Search results for: electronic medical record systems

Authors: Peter G. Hollis, Kim G. Clarke

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Accurate quantification of the overall volumetric oxygen transfer coefficient (KLa) is ubiquitously measured in bioprocesses by analysing the response of dissolved oxygen (DO) to a step change in the oxygen partial pressure in the sparge gas using a DO probe. Typically, the response lag (τ) of the probe has been ignored in the calculation of KLa when τ is less than the reciprocal KLa, failing which a constant τ has invariably been assumed. These conventions have now been reassessed in the context of multiphase bioprocesses, such as a hydrocarbon-based system. Here, significant variation of τ in response to changes in process conditions has been documented. Experiments were conducted in a 5 L baffled stirred tank bioreactor (New Brunswick) in a simulated hydrocarbon-based bioprocess comprising a C14-20 alkane-aqueous dispersion with suspended non-viable Saccharomyces cerevisiae solids. DO was measured with a polarographic DO probe fitted with a Teflon membrane (Mettler Toledo). The DO concentration response to a step change in the sparge gas oxygen partial pressure was recorded, from which KLa was calculated using a first order model (without incorporation of τ) and a second order model (incorporating τ). τ was determined as the time taken to reach 63.2% of the saturation DO after the probe was transferred from a nitrogen saturated vessel to an oxygen saturated bioreactor and is represented as the inverse of the probe constant (KP). The relative effects of the process parameters on KP were quantified using a central composite design with factor levels typical of hydrocarbon bioprocesses, namely 1-10 g/L yeast, 2-20 vol% alkane and 450-1000 rpm. A response surface was fitted to the empirical data, while ANOVA was used to determine the significance of the effects with a 95% confidence interval. KP varied with changes in the system parameters with the impact of solid loading statistically significant at the 95% confidence level. Increased solid loading reduced KP consistently, an effect which was magnified at high alkane concentrations, with a minimum KP of 0.024 s-1 observed at the highest solids loading of 10 g/L. This KP was 2.8 fold lower that the maximum of 0.0661 s-1 recorded at 1 g/L solids, demonstrating a substantial increase in τ from 15.1 s to 41.6 s as a result of differing process conditions. Importantly, exclusion of KP in the calculation of KLa was shown to under-predict KLa for all process conditions, with an error up to 50% at the highest KLa values. Accurate quantification of KLa, and therefore KP, has far-reaching impact on industrial bioprocesses to ensure these systems are not transport limited during scale-up and operation. This study has shown the incorporation of τ to be essential to ensure KLa measurement accuracy in multiphase bioprocesses. Moreover, since τ has been conclusively shown to vary significantly with process conditions, it has also been shown that it is essential for τ to be determined individually for each set of process conditions.

Keywords: effect of process conditions, measuring oxygen transfer coefficients, multiphase bioprocesses, oxygen probe response lag

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Authors: Marcin Debowski, Marcin Zielinski, Magdalena Zielinska, Paulina Rusanowska

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The problem with digestate management is one of the most important factors influencing on the development and operation of biogas plant. Turbidity and bacterial contamination negatively affect the growth of algae, which can limit the use of the effluent in the production of algae biomass on a large scale. These problems can be overcome by cultivating of algae species resistant to environmental factors, such as Chlorella sp., Scenedesmus sp., or reducing load of organic compounds to prevent bacterial contamination. The effluent requires dilution and/or purification. One of the methods of effluent treatment is the use of a membrane technology such as microfiltration (MF), ultrafiltration (UF), nanofiltration (NF) and reverse osmosis (RO), depending on the membrane pore size and the cut off point. Membranes are a physical barrier to solids and particles larger than the size of the pores. MF membranes have the largest pores and are used to remove turbidity, suspensions, bacteria and some viruses. UF membranes remove also color, odor and organic compounds with high molecular weight. In treatment of wastewater or other waste streams, MF and UF can provide a sufficient degree of purification. NF membranes are used to remove natural organic matter from waters, water disinfection products and sulfates. RO membranes are applied to remove monovalent ions such as Na⁺ or K⁺. The effluent was used in UF for medium to cultivation of two microalgae: Chlorella sp. and Phaeodactylum tricornutum. Growth rates of Chlorella sp. and P. tricornutum were similar: 0.216 d⁻¹ and 0.200 d⁻¹ (Chlorella sp.); 0.128 d⁻¹ and 0.126 d⁻¹ (P. tricornutum), on synthetic medium and permeate from UF, respectively. The final biomass composition was also similar, regardless of the medium. Removal of nitrogen was 92% and 71% by Chlorella sp. and P. tricornutum, respectively. The fermentation effluents after UF and dilution were also used for cultivation of algae Scenedesmus sp. that is resistant to environmental conditions. The authors recommended the development of biorafinery based on the production of algae for the biogas production. There are examples of using a multi-stage membrane system to purify the liquid fraction from digestate. After the initial UF, RO is used to remove ammonium nitrogen and COD. To obtain a permeate with a concentration of ammonium nitrogen allowing to discharge it into the environment, it was necessary to apply three-stage RO. The composition of the permeate after two-stage RO was: COD 50–60 mg/dm³, dry solids 0 mg/dm³, ammonium nitrogen 300–320 mg/dm³, total nitrogen 320–340 mg/dm³, total phosphorus 53 mg/dm³. However compostion of permeate after three-stage RO was: COD < 5 mg/dm³, dry solids 0 mg/dm³, ammonium nitrogen 0 mg/dm³, total nitrogen 3.5 mg/dm³, total phosphorus < 0,05 mg/dm³. Last stage of RO might be replaced by ion exchange process. The negative aspect of membrane filtration systems is the fact that the permeate is about 50% of the introduced volume, the remainder is the retentate. The management of a retentate might involve recirculation to a biogas plant.

Keywords: digestate, membrane filtration, microalgae cultivation, Chlorella sp.

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Authors: Arina V. Tankanag, Gennady V. Krasnikov, Nikolai K. Chemeris

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The development of respiration-dependent oscillations in the peripheral blood flow may occur by at least two mechanisms. The first mechanism is related to the change of venous pressure due to mechanical activity of lungs. This phenomenon is known as ‘respiratory pump’ and is one of the mechanisms of venous return of blood from the peripheral vessels to the heart. The second mechanism is related to the vasomotor reflexes controlled by the respiratory modulation of the activity of centers of the vegetative nervous system. Early high phase synchronization of respiration-dependent blood flow oscillations of left and right forearm skin in healthy volunteers at rest was shown. The aim of the work was to study the effect of deep controlled breathing on the phase synchronization of skin blood flow oscillations. 29 normotensive non-smoking young women (18-25 years old) of the normal constitution without diagnosed pathologies of skin, cardiovascular and respiratory systems participated in the study. For each of the participants six recording sessions were carried out: first, at the spontaneous breathing rate; and the next five, in the regimes of controlled breathing with fixed breathing depth and different rates of enforced breathing regime. The following rates of controlled breathing regime were used: 0.25, 0.16, 0.10, 0.07 and 0.05 Hz. The breathing depth amounted to 40% of the maximal chest excursion. Blood perfusion was registered by laser flowmeter LAKK-02 (LAZMA, Russia) with two identical channels (wavelength 0.63 µm; emission power, 0.5 mW). The first probe was fastened to the palmar surface of the distal phalanx of left forefinger; the second probe was attached to the external surface of the left forearm near the wrist joint. These skin zones were chosen as zones with different dominant mechanisms of vascular tonus regulation. The degree of phase synchronization of the registered signals was estimated from the value of the wavelet phase coherence. The duration of all recording was 5 min. The sampling frequency of the signals was 16 Hz. The increasing of synchronization of the respiratory-dependent skin blood flow oscillations for all controlled breathing regimes was obtained. Since the formation of respiration-dependent oscillations in the peripheral blood flow is mainly caused by the respiratory modulation of system blood pressure, the observed effects are most likely dependent on the breathing depth. It should be noted that with spontaneous breathing depth does not exceed 15% of the maximal chest excursion, while in the present study the breathing depth was 40%. Therefore it has been suggested that the observed significant increase of the phase synchronization of blood flow oscillations in our conditions is primarily due to an increase of breathing depth. This is due to the enhancement of both potential mechanisms of respiratory oscillation generation: venous pressure and sympathetic modulation of vascular tone.

Keywords: deep controlled breathing, peripheral blood flow oscillations, phase synchronization, wavelet phase coherence

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Authors: S.I.Mukhin, S. Seidov, A. Mukherjee

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The Dicke model is a key tool for the description of correlated states of quantum atomic systems, excited by resonant photon absorption and subsequently emitting spontaneous coherent radiation in the superradiant state. The Dicke Hamiltonian (DH) is successfully used for the description of the dynamics of the Josephson Junction (JJ) array in a resonant cavity under applied current. In this work, we have investigated a generalized model, which is described by DH with a frustrating interaction term. This frustrating interaction term is explicitly the infinite coordinated interaction between all the spin half in the system. In this work, we consider an array of N superconducting islands, each divided into two sub-islands by a Josephson Junction, taken in a charged qubit / Cooper Pair Box (CPB) condition. The array is placed inside the resonant cavity. One important aspect of the problem lies in the dynamical nature of the physical observables involved in the system, such as condensed electric field and dipole moment. It is important to understand how these quantities behave with time to define the quantum phase of the system. The Dicke model without frustrating term is solved to find the dynamical solutions of the physical observables in analytic form. We have used Heisenberg’s dynamical equations for the operators and on applying newly developed Rotating Holstein Primakoff (HP) transformation and DH we have arrived at the four coupled nonlinear dynamical differential equations for the momentum and spin component operators. It is possible to solve the system analytically using two-time scales. The analytical solutions are expressed in terms of Jacobi's elliptic functions for the metastable ‘bound luminosity’ dynamic state with the periodic coherent beating of the dipoles that connect the two double degenerate dipolar ordered phases discovered previously. In this work, we have proceeded the analysis with the extended DH with a frustrating interaction term. Inclusion of the frustrating term involves complexity in the system of differential equations and it gets difficult to solve analytically. We have solved semi-classical dynamic equations using the perturbation technique for small values of Josephson energy EJ. Because the Hamiltonian contains parity symmetry, thus phase transition can be found if this symmetry is broken. Introducing spontaneous symmetry breaking term in the DH, we have derived the solutions which show the occurrence of finite condensate, showing quantum phase transition. Our obtained result matches with the existing results in this scientific field.

Keywords: Dicke Model, nonlinear dynamics, perturbation theory, superconductivity

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Authors: Tom Turner

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The recent financial crisis in 2008 and the growing inequality in developed industrial societies would appear to present significant challenges to capitalism and the free market. Yet there have been few substantial mainstream political or economic challenges to the dominant capitalist and market paradigm to-date. There is no dearth of critical and theoretical (academic) analyses regarding the prevailing systems failures. Yet despite the growing inequality in the developed industrial societies and the financial crisis in 2008 few commentators have advocated the comprehensive socialization or state ownership of the means of production to our knowledge – a core principle of radical Marxism in the 19th and early part of the 20th century. Undoubtedly the experience in the Soviet Union and satellite countries in the 20th century has cast a dark shadow over the notion of centrally controlled economies and state ownership of the means of production. In this paper, we explore the history of a doctrine advocating the socialization or state ownership of the means of production that was central to Marxism and socialism generally. Indeed this doctrine provoked an intense and often acrimonious debate especially for left-wing parties throughout the 20th century. The debate within the political economy tradition has historically tended to divide into a radical and a revisionist approach to changing or reforming capitalism. The radical perspective views the conflict of interest between capital and labor as a persistent and insoluble feature of a capitalist society and advocates the public or state ownership of the means of production. Alternatively, the revisionist perspective focuses on issues of distribution rather than production and emphasizes the possibility of compromise between capital and labor in capitalist societies. Over the 20th century, the radical perspective has faded and even the social democratic revisionist tradition has declined in recent years. We conclude with the major challenges that confront both the radical and revisionist perspectives in the development of viable policy agendas in mature developed democratic societies. Additionally, we consider whether state ownership of the means of production still has relevance in the 21st century and to what extent state ownership is off the agenda as a political issue in the political mainstream in developed industrial societies. A central argument in the paper is that state ownership of the means of production is unlikely to feature as either a practical or theoretical solution to the problems of capitalism post the financial crisis among mainstream political parties of the left. Although the focus here is solely on the shifting views of the radical and revisionist socialist perspectives in the western European tradition the analysis has relevance for the wider socialist movement.

Keywords: sate ownership, ownership means of production, radicals, revisionists

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Authors: Katarina Pogacnik, Ursa Zakrajsek, Nejc Sirk, Ziga Lampret

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Due to an increase in living standards along with global population growth and a trend of urbanization, municipalities and regions are faced with an ever rising energy demand. A challenge has arisen for cities around the world to modify the energy supply chain in order to reduce its consumption and CO₂ emissions. The aim of our work is the development of a computational-analytical platform for dynamic support in decision-making and the determination of economic and technical indicators of energy efficiency in a smart city, named Energy Atlas. Similar products in this field focuse on a narrower approach, whereas in order to achieve its aim, this platform encompasses a wider spectrum of beneficial and important information for energy planning on a local or regional scale. GIS based interactive maps provide an extensive database on the potential, use and supply of energy and renewable energy sources along with climate, transport and spatial data of the selected municipality. Beneficiaries of Energy atlas are local communities, companies, investors, contractors as well as residents. The Energy Atlas platform consists of three modules named E-Planning, E-Indicators and E-Cooperation. The E-Planning module is a comprehensive data service, which represents a support towards optimal decision-making and offers a sum of solutions and feasibility of measures and their effects in the area of efficient use of energy and renewable energy sources. The E-Indicators module identifies, collects and develops optimal data and key performance indicators and develops an analytical application service for dynamic support in managing a smart city in regards to energy use and sustainable environment. In order to support cooperation and direct involvement of citizens of the smart city, the E-cooperation is developed with the purpose of integrating the interdisciplinary and sociological aspects of energy end-users. Interaction of all the above-described modules contributes to regional development because it enables for a precise assessment of the current situation, strategic planning, detection of potential future difficulties and also the possibility of public involvement in decision-making. From the implementation of the technology in Slovenian municipalities of Ljubljana, Piran, and Novo mesto, there is evidence to suggest that the set goals are to be achieved to a great extent. Such thorough urban energy planning tool is viewed as an important piece of the puzzle towards achieving a low-carbon society, circular economy and therefore, sustainable society.

Keywords: circular economy, energy atlas, energy management, energy planning, low-carbon society

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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Authors: Shahid Razzaq

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The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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Authors: Aparecida De Fatima Dutra, Freddie Avant, Wilma Cordova

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People living with HIV/AIDS (PLWHA) have benefited from advances in treatment. Medical costs are a challenge for some, but the real challenge is the stigma and discrimination PLWHA continue to face, even though the disease has festered for the last four decades. Few studies regarding stigma and discrimination give voice to those affected by these practices. This study provides a voice to PLWHA in Brazil and in the US as to how they perceive stigma and discrimination, as well as services they access. The methodology of this study was designed based on phenomenological research, which is a research that aims to identify what individuals facing the same situation have to share about their experiences. Qualitative research using in- depth interviews was used in order to gather participants’ perceptions about services they access, and stigma and discrimination they experience as PLWHA (hypothesis). The target population was a minority group of 13 Afro-descendant men, mean age of 48.3, residents in East Texas, United States and Salvador, Brazil. Our findings indicate that in both countries, overall, participants have reasonable access to medication and qualified services, except for some specialties, such as dentistry. With regard to stigma and discrimination the majority of participants have not disclosed their diagnosis. They state they prefer not to disclose for fear of being ostracized and rejected. Participants who did reveal their status indicate that stigma and discrimination is a daily occurrence. These experiences tend to occur within their own families, neighborhoods, and in public health agencies where HIV/AIDS is not the focus. Participants who did offer suggestions for social change indicated they would have to reveal their status even if it means being stigmatized and discriminated against. Other factors contributing to this discrimination include skin color and poverty. This study concludes that even after decades since the spread of this epidemic, nothing has changed regarding stigma and discrimination towards PLWHA. Lack of awareness, empathy and education continue to be a major challenge, not only at a local level but across the globe. In conclusion, as documented in previous studies while stigma and discrimination towards this population prevail, negative attitudes will continue to jeopardize all individuals from receiving equal access to prevention, treatment and care. It is crucial to face stigma and discrimination not only as individual experiences, but as social practices that violate and restrict human rights and that as a result, reinforce inequality and social exclusion. Policies should be at the forefront to eliminate the stigma and discrimination PLWHA experience. Health professionals and societies must take a stand in order to promote mindfulness about the negative effect of oppression towards individuals living with HIV/AIDS and the potential global impact of these practices.

Keywords: discrimination, HIV/AIDS, human rights, stigma

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Authors: Eleanor Nel

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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.

Keywords: evaluation, framework, impact, research output

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Authors: Chetra Mang, Ahmadali Tahmasebimoradi, Xavier Lorang

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Lattice structures are widely used in various applications, especially in aeronautic, aerospace, and medical applications because of their high performance properties. Thanks to advancement of the additive manufacturing technology, the lattice structures can be manufactured by different methods such as laser beam melting technology. However, the presence of geometric defects in the lattice structures is inevitable due to the manufacturing process. The geometric defects may have high impact on the mechanical strength of the structures. This work analyzes the correlation between the manufacturing parameters and the mechanical strengths of the lattice structures. To do that, two types of the lattice structures; body-centered cubic with z-struts (BCCZ) structures made of Inconel718, and body-centered cubic (BCC) structures made of Scalmalloy, are manufactured by laser melting beam machine using Taguchi design of experiment. Each structure is placed on the substrate with a specific position and orientation regarding the roller direction of deposed metal powder. The position and orientation are considered as the manufacturing parameters. The geometric defects of each beam in the lattice are characterized and used to build the geometric model in order to perform simulations. Then, the mechanical strengths are defined by the homogeneous response as Young's modulus and yield strength. The distribution of mechanical strengths is observed as a function of manufacturing parameters. The mechanical response of the BCCZ structure is stretch-dominated, i.e., the mechanical strengths are directly dependent on the strengths of the vertical beams. As the geometric defects of vertical beams are slightly changed based on their position/orientation on the manufacturing substrate, the mechanical strengths are less dispersed. The manufacturing parameters are less influenced on the mechanical strengths of the structure BCCZ. The mechanical response of the BCC structure is bending-dominated. The geometric defects of inclined beam are highly dispersed within a structure and also based on their position/orientation on the manufacturing substrate. For different position/orientation on the substrate, the mechanical responses are highly dispersed as well. This shows that the mechanical strengths are directly impacted by manufacturing parameters. In addition, this work is carried out to study the uncertainty propagation of the geometric defects on the mechanical strength of the BCC lattice structure made of Scalmalloy. To do that, we observe the distribution of mechanical strengths of the lattice according to the distribution of the geometric defects. A probability density law is determined based on a statistical hypothesis corresponding to the geometric defects of the inclined beams. The samples of inclined beams are then randomly drawn from the density law to build the lattice structure samples. The lattice samples are then used for simulation to characterize the mechanical strengths. The results reveal that the distribution of mechanical strengths of the structures with the same manufacturing parameters is less dispersed than one of the structures with different manufacturing parameters. Nevertheless, the dispersion of mechanical strengths due to the structures with the same manufacturing parameters are unneglectable.

Keywords: geometric defects, lattice structure, mechanical strength, uncertainty propagation

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Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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Authors: Maciej Czarnecki

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Even though growth is one of the most important strategic objectives for many enterprises, we know relatively little about this phenomenon. This research contributes to broaden our knowledge of managerial consequences of growth. Scales for measuring organizational development and growing pains were developed. Conceptual model of connections among growth, organizational development, growing pains, selected development factors and financial performance were examined. The research process contained literature review, 20 interviews with managers, examination of 12 raters’ opinions, pilot research and 7 point Likert scale questionnaire research on 138 Polish enterprises employing 50-249 people which increased their employment at least by 50% within last three years. Factor analysis, Pearson product-moment correlation coefficient, student’s t-test and chi-squared test were used to develop scales. High Cronbach’s alpha coefficients were obtained. The verification of correlations among the constructs was carried out with factor correlations, multiple regressions and path analysis. When the enterprise grows, it is necessary to implement changes in its structure, management practices etc. (organizational development) to meet challenges of growing complexity. In this paper, organizational development was defined as internal changes aiming to improve the quality of existing or to introduce new elements in the areas of processes, organizational structure and culture, operational and management systems. Thus; H1: Growth has positive effects on organizational development. The main thesis of the research is that if organizational development does not catch up　with growing complexity of growing enterprise, growing pains will arise (lower work comfort, conflicts, lack of control etc.). They will exert a negative influence on the financial performance and may result in serious organizational crisis or even bankruptcy. Thus; H2: Growth has positive effects on growing pains, H3: Organizational development has negative effects on growing pains, H4: Growing pains have negative effects on financial performance, H5: Organizational development has positive effects on financial performance. Scholars considered long lists of factors having potential influence on organizational development. The development of comprehensive model taking into account all possible variables may be beyond the capacity of any researcher or even statistical software used. After literature review, it was decided to increase the level of abstraction and to include following constructs in the conceptual model: organizational learning (OL), positive organization (PO) and high performance factors (HPF). H1a/b/c: OL/PO/HPF has positive effect on organizational development, H2a/b/c: OL/PO/HPF has negative effect on growing pains. The results of hypothesis testing: H1: partly supported, H1a/b/c: supported/not supported/supported, H2: not supported, H2a/b/c: not supported/partly supported/not supported, H3: supported, H4: partly supported, H5: supported. The research seems to be of a great value for both scholars and practitioners. It proved that OL and HPO matter for organizational development. Scales for measuring organizational development and growing pains were developed. Its main finding, though, is that organizational development is a good way of improving financial performance.

Keywords: organizational development, growth, growing pains, financial performance

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Authors: Amy Buckley

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The purpose of this article is to assess the problem of constitutional hyper-rigidity to consider how it and the associated tensions with democratic constitutionalism can be diminished by means of using digital democratic technologies. In other words, this article examines how digital technologies can assist us in ensuring fidelity to the will of the constituent power without paying the price of hyper-rigidity. In doing so, it is impossible to ignore that digital strategies can also harm democracy through, for example, manipulation, hacking, ‘fake news,’ and the like. This article considers the tension between constitutional hyper-rigidity and democratic constitutionalism and the relevant strengths and weaknesses of digital democratic strategies before undertaking a case study on Canadian e-consultations and drawing its conclusions. This article observes democratic constitutionalism through the lens of the theory of deliberative democracy to suggest that the application of digital strategies can, notwithstanding their pitfalls, improve a constituency’s amendment culture and, thus, diminish constitutional hyper-rigidity. Constitutional hyper-rigidity is not a new or underexplored concept. At a high level, a constitution can be said to be ‘hyper-rigid’ when its formal amendment procedure is so difficult to enact that it does not take place or is limited in its application. This article claims that hyper-rigidity is one problem with ordinary constitutionalism that fails to satisfy the principled requirements of democratic constitutionalism. Given the rise and development of technology that has taken place since the Digital Revolution, there has been a significant expansion in the possibility for digital democratic strategies to overcome the democratic constitutionalism failures resulting from constitutional hyper-rigidity. Typically, these strategies have included, inter alia, e- consultations, e-voting systems, and online polling forums, all of which significantly improve the ability of politicians and judges to directly obtain the opinion of constituents on any number of matters. This article expands on the application of these strategies through its Canadian e-consultation case study and presents them as a solution to poor amendment culture and, consequently, constitutional hyper-rigidity. Hyper-rigidity is a common descriptor of many written and unwritten constitutions, including the United States, Australian, and Canadian constitutions as just some examples. This article undertakes a case study on Canada, in particular, as it is a jurisdiction less commonly cited in academic literature generally concerned with hyper-rigidity and because Canada has to some extent, championed the use of e-consultations. In Part I of this article, I identify the problem, being that the consequence of constitutional hyper-rigidity is in tension with the principles of democratic constitutionalism. In Part II, I identify and explore a potential solution, the implementation of digital democratic strategies as a means of reducing constitutional hyper-rigidity. In Part III, I explore Canada’s e-consultations as a case study for assessing whether digital democratic strategies do, in fact, improve a constituency’s amendment culture thus reducing constitutional hyper-rigidity and the associated tension that arises with the principles of democratic constitutionalism. The idea is to run a case study and then assess whether I can generalise the conclusions.

Keywords: constitutional hyper-rigidity, digital democracy, deliberative democracy, democratic constitutionalism

Procedia PDF Downloads 55

Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald

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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.

Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography

Procedia PDF Downloads 130

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

Procedia PDF Downloads 313

Authors: Lou Gargouri

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This paper examines how Fanny Cabon's solo performance, Gardiennes (2018) strategically crafts empathetic witnessing through the artist's vocal and physical embodiment of her female ancestors' testimonies, dramatizing the cyclical inheritance of reproductive trauma across generations. Drawing on affect theory and the concept of ethical co-presence, we argue that Cabon's raw voicing of illegal abortions, miscarriages, and abuse through her shape-shifting presence generates an intimate energy loop with the audience. This affective resonance catalyzes recognition of historical injustices, consecrating each singular experience while building collective solidarity. Central to Cabon's political efficacy is her transparent self-revelation through intimate impersonation, which fosters identification with diverse characters as interconnected subjects rather than objectified others. Her solo form transforms the isolation often associated with women's marginalization into radical inclusion, repositioning them from victims to empowered survivors. Comparative analysis with other contemporary works addressing abortion rights illuminates how Gardiennes subverts the traditional medical and clerical gazes that have long governed women's bodies. Ultimately, we contend Gardiennes models the potential of solo performance to harness empathy as a subversive political force. Cabon's theatrical alchemy circulates the effects of injustice through the ethical co-presence of performer and spectator, forging intersubjective connections that reframe marginalized groups traditionally objectified within dominant structures of patriarchal power. In dramatizing how the act of witnessing another's trauma can generate solidarity and galvanize resistance, Cabon's work demonstrates the role of embodied performance in catalyzing social change through the recuperation of women's voices and lived experiences. This paper thus aims to contribute to the emerging field of feminist solo performance criticism by illuminating how Cabon's innovative dramaturgy bridges the personal and the political. Her strategic mobilization of intimacy, identification, and co-presence offers a model for how the affective dynamics of autobiographical performance can be harnessed to confront gendered oppression and imagine more equitable futures. Gardiennes invites us to consider how the circulation of empathy through ethical spectatorship can foster the collective alliances necessary for advancing the unfinished project of women's liberation.

Keywords: gender and sexuality studies, solo performance, trauma studies, affect theory

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Authors: Sara Bonetti

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The use of quantitative data to support policies and justify investments has become imperative in many fields including the field of education. However, the topic of data literacy has only marginally touched the early care and education (ECE) field. In California, within the ECE workforce, there is a group of professionals working in policy and advocacy that use quantitative data regularly and whose educational and professional experiences have been neglected by existing research. This study aimed at analyzing these experiences in accessing, using, and producing quantitative data. This study utilized semi-structured interviews to capture the differences in educational and professional backgrounds, policy contexts, and power relations. The participants were three key professionals from county-level organizations and one working at a State Department to allow for a broader perspective at systems level. The study followed Núñez’s multilevel model of intersectionality. The key in Núñez’s model is the intersection of multiple levels of analysis and influence, from the individual to the system level, and the identification of institutional power dynamics that perpetuate the marginalization of certain groups within society. In a similar manner, this study looked at the dynamic interaction of different influences at individual, organizational, and system levels that might intersect and affect ECE professionals’ experiences with quantitative data. At the individual level, an important element identified was the participants’ educational background, as it was possible to observe a relationship between that and their positionality, both with respect to working with data and also with respect to their power within an organization and at the policy table. For example, those with a background in child development were aware of how their formal education failed to train them in the skills that are necessary to work in policy and advocacy, and especially to work with quantitative data, compared to those with a background in administration and/or business. At the organizational level, the interviews showed a connection between the participants’ position within the organization and their organization’s position with respect to others and their degree of access to quantitative data. This in turn affected their sense of empowerment and agency in dealing with data, such as shaping what data is collected and available. These differences reflected on the interviewees’ perceptions and expectations for the ECE workforce. For example, one of the interviewees pointed out that many ECE professionals happen to use data out of the necessity of the moment. This lack of intentionality is a cause for, and at the same time translates into missed training opportunities. Another interviewee pointed out issues related to the professionalism of the ECE workforce by remarking the inadequacy of ECE students’ training in working with data. In conclusion, Núñez’s model helped understand the different elements that affect ECE professionals’ experiences with quantitative data. In particular, what was clear is that these professionals are not being provided with the necessary support and that we are not being intentional in creating data literacy skills for them, despite what is asked of them and their work.

Keywords: data literacy, early childhood professionals, intersectionality, quantitative data

Procedia PDF Downloads 236

Authors: Rainner Roweder

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Theme: The present paper aims to analyze the specificity of the judicial evidence linked to the subjects of dignity and personality rights, otherwise known as moral rights, in the determination of the truth and formation of the judicial reasoning in cases concerning these areas. This research is about the way courts in Brazilian domestic law search for truth and handles evidence in cases involving moral rights that are abundant and important in Brazil. The main object of the paper is to analyze the effectiveness of the evidence in the formation of judicial conviction in matters related to morally controverted rights, based on the Brazilian, and as a comparison, the Latin American legal systems. In short, the rights of dignity and personality are moral. However, the evidential legal system expects a rational demonstration of moral rights that generate judicial conviction or persuasion. Moral, in turn, tends to be difficult or impossible to demonstrate in court, generating the problem considered in this paper, that is, the study of the moral demonstration problem as proof in court. In this sense, the more linked to moral, the more difficult to be demonstrated in court that right is, expanding the field of judicial discretion, generating legal uncertainty. More specifically, the new personality rights, such as gender, and their possibility of alteration, further amplify the problem being essentially an intimate manner, which does not exist in the objective, rational evidential system, as normally occurs in other categories, such as contracts. Therefore, evidencing this legal category in court, with the level of security required by the law, is a herculean task. It becomes virtually impossible to use the same evidentiary system when judging the rights researched here; therefore, it generates the need for a new design of the evidential task regarding the rights of the personality, a central effort of the present paper. Methodology: Concerning the methodology, the Method used in the Investigation phase was Inductive, with the use of the comparative law method; in the data treatment phase, the Inductive Method was also used. Doctrine, Legislative, and jurisprudential comparison was the technique research used. Results: In addition to the peculiar characteristics of personality rights that are not found in other rights, part of them are essentially linked to morale and are not objectively verifiable by design, and it is necessary to use specific argumentative theories for their secure confirmation, such as interdisciplinary support. The traditional pragmatic theory of proof, for having an obvious objective character, when applied in the rights linked to the morale, aggravates decisionism and generates legal insecurity, being necessary its reconstruction for morally charged cases, with the possible use of the “predictive theory” ( and predictive facts) through algorithms in data collection and treatment.

Keywords: moral rights, proof, pragmatic proof theory, insufficiency, Brazil

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Authors: Michelle Rippy

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Medicolegal death investigation historically is a field that does not receive much research attention or advancement, as all of the subjects are deceased. Public health threats, drug epidemics and contagious diseases are typically recognized in decedents first, with thorough and accurate death investigations able to assist in epidemiology research and prevention programs. One vital component of medicolegal death investigation is determining the decedent’s time of death. An accurate time of death can assist in corroborating alibies, determining sequence of death in multiple casualty circumstances and provide vital facts in civil situations. Popular television portrays an unrealistic forensic ability to provide the exact time of death to the minute for someone found deceased with no witnesses present. The actuality of unattended decedent time of death determination can generally only be narrowed to a 4-6 hour window. In the mid- to late-20th century, liver temperatures were an invasive action taken by death investigators to determine the decedent’s core temperature. The core temperature was programmed into an equation to determine an approximate time of death. Due to many inconsistencies with the placement of the thermometer and other variables, the accuracy of the liver temperatures was dispelled and this once common place action lost scientific support. Currently, medicolegal death investigators utilize three major after death or post-mortem changes at a death scene. Many factors are considered in the subjective determination as to the time of death, including the cooling of the decedent, stiffness of the muscles, release of blood internally, clothing, ambient temperature, disease and recent exercise. Current research is utilizing non-invasive hospital grade tympanic thermometers to measure the temperature in the each of the decedent’s ears. This tool can be used at the scene and in conjunction with scene indicators may provide a more accurate time of death. The research is significant and important to investigations and can provide an area of accuracy to a historically inaccurate area, considerably improving criminal and civil death investigations. The goal of the research is to provide a scientific basis to unwitnessed deaths, instead of the art that the determination currently is. The research is currently in progress with expected termination in December 2018. There are currently 15 completed case studies with vital information including the ambient temperature, decedent height/weight/sex/age, layers of clothing, found position, if medical intervention occurred and if the death was witnessed. This data will be analyzed with the multiple variables studied and available for presentation in January 2019.

Keywords: algor mortis, forensic pathology, investigations, medicolegal, time of death, tympanic

Procedia PDF Downloads 103

Authors: Elena E. Lyakso, Olga V. Frolova, Yuri N. Matveev, Aleksey S. Grigorev, Alexander S. Nikolaev, Viktor A. Gorodnyi

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The study of the children’s emotional sphere depending on age and psychoneurological state is of great importance for the design of educational programs for children and their social adaptation. Atypical development may be accompanied by violations or specificities of the emotional sphere. To study characteristics of the emotional state reflection in the voice and speech features of children, the perceptual study with the participation of adults and the automatic recognition of speech were conducted. Speech of children with typical development (TD), with Down syndrome (DS), and with autism spectrum disorders (ASD) aged 6-12 years was recorded. To obtain emotional speech in children, model situations were created, including a dialogue between the child and the experimenter containing questions that can cause various emotional states in the child and playing with a standard set of toys. The questions and toys were selected, taking into account the child’s age, developmental characteristics, and speech skills. For the perceptual experiment by adults, test sequences containing speech material of 30 children: TD, DS, and ASD were created. The listeners were 100 adults (age 19.3 ± 2.3 years). The listeners were tasked with determining the children’s emotional state as “comfort – neutral – discomfort” while listening to the test material. Spectrographic analysis of speech signals was conducted. For automatic recognition of the emotional state, 6594 speech files containing speech material of children were prepared. Automatic recognition of three states, “comfort – neutral – discomfort,” was performed using automatically extracted from the set of acoustic features - the Geneva Minimalistic Acoustic Parameter Set (GeMAPS) and the extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS). The results showed that the emotional state is worse determined by the speech of TD children (comfort – 58% of correct answers, discomfort – 56%). Listeners better recognized discomfort in children with ASD and DS (78% of answers) than comfort (70% and 67%, respectively, for children with DS and ASD). The neutral state is better recognized by the speech of children with ASD (67%) than by the speech of children with DS (52%) and TD children (54%). According to the automatic recognition data using the acoustic feature set GeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.687; children with DS – 0.725; TD children – 0.641. When using the acoustic feature set eGeMAPSv01b, the accuracy of automatic recognition of emotional states for children with ASD is 0.671; children with DS – 0.717; TD children – 0.631. The use of different models showed similar results, with better recognition of emotional states by the speech of children with DS than by the speech of children with ASD. The state of comfort is automatically determined better by the speech of TD children (precision – 0.546) and children with ASD (0.523), discomfort – children with DS (0.504). The data on the specificities of recognition by adults of the children’s emotional state by their speech may be used in recruitment for working with children with atypical development. Automatic recognition data can be used to create alternative communication systems and automatic human-computer interfaces for social-emotional learning. Acknowledgment: This work was financially supported by the Russian Science Foundation (project 18-18-00063).

Keywords: autism spectrum disorders, automatic recognition of speech, child’s emotional speech, Down syndrome, perceptual experiment

Procedia PDF Downloads 172

Authors: Joe Kallas

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It is now widely accepted that the preservation of cultural heritage must go beyond simple restoration and renovation actions. While some historic monuments have been preserved for millennia, many of them, less important or simply neglected because of lack of money, have disappeared. As a result, the adaptation of monuments and archaeological sites to new functions allow them to 'survive'. Temporary activities or 'ephemeral' re-use, are increasingly recognized as a means of vitalization of deprived areas and enhancement of historic sites that became obsolete. They have the potential to increase economic and cultural value while making the best use of existing resources. However, there are often conservation and preservation issues related to the implementation of this type of re-use, which can also threaten the integrity and authenticity of archaeological sites and monuments if they have not been properly managed. This paper aims to get a better knowledge of the ephemeral re-use of heritage, and more specifically the subject of the incorporation of the festival phenomenon within the monuments and archaeological sites in Lebanon, a topic that is not yet studied enough. This paper tried to determine the elements that compose it, in order to analyze this phenomenon and to trace its good practices, by comparing international study cases to important national cases: the International Festival of Baalbek, the International Festival of Byblos and the International Festival of Beiteddine. Various factors have been studied and analyzed in order to best respond to the main problematic of this paper: 'How can we preserve the integrity of sites and monuments after the integration of an ephemeral function? And what are the preventive conservation measures to be taken when holding festivals in archaeological sites with fragile structures?' The impacts of the technical problems were first analyzed using various data and more particularly the effects of mass tourism, the integration of temporary installations, sound vibrations, the effects of unstudied lighting, until the mystification of heritage. Unfortunately, the DGA (General Direction of Antiquities in Lebanon) does not specify any frequency limit for the sound vibrations emitted by the speakers during musical festivals. In addition, there is no requirement from its part regarding the installations of the lighting systems in the historic monuments and no monitoring is done in situ, due to the lack of awareness of the impact that could be generated by such interventions, and due to the lack of materials and tools needed for the monitoring process. The study and analysis of the various data mentioned above led us to the elaboration of the main objective of this paper, which is the establishment of a list of recommendations. This list enables to define various preventive conservation measures to be taken during the holding of the festivals within the cultural heritage sites in Lebanon. We strongly hope that this paper will be an awareness document to start taking into consideration several factors previously neglected, in order to improve the conservation practices in the archaeological sites and monuments during the incorporation of the festival phenomenon.

Keywords: archaeology, authenticity, conservation, cultural heritage, festival, historic sites, integrity, monuments, tourism

Procedia PDF Downloads 106

Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

Procedia PDF Downloads 98

Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

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Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

Procedia PDF Downloads 58

Authors: Felicia Orah Rein Moshe

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Soil erosion has become a priority global concern, impairing water quality and degrading ecosystem services. In Mediterranean climates, following a long dry period, the onset of rain occurs when agricultural soils are often bare and most vulnerable to erosion. Early storms transport sediments and sediment-bound pollutants into streams, along with dissolved chemicals. This results in loss of valuable topsoil, water quality degradation, and potentially expensive dredged-material disposal costs. Information on the provenance of fine sediment and priority sources of adsorbed pollutants represents a critical need for developing effective control strategies aimed at source reduction. Modifying sediment traps designed for marine systems, this study tested a cost-effective method to collect suspended sediments on a catchment scale to characterize stream water quality during first-flush storm events in a flashy Eastern Mediterranean coastal perennial stream. This study investigated the Kishon Basin, deploying sediment traps in 23 locations, including 4 in the mainstream and one downstream in each of 19 tributaries, enabling the characterization of sediment as a vehicle for transporting chemicals. Further, it enabled direct comparison of sediment-bound pollutants transported during the first-flush winter storms of 2020 from each of 19 tributaries, allowing subsequent ecotoxicity ranking. Sediment samples were successfully captured in 22 locations. Pesticides, pharmaceuticals, nutrients, and metal concentrations were quantified, identifying a total of 50 pesticides, 15 pharmaceuticals, and 22 metals, with 16 pesticides and 3 pharmaceuticals found in all 23 locations, demonstrating the importance of this transport pathway. Heavy metals were detected in only one tributary, identifying an important watershed pollution source with immediate potential influence on long-term dredging costs. Simultaneous sediment sampling at first flush storms enabled clear identification of priority tributaries and their chemical contributions, advancing a new national watershed monitoring approach, facilitating strategic plan development based on source reduction, and advancing the goal of improving the farm-stream interface, conserving soil resources, and protecting water quality.

Keywords: adsorbed pollution, dredged material, heavy metals, suspended sediment, water quality monitoring

Procedia PDF Downloads 91

Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Mohsen Hababalahi, Morteza Bastami

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Buried pipeline damage correlations are critical part of loss estimation procedures applied to lifelines for future earthquakes. The vulnerability of buried pipelines against earthquake and liquefaction has been observed during some of previous earthquakes and there are a lot of comprehensive reports about this event. One of the main reasons for impairment of buried pipelines during earthquake is liquefaction. Necessary conditions for this phenomenon are loose sandy soil, saturation of soil layer and earthquake intensity. Because of this fact that pipelines structure are very different from other structures (being long and having light mass) by paying attention to the results of previous earthquakes and compare them with other structures, it is obvious that the danger of liquefaction for buried pipelines is not high risked, unless effective parameters like earthquake intensity and non-dense soil and other factors be high. Recent liquefaction researches for buried pipeline include experimental and theoretical ones as well as damage investigations during actual earthquakes. The damage investigations have revealed that a damage ratio of pipelines (Number/km ) has much larger values in liquefied grounds compared with one in shaking grounds without liquefaction according to damage statistics during past severe earthquakes, and that damages of joints and pipelines connected with manholes were remarkable. The purpose of this research is numerical study of buried pipelines under the effect of liquefaction by case study of the 2013 Dashti (Iran) earthquake. Water supply and electrical distribution systems of this township interrupted during earthquake and water transmission pipelines were damaged severely due to occurrence of liquefaction. The model consists of a polyethylene pipeline with 100 meters length and 0.8 meter diameter which is covered by light sandy soil and the depth of burial is 2.5 meters from surface. Since finite element method is used relatively successfully in order to solve geotechnical problems, we used this method for numerical analysis. For evaluating this case, some information like geotechnical information, classification of earthquakes levels, determining the effective parameters in probability of liquefaction, three dimensional numerical finite element modeling of interaction between soil and pipelines are necessary. The results of this study on buried pipelines indicate that the effect of liquefaction is function of pipe diameter, type of soil, and peak ground acceleration. There is a clear increase in percentage of damage with increasing the liquefaction severity. The results indicate that although in this form of the analysis, the damage is always associated to a certain pipe material, but the nominally defined “failures” include by failures of particular components (joints, connections, fire hydrant details, crossovers, laterals) rather than material failures. At the end, there are some retrofit suggestions in order to decrease the risk of liquefaction on buried pipelines.

Keywords: liquefaction, buried pipelines, lifelines, earthquake, finite element method

Procedia PDF Downloads 497

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

Abstract:

Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Tomas Makaras, Gintaras Svecevičius

Abstract:

Landfill waste is a common problem as it has an economic and environmental impact even if it is closed. Landfill waste contains a high density of various persistent compounds such as heavy metals, organic and inorganic materials. As persistent compounds are slowly-degradable or even non-degradable in the environment, they often produce sublethal or even lethal effects on aquatic organisms. The aims of the present study were to estimate sublethal effects of the Kairiai landfill (WGS: 55°55‘46.74“, 23°23‘28.4“) leachate on the locomotor activity of rainbow trout Oncorhynchus mykiss juveniles using the original system package developed in our laboratory for automated monitoring, recording and analysis of aquatic organisms’ activity, and to determine patterns of fish behavioral response to sublethal effects of leachate. Four different concentrations of leachate were chosen: 0.125; 0.25; 0.5 and 1.0 mL/L (0.0025; 0.005; 0.01 and 0.002 as part of 96-hour LC50, respectively). Locomotor activity was measured after 5, 10 and 30 minutes of exposure during 1-minute test-periods of each fish (7 fish per treatment). The threshold-effect-concentration amounted to 0.18 mL/L (0.0036 parts of 96-hour LC50). This concentration was found to be even 2.8-fold lower than the concentration generally assumed to be “safe” for fish. At higher concentrations, the landfill leachate solution elicited behavioral response of test fish to sublethal levels of pollutants. The ability of the rainbow trout to detect and avoid contaminants occurred after 5 minutes of exposure. The intensity of locomotor activity reached a peak within 10 minutes, evidently decreasing after 30 minutes. This could be explained by the physiological and biochemical adaptation of fish to altered environmental conditions. It has been established that the locomotor activity of juvenile trout depends on leachate concentration and exposure duration. Modeling of these parameters showed that the activity of juveniles increased at higher leachate concentrations, but slightly decreased with the increasing exposure duration. Experiment results confirm that the behavior of rainbow trout juveniles is a sensitive and rapid biomarker that can be used in combination with the system for fish behavior monitoring, registration and analysis to determine sublethal concentrations of pollutants in ambient water. Further research should be focused on software improvement aimed to include more parameters of aquatic organisms’ behavior and to investigate the most rapid and appropriate behavioral responses in different species. In practice, this study could be the basis for the development and creation of biological early-warning systems (BEWS).

Keywords: fish behavior biomarker, landfill leachate, locomotor activity, rainbow trout juveniles, sublethal effects

Procedia PDF Downloads 254

Authors: Douglas N. Simoes, Michele Pittol, Vanda F. Ribeiro, Daiane Tomacheski, Ruth M. C. Santana

Abstract:

Thermoplastic elastomers (TPE) compounds are used in a wide range of applications, like home appliances, automotive components, medical devices, footwear, and others. These materials are susceptible to microbial attack, causing a crack in polymer chains compounds based on SEBS copolymers, poly (styrene-b-(ethylene-co-butylene)-b-styrene, are a class of TPE, largely used in domestic appliances like refrigerator seals (gaskets), bath mats and sink squeegee. Moisture present in some areas (such as shower area and sink) in addition to organic matter provides favorable conditions for microbial survival and proliferation, contributing to the spread of diseases besides the reduction of product life cycle due the biodegradation process. Zinc oxide (ZnO) has been studied as an alternative antibacterial additive due its biocidal effect. It is important to know the influence of these additives in the properties of the compounds, both at the beginning and during the life cycle. In that sense, the aim of this study was to evaluate the effect of accelerated aging in oven on antibacterial and mechanical properties of ZnO loaded SEBS based TPE compounds. Two different comercial zinc oxide, named as WR and Pe were used in proportion of 1%. A compound with no antimicrobial additive (standard) was also tested. The compounds were prepared using a co-rotating double screw extruder (L/D ratio of 40/1 and 16 mm screw diameter). The extrusion parameters were kept constant for all materials, screw rotation rate was set at 226 rpm, with a temperature profile from 150 to 190 ºC. Test specimens were prepared using the injection molding machine at 190 ºC. The Standard Test Method for Rubber Property—Effect of Liquids was applied in order to simulate the exposition of TPE samples to detergent ingredients during service. For this purpose, ZnO loaded TPE samples were immersed in a 3.0% w/v detergent (neutral) and accelerated aging in oven at 70°C for 7 days. Compounds were characterized by changes in mechanical (hardness and tension properties) and mass. The Japan Industrial Standard (JIS) Z 2801:2010 was applied to evaluate antibacterial properties against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The microbiological tests showed a reduction up to 42% in E. coli and up to 49% in S. aureus population in non-aged samples. There were observed variations in elongation and hardness values with the addition of zinc The changes in tensile at rupture and mass were not significant between non-aged and aged samples.

Keywords: antimicrobial, domestic appliance, sebs, zinc oxide

Procedia PDF Downloads 235