Search results for: health risk assessment
Commenced in January 2007
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Edition: International
Paper Count: 16842

Search results for: health risk assessment

4362 Traffic Congestion: Causes, Consequences, and Planning Solutions

Authors: Raj Kumar Kama, Rajshree Kamat

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Traffic congestion is a serious problem that is to be considered, and it is increasing day-by-day in urban areas that is seriously affecting the urban society. From the study, it is understood that increased urbanization and growth of population are the principal causes of congestion. It has adverse effects on society, economy, environment, and health. This study mainly focussed on studying and understanding the causes of congestion, consequences faced by urban society, and planning solutions to mitigate congestion. Techniques like transit oriented development (TOD) and integrated transport systems are more effective in mitigating traffic congestion.

Keywords: traffic congestion, transit oriented development, integrated transport system, urbanization

Procedia PDF Downloads 289
4361 Determinants of Psychological Distress in Teenagers and Young Adults Affected by Cancer: A Systematic Review

Authors: Anna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally

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Background & Significance: Over half of Teenagers and Young Adults (TYAs) say that they experience psychological distress after cancer diagnosis and TYAs with cancer are at higher risk of developing distress compared to other age groups. Despite this there are no age-appropriate interventions to help TYAs manage distress and there is a lack of conceptual understanding of what causes distress in this population group. This makes it difficult to design a targeted, developmentally appropriate intervention. This review aims to identify the key determinants of distress in TYAs affected by cancer and to propose an integrative model of cancer-related distress for TYAs. Method: A literature search was performed in Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, EMBASE and PsycArticles in May-June, 2022. Quantitative literature was systematically reviewed on the relationship between psychological distress experienced by TYAs affected by cancer and a wide range of factors i.e. individual (demographic, psychological, developmental, and clinical factors) and contextual (social/environmental) factors. Evidence was synthesized and correlates were categorized using the Biopsychosocial Model. The full protocol is available from PROSPERO (CRD42022322069) Results: Thirty eligible quantitative studies met criteria for the review. A total of twenty-six studies were cross-sectional, three were longitudinal and one study was a case control study. The evidence on the relationship between the socio-demographic, illness and treatment-related factors and psychological distress is inconsistent and unclear. There is however consistent evidence on the link between psychological factors and psychological distress. For instance, the use of cognitive and defence coping, negative meta-cognitive beliefs, less optimism, a lack of sense of meaning and lower resilience levels were significantly associated with higher psychological distress. Furthermore, developmental factors such as poor self-image, identity issues and perceived conflict were strongly associated with higher distress levels. Conclusions: The current review suggests that psychological and developmental factors such as ineffective coping strategies, poor self-image and identity issues may play a key role in the development of psychological distress in TYAs affected by cancer. The review proposes a Positive Developmental Psychology Model of Distress for Teenagers and Young Adults affected by cancer. The review highlights that implementation of psychological interventions that foster optimism, improve resilience and address self-image may result in reduced distress in TYA’s with cancer.

Keywords: cancer, determinant, psychological distress, teenager and young adult, theoretical model

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4360 New Evaluation of the Richness of Cactus (Opuntia) in Active Biomolecules and their Use in Agri-Food, Cosmetic, and Pharmaceutical

Authors: Lazhar Zourgui

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Opuntia species are used as local medicinal interventions for chronic diseases and as food sources, mainly because they possess nutritional properties and biological activities. Opuntia ficus-indica (L.) Mill, commonly known as prickly pear or nopal cactus, is the most economically valuable plant in the Cactaceae family worldwide. It is a tropical or subtropical plant native to tropical and subtropical America, which can grow in arid and semi-arid climates. It belongs to the family of angiosperms dicotyledons Cactaceae of which about 1500 species of cacti are known. The Opuntia plant is distributed throughout the world and has great economic potential. There are differences in the phytochemical composition of Opuntia species between wild and domesticated species and within the same species. It is an interesting source of plant bioactive compounds. Bioactive compounds are compounds with nutritional benefits and are generally classified into phenolic and non-phenolic compounds and pigments. Opuntia species are able to grow in almost all climates, for example, arid, temperate, and tropical climates, and their bioactive compound profiles change depending on the species, cultivar, and climatic conditions. Therefore, there is an opportunity for the discovery of new compounds from different Opuntia cultivars. Health benefits of prickly pear are widely demonstrated: There is ample evidence of the health benefits of consuming prickly pear due to its source of nutrients and vitamins and its antioxidant properties due to its content of bioactive compounds. In addition, prickly pear is used in the treatment of hyperglycemia and high cholesterol levels, and its consumption is linked to a lower incidence of coronary heart disease and certain types of cancer. It may be effective in insulin-independent type 2 diabetes mellitus. Opuntia ficus-Indica seed oil has shown potent antioxidant and prophylactic effects. Industrial applications of these bioactive compounds are increasing. In addition to their application in the pharmaceutical industries, bioactive compounds are used in the food industry for the production of nutraceuticals and new food formulations (juices, drinks, jams, sweeteners). In my lecture, I will review in a comprehensive way the phytochemical, nutritional, and bioactive compound composition of the different aerial and underground parts of Opuntia species. The biological activities and applications of Opuntia compounds are also discussed.

Keywords: medicinal plants, cactus, Opuntia, actives biomolecules, biological activities

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4359 Circle of Learning Using High-Fidelity Simulators Promoting a Better Understanding of Resident Physicians on Point-of-Care Ultrasound in Emergency Medicine

Authors: Takamitsu Kodama, Eiji Kawamoto

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Introduction: Ultrasound in emergency room has advantages of safer, faster, repeatable and noninvasive. Especially focused Point-Of-Care Ultrasound (POCUS) is used daily for prompt and accurate diagnoses, for quickly identifying critical and life-threatening conditions. That is why ultrasound has demonstrated its usefulness in emergency medicine. The true value of ultrasound has been once again recognized in recent years. It is thought that all resident physicians working at emergency room should perform an ultrasound scan to interpret signs and symptoms of deteriorating patients in the emergency room. However, a practical education on ultrasound is still in development. To resolve this issue, we established a new educational program using high-fidelity simulators and evaluated the efficacy of this course. Methods: Educational program includes didactic lectures and skill stations in half-day course. Instructor gives a lecture on POCUS such as Rapid Ultrasound in Shock (RUSH) and/or Focused Assessment Transthoracic Echo (FATE) protocol at the beginning of the course. Then, attendees are provided for training of scanning with cooperation of normal simulated patients. In the end, attendees learn how to apply focused POCUS skills at clinical situation using high-fidelity simulators such as SonoSim® (SonoSim, Inc) and SimMan® 3G (Laerdal Medical). Evaluation was conducted through surveillance questionnaires to 19 attendees after two pilot courses. The questionnaires were focused on understanding course concept and satisfaction. Results: All attendees answered the questionnaires. With respect to the degree of understanding, 12 attendees (number of valid responses: 13) scored four or more points out of five points. High-fidelity simulators, especially SonoSim® was highly appreciated to enhance learning how to handle ultrasound at an actual practice site by 11 attendees (number of valid responses: 12). All attendees encouraged colleagues to take this course because the high level of satisfaction was achieved. Discussion: Newly introduced educational course using high-fidelity simulators realizes the circle of learning to deepen the understanding on focused POCUS by gradual stages. SonoSim® can faithfully reproduce scan images with pathologic findings of ultrasound and provide experimental learning for a growth number of beginners such as resident physicians. In addition, valuable education can be provided if it is used combined with SimMan® 3G. Conclusions: Newly introduced educational course using high-fidelity simulators is supposed to be effective and helps in providing better education compared with conventional courses for emergency physicians.

Keywords: point-of-care ultrasound, high-fidelity simulators, education, circle of learning

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4358 Sweet to Bitter Perception Parageusia: Case of Posterior Inferior Cerebellar Artery Territory Diaschisis

Authors: I. S. Gandhi, D. N. Patel, M. Johnson, A. R. Hirsch

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Although distortion of taste perception following a cerebrovascular event may seem to be a frivolous consequence of a classic stroke presentation, altered taste perception places patients at an increased risk for malnutrition, weight loss, and depression, all of which negatively impact the quality of life. Impaired taste perception can result from a wide variety of cerebrovascular lesions to various locations, including pons, insular cortices, and ventral posteromedial nucleus of the thalamus. Wallenberg syndrome, also known as a lateral medullary syndrome, has been described to impact taste; however, specific sweet to bitter taste dysgeusia from a territory infarction is an infrequent event; as such, a case is presented. One year prior to presentation, this 64-year-old right-handed woman, suffered a right posterior inferior cerebellar artery aneurysm rupture with resultant infarction, culminating in a ventriculoperitoneal shunt placement. One and half months after this event, she noticed the gradual onset of lack of ability to taste sweet, to eventually all sweet food tasting bitter. Since the onset of her chemosensory problems, the patient has lost 60-pounds. Upon gustatory testing, the patient's taste threshold showed ageusia to sucrose and hydrochloric acid, while normogeusia to sodium chloride, urea, and phenylthiocarbamide. The gustatory cortex is made in part by the right insular cortex as well as the right anterior operculum, which are primarily involved in the sensory taste modalities. In this model, sweet is localized in the posterior-most along with the rostral aspect of the right insular cortex, notably adjacent to the region responsible for bitter taste. The sweet to bitter dysgeusia in our patient suggests the presence of a lesion in this localization. Although the primary lesion in this patient was located in the right medulla of the brainstem, neurodegeneration in the rostal and posterior-most aspect, of the right insular cortex may have occurred due to diaschisis. Diaschisis has been described as neurophysiological changes that occur in remote regions to a focal brain lesion. Although hydrocephalus and vasospasm due to aneurysmal rupture may explain the distal foci of impairment, the gradual onset of dysgeusia is more indicative of diaschisis. The perception of sweet, now tasting bitter, suggests that in the absence of sweet taste reception, the intrinsic bitter taste of food is now being stimulated rather than sweet. In the evaluation and treatment of taste parageusia secondary to cerebrovascular injury, prophylactic neuroprotective measures may be worthwhile. Further investigation is warranted.

Keywords: diaschisis, dysgeusia, stroke, taste

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4357 Micro Plasma an Emerging Technology to Eradicate Pesticides from Food Surface

Authors: Muhammad Saiful Islam Khan, Yun Ji Kim

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Organophosphorus pesticides (OPPs) have been widely used to replace more persistent organochlorine pesticides because OPPs are more soluble in water and decompose rapidly in aquatic systems. Extensive uses of OPPs in modern agriculture are the major cause of the contamination of surface water. Regardless of the advantages gained by the application of pesticides in modern agriculture, they are a threat to the public health environment. With the aim of reducing possible health threats, several physical and chemical treatment processes have been studied to eliminate biological and chemical poisons from food stuff. In the present study, a micro-plasma device was used to reduce pesticides from the surface of food stuff. Pesticide free food items chosen in this study were perilla leaf, tomato, broccoli and blueberry. To evaluate the removal efficiency of pesticides, different washing methods were followed such as soaking with water, washing with bubbling water, washing with plasma-treated water and washing with chlorine water. 2 mL of 2000 ppm pesticide samples, namely, diazinone and chlorpyrifos were individuality inoculated on food surface and was air dried for 2 hours before treated with plasma. Plasma treated water was used in two different manners one is plasma treated water with bubbling the other one is aerosolized plasma treated water. The removal efficiency of pesticides from food surface was studied using HPLC. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows minimum 72% to maximum 87 % reduction for 4 min treatment irrespective to the types of food items and the types of pesticides sample, in case of soaking and bubbling the reduction is 8% to 48%. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows somewhat similar reduction ability which is significantly higher comparing to the soaking and bubbling washing system. The temperature effect of the washing systems was also evaluated; three different temperatures were set for the experiment, such as 22°C, 10°C and 4°C. Decreasing temperature from 22°C to 10°C shows a higher reduction in the case of washing with plasma and aerosolized plasma treated water, whereas an opposite trend was observed for the washing with chlorine water. Further temperature reduction from 10°C to 4°C does not show any significant reduction of pesticides, except for the washing with chlorine water. Chlorine water treatment shows lesser pesticide reduction with the decrease in temperature. The color changes of the treated sample were measured immediately and after one week to evaluate if there is any effect of washing with plasma treated water and with chlorine water. No significant color changes were observed for either of the washing systems, except for broccoli washing with chlorine water.

Keywords: chlorpyrifos, diazinone, pesticides, micro plasma

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4356 Challenges beyond the Singapore Future-Ready School ‘LEADER’ Qualities

Authors: Zoe Boon Suan Loy

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An exploratory research undertaken in 2000 at the beginning of the COVID-19 pandemic examined the changing roles of Singapore school leaders as they lead teachers in developing future-ready learners. While it is evident that ‘LEADER’ qualities epitomize the knowledge, competencies, and skills required, recent events in an increasing VUCA and BANI world characterized by massively disruptive Ukraine -Russian war, unabating tense US-Sino relations, issues related to sustainability, and rapid ageing will have an impact on school leadership. As an increasingly complex endeavour, this requires a relook as they lead teachers in nurturing holistically-developed future-ready students. Digitalisation, new technology, and the push for a green economy will be the key driving forces that will have an impact on job availability. Similarly, the rapid growth of artificial intelligence (AI) capabilities, including ChatGPT, will aggravate and add tremendous stress to the work of school leaders. This paper seeks to explore the key school leadership shifts required beyond the ‘LEADER’ qualities as school leaders respond to the changes, challenges, and opportunities in the 21st C new normal. The research findings for this paper are based on an exploratory qualitative study on the perceptions of 26 school leaders (vice-principals) who were attending a milestone educational leadership course at the National Institute of Education, Nanyang Technological University, Singapore. A structured questionnaire is designed to collect the data, which is then analysed using coding methodology. Broad themes on key competencies and skills of future-ready leaders in the Singapore education system are then identified. Key Findings: In undertaking their leadership roles as leaders of future-ready learners, school leaders need to demonstrate the ‘LEADER’ qualities. They need to have a long-term view, understand the educational imperatives, have a good awareness of self and the dispositions of a leader, be effective in optimizing external leverages and are clear about their role expectations. These ‘LEADER’ qualities are necessary and relevant in the post-Covid era. Beyond this, school leaders with ‘LEADER’ qualities are well supported by the Ministry of Education, which takes cognizance of emerging trends and continually review education policies to address related issues. Concluding Statement: Discussions within the education ecosystem and among other stakeholders on the implications of the use of artificial intelligence and ChatGPT on the school curriculum, including content knowledge, pedagogy, and assessment, are ongoing. This augurs well for school leaders as they undertake their responsibilities as leaders of future-ready learners.

Keywords: Singapore education system, ‘LEADER’ qualities, school leadership, future-ready leaders, future-ready learners

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4355 Feasibility of Implementing Digital Healthcare Technologies to Prevent Disease: A Mixed-Methods Evaluation of a Digital Intervention Piloted in the National Health Service

Authors: Rosie Cooper, Tracey Chantler, Ellen Pringle, Sadie Bell, Emily Edmundson, Heidi Nielsen, Sheila Roberts, Michael Edelstein, Sandra Mounier Jack

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Introduction: In line with the National Health Service’s (NHS) long-term plan, the NHS is looking to implement more digital health interventions. This study explores a case study in this area: a digital intervention used by NHS Trusts in London to consent adolescents for Human Papilloma Virus (HPV) immunisation. Methods: The electronic consent intervention was implemented in 14 secondary schools in inner city, London. These schools were statistically matched with 14 schools from the same area that were consenting using paper forms. Schools were matched on deprivation and English as an additional language. Consent form return rates and HPV vaccine uptake were compared quantitatively between intervention and matched schools. Data from observations of immunisation sessions and school feedback forms were analysed thematically. Individual and group interviews were undertaken with implementers parents and adolescents and a focus group with adolescents were undertaken and analysed thematically. Results: Twenty-eight schools (14 e-consent schools and 14 paper consent schools) comprising 3219 girls (1733 in paper consent schools and 1486 in e-consent schools) were included in the study. The proportion of pupils eligible for free school meals, with English as an additional language and students' ethnicity profile, was similar between the e-consent and paper consent schools. Return of consent forms was not increased by the implementation of the e-consent intervention. There was no difference in the proportion of pupils that were vaccinated at the scheduled vaccination session between the paper (n=14) and e-consent (n=14) schools (80.6% vs. 81.3%, p=0.93). The transition to using the system was not straightforward, whilst schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level or control from schools. Part of the reason for lower consent form return in e-consent schools was that some parents found the intervention difficult to use due to limited access to the internet, finding it hard to open the weblink, language barriers, and in some cases, the system closed a few days prior to sessions. Adolescents also highlighted the potential for e-consent interventions to by-pass their information needs. Discussion: We would advise caution against dismissing the e-consent intervention because it did not achieve its goal of increasing the return of consent forms. Given the problems embedding a news service, it was encouraging that HPV vaccine uptake remained stable. Introducing change requires stakeholders to understand, buy in, and work together with others. Schools and staff understood the potential benefits of using e-consent but found the new ways of working removed some level of control from schools, which they found hard to adapt to, possibly suggesting implementing digital technology will require an embedding process. Conclusion: The future direction of the NHS will require implementation of digital technology. Obtaining electronic consent from parents could help streamline school-based adolescent immunisation programmes. Findings from this study suggest that when implementing new digital technologies, it is important to allow for a period of embedding to enable them to become incorporated in everyday practice.

Keywords: consent, digital, immunisation, prevention

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4354 Development of Social Competence in the Preparation and Continuing Training of Adult Educators

Authors: Genute Gedviliene, Vidmantas Tutlys

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The aim of this paper is to reveal the deployment and development of the social competence in the higher education programmes of adult education and in the continuing training and competence development of the andragogues. There will be compared how the issues of cooperation and communication in the learning and teaching processes are treated in the study programmes and in the courses of continuing training of andragogues. Theoretical and empirical research methods were combined for research analysis. For the analysis the following methods were applied: 1) Literature and document analysis helped to highlight the communication and cooperation as fundamental phenomena of the social competence, it’s important for the adult education in the context of digitalization and globalization. There were also analyzed the research studies on the development of social competence in the field of andragogy, as well as on the place and weight of the social competence in the overall competence profile of the andragogue. 2) The empirical study is based on questionnaire survey method. The population of survey consists of 240 students of bachelor and master degree studies of andragogy in Lithuania and of 320 representatives of the different bodies and institutions involved in the continuing training and professional development of the adult educators in Lithuania. The themes of survey questionnaire were defined on the basis of findings of the literature review and included the following: 1) opinions of the respondents on the role and place of a social competence in the work of andragogue; 2) opinions of the respondents on the role and place of the development of social competence in the curricula of higher education studies and continuing training courses; 3) judgements on the implications of the higher education studies and courses of continuing training for the development of social competence and it’s deployment in the work of andragogue. Data analysis disclosed a wide range of ways and modalities of the deployment and development of social competence in the preparation and continuing training of the adult educators. Social competence is important for the students and adult education providers not only as the auxiliary capability for the communication and transfer of information, but also as the outcome of collective learning leading to the development of new capabilities applied by the learners in the learning process, their professional field of adult education and their social life. Equally so, social competence is necessary for the effective adult education activities not only as an auxiliary capacity applied in the teaching process, but also as a potential for improvement, development and sustainability of the didactic competence and know-how in this field. The students of the higher education programmes in the field of adult education treat social competence as important generic capacity important for the work of adult educator, whereas adult education providers discern the concrete issues of application of social competence in the different processes of adult education, starting from curriculum design and ending with assessment of learning outcomes.

Keywords: adult education, andragogues, social competence, curriculum

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4353 Vulnerability Assessment of Groundwater Quality Deterioration Using PMWIN Model

Authors: A. Shakoor, M. Arshad

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The utilization of groundwater resources in irrigation has significantly increased during the last two decades due to constrained canal water supplies. More than 70% of the farmers in the Punjab, Pakistan, depend directly or indirectly on groundwater to meet their crop water demands and hence, an unchecked paradigm shift has resulted in aquifer depletion and deterioration. Therefore, a comprehensive research was carried at central Punjab-Pakistan, regarding spatiotemporal variation in groundwater level and quality. Processing MODFLOW for window (PMWIN) and MT3D (solute transport model) models were used for existing and future prediction of groundwater level and quality till 2030. The comprehensive data set of aquifer lithology, canal network, groundwater level, groundwater salinity, evapotranspiration, groundwater abstraction, recharge etc. were used in PMWIN model development. The model was thus, successfully calibrated and validated with respect to groundwater level for the periods of 2003 to 2007 and 2008 to 2012, respectively. The coefficient of determination (R2) and model efficiency (MEF) for calibration and validation period were calculated as 0.89 and 0.98, respectively, which argued a high level of correlation between the calculated and measured data. For solute transport model (MT3D), the values of advection and dispersion parameters were used. The model used for future scenario up to 2030, by assuming that there would be no uncertain change in climate and groundwater abstraction rate would increase gradually. The model predicted results revealed that the groundwater would decline from 0.0131 to 1.68m/year during 2013 to 2030 and the maximum decline would be on the lower side of the study area, where infrastructure of canal system is very less. This lowering of groundwater level might cause an increase in the tubewell installation and pumping cost. Similarly, the predicted total dissolved solids (TDS) of the groundwater would increase from 6.88 to 69.88mg/L/year during 2013 to 2030 and the maximum increase would be on lower side. It was found that in 2030, the good quality would reduce by 21.4%, while marginal and hazardous quality water increased by 19.28 and 2%, respectively. It was found from the simulated results that the salinity of the study area had increased due to the intrusion of salts. The deterioration of groundwater quality would cause soil salinity and ultimately the reduction in crop productivity. It was concluded from the predicted results of groundwater model that the groundwater deteriorated with the depth of water table i.e. TDS increased with declining groundwater level. It is recommended that agronomic and engineering practices i.e. land leveling, rainwater harvesting, skimming well, ASR (Aquifer Storage and Recovery Wells) etc. should be integrated to meliorate management of groundwater for higher crop production in salt affected soils.

Keywords: groundwater quality, groundwater management, PMWIN, MT3D model

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4352 Modelling and Assessment of an Off-Grid Biogas Powered Mini-Scale Trigeneration Plant with Prioritized Loads Supported by Photovoltaic and Thermal Panels

Authors: Lorenzo Petrucci

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This paper is intended to give insight into the potential use of small-scale off-grid trigeneration systems powered by biogas generated in a dairy farm. The off-grid plant object of analysis comprises a dual-fuel Genset as well as electrical and thermal storage equipment and an adsorption machine. The loads are the different apparatus used in the dairy farm, a household where the workers live and a small electric vehicle whose batteries can also be used as a power source in case of emergency. The insertion in the plant of an adsorption machine is mainly justified by the abundance of thermal energy and the simultaneous high cooling demand associated with the milk-chilling process. In the evaluated operational scenario, our research highlights the importance of prioritizing specific small loads which cannot sustain an interrupted supply of power over time. As a consequence, a photovoltaic and thermal panel is included in the plant and is tasked with providing energy independently of potentially disruptive events such as engine malfunctioning or scarce and unstable supplies of fuels. To efficiently manage the plant an energy dispatch strategy is created in order to control the flow of energy between the power sources and the thermal and electric storages. In this article we elaborate on models of the equipment and from these models, we extract parameters useful to build load-dependent profiles of the prime movers and storage efficiencies. We show that under reasonable assumptions the analysis provides a sensible estimate of the generated energy. The simulations indicate that a Diesel Generator sized to a value 25% higher than the total electrical peak demand operates 65% of the time below the minimum acceptable load threshold. To circumvent such a critical operating mode, dump loads are added through the activation and deactivation of small resistors. In this way, the excess of electric energy generated can be transformed into useful heat. The combination of PVT and electrical storage to support the prioritized load in an emergency scenario is evaluated in two different days of the year having the lowest and highest irradiation values, respectively. The results show that the renewable energy component of the plant can successfully sustain the prioritized loads and only during a day with very low irradiation levels it also needs the support of the EVs’ battery. Finally, we show that the adsorption machine can reduce the ice builder and the air conditioning energy consumption by 40%.

Keywords: hybrid power plants, mathematical modeling, off-grid plants, renewable energy, trigeneration

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4351 Functional Snacks Bars: A Healthy Alternative to a Poor Diet Quality

Authors: Daniela Istrati, Camelia Vizireanu, Camelia Grozavu, Rodica Mihaela Dinica

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In last years, eating habits have changed, and snacking has become more common. Snacking habits, including eating whole fruit, vegetables and crackers, were found to contribute to better overall diet quality, while consuming snacks such as cookies, pastries, sweets, milk desserts and soft drinks was associated with poorer diet quality. The nutritional quality of the snack is very important and choosing nutritious foods as snacks can be beneficial for our health. For this reason, the development of functional snacks bars represents a necessity for this niche market. The aim of this work was to develop some formulations of energizing snack bars with high dietary fibers and antioxidant activity. Snack bars contain both fruits with antioxidant activity and components (cereals and seeds) rich in carbohydrates and polyunsaturated fats that provide energy during sports activities, physical and mental stress. Three types of samples were prepared and stored in refrigerated conditions at 40°C for 30 days. The first sample (S1) contains wheat germs, raw pumpkin seeds, toasted oat flakes, flaxseeds flour, cinnamon honey, raw sunflower seeds, sea buckthorn, amaranth flour, cinnamon and olive oil. The second sample (S2) has the same composition as the first, less flour and cinnamon flour and the honey used was ginger, honey. The third sample (S3) is like the first less amaranth flour and the honey used was buckthorn sea honey. The physicochemical, antioxidant activity, polyphenolic and flavonoid content and sensorial characteristics of the samples were investigated. Results showed that snacks bars had important level of extracted phenolics, flavonoids, fibers, proteins, carbohydrates and fats. Therefore, snack bars may be a convenient functional food, offering an important source of flavonoids and polyphenols, a healthy alternative to a poor diet quality, with balanced nutritional and sensory characteristics that recommend it in the diet of all consumers concerned with maintaining health. Acknowledgment: This study has been founded by the Francophone University Agency, Project Réseau régional dans le domaine de la santé, la nutrition et la sécurité alimentaire (SaIN), No. at Dunarea de Jos University of Galati 21899/ 06.09.2017

Keywords: antioxidant activity, functional food, sea buckthorn, snack bars

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4350 The Application of Raman Spectroscopy in Olive Oil Analysis

Authors: Silvia Portarena, Chiara Anselmi, Chiara Baldacchini, Enrico Brugnoli

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Extra virgin olive oil (EVOO) is a complex matrix mainly composed by fatty acid and other minor compounds, among which carotenoids are well known for their antioxidative function that is a key mechanism of protection against cancer, cardiovascular diseases, and macular degeneration in humans. EVOO composition in terms of such constituents is generally the result of a complex combination of genetic, agronomical and environmental factors. To selectively improve the quality of EVOOs, the role of each factor on its biochemical composition need to be investigated. By selecting fruits from four different cultivars similarly grown and harvested, it was demonstrated that Raman spectroscopy, combined with chemometric analysis, is able to discriminate the different cultivars, also as a function of the harvest date, based on the relative content and composition of fatty acid and carotenoids. In particular, a correct classification up to 94.4% of samples, according to the cultivar and the maturation stage, was obtained. Moreover, by using gas chromatography and high-performance liquid chromatography as reference techniques, the Raman spectral features further allowed to build models, based on partial least squares regression, that were able to predict the relative amount of the main fatty acids and the main carotenoids in EVOO, with high coefficients of determination. Besides genetic factors, climatic parameters, such as light exposition, distance from the sea, temperature, and amount of precipitations could have a strong influence on EVOO composition of both major and minor compounds. This suggests that the Raman spectra could act as a specific fingerprint for the geographical discrimination and authentication of EVOO. To understand the influence of environment on EVOO Raman spectra, samples from seven regions along the Italian coasts were selected and analyzed. In particular, it was used a dual approach combining Raman spectroscopy and isotope ratio mass spectrometry (IRMS) with principal component and linear discriminant analysis. A correct classification of 82% EVOO based on their regional geographical origin was obtained. Raman spectra were obtained by Super Labram spectrometer equipped with an Argon laser (514.5 nm wavelenght). Analyses of stable isotope content ratio were performed using an isotope ratio mass spectrometer connected to an elemental analyzer and to a pyrolysis system. These studies demonstrate that RR spectroscopy is a valuable and useful technique for the analysis of EVOO. In combination with statistical analysis, it makes possible the assessment of specific samples’ content and allows for classifying oils according to their geographical and varietal origin.

Keywords: authentication, chemometrics, olive oil, raman spectroscopy

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4349 Predicting the Impact of Scope Changes on Project Cost and Schedule Using Machine Learning Techniques

Authors: Soheila Sadeghi

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In the dynamic landscape of project management, scope changes are an inevitable reality that can significantly impact project performance. These changes, whether initiated by stakeholders, external factors, or internal project dynamics, can lead to cost overruns and schedule delays. Accurately predicting the consequences of these changes is crucial for effective project control and informed decision-making. This study aims to develop predictive models to estimate the impact of scope changes on project cost and schedule using machine learning techniques. The research utilizes a comprehensive dataset containing detailed information on project tasks, including the Work Breakdown Structure (WBS), task type, productivity rate, estimated cost, actual cost, duration, task dependencies, scope change magnitude, and scope change timing. Multiple machine learning models are developed and evaluated to predict the impact of scope changes on project cost and schedule. These models include Linear Regression, Decision Tree, Ridge Regression, Random Forest, Gradient Boosting, and XGBoost. The dataset is split into training and testing sets, and the models are trained using the preprocessed data. Cross-validation techniques are employed to assess the robustness and generalization ability of the models. The performance of the models is evaluated using metrics such as Mean Squared Error (MSE) and R-squared. Residual plots are generated to assess the goodness of fit and identify any patterns or outliers. Hyperparameter tuning is performed to optimize the XGBoost model and improve its predictive accuracy. The feature importance analysis reveals the relative significance of different project attributes in predicting the impact on cost and schedule. Key factors such as productivity rate, scope change magnitude, task dependencies, estimated cost, actual cost, duration, and specific WBS elements are identified as influential predictors. The study highlights the importance of considering both cost and schedule implications when managing scope changes. The developed predictive models provide project managers with a data-driven tool to proactively assess the potential impact of scope changes on project cost and schedule. By leveraging these insights, project managers can make informed decisions, optimize resource allocation, and develop effective mitigation strategies. The findings of this research contribute to improved project planning, risk management, and overall project success.

Keywords: cost impact, machine learning, predictive modeling, schedule impact, scope changes

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4348 An Integrative Review on the Experiences of Integration of Quality Assurance Systems in Universities

Authors: Laura Mion

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Concepts of quality assurance and management are now part of the organizational culture of the Universities. Quality Assurance (QA) systems are, in large part, provided for by national regulatory dictates or supranational indications (such as, for example, at European level are, the ESG Guidelines "European Standard Guidelines"), but their specific definition, in terms of guiding principles, requirements and methodologies, are often delegated to the national evaluation agencies or to the autonomy of individual universities. For this reason, the experiences of implementation of QA systems in different countries and in different universities is an interesting source of information to understand how quality in universities is understood, pursued and verified. The literature often deals with the treatment of the experiences of implementation of QA systems in the individual areas in which the University's activity is carried out - teaching, research, third mission - but only rarely considers quality systems with a systemic and integrated approach, which allows to correlate subjects, actions, and performance in a virtuous circuit of continuous improvement. In particular, it is interesting to understand how to relate the results and uses of the QA in the triple distinction of university activities, identifying how one can cause the performance of the other as a function of an integrated whole and not as an exploit of specific activities or processes conceived in an abstractly atomistic way. The aim of the research is, therefore, to investigate which experiences of "integrated" QA systems are present on the international scene: starting from the experience of European countries that have long shared the Bologna Process for the creation of a European space for Higher Education (EHEA), but also considering experiences from emerging countries that use QA processes to develop their higher education systems to keep them up to date with international levels. The concept of "integration", in this research, is understood in a double meaning: i) between the different areas of activity, in particular between the didactic and research areas, and possibly with the so-called "third mission" "ii) the functional integration between those involved in quality assessment and management and the governance of the University. The paper will present the results of a systematic review conducted according with a method of an integrative review aimed at identifying best practices of quality assurance systems, in individual countries or individual universities, with a high level of integration. The analysis of the material thus obtained has made it possible to grasp common and transversal elements of QA system integration practices or particularly interesting elements and strengths of these experiences that can, therefore, be considered as winning aspects in a QA practice. The paper will present the method of analysis carried out, and the characteristics of the experiences identified, of which the structural elements will be highlighted (level of integration, areas considered, organizational levels included, etc.) and the elements for which these experiences can be considered as best practices.

Keywords: quality assurance, university, integration, country

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4347 Artificial Intelligence Technologies Used in Healthcare: Its Implication on the Healthcare Workforce and Applications in the Diagnosis of Diseases

Authors: Rowanda Daoud Ahmed, Mansoor Abdulhak, Muhammad Azeem Afzal, Sezer Filiz, Usama Ahmad Mughal

Abstract:

This paper discusses important aspects of AI in the healthcare domain. The increase of data in healthcare both in size and complexity, opens more room for artificial intelligence applications. Our focus is to review the main AI methods within the scope of the health care domain. The results of the review show that recommendations for diagnosis and recommendations for treatment, patent engagement, and administrative tasks are the key applications of AI in healthcare. Understanding the potential of AI methods in the domain of healthcare would benefit healthcare practitioners and will improve patient outcomes.

Keywords: AI in healthcare, technologies of AI, neural network, future of AI in healthcare

Procedia PDF Downloads 100
4346 The Reliability and Shape of the Force-Power-Velocity Relationship of Strength-Trained Males Using an Instrumented Leg Press Machine

Authors: Mark Ashton Newman, Richard Blagrove, Jonathan Folland

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The force-velocity profile of an individual has been shown to influence success in ballistic movements, independent of the individuals' maximal power output; therefore, effective and accurate evaluation of an individual’s F-V characteristics and not solely maximal power output is important. The relatively narrow range of loads typically utilised during force-velocity profiling protocols due to the difficulty in obtaining force data at high velocities may bring into question the accuracy of the F-V slope along with predictions pertaining to the maximum force that the system can produce at a velocity of null (F₀) and the theoretical maximum velocity against no load (V₀). As such, the reliability of the slope of the force-velocity profile, as well as V₀, has been shown to be relatively poor in comparison to F₀ and maximal power, and it has been recommended to assess velocity at loads closer to both F₀ and V₀. The aim of the present study was to assess the relative and absolute reliability of an instrumented novel leg press machine which enables the assessment of force and velocity data at loads equivalent to ≤ 10% of one repetition maximum (1RM) through to 1RM during a ballistic leg press movement. The reliability of maximal and mean force, velocity, and power, as well as the respective force-velocity and power-velocity relationships and the linearity of the force-velocity relationship, were evaluated. Sixteen male strength-trained individuals (23.6 ± 4.1 years; 177.1 ± 7.0 cm; 80.0 ± 10.8 kg) attended four sessions; during the initial visit, participants were familiarised with the leg press, modified to include a mounted force plate (Type SP3949, Force Logic, Berkshire, UK) and a Micro-Epsilon WDS-2500-P96 linear positional transducer (LPT) (Micro-Epsilon, Merseyside, UK). Peak isometric force (IsoMax) and a dynamic 1RM, both from a starting position of 81% leg length, were recorded for the dominant leg. Visits two to four saw the participants carry out the leg press movement at loads equivalent to ≤ 10%, 30%, 50%, 70%, and 90% 1RM. IsoMax was recorded during each testing visit prior to dynamic F-V profiling repetitions. The novel leg press machine used in the present study appears to be a reliable tool for measuring F and V-related variables across a range of loads, including velocities closer to V₀ when compared to some of the findings within the published literature. Both linear and polynomial models demonstrated good to excellent levels of reliability for SFV and F₀ respectively, with reliability for V₀ being good using a linear model but poor using a 2nd order polynomial model. As such, a polynomial regression model may be most appropriate when using a similar unilateral leg press setup to predict maximal force production capabilities due to only a 5% difference between F₀ and obtained IsoMax values with a linear model being best suited to predict V₀.

Keywords: force-velocity, leg-press, power-velocity, profiling, reliability

Procedia PDF Downloads 38
4345 Marketing and Pharmaceutical Analysis of Medical Cosmetics in Bulgaria and Japan

Authors: V. Petkova, V. Valchanova, D. Grekova, K. Andreevska, S. T. Geurguiev, V. Madgarov, D. Grekov

Abstract:

Introduction: Production, distribution and sale of cosmetics is a global industry, which played a key role in the European Union (EU), the US and Japan. A major participant EU whose market cosmetics is greater than in the US and 2 times greater than that in Japan. The output value of the cosmetics industry in the EU is estimated at about € 35 billion in 2001. Nearly 5 billion cosmetic products (number of packages) are sold annually in the EU, and the main markets are France, Germany, Italy, Spain and the UK. The aim of the study is legal and marketing analysis of cosmetic products dispensed in a pharmacy. Materials and methodology: Historical legislative analysis - the method is applied in the analysis of changes in the legislative regulation of the activities of cosmetic products in Japan and Bulgaria Comparative legislative analysis - the method is applied when comparing the legislative requirements for cosmetic products in the already mentioned countries. Both methods are applied to the following regulations: 1) Japanese Pharmaceuticals Affairs Law, Tokyo, Japan, Ministry of Health, Labour and Welfare; 2) Law on Medicinal Products for Human Use; effective from 3.01.2014. Results: The legislative framework for cosmetic products in Bulgaria and Japan is close and generally includes general guidelines: Definition of a medicinal product; Categorization of drugs (with differences in sub-categories); Pre-registration and marketing approval of the competent authorities; Compulsory compliance with gmp (unlike cosmetics); Regulatory focus on product quality, efficacy and safety; Obligations for labeling of such products; Created systems Pharmacovigilance and commitment of all parties - industry and health professionals; The main similarities in the regulation of products classified as cosmetics are in the following segments: Full producer responsibility for product safety; Surveillance of market regulatory authorities; No need for pre-registration or pre-marketing approval (a basic requirement for notification); Without restrictions on sales channels; GMP manuals for cosmetics; Regulatory focus on product safety (than over efficiency); General requirements in labeling: The main differences in the regulation of products classified as cosmetics are in the following segments: Details in the regulation of cosmetic products; Future convergence of regulatory frameworks can contribute to the removal of barriers to trade, to encourage innovation, while simultaneously ensuring a high level of protection of consumer safety.

Keywords: cosmetics, legislation, comparative analysis, Bulgaria, Japan

Procedia PDF Downloads 582
4344 The Effect of Paper Based Concept Mapping on Students' Academic Achievement and Attitude in Science Education

Authors: Orhan Akınoğlu, Arif Çömek, Ersin Elmacı, Tuğba Gündoğdu

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The concept map is known to be a powerful tool to organize the ideas and concepts of an individuals’ mind. This tool is a kind of visual map that illustrates the relationships between the concepts of a certain subject. The effect of concept mapping on cognitive and affective qualities is one of the research topics among educational researchers for last decades. We educators want to utilize it both as an instructional tool or an assessment tool in classes. For that reason, this study aimed to determine the effect of concept mapping as a learning strategy in science classes on students’ academic achievement and attitude. The research employed a randomized pre-test post-test control group design. Data collected from 60 sixth grade students participated in the study from a randomly selected primary school in Turkey. Sixth-grade classes of the school were analyzed according to students’ academic achievement, science attitude, gender, mathematics, science courses grades, and their GPAs before the implementation. Two of the classes found to be equivalent (t=0,983, p>0,05) and one of them was defined as experimental and the other one control group randomly. During a 5-weeks period, the experimental group students (N=30) used the paper-based concept mapping method while the control group students (N=30) were taught with the traditional approach according to the science and technology education curriculum for light and sound subject. Both groups were taught by the same teacher who is experienced using concept mapping in science classes. Before the implementation, the teacher explained the theory of the concept maps and showed how to create paper-based concept mapping individually to the experimental group students for two hours. Then for two following hours she asked them to create some concept maps related to their former science subjects and gave them feedback by reviewing their concept maps to be sure that they can create during the implementation. The data were collected by science achievement test, science attitude scale and personal information form. Science achievement test and science attitude scale were implemented as pre-test and post-test while personal information form was implemented just as once. The reliability coefficient of the achievement test was KR20=0,76 and Cronbach’s Alpha of the attitude scale was 0,89. SPSS statistical software was used to analyze the data. According to the results, there was a statistically significant difference between the experimental and control group for academic achievement but not for attitude. The experimental group had significantly greater gains from academic achievement test than the control group (t=0,02, p<0,05). The findings showed that the paper-and-pencil concept mapping can be used as an effective method for students’ academic achievement in science classes. The results have implications for further researches.

Keywords: concept mapping, science education, constructivism, academic achievement, science attitude

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4343 Improving Screening and Treatment of Binge Eating Disorders in Pediatric Weight Management Clinic through a Quality Improvement Framework

Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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4342 Predictors of Pericardial Effusion Requiring Drainage Following Coronary Artery Bypass Graft Surgery: A Retrospective Analysis

Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

Abstract:

Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

Procedia PDF Downloads 153
4341 Analyzing the Impact of Bariatric Surgery in Obesity Associated Chronic Kidney Disease: A 2-Year Observational Study

Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

Abstract:

Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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4340 A Prospective Study of a Clinically Significant Anatomical Change in Head and Neck Intensity-Modulated Radiation Therapy Using Transit Electronic Portal Imaging Device Images

Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

Abstract:

The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

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4339 Optimal Uses of Rainwater to Maintain Water Level in Gomti Nagar, Uttar Pradesh, India

Authors: Alok Saini, Rajkumar Ghosh

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Water is nature's important resource for survival of all living things, but freshwater scarcity exists in some parts of world. This study has predicted that Gomti Nagar area (49.2 sq. km.) will harvest about 91110 ML of rainwater till 2051 (assuming constant and present annual rainfall). But 17.71 ML of rainwater was harvested from only 53 buildings in Gomti Nagar area in the year 2021. Water level will be increased (rise) by 13 cm in Gomti Nagar from such groundwater recharge. The total annual groundwater abstraction from Gomti Nagar area was 35332 ML (in 2021). Due to hydrogeological constraints and lower annual rainfall, groundwater recharge is less than groundwater abstraction. The recent scenario is only 0.07% of rainwater recharges by RTRWHs in Gomti Nagar. But if RTRWHs would be installed in all buildings then 12.39% of rainwater could recharge groundwater table in Gomti Nagar area. But if RTRWHs would be installed in all buildings then 12.39% of rainwater could recharge groundwater table in Gomti Nagar area. Gomti Nagar is situated in 'Zone–A' (water distribution area) and groundwater is the primary source of freshwater supply. Current scenario indicates only 0.07% of rainwater recharges by RTRWHs in Gomti Nagar. In Gomti Nagar, the difference between groundwater abstraction and recharge will be 735570 ML in 30 yrs. Statistically, all buildings at Gomti Nagar (new and renovated) could harvest 3037 ML of rainwater through RTRWHs annually. The most recent monsoonal recharge in Gomti Nagar was 10813 ML/yr. Harvested rainwater collected from RTRWHs can be used for rooftop irrigation, and residential kitchen and gardens (home grown fruit and vegetables). According to bylaws, RTRWH installations are required in both newly constructed and existing buildings plot areas of 300 sq. m or above. Harvested rainwater is of higher quality than contaminated groundwater. Harvested rainwater from RTRWHs can be considered water self-sufficient. Rooftop Rainwater Harvesting Systems (RTRWHs) are least expensive, eco-friendly, most sustainable, and alternative water resource for artificial recharge. This study also predicts about 3.9 m of water level rise in Gomti Nagar area till 2051, only when all buildings will install RTRWHs and harvest for groundwater recharging. As a result, this current study responds to an impact assessment study of RTRWHs implementation for the water scarcity problem in the Gomti Nagar area (1.36 sq.km.). This study suggests that common storage tanks (recharge wells) should be built for a group of at least ten (10) households and optimal amount of harvested rainwater will be stored annually. Artificial recharge from alternative water sources will be required to improve the declining water level trend and balance the groundwater table in this area. This over-exploitation of groundwater may lead to land subsidence, and development of vertical cracks.

Keywords: aquifer, aquitard, artificial recharge, bylaws, groundwater, monsoon, rainfall, rooftop rainwater harvesting system, RTRWHs water table, water level

Procedia PDF Downloads 72
4338 Monitoring of Serological Test of Blood Serum in Indicator Groups of the Population of Central Kazakhstan

Authors: Praskovya Britskaya, Fatima Shaizadina, Alua Omarova, Nessipkul Alysheva

Abstract:

Planned preventive vaccination, which is carried out in the Republic of Kazakhstan, promoted permanent decrease in the incidence of measles and viral hepatitis B. In the structure of VHB patients prevail people of young, working age. Monitoring of infectious incidence, monitoring of coverage of immunization of the population, random serological control over the immunity enable well-timed identification of distribution of the activator, effectiveness of the taken measures and forecasting. The serological blood analysis was conducted in indicator groups of the population of Central Kazakhstan for the purpose of identification of antibody titre for vaccine preventable infections (measles, viral hepatitis B). Measles antibodies were defined by method of enzyme-linked assay (ELA) with test-systems "VektoKor" – Ig G ('Vektor-Best' JSC). Antibodies for HBs-antigen of hepatitis B virus in blood serum was identified by method of enzyme-linked assay (ELA) with VektoHBsAg test systems – antibodies ('Vektor-Best' JSC). The result of the analysis is positive, the concentration of IgG to measles virus in the studied sample is equal to 0.18 IU/ml or more. Protective level of concentration of anti-HBsAg makes 10 mIU/ml. The results of the study of postvaccinal measles immunity showed that the share of seropositive people made 87.7% of total number of surveyed. The level of postvaccinal immunity to measles in age groups differs. So, among people older than 56 the percentage of seropositive made 95.2%. Among people aged 15-25 were registered 87.0% seropositive, at the age of 36-45 – 86.6%. In age groups of 25-35 and 36-45 the share of seropositive people was approximately at the same level – 88.5% and 88.8% respectively. The share of people seronegative to a measles virus made 12.3%. The biggest share of seronegative people was found among people aged 36-45 – 13.4% and 15-25 – 13.0%. The analysis of results of the examined people for the existence of postvaccinal immunity to viral hepatitis B showed that from all surveyed only 33.5% have the protective level of concentration of anti-HBsAg of 10 mIU/ml and more. The biggest share of people protected from VHB virus is observed in the age group of 36-45 and makes 60%. In the indicator group – above 56 – seropositive people made 4.8%. The high percentage of seronegative people has been observed in all studied age groups from 40.0% to 95.2%. The group of people which is least protected from getting VHB is people above 56 (95.2%). The probability to get VHB is also high among young people aged 25-35, the percentage of seronegative people made 80%. Thus, the results of the conducted research testify to the need for carrying out serological monitoring of postvaccinal immunity for the purpose of operational assessment of the epidemiological situation, early identification of its changes and prediction of the approaching danger.

Keywords: antibodies, blood serum, immunity, immunoglobulin

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4337 Development of Perovskite Quantum Dots Light Emitting Diode by Dual-Source Evaporation

Authors: Antoine Dumont, Weiji Hong, Zheng-Hong Lu

Abstract:

Light emitting diodes (LEDs) are steadily becoming the new standard for luminescent display devices because of their energy efficiency and relatively low cost, and the purity of the light they emit. Our research focuses on the optical properties of the lead halide perovskite CsPbBr₃ and its family that is showing steadily improving performances in LEDs and solar cells. The objective of this work is to investigate CsPbBr₃ as an emitting layer made by physical vapor deposition instead of the usual solution-processed perovskites, for use in LEDs. The deposition in vacuum eliminates any risk of contaminants as well as the necessity for the use of chemical ligands in the synthesis of quantum dots. Initial results show the versatility of the dual-source evaporation method, which allowed us to create different phases in bulk form by altering the mole ratio or deposition rate of CsBr and PbBr₂. The distinct phases Cs₄PbBr₆, CsPbBr₃ and CsPb₂Br₅ – confirmed through XPS (x-ray photoelectron spectroscopy) and X-ray diffraction analysis – have different optical properties and morphologies that can be used for specific applications in optoelectronics. We are particularly focused on the blue shift expected from quantum dots (QDs) and the stability of the perovskite in this form. We already obtained proof of the formation of QDs through our dual source evaporation method with electron microscope imaging and photoluminescence testing, which we understand is a first in the community. We also incorporated the QDs in an LED structure to test the electroluminescence and the effect on performance and have already observed a significant wavelength shift. The goal is to reach 480nm after shifting from the original 528nm bulk emission. The hole transport layer (HTL) material onto which the CsPbBr₃ is evaporated is a critical part of this study as the surface energy interaction dictates the behaviour of the QD growth. A thorough study to determine the optimal HTL is in progress. A strong blue shift for a typically green emitting material like CsPbBr₃ would eliminate the necessity of using blue emitting Cl-based perovskite compounds and could prove to be more stable in a QD structure. The final aim is to make a perovskite QD LED with strong blue luminescence, fabricated through a dual-source evaporation technique that could be scalable to industry level, making this device a viable and cost-effective alternative to current commercial LEDs.

Keywords: material physics, perovskite, light emitting diode, quantum dots, high vacuum deposition, thin film processing

Procedia PDF Downloads 153
4336 Additional Pathological Findings Using MRI on Patients with First Time Traumatic Lateral Patella Dislocation: A Study of 150 Patients

Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

Abstract:

Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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4335 'Sit Down, Breathe, and Feel What?' Bringing a Contemplative Intervention into a Public Urban Middle School

Authors: Lunthita M. Duthely, John T. Avella, John Ganapati Coleman

Abstract:

For as many as one in three adolescents living in the United States, the adolescent years is a period of low well-being and mental health challenges—from depressive symptoms to mild to moderate psychological diagnoses. Longitudinal population health studies demonstrated that these challenges persist in young adulthood, and beyond. The positive psychology (PS) approach is a more preventative approach to well-being, which contrasts the traditional, deficits approach to curing mental illness. The research among adult populations formed the basis for PS studies among adolescents. The empirical evidence for the effectiveness of PS interventions exists for both adult and youth populations. Positive Psychology interventions target individuals’ strengths, such as hope and optimism, and positive emotions, such as gratitude. Positive psychology interventions such as increasing gratitude, proved effective in many outcomes among youth, including psychological, social, and academically-related outcomes. Although gratitude-inducing studies have been conducted for the past decade in the United States, few studies have been conducted among samples of urban youth, particularly youth of diverse cultural backgrounds. For nearly two decades, the secular practice of meditation has been tested among adults and more recently among youth, focused mostly among clinical samples. The field of Contemplative Sciences explores practices such as Hatha Yoga, Tai Chi, and Meditation, as preventative practices among children and adolescents. A more recent initiative is to explore Contemplative Practices in the school environment. Contemplative Practices yield a variety of positive outcomes, including academic, social, psychological, physiological, and neurological changes among children and adolescents. Again, few studies were conducted among adolescents of diverse cultural backgrounds. The purpose of this doctoral dissertation research study was to test a gratitude-meditation intervention among middle school students attending a public charter school, located in an urban region of Metropolitan Miami. The objective of this presentation is to summarize the challenges and success of bringing a positive psychology and meditation intervention into an urban middle school. Also, the most recent findings on positive psychology and meditation interventions conducted in school environments will be presented as well.

Keywords: adolescents, contemplative intervention, gratitude, secular meditation, positive psychology, school engagement, Sri Chinmoy

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4334 Chronic Hepatitis C Virus Screening: The Role, Strategies and Challenging of Primary Healthcare Faced to Augment and Identify Asymptomatic Infected Patients

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

Abstract:

Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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4333 Stochastic Modelling for Mixed Mode Fatigue Delamination Growth of Wind Turbine Composite Blades

Authors: Chi Zhang, Hua-Peng Chen

Abstract:

With the increasingly demanding resources in the word, renewable and clean energy has been considered as an alternative way to replace traditional ones. Thus, one of practical examples for using wind energy is wind turbine, which has gained more attentions in recent research. Like most offshore structures, the blades, which is the most critical components of the wind turbine, will be subjected to millions of loading cycles during service life. To operate safely in marine environments, the blades are typically made from fibre reinforced composite materials to resist fatigue delamination and harsh environment. The fatigue crack development of blades is uncertain because of indeterminate mechanical properties for composite and uncertainties under offshore environment like wave loads, wind loads, and humid environments. There are three main delamination failure modes for composite blades, and the most common failure type in practices is subjected to mixed mode loading, typically a range of opening (mode 1) and shear (mode 2). However, the fatigue crack development for mixed mode cannot be predicted as deterministic values because of various uncertainties in realistic practical situation. Therefore, selecting an effective stochastic model to evaluate the mixed mode behaviour of wind turbine blades is a critical issue. In previous studies, gamma process has been considered as an appropriate stochastic approach, which simulates the stochastic deterioration process to proceed in one direction such as realistic situation for fatigue damage failure of wind turbine blades. On the basis of existing studies, various Paris Law equations are discussed to simulate the propagation of the fatigue crack growth. This paper develops a Paris model with the stochastic deterioration modelling according to gamma process for predicting fatigue crack performance in design service life. A numerical example of wind turbine composite materials is investigated to predict the mixed mode crack depth by Paris law and the probability of fatigue failure by gamma process. The probability of failure curves under different situations are obtained from the stochastic deterioration model for comparisons. Compared with the results from experiments, the gamma process can take the uncertain values into consideration for crack propagation of mixed mode, and the stochastic deterioration process shows a better agree well with realistic crack process for composite blades. Finally, according to the predicted results from gamma stochastic model, assessment strategies for composite blades are developed to reduce total lifecycle costs and increase resistance for fatigue crack growth.

Keywords: Reinforced fibre composite, Wind turbine blades, Fatigue delamination, Mixed failure mode, Stochastic process.

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