Search results for: physical quality

Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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Authors: Mathilde Kirkegaard

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The paper will focus on management of heritage that integrates the local community, and argue towards an obligation to integrate this social aspect in heritage management. By broadening the understanding of heritage, a sustainable heritage management takes its departure in more than a continual conservation of the physicality of heritage. The social aspect, or the local community, is in many govern heritage management situations being overlooked and it is not managed through community based urban planning methods, e.g.: citizen-inclusion, a transparent process, informative and inviting initiatives, etc. Historical sites are often being described by embracing terms such as “ours” and “us”: “our history” and “a history that is part of us”. Heritage is not something static, it is a link between the life that has been lived in the historical frames, and the life that is defining it today. This view on heritage is rooted in the strive to ensure that heritage sites, besides securing the national historical interest, have a value for those people who are affected by it: living in it or visiting it. Antigua Guatemala is a UNESCO-defined heritage site and this site is being ‘threatened’ by tourism, habitation and recreation. In other words: ‘the use’ of the site is considered a threat of the preservation of the heritage. Contradictory the same types of use (tourism and habitation) can also be considered development ability, and perhaps even a sustainable management solution. ‘The use’ of heritage is interlinked with the perspective that heritage sites ought to have a value for people today. In other words, the heritage sites should be comprised of a contemporary substance. Heritage is entwined in its context of physical structures and the social layer. A synergy between the use of heritage and the knowledge about the heritage can generate a sustainable preservation solution. The paper will exemplify this symbiosis with different examples of a heritage management that is centred around a local community inclusion. The inclusive method is not new in architectural planning and it refers to a top-down and bottom-up balance in decision making. It can be endeavoured through designs of an inclusive nature. Catalyst architecture is a planning method that strives to move the process of design solutions into the public space. Through process-orientated designs, or catalyst designs, the community can gain an insight into the process or be invited to participate in the process. A balance between bottom-up and top-down in the development process of a heritage site can, in relation to management measures, be understood to generate a socially sustainable solution. The ownership and engagement that can be created among the local community, along with the use that ultimately can gain an economic benefit, can delegate the maintenance and preservation. Informative, inclusive and transparent planning methods can generate a heritage management that is long-term due to the collective understanding and effort. This method handles sustainable management on two levels: the current preservation necessities and the long-term management, while ensuring a value for people today.

Keywords: community, intangible, inclusion, planning

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Authors: Hamada Ahmed, Mervat A. Abdel-Latif, Alaa. A. Ghoraba, Samah A. Ganna

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An experiment was conducted to determine the effect of microbial phytase (Quantum Blue®) supplementation on layer chickens fed diets with required or low phosphorous level in corn-soybean based diets. One hundred and sixteen 23-week-old Lohman brown laying hens were used in 8-week feeding trial. Hens were randomly allotted into four treatments where the group (1) (control group) was fed basal diet without phytase, group (2) fed basal diet supplemented with phytase, group (3) fed diet supplemented with phytase as a replacement of 25% of monocalcium phosphate and group (4) fed diet supplemented with phytase as a replacement of 50% of monocalcium phosphate. Records on daily egg production, egg mass, egg weight and body weight of hens at the end of experimental period were recorded. Results revealed no significant (p ≥ 0.05) differences were observed among the other dietary treatments in BW, egg production, egg mass, feed intake or feed conversion when these parameters were evaluated over the duration of the experiment while egg weight showed significant (p < 0.05) increase in all phytase supplemented groups. There was no significant (p ≥ 0.05) differences in egg quality including egg length, egg width, egg shape index, yolk height, yolk width, yolk index, yolk weight and yolk albumin ratio while egg albumin was significantly increased (p < 0.05) in group (2) and group (3). Egg shell weight increased significantly (p < 0.05) in all phytase supplemented groups when compared with the control group also shell thickness increased significantly (p < 0.05) in both group (2 &3). No significant (P ≥ 0.05) difference was observed in serum Ca, P level while alkaline phosphatase was significantly (P ˂ 0.05) increased in group (3). Egg shell analysis showed increase in egg shell ash% in all phytase supplemented groups when compared with the control group, egg shell calcium % was higher in group (3) and group (4) than the control group while group (2) showed lower egg shell calcium% than the other experimental groups, egg shell phosphorous% was higher in all phytase supplemented groups than the control group. Phosphorous digestability was significantly (P ˂ 0.05) increased in all phytase supplemented groups than the control group and the highest p digestability was in group (4). Calcium digestability showed significant (P ˂ 0.05) increase in all phytase supplemented groups when compared with the control group and the highest digetability was in group (4).

Keywords: layers, microbial phytase, Ca and P availability, egg production, egg characteristics

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Authors: Rosa S. Wong, Keith T. S. Tung, Frederick K. Ho, Winnie W. Y. Tso, King-wa Fu, Nirmala Rao, Patrick Ip

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As technology advances, exposures in early childhood are no longer confined to stimulations in the surrounding physical environments. Children nowadays are also subject to influences from the digital world. In particular, early access to game consoles can cause risks to child development, especially when the game is not developmentally appropriate for young children. Overstimulation is possible and could impair brain development. On the other hand, recreational parent-child activities, including outdoor activities and visits to museums, require child interaction with parents, which is beneficial for developing adaptive emotion regulation and social skills. Given the differences between these two types of exposures, this study investigated and compared the independent effects of early exposure to a game console and early play-based parent-child activities on children’s long-term psychosocial outcomes. This study used data from a subset of children (n=304, 142 male and 162 female) in the longitudinal cohort study, which studied the long-term impact of family socioeconomic status on child development. In 2012/13, we recruited a group of children at Kindergarten 3 (K3) randomly from Hong Kong local kindergartens and collected data regarding their duration of exposure to game console and recreational parent-child activities at that time. In 2018/19, we re-surveyed the parents of these children who were matriculated as Form 1 (F1) students (ages ranging from 11 to 13 years) in secondary schools and asked the parents to rate their children’s psychosocial problems in F1. Linear regressions were conducted to examine the associations between early exposures and adolescent psychosocial problems with and without adjustment for child gender and K3 family socioeconomic status. On average, K3 children spent about 42 minutes on a game console every day and had 2-3 recreational activities with their parents every week. Univariate analyses showed that more time spent on game consoles at K3 was associated with more psychosocial difficulties in F1 particularly more externalizing problems. The effect of early exposure to game console on externalizing behavior remained significant (B=0.59, 95%CI: 0.15 to 1.03, p=0.009) after adjusting for recreational parent-child activities and child gender. For recreational parent-child activities at K3, its effect on overall psychosocial difficulties became insignificant after adjusting for early exposure to game consoles and child gender. However, it was found to have significant protective effect on externalizing problems (B=-0.65, 95%CI: -1.23 to -0.07, p=0.028) even after adjusting for the confounders. Early exposure to game consoles has negative impact on children’s psychosocial health, whereas play-based parent-child activities can foster positive psychosocial outcomes. More efforts should be directed to propagate the risks and benefits of these activities and urge the parents and caregivers to replace child-alone screen time with parent-child play time in daily routine.

Keywords: early childhood, electronic device, parenting, psychosocial wellbeing

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Authors: Lukasz Szymanski, Zbigniew Kolacinski, Grzegorz Raniszewski, Slawomir Wiak, Lukasz Pietrzak, Dariusz Koza, Karolina Przybylowska-Sygut, Ireneusz Majsterek, Zbigniew Kaminski, Justyna Fraczyk, Malgorzata Walczak, Beata Kolasinska, Adam Bednarek, Joanna Konka

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The aim of this work is to investigate the influence of electromagnetic field from the range of radio frequencies on the desired nanoparticles for cancer therapy. In the article, the development and demonstration of the method and the model device for hyperthermic selective destruction of cancer cells are presented. This method was based on the synthesis and functionalization of carbon nanotubes serving as ferromagnetic material nanocontainers. The methodology of the production carbon - ferromagnetic nanocontainers (FNCs) includes: The synthesis of carbon nanotubes, chemical, and physical characterization, increasing the content of a ferromagnetic material and biochemical functionalization involving the attachment of the key addresses. The ferromagnetic nanocontainers were synthesised in CVD and microwave plasma system. Biochemical functionalization of ferromagnetic nanocontainers is necessary in order to increase the binding selectively with receptors presented on the surface of tumour cells. Multi-step modification procedure was finally used to attach folic acid on the surface of ferromagnetic nanocontainers. Pristine ferromagnetic carbon nanotubes are not suitable for application in medicine and biotechnology. Appropriate functionalization of ferromagnetic carbon nanotubes allows to receiving materials useful in medicine. Finally, a product contains folic acids on the surface of FNCs. The folic acid is a ligand of folate receptors – α which is overexpressed on the surface of epithelial tumours cells. It is expected that folic acids will be recognized and selectively bound by receptors presented on the surface of tumour cells. In our research, FNCs were covalently functionalized in a multi-step procedure. Ferromagnetic carbon nanotubes were oxidated using different oxidative agents. For this purpose, strong acids such as HNO3, or mixture HNO3 and H2SO4 were used. Reactive carbonyl and carboxyl groups were formed on the open sides and at the defects on the sidewalls of FNCs. These groups allow further modification of FNCs as a reaction of amidation, reaction of introduction appropriate linkers which separate solid surface of FNCs and ligand (folic acid). In our studies, amino acid and peptide have been applied as ligands. The last step of chemical modification was reaction-condensation with folic acid. In all reaction as coupling reagents were used derivatives of 1,3,5-triazine. The first trials in the device for hyperthermal RF generator have been done. The frequency of RF generator was in the ranges from 10 to 14Mhz and from 265 to 621kHz. Obtained functionalized nanoparticles enabled to reach the temperature of denaturation tumor cells in given frequencies.

Keywords: cancer colon cells, carbon nanotubes, hyperthermia, ligands

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Authors: Alena Kulikova, Tatjana Kanonire

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Intelligence research is one of the oldest fields of psychology. Many factors have made a research on intelligence, defined as reasoning and problem solving [1, 2], a very acute and urgent problem. Thus, it has been repeatedly shown that intelligence is a predictor of academic, professional, and social achievement in adulthood (for example, [3]); Moreover, intelligence predicts these achievements better than any other trait or ability [4]. The individual level, a comprehensive assessment of intelligence is a necessary criterion for the diagnosis of various mental conditions. For example, it is a necessary condition for psychological, medical and pedagogical commissions when deciding on educational needs and the most appropriate educational programs for school children. Assessment of intelligence is crucial in clinical psychodiagnostic and needs high-quality intelligence measurement tools. Therefore, it is not surprising that the development of intelligence tests is an essential part of psychological science and practice. Many modern intelligence tests have a long history and have been used for decades, for example, the Stanford-Binet test or the Wechsler test. However, the vast majority of these tests are based on the classic linear test structure, in which all respondents receive all tasks (see, for example, a critical review by [5]). This understanding of the testing procedure is a legacy of the pre-computer era, in which blank testing was the only diagnostic procedure available [6] and has some significant limitations that affect the reliability of the data obtained [7] and increased time costs. Another problem with measuring IQ is that classical line-structured tests do not fully allow to measure respondent's intellectual progress [8], which is undoubtedly a critical limitation. Advances in modern psychometrics allow for avoiding the limitations of existing tools. However, as in any rapidly developing industry, at the moment, psychometrics does not offer ready-made and straightforward solutions and requires additional research. In our presentation we would like to discuss the strengths and weaknesses of the current approaches to intelligence measurement and highlight “points of growth” for creating a test in accordance with modern psychometrics. Whether it is possible to create the instrument that will use all achievements of modern psychometric and remain valid and practically oriented. What would be the possible limitations for such an instrument? The theoretical framework and study design to create and validate the original Russian comprehensive computer test for measuring the intellectual development in school-age children will be presented.

Keywords: Intelligence, psychometrics, psychological measurement, computerized adaptive testing, multistage testing

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Authors: Tayyab Ahmad, Gerard Healey

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Sustainability in built environment sector is subject to many development constraints. Building projects are developed under different requirements of deliverables which makes each project unique. For an owner organization, i.e., a higher-education institution, involved in a significant building stock, it is important to prioritize some of the sustainability initiatives over the others in order to align the sustainable building development with organizational goals. The point-based green building rating tools i.e. Green Star, LEED, BREEAM are becoming increasingly popular and are well-acknowledged worldwide for verifying a sustainable development. It is imperative to synthesize a multi-criteria decision-making tool that can capitalize on the point-based methodology of rating systems while customizing the sustainable development of building projects according to the individual requirements and constraints of the client organization. A multi-criteria decision-making tool for the University of Melbourne is developed that builds on the action-learning and experience of implementing Green Buildings at the University of Melbourne. The tool evaluates the different sustainable building initiatives based on the framework of Green Star rating tool of Green Building Council of Australia. For each different sustainability initiative the decision-making tool makes an assessment based on at least five performance criteria including the ease with which a sustainability initiative can be achieved and the potential of a sustainability initiative to enhance project objectives, reduce life-cycle costs, enhance University’s reputation, and increase the confidence in quality construction. The use of a weighted aggregation mathematical model in the proposed tool can have a considerable role in the decision-making process of a Green Building project by indexing the Green Building initiatives in terms of organizational priorities. The index value of each initiative will be based on its alignment with some of the key performance criteria. The usefulness of the decision-making tool is validated by conducting structured interviews with some of the key stakeholders involved in the development of sustainable building projects at the University of Melbourne. The proposed tool is realized to help a client organization in deciding that within limited resources which sustainability initiatives and practices are more important to be pursued than others.

Keywords: higher education institution, multi-criteria decision-making tool, organizational values, prioritizing sustainability initiatives, weighted aggregation model

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Authors: Riya Bose, Ashok Bera, Manas R. Parida, Anirudhha Adhikari, Basamat S. Shaheen, Erkki Alarousu, Jingya Sun, Tom Wu, Osman M. Bakr, Omar F. Mohammed

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This work reports visualization of charge carrier dynamics on the surface of copper indium gallium selenide (CIGSe) nanocrystals in real space and time using four-dimensional scanning ultrafast electron microscopy (4D S-UEM) and correlates it with the optoelectronic properties of the nanocrystals. The surface of the nanocrystals plays a key role in controlling their applicability for light emitting and light harvesting purposes. Typically for quaternary systems like CIGSe, which have many desirable attributes to be used for optoelectronic applications, relative abundance of surface trap states acting as non-radiative recombination centre for charge carriers remains as a major bottleneck preventing further advancements and commercial exploitation of these nanocrystals devices. Though ultrafast spectroscopic techniques allow determining the presence of picosecond carrier trapping channels, because of relative larger penetration depth of the laser beam, only information mainly from the bulk of the nanocrystals is obtained. Selective mapping of such ultrafast dynamical processes on the surfaces of nanocrystals remains as a key challenge, so far out of reach of purely optical probing time-resolved laser techniques. In S-UEM, the optical pulse generated from a femtosecond (fs) laser system is used to generate electron packets from the tip of the scanning electron microscope, instead of the continuous electron beam used in the conventional setup. This pulse is synchronized with another optical excitation pulse that initiates carrier dynamics in the sample. The principle of S-UEM is to detect the secondary electrons (SEs) generated in the sample, which is emitted from the first few nanometers of the top surface. Constructed at different time delays between the optical and electron pulses, these SE images give direct and precise information about the carrier dynamics on the surface of the material of interest. In this work, we report selective mapping of surface dynamics in real space and time of CIGSe nanocrystals applying 4D S-UEM. We show that the trap states can be considerably passivated by ZnS shelling of the nanocrystals, and the carrier dynamics can be significantly slowed down. We also compared and discussed the S-UEM kinetics with the carrier dynamics obtained from conventional ultrafast time-resolved techniques. Additionally, a direct effect of the state trap removal can be observed in the enhanced photoresponse of the nanocrystals after shelling. Direct observation of surface dynamics will not only provide a profound understanding of the photo-physical mechanisms on nanocrystals’ surfaces but also enable to unlock their full potential for light emitting and harvesting applications.

Keywords: 4D scanning ultrafast microscopy, charge carrier dynamics, nanocrystals, optoelectronics, surface passivation, trap states

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Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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Authors: Carolina Silva Ansélmo

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Airports are demand-generating poles that affect the flow of traffic around them. The airport access system must be fast, convenient, and adequately planned, considering its potential users. An airport with good ground access conditions can provide the user with a more satisfactory access experience. When several transport options are available, service providers must understand users' preferences and the expected quality of service. The present study focuses on airport access in a comparative scenario between bus, private vehicle, subway, taxi and urban mobility transport applications to São Paulo/Guarulhos International Airport. The objectives are (i) to identify the factors that influence the choice, (ii) to measure Willingness to Pay (WTP), and (iii) to estimate the market share for each modal. The applied method was Adaptive Choice-based Conjoint Analysis (ACBC) technique using Sawtooth Software. Conjoint analysis, rooted in Utility Theory, is a survey technique that quantifies the customer's perceived utility when choosing alternatives. Assessing user preferences provides insights into their priorities for product or service attributes. An additional advantage of conjoint analysis is its requirement for a smaller sample size compared to other methods. Furthermore, ACBC provides valuable insights into consumers' preferences, willingness to pay, and market dynamics, aiding strategic decision-making to provide a better customer experience, pricing, and market segmentation. In the present research, the ACBC questionnaire had the following variables: (i) access time to the boarding point, (ii) comfort in the vehicle, (iii) number of travelers together, (iv) price, (v) supply power, and (vi) type of vehicle. The case study questionnaire reached 213 valid responses considering the scenario of access from the São Paulo city center to São Paulo/Guarulhos International Airport. As a result, the price and the number of travelers are the most relevant attributes for the sample when choosing airport access. The market share of the selection is mainly urban mobility transport applications, followed by buses, private vehicles, taxis and subways.

Keywords: adaptive choice-based conjoint analysis, ground access to airport, market share, willingness to pay

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Authors: Shaurya Chauhan, Sagar Gupta

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Prominent urbanizing centres across the globe like Delhi, Dhaka, or Manila have exhibited that development often faces a challenge in bridging the gap among the top-down collective requirements of the city and the bottom-up individual aspirations of the ever-diversifying population. When this exclusion is intertwined with rapid urbanization and diversifying urban demography: unplanned sprawl, poor planning, and low-density development emerge as automated responses. In parallel, new ideas and methods of densification and public participation are being widely adopted as sustainable alternatives for the future of urban development. This research advocates a collaborative design method for future development: one that allows rapid application with its prototypical nature and an inclusive approach with mediation between the 'user' and the 'urban', purely with the use of empirical tools. Building upon the concepts and principles of 'open-sourcing' in design, the research establishes a design framework that serves the current user requirements while allowing for future citizen-driven modifications. This is synthesized as a 3-tiered model: user needs – design ideology – adaptive details. The research culminates into a context-responsive 'open source project development framework' (hereinafter, referred to as OSPDF) that can be used for on-ground field applications. To bring forward specifics, the research looks at a 300-acre redevelopment in the core of a rapidly urbanizing city as a case encompassing extreme physical, demographic, and economic diversity. The suggestive measures also integrate the region’s cultural identity and social character with the diverse citizen aspirations, using architecture and urban design tools, and references from recognized literature. This framework, based on a vision – feedback – execution loop, is used for hypothetical development at the five prevalent scales in design: master planning, urban design, architecture, tectonics, and modularity, in a chronological manner. At each of these scales, the possible approaches and avenues for open- sourcing are identified and validated, through hit-and-trial, and subsequently recorded. The research attempts to re-calibrate the architectural design process and make it more responsive and people-centric. Analytical tools such as Space, Event, and Movement by Bernard Tschumi and Five-Point Mental Map by Kevin Lynch, among others, are deep rooted in the research process. Over the five-part OSPDF, a two-part subsidiary process is also suggested after each cycle of application, for a continued appraisal and refinement of the framework and urban fabric with time. The research is an exploration – of the possibilities for an architect – to adopt the new role of a 'mediator' in development of the contemporary urbanity.

Keywords: open source, public participation, urbanization, urban development

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Authors: Carlos Alberto Rivera-corredor, Angie Dayana Vargas-Ceballos, Edison Gilpavas, Izabela Dobrosz-Gómez, Miguel Ángel Gómez-García

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Hexavalent chromium, Cr (VI) is present in the effluents from different industries such as electroplating, mining, leather tanning, etc. This compound is of great academic and industrial concern because of its toxic and carcinogenic behavior. Its dumping to both environmental and public health for animals and humans causes serious problems in water sources. The amount of Cr (VI) in industrial wastewaters ranges from 0.5 to 270,000 mgL-1. According to the Colombian standard for water quality (NTC-813-2010), the maximum allowed concentration for the Cr (VI) in drinking water is 0.05 mg L-1. To comply with this limit, it is essential that industries treat their effluent to reduce the Cr (VI) to acceptable levels. Numerous methods have been reported for the treatment removing metal ions from aqueous solutions such as: reduction, ion exchange, electrodialysis, etc. Adsorption has become a promising method for the purification of metal ions in water, since its application corresponds with an economic and efficient technology. The absorbent selection and the kinetic and thermodynamic study of the adsorption conditions are key to the development of a suitable adsorption technology. The Ce0.25Zr0.75O2.nH2O presents higher adsorption capacity between a series of hydrated mixed oxides Ce1-xZrxO2 (x = 0, 0.25, 0.5, 0.75, 1). This work presents the kinetic and thermodynamic study of Cr (VI) adsorption on Ce0.25Zr0.75O2.nH2O. Experiments were performed under the following experimental conditions: initial Cr (VI) concentration = 25, 50 and 100 mgL-1, pH = 2, adsorbent charge = 4 gL-1, stirring time = 60 min, temperature=20, 28 and 40 °C. The Cr (VI) concentration was spectrophotometrically estimated by the method of difenilcarbazide with monitoring the absorbance at 540 nm. The Cr (VI) adsorption over hydrated Ce0.25Zr0.75O2.nH2O models was analyzed using pseudo-first and pseudo-second order kinetics. The Langmuir and Freundlich models were used to model the experimental data. The convergence between the experimental values and those predicted by the model, is expressed as a linear regression correlation coefficient (R2) and was employed as the model selection criterion. The adsorption process followed the pseudo-second order kinetic model and obeyed the Langmuir isotherm model. The thermodynamic parameters were calculated as: ΔH°=9.04 kJmol-1,ΔS°=0.03 kJmol-1 K-1, ΔG°=-0.35 kJmol-1 and indicated the endothermic and spontaneous nature of the adsorption process, governed by physisorption interactions.

Keywords: adsorption, hexavalent chromium, kinetics, thermodynamics

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Authors: Nadia Noor, Farida Faisal

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Horizontal hostility has been identified as a special type of workplace violence and refers to the aggressive behavior inflicted by women towards other women due to gender issues or towards minority group members due to minority issues. Many women, while they want eagerly to succeed and invest invigorated efforts to achieve success, harbor negative feelings for other women to succeed in their career. This phenomenon has been known as Horizontal Violence, Horizontal Hostility, Lateral Violence, Indirect Aggression, or The Tall Poppy Syndrome in Australian culture. Tall Poppy is referred to as a visibly successful individual who attracts envy or hostility due to distinctive characteristics. Therefore, horizontal hostility provides theoretical foundation to examine fierce competition among females than males for their limited access to top level management positions. In Pakistan, gender discrimination persists due to male dominance in the society and women do not enjoy basic equality rights in all aspects of life. They are oppressed at social and organizational level. As Government has been trying to enhance women participation through providing more employment opportunities, provision of peaceful workplace is mandatory that will enable aspiring females to achieve objectives of career success. This research study will help to understand antecedents, dimensions and outcomes of horizontal hostility that hinder career success of competitive females. The present paper is a review paper and various forms of horizontal hostility have been discussed in detail. Different psychological and organizational level drivers of horizontal hostility have been explored through literature. Psychological drivers include oppression, lack of empowerment, learned helplessness and low self-esteem. Organizational level drivers include sticky floor, glass ceiling, toxic work environment and leadership role. Horizontal hostility among working women results in psychological and physical outcomes including stress, low motivation, poor job performance and intention to leave. The study recommends provision of healthy and peaceful work environment that will enable competent women to achieve objectives of career success. In this regard, concrete actions and effective steps are required to promote gender equality at social and organizational level. The need is to ensure the enforcement of legal frameworks by government agencies in order to provide healthy working environment to women by reducing harassment and violence against them. Organizations must eradicate drivers of horizontal hostility and provide women peaceful work environment. In order to develop coping skills, training and mentoring must be provided to them.

Keywords: gender discrimination, glass ceiling, horizontal hostility, oppression

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Authors: Indujeeva Keerthila Peiris

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The secular view of mindfulness has some connotation to the original meaning of mindfulness mentioned in the Theravada Buddhist texts (Pāli Canon), but there is a substantial difference in the meaning of the two. Secular Mindfulness Based Interventions (MBI) focus on stilling the mind, which may provide short-term benefits and help individuals to deal with physical pain, grief, and distress. However, as with many popular educational innovations, the foundational values of mindfulness strategies have been distorted and subverted in a number of instances in which ‘McMindfulness’ programmes have been implemented with a view to reducing mindfulness mediation as a self-help technique that is easily misappropriated for the exclusive pursuit of corporate objectives, employee pacification, and commercial profit. The intention of this paper is not to critique the misappropriations of mindfulness. Instead, to go back to the root source and bring insights from the Buddhist Pāli Canon and its associated teachings on mindfulness in its own terms. In the Buddha’s discourses, as preserved in the Pāli Canon, there is nothing more significant than the understanding and practice of ‘Satipatthãna’. The Satipatthāna Sutta , the ‘Discourse on the Establishment of Mindfulness,’ opens with a proclamation highlighting both the purpose of this training and its methodology. The right practice of mindfulness is the gateway to understanding the Buddha’s teaching. However, although this concept is widely discussed among the Dhamma practitioners, it is the least understood one of them all. The purpose of this paper is to understand deeper meaning of mindfulness as it was originally intended by the Teacher. The natural state of mind is that it wanders. It wanders into the past, the present, and the future. One’s ability to hold attention to a mind object (emotion, thought, feeling, sensation, sense impression) called ‘concentration’. The intentional concentration process does not lead to wisdom. However, the development of wisdom starts when the mind is calm, concentrated, and unified. The practice of insight contemplation aims at gaining a direct understanding of the real nature of phenomena. According to the Buddha’s teaching, there are three basic facts of all existence: 1) impermanence (anicca in Pāli) ; 2) fabrication (also commonly known as suffering, unsatisfactoriness, sankhara or dukka in Pāli); 3) not-self (insubstantiality or impersonality, annatta in Pāli ). The entire Buddhist doctrine is based on these three facts. The problem is our ignorance covers reality. It is not that a person sees the emptiness of them or that we try to see the emptiness of our experience by conceptually thinking that they are empty. It is an experiential outcome that happens when the cause-and- effect overrides the self-view (sakkaya dhitti), and ignorance is known as ignorance and eradicated once and for all. Therefore, the right view (samma dhitti) is the starting point of the path, not ethical conduct (sila) or samadhi (jhana). In order to develop the right view, we need to first listen to the correct Dhamma and possess Yoniso manasikara (right comprehension) to know the five aggregates as five aggregates.

Keywords: mindfulness, spirituality, buddhism, pali canon

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Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: Maxence Queyrel, Edi Prifti, Alexandre Templier, Jean-Daniel Zucker

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Analysis of the human microbiome using metagenomic sequencing data has demonstrated high ability in discriminating various human diseases. Raw metagenomic sequencing data require multiple complex and computationally heavy bioinformatics steps prior to data analysis. Such data contain millions of short sequences read from the fragmented DNA sequences and stored as fastq files. Conventional processing pipelines consist in multiple steps including quality control, filtering, alignment of sequences against genomic catalogs (genes, species, taxonomic levels, functional pathways, etc.). These pipelines are complex to use, time consuming and rely on a large number of parameters that often provide variability and impact the estimation of the microbiome elements. Training Deep Neural Networks directly from raw sequencing data is a promising approach to bypass some of the challenges associated with mainstream bioinformatics pipelines. Most of these methods use the concept of word and sentence embeddings that create a meaningful and numerical representation of DNA sequences, while extracting features and reducing the dimensionality of the data. In this paper we present an end-to-end approach that classifies patients into disease groups directly from raw metagenomic reads: metagenome2vec. This approach is composed of four steps (i) generating a vocabulary of k-mers and learning their numerical embeddings; (ii) learning DNA sequence (read) embeddings; (iii) identifying the genome from which the sequence is most likely to come and (iv) training a multiple instance learning classifier which predicts the phenotype based on the vector representation of the raw data. An attention mechanism is applied in the network so that the model can be interpreted, assigning a weight to the influence of the prediction for each genome. Using two public real-life data-sets as well a simulated one, we demonstrated that this original approach reaches high performance, comparable with the state-of-the-art methods applied directly on processed data though mainstream bioinformatics workflows. These results are encouraging for this proof of concept work. We believe that with further dedication, the DNN models have the potential to surpass mainstream bioinformatics workflows in disease classification tasks.

Keywords: deep learning, disease prediction, end-to-end machine learning, metagenomics, multiple instance learning, precision medicine

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Authors: Marco Furinghetti, Alberto Pavese, Michele Rinaldi

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Concave Surface Slider devices have been more and more used in real applications for seismic protection of both bridge and building structures. Several research activities have been carried out, in order to investigate the lateral response of such a typology of devices, and a reasonably high level of knowledge has been reached. If radial analysis is performed, the frictional force is always aligned with respect to the restoring force, whereas under bidirectional seismic events, a bi-axial interaction of the directions of motion occurs, due to the step-wise projection of the main frictional force, which is assumed to be aligned to the trajectory of the isolator. Nonetheless, if non-linear time history analyses have to be performed, standard codes provide precise rules for the definition of an averagely spectrum-compatible set of accelerograms in radial conditions, whereas for bidirectional motions different combinations of the single components spectra can be found. Moreover, nowadays software for the adjustment of natural accelerograms are available, which lead to a higher quality of spectrum-compatibility and to a smaller dispersion of results for radial motions. In this endeavor a simplified design procedure is defined, for building structures, base-isolated by means of Concave Surface Slider devices. Different case study structures have been analyzed. In a first stage, the capacity curve has been computed, by means of non-linear static analyses on the fixed-base structures: inelastic fiber elements have been adopted and different direction angles of lateral forces have been studied. Thanks to these results, a linear elastic Finite Element Model has been defined, characterized by the same global stiffness of the linear elastic branch of the non-linear capacity curve. Then, non-linear time history analyses have been performed on the base-isolated structures, by applying seven bidirectional seismic events. The spectrum-compatibility of bidirectional earthquakes has been studied, by considering different combinations of single components and adjusting single records: thanks to the proposed procedure, results have shown a small dispersion and a good agreement in comparison to the assumed design values.

Keywords: concave surface slider, spectrum-compatibility, bidirectional earthquake, base isolation

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Authors: Anderson Rocha-Buelvas, Jaqueline Mena Huertas, Edith Burbano Rosero, Arsenio Hidalgo Troya, Mauricio Casas Cruz

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COVID-19 is a disruptive pandemic for the public health and economic system of whole countries, including Colombia. Nariño Department is the southwest of the country and draws attention to being on the border with Ecuador, constantly facing demographic transition affecting infections between countries. In Nariño, the early routine diagnosis of SARS-CoV-2, which can be handled at BSL-2, has affected the transmission dynamics of COVID-19. However, new emerging and re-emerging viruses with biological flexibility classified as a Risk Group 3 agent can take advantage of epidemiological opportunities, generating the need to increase clinical diagnosis, mainly in border regions between countries. The overall objective of this project was to assure the quality of the analytical process in the diagnosis of high biological risk pathogens in Nariño by building a laboratory that includes biosafety level (BSL)-2 and (BSL)-3 containment zones. The delimitation of zones was carried out according to the Verification Tool of the National Health Institute of Colombia and following the standard requirements for the competence of testing and calibration laboratories of the International Organization for Standardization. This is achieved by harmonization of methods and equipment for effective and durable diagnostics of the large-scale spread of highly pathogenic microorganisms, employing negative-pressure containment systems and UV Systems in accordance with a finely controlled electrical system and PCR systems as new diagnostic tools. That increases laboratory capacity. Protection in BSL-3 zones will separate the handling of potentially infectious aerosols within the laboratory from the community and the environment. It will also allow the handling and inactivation of samples with suspected pathogens and the extraction of molecular material from them, allowing research with pathogens with high risks, such as SARS-CoV-2, Influenza, and syncytial virus, and malaria, among others. The diagnosis of these pathogens will be articulated across the spectrum of basic, applied, and translational research that could receive about 60 daily samples. It is expected that this project will be articulated with the health policies of neighboring countries to increase research capacity.

Keywords: medical laboratory science, SARS-CoV-2, public health surveillance, Colombia

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Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

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Authors: S. Gariani, I. Shyha

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Cutting titanium alloys are usually accompanied with low productivity, poor surface quality, short tool life and high machining costs. This is due to the excessive generation of heat at the cutting zone and difficulties in heat dissipation due to relatively low heat conductivity of this metal. The cooling applications in machining processes are crucial as many operations cannot be performed efficiently without cooling. Improving machinability, increasing productivity, enhancing surface integrity and part accuracy are the main advantages of cutting fluids. Conventional fluids such as mineral oil-based, synthetic and semi-synthetic are the most common cutting fluids in the machining industry. Although, these cutting fluids are beneficial in the industries, they pose a great threat to human health and ecosystem. Vegetable oils (VOs) are being investigated as a potential source of environmentally favourable lubricants, due to a combination of biodegradability, good lubricous properties, low toxicity, high flash points, low volatility, high viscosity indices and thermal stability. Fatty acids of vegetable oils are known to provide thick, strong, and durable lubricant films. These strong lubricating films give the vegetable oil base stock a greater capability to absorb pressure and high load carrying capacity. This paper details preliminary experimental results when turning Ti-6Al-4V. The impact of various VO-based cutting fluids, cutting tool materials, working conditions was investigated. The full factorial experimental design was employed involving 24 tests to evaluate the influence of process variables on average surface roughness (Ra), tool wear and chip formation. In general, Ra varied between 0.5 and 1.56 µm and Vasco1000 cutting fluid presented comparable performance with other fluids in terms of surface roughness while uncoated coarse grain WC carbide tool achieved lower flank wear at all cutting speeds. On the other hand, all tools tips were subjected to uniform flank wear during whole cutting trails. Additionally, formed chip thickness ranged between 0.1 and 0.14 mm with a noticeable decrease in chip size when higher cutting speed was used.

Keywords: cutting fluids, turning, Ti-6Al-4V, vegetable oils, working conditions

Procedia PDF Downloads 255

Authors: Morteza Esfandiari, Shabnam Jabari, Heather MacGrath, David Coleman

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Flood is a severe issue in different places in the world as well as the city of Fredericton, New Brunswick, Canada. The downtown area of Fredericton is close to the Saint John River, which is susceptible to flood around May every year. Recently, the frequency of flooding seems to be increased, especially after the fact that the downtown area and surrounding urban/agricultural lands got flooded in two consecutive years in 2018 and 2019. In order to have an explicit vision of flood span and damage to affected areas, it is necessary to use either flood inundation modelling or satellite data. Due to contingent availability and weather dependency of optical satellites, and limited existing data for the high cost of hydrodynamic models, it is not always feasible to rely on these sources of data to generate quality flood maps after or during the catastrophe. Height Above the Nearest Drainage (HAND), a state-of-the-art topo-hydrological index, normalizes the height of a basin based on the relative elevation along with the stream network and specifies the gravitational or the relative drainage potential of an area. HAND is a relative height difference between the stream network and each cell on a Digital Terrain Model (DTM). The stream layer is provided through a multi-step, time-consuming process which does not always result in an optimal representation of the river centerline depending on the topographic complexity of that region. HAND is used in numerous case studies with quite acceptable and sometimes unexpected results because of natural and human-made features on the surface of the earth. Some of these features might cause a disturbance in the generated model, and consequently, the model might not be able to predict the flow simulation accurately. We propose to include a previously existing stream layer generated by the province of New Brunswick and benefit from culvert maps to improve the water flow simulation and accordingly the accuracy of HAND model. By considering these parameters in our processing, we were able to increase the accuracy of the model from nearly 74% to almost 92%. The improved model can be used for generating highly accurate flood maps, which is necessary for future urban planning and flood damage estimation without any need for satellite imagery or hydrodynamic computations.

Keywords: HAND, DTM, rapid floodplain, simplified conceptual models

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Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Venkata Srikanth Meka, Nur Arthirah Binti Ahmad Tarmizi Tan, Muhammad Syahmi Bin Md Nazir, Adinarayana Gorajana, Senthil Rajan Dharmalingam

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Biphasic drug delivery systems are designed to release drug at two different rates, either fast/prolonged or prolonged/fast. A fast/prolonged release system provides a burst drug release at initial stage followed by a slow release over a prolonged period of time and in case of prolonged/fast release system, the release pattern is vice versa. Terminalia catappa gum (TCG) is a natural polymer and was successfully proven as a novel pharmaceutical excipient. The main objective of the present research is to investigate the applicability of natural polymer, Terminalia catappa gum in the design of oral biphasic drug delivery system in the form of mini tablets by using a model drug, buspirone HCl. This investigation aims to produce a biphasic release drug delivery system of buspirone by combining immediate release and prolonged release mini tablets into a capsule. For immediate release mini tablets, a dose of 4.5 mg buspirone was prepared by varying the concentration of superdisintegrant; crospovidone. On the other hand, prolonged release mini tablets were produced by using different concentrations of the natural polymer; TCG with a buspirone dose of 3mg. All mini tablets were characterized for weight variation, hardness, friability, disintegration, content uniformity and dissolution studies. The optimized formulations of immediate and prolonged release mini tablets were finally combined in a capsule and was evaluated for release studies. FTIR and DSC studies were conducted to study the drug-polymer interaction. All formulations of immediate release and prolonged release mini tablets were passed all the in-process quality control tests according to US Pharmacopoeia. The disintegration time of immediate release mini tablets of different formulations was varied from 2-6 min, and maximum drug release was achieved in lesser than 60 min. Whereas prolonged release mini tablets made with TCG have shown good drug retarding properties. Formulations were controlled for about 4-10 hrs with varying concentration of TCG. As the concentration of TCG increased, the drug release retarding property also increased. The optimised mini tablets were packed in capsules and were evaluated for the release mechanism. The capsule dosage form has clearly exhibited the biphasic release of buspirone, indicating that TCG is a suitable natural polymer for this study. FTIR and DSC studies proved that there was no interaction between the drug and polymer. Based on the above positive results, it can be concluded that TCG is a suitable polymer for the biphasic drug delivery systems.

Keywords: Terminalia catappa gum, biphasic release, mini tablets, tablet in capsule, natural polymers

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Authors: Diego S. Caetano, Doreen E. Kalz, Louise L. B. Lomardo, Luiz P. Rosa

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The energy consumption in non-residential buildings in Brazil has a great impact on the national infrastructure. The growth of the energy consumption has a special role over the building cooling systems, supported by the increased people's requirements on hygrothermal comfort. This paper presents how the occupants of office buildings notice and evaluate the hygrothermic comfort regarding temperature, humidity, and air movement, considering the cooling systems presented at the buildings studied, analyzed by real occupants in areas of hot and humid climate. The paper presents results collected over a long time from 3 office buildings in the cities of Rio de Janeiro and Niteroi (Brazil) in 2015 and 2016, from daily questionnaires with eight questions answered by 114 people between 3 to 5 weeks per building, twice a day (10 a.m. and 3 p.m.). The paper analyses 6 out of 8 questions, emphasizing on the perception of temperature, humidity, and air movement. Statistics analyses were made crossing participant answers and humidity and temperature data related to time high time resolution time. Analyses were made from regressions comparing: internal and external temperature, and then compared with the answers of the participants. The results were put in graphics combining statistic graphics related to temperature and air humidity with the answers of the real occupants. Analysis related to the perception of the participants to humidity and air movements were also analyzed. The hygrothermal comfort statistic model of the European standard DIN EN 15251 and that from the Brazilian standard NBR 16401 were compared taking into account the perceptions of the hygrothermal comfort of the participants, with emphasis on air humidity, taking basis on prior studies published on this same research. The studies point out a relative tolerance for higher temperatures than the ones determined by the standards, besides a variation on the participants' perception concerning air humidity. The paper presents a group of detailed information that permits to improve the quality of the buildings based on the perception of occupants of the office buildings, contributing to the energy reduction without health damages and demands of necessary hygrothermal comfort, reducing the consumption of electricity on cooling.

Keywords: thermal comfort, energy consumption, energy standards, comfort models

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Authors: Vinu Elias Jacob, Manoj Kumar Kini

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Disasters of all types are occurring more frequently and are becoming more costly than ever due to various manmade factors including climate change. A better utilisation of the concept of governance and management within disaster risk reduction is inevitable and of utmost importance. There is a need to explore the role of pre- and post-disaster public policies. The role of urban planning/design in shaping the opportunities of households, individuals and collectively the settlements for achieving recovery has to be explored. Governance strategies that can better support the integration of disaster risk reduction and management has to be examined. The main aim is to thereby build the resilience of individuals and communities and thus, the states too. Resilience is a term that is usually linked to the fields of disaster management and mitigation, but today has become an integral part of planning and design of cities. Disaster resilience broadly describes the ability of an individual or community to 'bounce back' from disaster impacts, through improved mitigation, preparedness, response, and recovery. The growing population of the world has resulted in the inflow and use of resources, creating a pressure on the various natural systems and inequity in the distribution of resources. This makes cities vulnerable to multiple attacks by both natural and man-made disasters. Each urban area needs elaborate studies and study based strategies to proceed in the discussed direction. Cochin in Kerala is the fastest and largest growing city with a population of more than 26 lakhs. The main concern that has been looked into in this paper is making cities resilient by designing a framework of strategies based on urban design principles for an immediate response system especially focussing on the city of Cochin, Kerala, India. The paper discusses, understanding the spatial transformations due to disasters and the role of spatial planning in the context of significant disasters. The paper also aims in developing a model taking into consideration of various factors such as land use, open spaces, transportation networks, physical and social infrastructure, building design, and density and ecology that can be implemented in any city of any context. Guidelines are made for the smooth evacuation of people through hassle-free transport networks, protecting vulnerable areas in the city, providing adequate open spaces for shelters and gatherings, making available basic amenities to affected population within reachable distance, etc. by using the tool of urban design. Strategies at the city level and neighbourhood level have been developed with inferences from vulnerability analysis and case studies.

Keywords: disaster management, resilience, spatial planning, spatial transformations

Procedia PDF Downloads 278

Authors: Hachul Jung, Ahee Kim, Sanghoon Lee, Dahye Kwon, Songwoo Yoon, Jinhee Moon

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We fabricated a wearable patch device including novel patch type flexible dry electrode based on carbon nanofibers (CNFs) and silicone-based elastomer (MED 6215) for real-time ECG monitoring. There are many methods to make flexible conductive polymer by mixing metal or carbon-based nanoparticles. In this study, CNFs are selected for conductive nanoparticles because carbon nanotubes (CNTs) are difficult to disperse uniformly in elastomer compare with CNFs and silver nanowires are relatively high cost and easily oxidized in the air. Wearable patch is composed of 2 parts that dry electrode parts for recording bio signal and sticky patch parts for mounting on the skin. Dry electrode parts were made by vortexer and baking in prepared mold. To optimize electrical performance and diffusion degree of uniformity, we developed unique mixing and baking process. Secondly, sticky patch parts were made by patterning and detaching from smooth surface substrate after spin-coating soft skin adhesive. In this process, attachable and detachable strengths of sticky patch are measured and optimized for them, using a monitoring system. Assembled patch is flexible, stretchable, easily skin mountable and connectable directly with the system. To evaluate the performance of electrical characteristics and ECG (Electrocardiography) recording, wearable patch was tested by changing concentrations of CNFs and thickness of the dry electrode. In these results, the CNF concentration and thickness of dry electrodes were important variables to obtain high-quality ECG signals without incidental distractions. Cytotoxicity test is conducted to prove biocompatibility, and long-term wearing test showed no skin reactions such as itching or erythema. To minimize noises from motion artifacts and line noise, we make the customized wireless, light-weight data acquisition system. Measured ECG Signals from this system are stable and successfully monitored simultaneously. To sum up, we could fully utilize fabricated wearable patch devices for real-time ECG monitoring easily.

Keywords: carbon nanofibers, ECG monitoring, flexible dry electrode, wearable patch

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Authors: Arianna Nativio, Zoran Kapelan, Jan Peter van der Hoek

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Bio-composite materials are becoming increasingly popular in various applications, such as the automotive industry. Usually, bio-composite materials are made from natural resources recovered from plants, now, a new type of bio-composite material has begun to be produced in the Netherlands. This material is made from resources recovered from drinking water treatments (calcite), wastewater treatment (cellulose), and material from surface water management (aquatic plants). Surface water, raw drinking water, and wastewater can be contaminated with pathogens and chemical compounds. Therefore, it would be valuable to develop a framework to assess, monitor, and control the potential risks. Indeed, the goal is to define the major risks in terms of human health, quality of materials, and environment associated with the production and application of these new materials. This study describes the general risk assessment framework, starting with a qualitative risk assessment. The qualitative risk analysis was carried out by using the HAZOP methodology for the hazard identification phase. The HAZOP methodology is logical and structured and able to identify the hazards in the first stage of the design when hazards and associated risks are not well known. The identified hazards were analyzed to define the potential associated risks, and then these were evaluated by using the qualitative Event Tree Analysis. ETA is a logical methodology used to define the consequences for a specific hazardous incidents, evaluating the failure modes of safety barriers and dangerous intermediate events that lead to the final scenario (risk). This paper shows the effectiveness of combining of HAZOP and qualitative ETA methodologies for hazard identification and risk mapping. Then, key risks were identified, and a quantitative framework was developed based on the type of risks identified, such as QMRA and QCRA. These two models were applied to assess human health risks due to the presence of pathogens and chemical compounds such as heavy metals into the bio-composite materials. Thus, due to these contaminations, the bio-composite product, during its application, might release toxic substances into the environment leading to a negative environmental impact. Therefore, leaching tests are going to be planned to simulate the application of these materials into the environment and evaluate the potential leaching of inorganic substances, assessing environmental risk.

Keywords: bio-composite, risk assessment, water reuse, resource recovery

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Authors: Sri Sai Ramya Bojedla, Falguni Pati

Abstract:

Nature provides the best of solutions to humans. One such incredible gift to regenerative medicine is silk. The literature has publicized a long appreciation for silk owing to its incredible physical and biological assets. Its bioactive nature, unique mechanical strength, and processing flexibility make us curious to explore further to apply it in the clinics for the welfare of mankind. In this study, Antheraea mylitta and Bombyx mori silk fibroin microfibers are developed by two economical and straightforward steps via degumming and hydrolysis for the first time, and a bioactive composite is manufactured by mixing silk fibroin microfibers at various concentrations with polycaprolactone (PCL), a biocompatible, aliphatic semi-crystalline synthetic polymer. Reconstructive surgery in any part of the body except for the maxillofacial region deals with replacing its function. But answering both the aesthetics and function is of utmost importance when it comes to facial reconstruction as it plays a critical role in the psychological and social well-being of the patient. The main concern in developing adequate bone graft substitutes or a scaffold is the noteworthy variation in each patient's bone anatomy. Additionally, the anatomical shape and size will vary based on the type of defect. The advent of additive manufacturing (AM) or 3D printing techniques to bone tissue engineering has facilitated overcoming many of the restraints of conventional fabrication techniques. The acquired patient's CT data is converted into a stereolithographic (STL)-file which is further utilized by the 3D printer to create a 3D scaffold structure in an interconnected layer-by-layer fashion. This study aims to address the limitations of currently available materials and fabrication technologies and develop a customized biomaterial implant via 3D printing technology to reconstruct complex form, function, and aesthetics of the facial anatomy. These composite scaffolds underwent structural and mechanical characterization. Atomic force microscopic (AFM) and field emission scanning electron microscopic (FESEM) images showed the uniform dispersion of the silk fibroin microfibers in the PCL matrix. With the addition of silk, there is improvement in the compressive strength of the hybrid scaffolds. The scaffolds with Antheraea mylitta silk revealed higher compressive modulus than that of Bombyx mori silk. The above results of PCL-silk scaffolds strongly recommend their utilization in bone regenerative applications. Successful completion of this research will provide a great weapon in the maxillofacial reconstructive armamentarium.

Keywords: compressive modulus, 3d printing, maxillofacial reconstruction, natural fiber reinforced composites, silk fibroin microfibers

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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