Search results for: public health management

Authors: Guilherme B. B. Vieira, Rafael M. da Silva, Eliana T. P. Senna, Luiz A. S. Senna, Francisco J. Kliemann Neto

Abstract:

Given the importance of ports as links in the global supply chains and because they are key elements to induce competitiveness in their hinterlands, the number of studies devoted to port governance, management and operations has increased in the last decades. Some of these studies address the port governance model as an element to improve coordination among the actors of the port logistics chain and to generate a better port performance. In this context, the present study analyzes the governance of Port of Santos through individual interviews with port managers, based on a conceptual model that considers the key dimensions associated with port governance. The results reinforce the usefulness of the applied model and highlight some existing improvement opportunities in the port studied.

Keywords: port governance, model, Port of Santos, managers’ perception

Procedia PDF Downloads 522

Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

Abstract:

Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

Procedia PDF Downloads 432

Authors: Danica Maljkovic, Igor Balen, Bojana Dalbelo Basic

Abstract:

Following the regulation of EU Directive on Energy Efficiency, specifically Article 9, individual metering in district heating systems has to be introduced by the end of 2016. These directions have been implemented in member state’s legal framework, Croatia is one of these states. The directive allows installation of both heat metering devices and heat cost allocators. Mainly due to bad communication and PR, the general public false image was created that the heat cost allocators are devices that save energy. Although this notion is wrong, the aim of this work is to develop a model that would precisely express the influence of installation heat cost allocators on potential energy savings in each unit within multifamily buildings. At the same time, in recent years, a science of machine learning has gain larger application in various fields, as it is proven to give good results in cases where large amounts of data are to be processed with an aim to recognize a pattern and correlation of each of the relevant parameter as well as in the cases where the problem is too complex for a human intelligence to solve. A special method of machine learning, decision tree method, has proven an accuracy of over 92% in prediction general building consumption. In this paper, a machine learning algorithms will be used to isolate the sole impact of installation of heat cost allocators on a single building in multifamily houses connected to district heating systems. Special emphasises will be given regression analysis, logistic regression, support vector machines, decision trees and random forest method.

Keywords: district heating, heat cost allocator, energy efficiency, machine learning, decision tree model, regression analysis, logistic regression, support vector machines, decision trees and random forest method

Procedia PDF Downloads 241

Authors: Sheriff Folarin, Oluwafunke Folarin, Hadassah Hussaini, Victor Jubril, Olaniyi Ayodele

Abstract:

Using a famous, unrestrained and fiery United States-based, Nigerian-owned Sahara Reporters as a case study, this paper examined the impact of online-based media on governance in Nigeria. The discourse is premised on the thesis that the internet has changed the face of journalism and that the mainstream but online-based media have made journalism more participatory than ever. Everyone who has something to say finds it easy to say it quickly and conveniently, unhinged or without being censored. This has made online journalism very popular and the number of online-based news platforms to be on the increase. As these platforms have given the citizens a means to interact and added to the content of the news, they have also succeeded in promoting partisanship. It thus becomes necessary to study the impact of the rabid news platform, Sahara Reporters, on governance in Africa’s biggest democracy, Nigeria. Few studies have examined the impact on governance of mainstream-online media platforms and those studies that did, have only focused on social media, such as Facebook and Twitter. This paper is a product of a bigger study, in which the research design entailed semi-structured interviews with participants from different sectors of the society and an analysis of contents from the Sahara Reporters website, from which data were collected. The findings revealed that through uncensored reporting and citizen participation on the platform of Sahara Reporters, there had been a significant people influence on governance in Nigeria, with government at two levels (national and state) sometimes shifting or yielding grounds, particularly from 2011-2016. The study also recognized the presence of counter-forces in the online community who want to discredit the information on the site. Through the lens of media dependency theory, the study concluded that the public now increasingly depends on online news media for information and the more news these media provide, the more the people depend on it, making it easy for them to influence governance.

Keywords: governance, media, online news, Sahara reporters

Procedia PDF Downloads 92

Authors: M. L. Gaol, I. W. Mudita

Abstract:

Indonesia is well known as a country covered by lush tropical rain forests, but in fact, the northeastern part of the country, within the areas geologically known as Lesser Sunda, the dominant vegetation is tropical savanna. Lesser Sunda is a chain of islands located closer to Australia than to islands in the other parts of the country. Among those of islands in the chain which is closes to Australia, and thereby most strongly affected by the hot and dry Australian climate, is the island of Timor, the western part of which belongs to Indonesia and the eastern part is a sovereign state East Timor. Regardless of being the most dominant vegetation cover, tropical savanna in West Timor, especially its understory, is rarely investigated. This research was therefore carried out to investigate the structure, composition and diversity of the understory of this tropical savanna as the basis for looking at the possibility of introducing other spesieis for various purposes. For this research, 14 terrestrial communities representing major types of the existing savannas in West Timor was selected with aid of the most recently available satellite imagery. At each community, one stand of the size of 50 m x 50 m most likely representing the community was as the site of observation for the type of savanna under investigation. At each of the 14 communities, 20 plots of 1 m x 1 m in size was placed at random to identify understory species and to count the total number of individuals and to estimate the cover of each species. Based on such counts and estimation, the important value of each species was later calculated. The results of this research indicated that the understory of savanna in West Timor consisted of 73 understory species. Of this number of species, 18 species are grasses and 55 are non-grasses. Although lower than non-grass species, grass species indeed dominated the savanna as indicated by their number of individuals (65.33 vs 34.67%), species cover (57.80 vs 42.20%), and important value (123.15 vs 76.85). Of the 14 communities, the lowest density of grass was 13.50/m2 and the highest was 417.50/m2. Of 18 grass species found, all were commonly found as agricultural weeds, whereas of 55 non-grass, 10 species were commonly found as agricultural weeds, environmental weeds, or invasive species. In terms of better managing the savanna in the region, these findings provided the basis for planning a more integrated approach in managing such agricultural and environmental weeds as well as invasive species by considering the structure, composition, and species diversity of the understory species existing in each site. These findings also provided the basis for better understanding the flora of the region as a whole and for developing a flora database of West Timor in future.

Keywords: tropical savanna, understory species, integrated management, weedy and invasive species

Procedia PDF Downloads 124

Authors: Sung Hyun You, Jeong Hoon Kim, Dae Ki Kim, Choon Ki Ahn

Abstract:

In this paper, we proposed a new strategy for estimating indoor temperature based on the modified resistance capacitance (R–C) network thermal dynamic model. Using minimum variance finite impulse response (FIR) filter, accurate indoor temperature estimation can be achieved. Our study is clarified by the experimental validation of the proposed indoor temperature estimation method. This experiment scenario environment is composed of a demand response (DR) server and home energy management system (HEMS) in a test bed.

Keywords: energy consumption, resistance-capacitance network model, demand response, finite impulse response filter

Procedia PDF Downloads 439

Authors: Attahiru Sifawa Ahmad

Abstract:

The media; electronic, print, and social, is playing very significant roles towards promoting political awareness and stability of any nation. However, for the media to play its role effectively, a clear and sound grasp of the language of communication is necessary. Otherwise, there is the tendency of the media spreading wrong and, or, misinterpreted information to the public, capable of generating rancour and political instability. One such clear misinterpretation or misrepresentation of information was the Hausa metaphorical expression, Kare Jinni Biri Jinni quoted from the statement made by Rtd. General Muhammadu Buhari, sometimes in April, 2013, while addressing his supporters from Niger State. In the political presentation of the term Kare - Jini Biri – Jini, quoted and translated by many print media in Nigeria, it was interpreted to mean; ‘The Dog and the Baboon will be soaked in blood’, denoting bloodshed and declaration of war. However, the term Kare - jini Biri - Jini, literally; the Dog with blood and the Baboon with blood, or, the Dog is bleeding the Baboon is bleeding, or, both the Dog and the Baboon sustained injuries. It is a metaphorical expression denoting a hot competition, and serious struggle, between two competing parties that are closer in strength and stamina. The expression got its origin among the hunting communities in traditional Hausa Societies. From experience, it was always not easy to wrestle and hunt Baboon by the Hunter’s Dog. In many instances, it ended a futile exercise, and even at instances whereby the latter hunted the former, it would be after a serious struggle with both two sustaining injuries. This paper seeks to highlight the poverty of vocabulary, and poor grasp of Nigerian languages among Journalists and young citizens in the country. The paper, therefore, advocated for the retention and effective teaching of the indigenous languages in primary and secondary school’s curriculums in Nigeria. The paper equally analysed the political origin of the print media in Nigeria, how since its first appearance, the print Media is being assigned very important political role by political elites in the country.

Keywords: Baboon, dog, media, politics

Procedia PDF Downloads 215

Authors: Sadia Imran, Zenab Naseem

Abstract:

Dengue fever is one of the most alarming mosquito-borne viral diseases. Dengue virus has been distributed over the years exponentially throughout the world be it tropical or sub-tropical regions of the world, particularly in the last ten years. Changing topography, climate change in terms of erratic seasonal trends, rainfall, untimely monsoon early or late and longer or shorter incidences of either summer or winter. Globalization, frequent travel throughout the world and viral evolution has lead to more severe forms of Dengue. Global incidence of dengue infections per year have ranged between 50 million and 200 million; however, recent estimates using cartographic approaches suggest this number is closer to almost 400 million. In recent years, Pakistan experienced a deadly outbreak of the disease. The reason could be that they have the maximum exposure outdoors. Public organizations have observed that changing climate, especially lower average summer temperature, and increased vegetation have created tropical-like conditions in the city, which are suitable for Dengue virus growth. We will conduct a time-series analysis to study the interrelationship between dengue incidence and diurnal ranges of temperature and humidity in Pakistan, Lahore being the main focus of our study. We have used annual data from 2005 to 2015. We have investigated the relationship between climatic variables and dengue incidence. We used time series analysis to describe temporal trends. The result shows rising trends of Dengue over the past 10 years along with the rise in temperature & rainfall in Lahore. Hence this seconds the popular statement that the world is suffering due to Climate change and Global warming at different levels. Disease outbreak is one of the most alarming indications of mankind heading towards destruction and we need to think of mitigating measures to control epidemic from spreading and enveloping the cities, countries and regions.

Keywords: Dengue, epidemic, globalization, climate change

Procedia PDF Downloads 227

Authors: Prasansha Kumari

Abstract:

Financial Literacy is the possession of knowledge and understanding of financial matters. Financial Literacy often entails the knowledge of properly making decisions pertaining to certain personal financial areas like real estate, insurance investing, and savings. This paper intends to identify and analyze the financial knowledge among university undergraduates by using 200 undergraduates in four faculties of University of Kelaniya, Sri Lanka. Collected data will be analyzed by descriptive research method using SPSS package. Expected outcomes are considerable percentage of undergraduates have basic knowledge on financial matters while it has a law percentage for advanced financial literacy among undergraduates. Students from faculty of Commerce and Management and Science have good understanding about financial matters than undergraduates in other two faculties

Keywords: advanced finance, undergraduates, financial literacy, savings

Procedia PDF Downloads 335

Authors: Sofia Baldelli, Aman More

Abstract:

Milk curd obstruction is commonly reported as being misdiagnosed for NEC, and they predominantly mimic each other in clinical presentation, including abdominal distension, vomiting, constipation, feeding intolerance and frank or occult blood PR. Using the case of a pre-term neonate misdiagnosed with necrotising enterocolitis when in fact, they had milk curd obstruction, we compare the two diagnoses and why they are hard to differentiate, the risk factors for clinicians to consider and the different management options. The main diagnostic tool for these conditions remains the plain radiograph and here we present the original radiograph of the neonate and discuss the classical radiological features of both diagnoses. We conclude that further imaging techniques such as ultrasound might be used to improve diagnosis when X-ray is inconclusive.

Keywords: milk curd obstruction, Necrotising Enterocolitis, radiology, pediatric surgery

Procedia PDF Downloads 95

Authors: Jill Villarreal, Kristalyn Cooksey, Kai Lloyd, Daniel Ha

Abstract:

Little research has been conducted to examine college students' reading attitudes, including students' perceptions of reading behaviors and reading abilities. This is problematic, as reading assigned course material is a critical component to an undergraduate student's academic success. For this study, flyers were electronically disseminated to instructors at 24 public and 10 private U.S. institutions in “Reading-Intensive Departments” including Psychology, Sociology, Education, Business, and Communications. We requested the online survey be completed as an in-class activity during the fall 2019 and spring 2020 semesters. All participants voluntarily completed the questionnaire anonymously. Of the participants, 280 self-identified their race as Black and 280 self-identified their race as White. Of the participants, 177 self-identified their gender as Male and 383 self-identified their Gender as Female. Participants ranged in age from 18-24. Factor analysis found four dimensions resulting from the questions regarding reading. The first we interpret as “Reading Proficiency”, accounted for 19% of the variability. The second dimension was “Reading Anxiety” (15%), the third was “Textbook Reading Ability” (9%), and the fourth was “Reading Enjoyment” (8%). Linear models on each of these dimensions revealed no effect of Age, Gender, Race, or Income on “Reading proficiency”. The linear model of “Reading Anxiety” showed a significant effect of race (p = 0.02), with higher anxiety in white students, as well as higher reading anxiety in female students (p < 0.001). The model of “Textbook Reading Ability” found a significant effect of race (p < 0.001), with higher textbook problems in white students. The model of “Reading Enjoyment” showed significant effects of race (p = 0.013) with more enjoyment for white students, gender (p = 0.001) with higher enjoyment for female students, and age (p = 0.033) with older students showing higher enjoyment. These findings suggest that gender, age, and race are important factors in many aspects of college students' reading attitudes. Further research will investigate possible causes for these differences. In addition, the effectiveness of college-level programs to reduce reading anxiety, promote the reading of textbooks, and foster a love of reading will be assessed.

Keywords: age, college, gender, race, reading

Procedia PDF Downloads 143

Authors: Shima Nabinejad, Holger Schüttrumpf

Abstract:

Farmers who are living in flood-prone areas such as coasts are exposed to storm surges increased due to climate change. Crop cultivation is the most important economic activity of farmers, and in the time of flooding, agricultural lands are subject to inundation. Additionally, overflow saline water causes more severe damage outcomes than riverine flooding. Agricultural crops are more vulnerable to salinity than other land uses for which the economic damages may continue for a number of years even after flooding and affect farmers’ decision-making for the following year. Therefore, it is essential to assess what extent the agricultural areas are flooded and how much the associated flood damage to each individual farmer is. To address these questions, we integrated farmers’ decision-making at farm-scale with flood risk management. The integrated model includes identification of hazard scenarios, failure analysis of structural measures, derivation of hydraulic parameters for the inundated areas and analysis of the economic damages experienced by each farmer. The present study has two aims; firstly, it attempts to investigate the flooded cropland and potential crop damages for the whole area. Secondly, it compares them among farmers’ field for three flood scenarios, which differ in breach locations of the flood protection structure. To achieve its goal, the spatial distribution of fields and cultivated crops of farmers were fed into the flood risk model, and a 100-year storm surge hydrograph was selected as the flood event. The study area was Pellworm Island that is located in the German Wadden Sea National Park and surrounded by North Sea. Due to high salt content in seawater of North Sea, crops cultivated in the agricultural areas of Pellworm Island are 100% destroyed by storm surges which were taken into account in developing of depth-damage curve for analysis of consequences. As a result, inundated croplands and economic damages to crops were estimated in the whole Island which was further compared for six selected farmers under three flood scenarios. The results demonstrate the significance and the flexibility of the proposed model in flood risk assessment of flood-prone areas by integrating flood risk management and decision-making.

Keywords: crop damages, flood risk analysis, individual farmer, inundated cropland, Pellworm Island, storm surges

Procedia PDF Downloads 254

Authors: Aliro Villacorta, Laura Rubio, Mohamed Alaraby, Montserrat López Mesas, Victor Fuentes-Cebrian, Oscar H. Moriones, Ricard Marcos, Alba Hernández.

Abstract:

Micro and nano plastics (MNPLs) are emergent environmental pollutants requiring urgent information on their potential risks to human health. One of the problems associated with the evaluation of their undesirable effects is the lack of real samples matching those resulting from the environmental degradation of plastic wastes. To such end, we propose an easy method to obtain polyethylene terephthalate nano plastics from water plastic bottles (PET-NPLs) but, in principle, applicable to any other plastic goods sources. An extensive characterization indicates that the proposed process produces uniform samples of PET-NPLs of around 100 nm, as determined by using a multi-angle and dynamic light scattering methodology. An important point to be highlighted is that to avoid the metal contamination resulting from methods using metal blades/burrs for milling, trituration, or sanding, we propose to use diamond burrs to produce metal-free samples. To visualize the toxicological profile of the produced PET-NPLs, we have evaluated their ability to be internalized by cells, their cytotoxicity, and their ability to induce oxidative stress and induce DNA damage. In this preliminary approach, we have detected their cellular uptake, but without the induction of significant biological effects. Thus, no relevant increases in toxicity, reactive oxygen species (ROS) induction, or DNA damage -as detected with the comet assay- have been observed. The use of real samples, as produced in this study, will generate relevant data in the discussion about the potential health risks associated with MNPLs exposures.

Keywords: nanoplastics, polyethylene terephthalate, physicochemical characterization, cell uptake, cytotoxicity

Procedia PDF Downloads 88

Authors: Garima Sarkar

Abstract:

The main purpose of the present paper is to investigate the development and progress achieved by women in the decision-making sphere and to access the level of their political-participation in Parliamentary Elections of Malaysia and their status in overall Malaysian political domain. The paper also focuses on the role and status of women in the major political parties of the state both the parties in power as well as the parties in opposition. The primary objective of the study is to focus on the major hindrances and social malpractices faced by women and also Muslim women’s access to justice in Malaysia. It also demonstrates the linkages between national policy initiatives and the advancement of women in various areas, such as economics, health, employment, politics, power-sharing, social development and law and most importantly evaluating their status in the dominant religion of the nation. In Malaysia, women’s political participation is being challenged from every nook and corner of the society. A high percentage of women are getting educated, forming a significant labor force in present day Malaysia, who can be employed in the manufacturing sector, retail trade, hotels and restaurant, agriculture etc. Women today consist of almost half of the population and exceed boys in the tertiary sector by a ratio of 80:20. Despite these achievements, however, women’s labor force engagement remains confined to ‘ traditional women’s occupations’, such as those of primary school teachers, data entry clerks and organizing polls during elections and motivating other less enlightened women to cast their votes. In the political arena, the past few General Elections of Malaysia clearly exhibited a slight change in the number of women Members of Parliament from 10.6% (20 out of 193 Parliamentary seats in 1999) to 10.5% (23 out of 219 Parliamentary seats in 2004). Amidst the political posturing for the recent General Election in 2013 of Malaysia, women’s political participation remains a prime concern in Malaysia. It is evident that while much of the attention of women revolves around charitable assistance, they are much less likely to be portrayed as active participants in electoral politics and governance. According to the electoral roll for the third quarter of 2012, 6,578,916 women are registered as voters. They represent 50.2% of the total number of the registered voters. However, this parity in terms of voter registration is not reflected in the number of elected representatives at the Parliamentary level. Only 10.4% of sitting Members of Parliament are women. The women’s participation in the legislature and executive branches are important since their presence brings the spotlight squarely on issues that have been historically neglected and overlooked. In the recent 2013 General Elections in Malaysia out of 35 full ministerial position only two, or 5.7% have been filled by women. In each of the 2009, 2010, and in the present 2013 Cabinet members, there have only been two women ministers, with this number reduced to one briefly when the Prime Minister appointed himself placeholder in the Ministry of Women, Family and Community Development. In the recent past, in its Election Manifesto, Barisan Nasional made a pledge of ‘increasing the number of women participating in national decision-making processes’. Even after such pledges, the Malaysian leadership has failed to mirror the strong presence of women in leadership positions of public life which primarily includes politics, the judiciary and in business. There has been a strong urge to political parties by various gender-sensitive groups to nominate more women as candidates for contesting elections at the Parliamentary as well as at the State level. The democratization process will never be truly democratic without a proper gender agenda and representation. Although Malaysia signed the Beijing Platform for Action document in 1995, the state has a long way to go in enhancing the participation of women in every segment of Malaysian political, economic and cultural. There has been a small percentage of women representation in decision-making bodies compared to the 30% targeted by the Beijing Platform for Action. Thus, democratization in terms of representation of women in leadership positions and decision-making positions or bodies is essential since it’s a move towards a qualitative transformation of women in shaping national decision-making processes. The democratization process has to ensure women’s full participation and their goals of development and their full participation has to be included in the process of formulating and shaping the developmental goals.

Keywords: women, gender equality, Islam, democratization, political representation, Parliament

Procedia PDF Downloads 247

Authors: Gerald Abdesaken, Thomas O. Miller

Abstract:

This paper analyzes the performance of gold as a safe-haven investment. Assuming high market volatility as an impetus to seek a safe haven in gold, the return of gold relative to the stock market, as measured by the S&P 500, is tracked. Using the Chicago Board Options Exchange (CBOE) volatility index (VIX) as a measure of stock market volatility, various criteria are established for when an investor would seek a safe haven to avoid high levels of risk. The results show that in a vast majority of cases, the S&P 500 outperforms gold during these periods of high volatility and suggests investors who seek safe haven are underperforming the market.

Keywords: gold, portfolio management, safe haven, VIX

Procedia PDF Downloads 154

Authors: K. Rajarajeswaran, Krishna Prasad

Abstract:

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

Procedia PDF Downloads 9

Authors: Mbuso Siwela

Abstract:

Background: The Sub-Saharan Africa region has the greatest number of people eligible to receive antiretroviral treatment (ART). Multi-month Drug dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. In Eswatini, however, few children and adolescents are on MMD. Young Heroes is implementing an HIV program that aims to avert new HIV infections in children and youth and improve treatment outcomes for children and adolescents living with HIV (C/ALHIV: 0-19 Years) and OVC caregivers with HIV prevention and impact mitigation interventions that prevent new HIV infections and reduce vulnerability. Aim of the study: The study aimed to ascertain factors that are associated with the assignment of the MMD model on C/ALHIVs. Methodology: The project provides treatment adherence support through well-trained community cadres (Home Visitors - HVs) at both community and health facility levels. During door-to-door visits, HVs track all C/ALHIV enrolled in the project monthly and refer any who might have stopped or interrupted treatment. C/ALHIV with unsuppressed viral load is supported through case conferencing and teen clubs. A quantitative cross-sectional analysis was conducted using STATA for children and adolescents living with HIV enrolled in the project. Bivariate analysis was conducted, and the Logistic Regression model was used to ascertain the effects of duration on ART on the choice of MMD model. Results: Data for 544 C/ALHIV (0-19 Years) was analyzed in STATA. Results show a strong association between (duration on ART, Age, being in teen club) and enrolment in an MMD model. Duration on ART is a major predictor for the choice of MMD model at (95% CI: 0.0012905 – 0.0039812; P = <0.0001). C/ALHIV who have been on ART for less than a year are less likely to be on MMD. C/ALHIVs who are 1 or more years on ART are more likely to be in 3 months dispensing, while those who are 5 years or more are most likely to be in 6 months model.

Keywords: C/ALHIV, OVC, HIV, treatment

Procedia PDF Downloads 15

Authors: David Ugalde, Arturo Castillo, Leopoldo Breschi

Abstract:

The Tuned Mass Dampers (TMDs) are an effective system for mitigating vibrations in building structures. These dampers have traditionally focused on the protection of high-rise buildings against earthquakes and wind loads. The Camara Chilena de la Construction (CChC) building, built in 2018 in Santiago, Chile, is a 21-story RC wall building equipped with a 150-ton TMD and instrumented with six permanent accelerometers, offering an opportunity to monitor the dynamic response of this damped structure. This paper presents the system identification of the CChC building using power spectral density plots of ambient vibration and two seismic events (5.5 Mw and 6.7 Mw). Linear models of the building with and without the TMD are used to compute the theoretical natural periods through modal analysis and simulate the response of the building through response history analysis. Results show that natural periods obtained from both ambient vibrations and earthquake records are quite similar to the theoretical periods given by the modal analysis of the building model. Some of the experimental periods are noticeable by simple inspection of the earthquake records. The accelerometers in the first story better captured the modes related to the building podium while the upper accelerometers clearly captured the modes related to the tower. The earthquake simulation showed smaller accelerations in the model with TMD that are similar to that measured by the accelerometers. It is concluded that the system identification through power spectral density shows consistency with the expected dynamic properties. The structural health monitoring of the CChC building confirms the advantages of seismic protection technologies such as TMDs in seismic prone areas.

Keywords: system identification, tuned mass damper, wall buildings, seismic protection

Procedia PDF Downloads 120

Authors: Wissam Saliba, Mandy Nicholson

Abstract:

Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.

Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor

Procedia PDF Downloads 105

Authors: Danilo Di Donato

Abstract:

The continuous new releases of free and open source software (FOSS) and the high costs of proprietary software -whose monopoly is characterized by closed codes and the low level of implementation and customization of software by end-users- impose a reflection on possible tools that can be chosen and adopted for the design and the representation of new steel constructions. The paper aims to show experimentation carried out to verify the actual potential and the effective applicability of FOSS supports to the BIM modeling of steel structures, particularly considering the goal of a possible workflow in order to achieve high level of development (LOD); allow effective interchange methods between different software. To this end, the examined software packages are those with open source or freeware licenses, in order to evaluate their use in architectural praxis. The test has primarily involved the experimentation of Freecad -the only Open Source software that allows a complete and integrated BIM workflow- and then the results have been compared with those of two proprietary software, Sketchup and TeklaBim Sight, which are released with a free version, but not usable for commercial purposes. The experiments carried out on Open Source, and freeware software was then compared with the outcomes that are obtained by two proprietary software, Sketchup Pro and Tekla Structure which has special modules particularly addressed to the design of steel structures. This evaluation has concerned different comparative criteria, that have been defined on the basis of categories related to the reliability, the efficiency, the potentiality, achievable LOD and user-friendliness of the analyzed software packages. In order to verify the actual outcomes of FOSS BIM for the steel structure projects, these results have been compared with a simulation related to a real case study and carried out with a proprietary software BIM modeling. Therefore, the same design theme, the project of a shelter of public space, has been developed using different software. Therefore the purpose of the contribution is to assess what are the developments and potentialities inherent in FOSS BIM, in order to estimate their effective applicability to professional practice, their limits and new fields of research they propose.

Keywords: BIM, steel buildings, FOSS, LOD

Procedia PDF Downloads 168

Authors: Asem M. Othman

Abstract:

The expansion of the hospitality industry is unmistakable. Services, by nature, are intangible. Hence, service quality, in general, is a complicated process to be measured and evaluated. Hotels, as a service sector and part of the hospitality industry, are growing rapidly. This research paper was carried out to identify the quality determinants that may affect hotel guests’ service quality perception. In this research paper, each quality determinant will be discussed, illustrated, and justified thoroughly via a systematic literature review. The purpose of this paper is to set the stage to measure the significant influence of the service quality determinants on guest satisfaction. The knowledge produced from this study will assist practitioners and/or hotel service providers to imply into their policies.

Keywords: service quality, hotel service, quality management, quality determinants

Procedia PDF Downloads 253

Authors: Meron Zenaselase Rata, Euridice Leyequien Abarca

Abstract:

The production of major crops in Northern Ethiopia, especially the Tigray Region, is at subsistence level due to drought, erratic rainfall, and poor soil fertility. Since cactus pear is a drought-resistant plant, it is considered as a lifesaver fruit and a strategy for poverty reduction in a drought-affected area of the region. Despite its contribution to household income and food security in the area, the cactus pear sub-sector is experiencing many constraints with limited attention given to its post-harvest loss management. Therefore, this research was carried out to identify opportunities for reducing post-harvest losses and recommend possible strategies to reduce post-harvest losses, thereby improving production and smallholder’s income. Both probability and non-probability sampling techniques were employed to collect the data. Ganta Afeshum district was selected from Eastern Tigray, and two peasant associations (Buket and Golea) were also selected from the district purposively for being potential in cactus pear production. Simple random sampling techniques were employed to survey 30 households from each of the two peasant associations, and a semi-structured questionnaire was used as a tool for data collection. Moreover, in this research 2 collectors, 2 wholesalers, 1 processor, 3 retailers, 2 consumers were interviewed; and two focus group discussion was also done with 14 key farmers using semi-structured checklist; and key informant interview with governmental and non-governmental organizations were interviewed to gather more information about the cactus pear production, post-harvest losses, the strategies used to reduce the post-harvest losses and suggestions to improve the post-harvest management. To enter and analyze the quantitative data, SPSS version 20 was used, whereas MS-word were used to transcribe the qualitative data. The data were presented using frequency and descriptive tables and graphs. The data analysis was also done using a chain map, correlations, stakeholder matrix, and gross margin. Mean comparisons like ANOVA and t-test between variables were used. The analysis result shows that the present cactus pear value chain involves main actors and supporters. However, there is inadequate information flow and informal market linkages among actors in the cactus pear value chain. The farmer's gross margin is higher when they sell to the processor than sell to collectors. The significant postharvest loss in the cactus pear value chain is at the producer level, followed by wholesalers and retailers. The maximum and minimum volume of post-harvest losses at the producer level is 4212 and 240 kgs per season. The post-harvest loss was caused by limited farmers skill on-farm management and harvesting, low market price, limited market information, absence of producer organization, poor post-harvest handling, absence of cold storage, absence of collection centers, poor infrastructure, inadequate credit access, using traditional transportation system, absence of quality control, illegal traders, inadequate research and extension services and using inappropriate packaging material. Therefore, some of the recommendations were providing adequate practical training, forming producer organizations, and constructing collection centers.

Keywords: cactus pear, post-harvest losses, profit margin, value-chain

Procedia PDF Downloads 110

Authors: Elisa Bertagna

Abstract:

The aim of the research is to study diversity issues and gender equality in the Finnish and Italian oil and gas companies. Particular attention is given to the effects on the organization’s and employees’ interactions resulting from intersecting social categories. The study is aimed to be settled in companies where social inequalities and diversity management problematics are present. Consequently, ten semi-structured interviews with key managers from the companies and four focus groups composed of culturally diverse employees aim to depict and analyze the situation from both points of view. Social discourse and intersectionality are employed as the analysis methods. Trainings, workshops, and suggestions are to be offered in the required situations.

Keywords: diversity, gender, intersectionality, oil and gas companies, social constructionism

Procedia PDF Downloads 170

Authors: Simont Toussi

Abstract:

Cameroon and the Central African Republic arebound by the provisions of many regional and international charters, which condemn the manipulation of information, obstacles to access reliable information, or the limitation of freedoms of expression and opinion. These two countries also have constitutional guarantees for free speech and access to true and liable information. However, they are yet to define specific policies and regulations for access to information, disinformation, or misinformation. Yet, certain countries’ laws and regulations related to information and communication technologies, to criminal procedures, to terrorism, or intelligence services contain provisions that rather hider human rights by condemning false information. Like many other African countries, Cameroon and the Central African Republic face a profound democratic regression, and governments use multiple methods to stifle online discourse and digital rights. Despite the increased uptake of digital tools for political participation, there is a lack of interactivity and adoption of these tools. This enables a scarcity of information and creates room for the spreading of disinformation in the public space, hamperingdemocracy and the respect for human rights. This research aims to analyse the adequacy of stakeholders’ responses to disinformation in Cameroon and the Central African Republic in periods of political contestation, such as elections and anti-government protests, to highlight the nature, perpetrators, strategies, and channels of disinformation, as well as its effects on democratic actors, including civil society, bloggers, government critics, activists, and other human rights defenders. The study follows a qualitative method with literature review, content analysis, andkey informant’sinterviews with stakeholders’ representatives, emphasized crowdsourcing as a data and information collecting method in the two countries.

Keywords: disinformation, democracy, political manipulation, social media, media, fake news, central Africa, cameroon, misinformation, free speech

Procedia PDF Downloads 100

Authors: Ravinder Kaur

Abstract:

Introduction Global cerebrovascular reactivity (CVR) mapping is a promising clinical assessment for stress-testing the brain using physiological challenges, such as CO₂, to elicit changes in perfusion. It enables real-time assessment of cerebrovascular integrity and health. Conventional imaging approaches solely use steady-state parameters, like cerebral blood flow (CBF), to evaluate the integrity of the resting parenchyma and can erroneously show a healthy brain at rest, despite the underlying pathogenesis in the presence of cerebrovascular disease. Conversely, coupling CO₂ inhalation with phase-contrast MRI neuroimaging interrogates the capacity of the vasculature to respond to changes under stress. It shows promise in providing prognostic value as a novel health marker to measure neurovascular function in disease and to detect early brain vasculature dysfunction. Objective This exploratory study was established to:(a) quantify the CBF response to CO₂ in hypocapnia and hypercapnia,(b) evaluate disparities in CVR between internal carotid (ICA) and vertebral artery (VA), and (c) assess sex-specific variation in CVR. Methodology Phase-contrast MRI was employed to measure the cerebrovascular reactivity to CO₂ (±10 mmHg). The respiratory interventions were presented using the prospectively end-tidal targeting RespirActTM Gen3 system. Post-processing and statistical analysis were conducted. Results In 9 young, healthy subjects, the CBF increased from hypocapnia to hypercapnia in all vessels (4.21±0.76 to 7.20±1.83 mL/sec in ICA, 1.36±0.55 to 2.33±1.31 mL/sec in VA, p < 0.05). The CVR was quantitatively higher in ICA than VA (slope of linear regression: 0.23 vs. 0.07 mL/sec/mmHg, p < 0.05). No statistically significant effect was observed in CVR between male and female (0.25 vs 0.20 mL/sec/mmHg in ICA, 0.09 vs 0.11 mL/sec/mmHg in VA, p > 0.05). Conclusions The principal finding in this investigation validated the modulation of CBF by CO₂. Moreover, it has indicated that regional heterogeneity in hemodynamic response exists in the brain. This study provides scope to standardize the quantification of CVR prior to its clinical translation.

Keywords: cerebrovascular disease, neuroimaging, phase contrast MRI, cerebrovascular reactivity, carbon dioxide

Procedia PDF Downloads 137

Authors: Maciej Zaręba, Sławomir Lasota

Abstract:

Knowing the degree of dependencies between the sets of input signals and selected sets of indicators that measure a production system's effectiveness is of great importance in the industry. This paper introduces the SELM method that enables the selection of sets of input signals, which affects the most the selected subset of indicators that measures the effectiveness of a production system. For defined set of output indicators, the method quantifies the impact of input signals that are gathered in the continuous monitoring production system.

Keywords: manufacturing operation management, signal relationship, continuous monitoring, production systems

Procedia PDF Downloads 108

Authors: Isabelle Gobatto

Abstract:

Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

Procedia PDF Downloads 63

Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

Abstract:

Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

Procedia PDF Downloads 326

Authors: Mehran Dizbadi, Daniyal Safarzadeh, Behrooz Arastoo, Ansgar Brunn

Abstract:

Rapid and uncontrolled expansion of cities has led to unplanned aerial development. In this way, modeling and predicting the urban growth of a city helps decision-makers. In this study, the aspect of sustainable urban development has been studied for the city of Mashhad. In general, the prediction of urban aerial development is one of the most important topics of modern town management. In this research, using the Cellular Automaton (CA) model developed for geo data of Geographic Information Systems (GIS) and presenting a simple and powerful model, a simulation of complex urban processes has been done.

Keywords: urban modeling, sustainable development, fuzzy cellular automaton, geo-information system

Procedia PDF Downloads 122

Authors: Henry O. Udeha, Kwaku G. Duodub, Afam I. O. Jideanic

Abstract:

Finger millet (FM) [Eleusine coracana] is considered as a potential ‘‘super grain’’ by the United States National Academies as one of the most nutritious among all the major cereals. The regular consumption of FM-based diets has been associated with reduced risk of diabetes, cataract and gastrointestinal tract disorder. Hyperglycaemic, hypocholesterolaemic and anticataractogenic, and other health improvement properties have been reported. This study examined the effect of fermentation time and microbial source on physicochemical properties, phenolic compounds and antioxidant activity of two finger millet (FM) malt flours. Sorghum was used as an external reference. The grains were malted, mashed and fermented using the grain microflora and Lactobacillus fermentum. The phenolic compounds of the resulting beverage were identified and quantified using ultra-performance liquid chromatography (UPLC) and mass spectrometer system (MS). A fermentation-time dependent decrease in pH and viscosities of the beverages, with a corresponding increase in sugar content were noted. The phenolic compounds found in the FM beverages were protocatechuic acid, catechin and epicatechin. Decrease in total phenolics of the beverages was observed with increased fermentation time. The beverages exhibited 2, 2-diphenyl-1-picrylhydrazyl, 2, 2՛-azinobis-3-ethylbenzthiazoline-6-sulfonic acid radical scavenging action and iron reducing activities, which were significantly (p < 0.05) reduced at 96 h fermentation for both microbial sources. The 24 h fermented beverages retained a higher amount of total phenolics and had higher antioxidant activity compared to other fermentation periods. The study demonstrates that FM could be utilised as a functional grain in the production of non-alcoholic beverage with important phenolic compounds for health promotion and wellness.

Keywords: antioxidant activity, eleusine coracana, fermentation, phenolic compounds

Procedia PDF Downloads 101