrieved. Assessment of the location, shape, border, cortication, locularity, the relationship of lesion to embedded tooth, displacement of adjacent tooth, root resorption and bony expansion of the lesion were conducted. RESULTS: Radiographs of 91 patients (44 males, 47 females) with the mean age of 31 years old (10 to 84 years) were analyzed. Among all patients, 5 cases were syndromic patients. Hence, a total of 103 OKCs were studied. The most common location was at the ramus of mandible (32%) followed by posterior maxilla (29%). Most cases presented as a well-defined unilocular radiolucency with smooth and corticated border. The lesion was in associated with embedded tooth in 48 lesions (47%). Eighty five percent of embedded tooth are impacted 3rd molar. Thirty-seven percentage of embedded tooth were entirely encapsulated in the lesion. The lesion attached to the embedded tooth at the cementoenamel junction (CEJ) in 40% and extended to part of root in 23% of cases. Teeth displacement and root resorption were found in 29% and 6% of cases, respectively. Bony expansion in bucco-lingual dimension was seen in 63% of cases. CONCLUSION: OKCs were predominant in the posterior region of the mandible with radiographic features of a well-defined, unilocular radiolucency with smooth and corticated margin. The lesions might relate to an embedded tooth by surrounding an entire tooth, attached to the CEJ level or extending to part of root. Bony expansion could be found but teeth displacement and root resorption were not common. These features might help in giving the differential diagnosis.

Keywords: cone beam computed tomography, imaging dentistry, odontogenic keratocyst, radiographic features

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Authors: Jungyeol Hong, Dongjoo Park

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The urban transit system is a critical part of a solution to the economic, energy, and environmental challenges. Furthermore, it ultimately contributes the improvement of people’s quality of lives. For taking these kinds of advantages, the city of Seoul has tried to construct an integrated transit system including both subway and buses. The effort led to the fact that approximately 6.9 million citizens use the integrated transit system every day for their trips. Diagnosing the current transit network is a significant task to provide more convenient and pleasant transit environment. Therefore, the critical objective of this study is to establish a methodological framework for the analysis of an integrated bus-subway network and to examine the relationship between subway ridership and parameters such as network topology measures, bus demand, and a variety of commercial business facilities. Regarding a statistical approach to estimate subway ridership at a station level, many previous studies relied on Ordinary Least Square regression, but there was lack of studies considering the endogeneity issues which might show in the subway ridership prediction model. This study focused on both discovering the impacts of integrated transit network topology measures and endogenous effect of bus demand on subway ridership. It could ultimately contribute to developing more accurate subway ridership estimation accounting for its statistical bias. The spatial scope of the study covers Seoul city in South Korea, and it includes 243 subway stations and 10,120 bus stops with the temporal scope set during twenty-four hours with one-hour interval time panels each. The subway and bus ridership information in detail was collected from the Seoul Smart Card data in 2015 and 2016. First, integrated subway-bus network topology measures which have characteristics regarding connectivity, centrality, transitivity, and reciprocity were estimated based on the complex network theory. The results of integrated transit network topology analysis were compared to subway-only network topology. Also, the non-recursive approach which is Three-Stage Least Square was applied to develop the daily subway ridership model as capturing the endogeneity between bus and subway demands. Independent variables included roadway geometry, commercial business characteristics, social-economic characteristics, safety index, transit facility attributes, and dummies for seasons and time zone. Consequently, it was found that network topology measures were significant size effect. Especially, centrality measures showed that the elasticity was a change of 4.88% for closeness centrality, 24.48% for betweenness centrality while the elasticity of bus ridership was 8.85%. Moreover, it was proved that bus demand and subway ridership were endogenous in a non-recursive manner as showing that predicted bus ridership and predicted subway ridership is statistically significant in OLS regression models. Therefore, it shows that three-stage least square model appears to be a plausible model for efficient subway ridership estimation. It is expected that the proposed approach provides a reliable guideline that can be used as part of the spectrum of tools for evaluating a city-wide integrated transit network.

Keywords: integrated transit system, network topology measures, three-stage least squared, endogeneity, subway ridership

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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Authors: Stefan Ninković

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The main purpose of this paper is to examine the different theoretical approaches and relevant empirical evidence and thus, recognize some of the most pressing challenges faced by school leaders. This paper starts from the fact that the new mission of the school is characterized by the need for stronger coordination among students' academic, social and emotional learning. In this sense, school leaders need to focus their commitment, vision and leadership on the issues of students' attitudes, language, cultural and social background, and sexual orientation. More specifically, they should know what a good teaching is for student’s at-risk, students whose first language is not dominant in school, those who’s learning styles are not in accordance with usual teaching styles, or who are stigmatized. There is a rather wide consensus around the fact that the traditionally popular concept of instructional leadership of the school principal is no longer sufficient. However, in a number of "pro-leadership" circles, including certain groups of academic researchers, consultants and practitioners, there is an established tendency of attributing school principal an extraordinary influence towards school achievements. On the other hand, the situation in which all employees in the school are leaders is a utopia par excellence. Although leadership obviously can be efficiently distributed across the school, there are few findings that speak about sources of this distribution and factors making it sustainable. Another idea that is not particularly new, but has only recently gained in importance is related to the fact that the collective capacity of the school is an important resource that often remains under-cultivated. To understand the nature and power of collaborative school cultures, it is necessary to know that these operate in a way that they make their all collective members' tacit knowledge explicit. In this sense, the question is how leaders in schools can shape collaborative culture and create social capital in the school. Pressure exerted on schools to systematically collect and use the data has been accompanied by the need for school leaders to develop new competencies. The role of school leaders is critical in the process of assessing what data are needed and for what purpose. Different types of data are important: test results, data on student’s absenteeism, satisfaction with school, teacher motivation, etc. One of the most important tasks of school leaders are data-driven decision making as well as ensuring transparency of the decision-making process. Finally, the question arises whether the existing models of school leadership are compatible with the current social and economic trends. It is necessary to examine whether and under what conditions schools are in need for forms of leadership that are different from those that currently prevail. Closely related to this issue is also to analyze the adequacy of different approaches to leadership development in the school.

Keywords: educational changes, leaders, leadership, school

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Authors: Farhad Azadi, Mohammad Mahdi Mohammadi, Mohsen Vahedi, Zahra Mahdiin

Abstract:

Context: The aging population is growing all over the world and maintaining physical activity is essential for healthy aging. However, fear of falling is a major obstacle to physical activity among the elderly. The aim of this study is to investigate and compare the relationship between fear of falling and physical activity in Iranian urban and rural elderly. Research Aim: The main aim of this cross-sectional analytical study is to investigate and compare the relationship between fear of falling and physical activity in Iranian rural and urban elderly. Methodology: The study used simple non-probability sampling to select 350 participants aged 60 years and older from rural and urban areas of Konarak, Sistan and Baluchistan provinces in Iran. The Persian versions of the Falls Efficacy Scale - International, Rapid Physical Activity Assessment, Activities of Daily Living, and Instrumental Activities of Daily Living questionnaires were used to assess fear of falling and physical activity. The data were analyzed using Pearson correlation tests. Findings: The study found a statistically significant negative correlation between fear of falling and physical activity, as measured by ADL, IADL, and RAPA1(aerobic ), in all elderly and rural and urban elderly (p<0.001). Fear of falling was higher in rural areas, while physical activity levels measured by ADL and RAPA1 were higher in urban areas. No significant difference was found between the two groups in IADL and RAPA2 (strength and flexibility) scores. Theoretical Importance: This study highlights the importance of considering the fear of falling as a significant obstacle to proper physical activity, especially among the elderly living in rural areas. Furthermore, the study provides insight into the difference between rural and urban elderly people in terms of fear of falling and physical activity. Data Collection and Analysis Procedures: Data was collected through questionnaires and analyzed using Pearson correlation tests. Questions Addressed: The study attempted to answer the following questions: Is there a relationship between fear of falling and physical activity in Iranian urban and rural elderly people? Is there a difference in fear of falling and physical activity between rural and urban elderly? Conclusion: Fear of falling is a major obstacle to physical activity among the elderly, especially in rural areas. The study found a significant negative correlation between fear of falling and physical activity in all elderly and rural and urban elderly. In addition, urban and rural elderly have differences in aerobic activity levels, but they do not differ in terms of flexibility and strength. Therefore, proper interventions are required to ensure that the elderly can maintain physical activity, especially in rural and deprived areas.

Keywords: aged, fear of falling, physical activity, urban population, rural population

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Authors: Zhuang Yiwen

Abstract:

The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

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Authors: David Delpine Leila, Demnyo Sunita Femi, Musa David Garkida, Elisha Emmanuel Barde, Emmanuel Allahnanan, Yani Julius Philip

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Birds are among the key components of the earth’s biodiversity and the most diverse and evolutionarily successful groups of animals. The weaverbirds are a large family of birds found mostly in Africa, with a few species found in southern Asia and the West Indian Ocean islands. This study assessed the diversity and abundance of weaver birds and their allies within and around Ngel-Nyaki Forest Reserve in Yelwa, Sardauna Local Government Area of Taraba State, Nigeria. A total of 602 weaver birds and allies’ bird species were recorded using the Point Count Line Transect. The data collected during the research period were analyzed using simple percentages, and diversity was calculated using the Shannon Wiener Diversity Index. The fenced (ungrazed area) was more abundant with 351 individuals while the unfenced (grazed area) was less abundant with 251 individuals recorded. In the fenced (ungrazed area), Yellow Bishop (Euplectes capensis) had the highest abundance of (102; 29.01%), followed by Village Weaver (Ploceus cucullatus) (80; 22.79%), then Vieillot's Black Weaver (Ploceus nigerrimus) (40; 11.42%), Red-collard Widowbird (Ploceus ardens) (6; 1.71%), Dark-backed Weaver (5; 1.42%) and the least was Hartlaub Marsh Widowbird (1; 0.28%) while in the unfenced (grazed area), the Village weaver (Ploceus cucullatus) (85; 33.86%) was the most abundant, followed by Spectacled Weaver (Ploceus ocularis) (36; 14.34%), then Yellow Bishop (Euplectes capensis) (30; 11.95%), Baglefecht Weaver (Ploceus baglafecht) (23; 9.16%), Bannerman’s Weaver (Ploceus bannermani) (17; 6.77%) and the least was Yellow-mantled Widowbird (Euplectes macroura) (5; 1.99%). In terms of diversity, there were more weaver bird species in the fenced area with a Shannon Wiener Diversity Index of (Hˈ 2.03417) than in the unfenced area with a Shannon Wiener Diversity Index of (Hˈ 1.862671). The Shannon Wiener Diversity Index in both fenced and unfenced areas is significant. There was more abundance of bird species in the fenced area than in the unfenced area of the Forest Reserve. Thorough research should be conducted on the abundance and diversity of weavers and their allies because we were only able to access 4 km2 out of 46 km2 of land available, according to the Annual Report of Ngel-Nyaki Forest Reserve of 2020. It shows that there are many species of weaver birds and their allies, such as the Black-billed Weaver (Ploceus melanogaster) and the Red-billed Quelea (Quelea quelea), which are available within the reserve.

Keywords: abundance, diversity, weaver birds, allies, Ngel-Nyaki

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