Search results for: frequency rate of change
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17635

Search results for: frequency rate of change

4135 The Effects of Traditional Thai Massage Technique Delivered by Parents on Stereotypical Behaviors in Children with Autism: A Pilot Study

Authors: Chanada Aonsri, Wichai Eungpinichpong

Abstract:

Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

Procedia PDF Downloads 72
4134 A System Dynamics Model for Analyzing Customer Satisfaction in Healthcare Systems

Authors: Mahdi Bastan, Ali Mohammad Ahmadvand, Fatemeh Soltani Khamsehpour

Abstract:

Health organizations’ sustainable development has nowadays become highly affected by customers’ satisfaction due to significant changes made in the business environment of the healthcare system and emerging of Competitiveness paradigm. In case we look at the hospitals and other health organizations as service providers concerning profit issues, the satisfaction of employees as interior customers, and patients as exterior customers would be of significant importance in health business success. Furthermore, satisfaction rate could be considered in performance assessment of healthcare organizations as a perceived quality measure. Several researches have been carried out in identification of effective factors on patients’ satisfaction in health organizations. However, considering a systemic view, the complex causal relations among many components of healthcare system would be an issue that its acquisition and sustainability requires an understanding of the dynamic complexity, an appropriate cognition of different components, and effective relationships among them resulting ultimately in identifying the generative structure of patients’ satisfaction. Hence, the presenting paper applies system dynamics approaches coherently and methodologically to represent the systemic structure of customers’ satisfaction of a health system involving the constituent components and interactions among them. Then, the results of different policies taken on the system are simulated via developing mathematical models, identifying leverage points, and using scenario making technique and then, the best solutions are presented to improve customers’ satisfaction of the services. The presenting approach supports taking advantage of decision support systems. Additionally, relying on understanding of system behavior Dynamics, the effective policies for improving the health system would be recognized.

Keywords: customer satisfaction, healthcare, scenario, simulation, system dynamics

Procedia PDF Downloads 417
4133 A Method to Identify the Critical Delay Factors for Building Maintenance Projects of Institutional Buildings: Case Study of Eastern India

Authors: Shankha Pratim Bhattacharya

Abstract:

In general building repair and renovation projects are minor in nature. It requires less attention as the primary cost involvement is relatively small. Although the building repair and maintenance projects look simple, it involves much complexity during execution. Many of the present research indicate that few uncertain situations are usually linked with maintenance projects. Those may not be read properly in the planning stage of the projects, and finally, lead to time overrun. Building repair and maintenance become essential and periodical after commissioning of the building. In Institutional buildings, the regular maintenance projects also include addition –alteration, modification activities. Increase in the student admission, new departments, and sections, new laboratories and workshops, up gradation of existing laboratories are very common in the institutional buildings in the developing nations like India. The project becomes very critical because it undergoes space problem, architectural design issues, structural modification, etc. One of the prime factors in the institutional building maintenance and modification project is the time constraint. Mostly it required being executed a specific non-work time period. The present research considered only the institutional buildings of the Eastern part of India to analyse the repair and maintenance project delay. A general survey was conducted among the technical institutes to find the causes and corresponding nature of construction delay factors. Five technical institutes are considered in the present study with repair, renovation, modification and extension type of projects. Construction delay factors are categorically subdivided into four groups namely, material, manpower (works), Contract and Site. The survey data are collected for the nature of delay responsible for a specific project and the absolute amount of delay through proposed and actual duration of work. In the first stage of the paper, a relative importance index (RII) is proposed for the delay factors. The occurrence of the delay factors is also judged by its frequency-severity nature. Finally, the delay factors are then rated and linked with the type of work. In the second stage, a regression analysis is executed to establish an empirical relationship between the actual time of a project and the percentage of delay. It also indicates the impact of the factors for delay responsibility. Ultimately, the present paper makes an effort to identify the critical delay factors for the repair and renovation type project in the Eastern Indian Institutional building.

Keywords: delay factor, institutional building, maintenance, relative importance index, regression analysis, repair

Procedia PDF Downloads 252
4132 Hydrological Response of the Glacierised Catchment: Himalayan Perspective

Authors: Sonu Khanal, Mandira Shrestha

Abstract:

Snow and Glaciers are the largest dependable reserved sources of water for the river system originating from the Himalayas so an accurate estimate of the volume of water contained in the snowpack and the rate of release of water from snow and glaciers are, therefore, needed for efficient management of the water resources. This research assess the fusion of energy exchanges between the snowpack, air above and soil below according to mass and energy balance which makes it apposite than the models using simple temperature index for the snow and glacier melt computation. UEBGrid a Distributed energy based model is used to calculate the melt which is then routed by Geo-SFM. The model robustness is maintained by incorporating the albedo generated from the Landsat-7 ETM images on a seasonal basis for the year 2002-2003 and substrate map derived from TM. The Substrate file includes predominantly the 4 major thematic layers viz Snow, clean ice, Glaciers and Barren land. This approach makes use of CPC RFE-2 and MERRA gridded data sets as the source of precipitation and climatic variables. The subsequent model run for the year between 2002-2008 shows a total annual melt of 17.15 meter is generate from the Marshyangdi Basin of which 71% is contributed by the glaciers , 18% by the rain and rest being from the snow melt. The albedo file is decisive in governing the melt dynamics as 30% increase in the generated surface albedo results in the 10% decrease in the simulated discharge. The melt routed with the land cover and soil variables using Geo-SFM shows Nash-Sutcliffe Efficiency of 0.60 with observed discharge for the study period.

Keywords: Glacier, Glacier melt, Snowmelt, Energy balance

Procedia PDF Downloads 458
4131 The Effect of Metal Transfer Modes on Mechanical Properties of 3CR12 Stainless Steel

Authors: Abdullah Kaymakci, Daniel M. Madyira, Ntokozo Nkwanyana

Abstract:

The effect of metal transfer modes on mechanical properties of welded 3CR12 stainless steel were investigated. This was achieved by butt welding 10 mm thick plates of 3CR12 in different positions while varying the welding positions for different metal transfer modes. The ASME IX: 2010 (Welding and Brazing Qualifications) code was used as a basis for welding variables. The material and the thickness of the base metal were kept constant together with the filler metal, shielding gas and joint types. The effect of the metal transfer modes on the microstructure and the mechanical properties of the 3CR12 steel was then investigated as it was hypothesized that the change in welding positions will affect the transfer modes partly due to the effect of gravity. The microscopic examination revealed that the substrate was characterized by dual phase microstructure, that is, alpha phase and beta phase grain structures. Using the spectroscopic examination results and the ferritic factor calculation had shown that the microstructure was expected to be ferritic-martensitic during air cooling process. The tested tensile strength and Charpy impact energy were measured to be 498 MPa and 102 J which were in line with mechanical properties given in the material certificate. The heat input in the material was observed to be greater than 1 kJ/mm which is the limiting factor for grain growth during the welding process. Grain growths were observed in the heat affected zone of the welded materials. Ferritic-martensitic microstructure was observed in the microstructure during the microscopic examination. The grain growth altered the mechanical properties of the test material. Globular down hand had higher mechanical properties than spray down hand. Globular vertical up had better mechanical properties than globular vertical down.

Keywords: welding, metal transfer modes, stainless steel, microstructure, hardness, tensile strength

Procedia PDF Downloads 255
4130 Effect of Fiber Inclusion on the Geotechnical Parameters of Clayey Soil Subjected to Freeze-Thaw Cycles

Authors: Arun Prasad, P. B. Ramudu, Deep Shikha, Deep Jyoti Singh

Abstract:

A number of studies have been conducted recently to investigate the influence of randomly oriented fibers on some engineering properties of cohesive soils.Freezing and thawing of soil affects the strength, durability and permeability of soil adversely. Experiments were carried out in order to investigate the effect of inclusion of randomly distributed polypropylene fibers on the strength, hydraulic conductivity and durability of local soil (CL) subjected to freeze–thaw cycles. For evaluating the change in strength of soil, a series of unconfined compression tests as well as tri-axial tests were carried out on reinforced and unreinforced soil samples. All the samples were subjected to seven cycles of freezing and thawing. Freezing was carried out at a temperature of - 15 to -18 °C; and thawing was carried out by keeping the samples at room temperature. The reinforcement of soil samples was done by mixing with polypropylene fibers, 12 mm long and with an aspect ratio of 240. The content of fibers was varied from 0.25 to 1% by dry weight of soil. The maximum strength of soil was found in samples having a fiber content of 0.75% for all the samples that were prepared at optimum moisture content (OMC), and if the OMC was increased (+2% OMC) or decreased (-2% OMC), the maximum strength observed at 0.5% fiber inclusion. The effect of fiber inclusion and freeze–thaw on the hydraulic conductivity was studied increased from around 25 times to 300 times that of the unreinforced soil, without subjected to any freeze-thaw cycles. For studying the increased durability of soil, mass loss after each freeze-thaw cycle was calculated and it was found that samples reinforced with polypropylene fibers show 50-60% less loss in weight than that of the unreinforced soil.

Keywords: fiber reinforcement, freezingand thawing, hydraulic conductivity, unconfined compressive strength

Procedia PDF Downloads 406
4129 The Impact of E-Commerce on the Physical Space of Traditional Retail System

Authors: Sumayya S.

Abstract:

Making cities adaptive and inclusive is one among the inherent goal and challenge for contemporary cities. This is a serious concern when the urban transformations occur in varying magnitude due to visible and invisible factors. One type of visibly invisible factor is ecommerce and its expanding operation that is understood to cause changes to the conventional spatial structure positively and negatively. With the continued growth in e-commerce activities and its future potential, market analysts, media, and even retailers have questioned the importance of a future presence of traditional Brick-and-mortar stores in cities as a critical element, with some even referring to the repeated announcement of the closure of some store chains as the end of the online shopping era. Essentially this raises the question of how adaptive and inclusive the cities are to the dynamics of transformative changes that are often unseen. People have become more comfortable with seating inside and door delivery systems, and this increased change in usage of public spaces, especially the commercial corridors. Through this research helped in presetting a new approach for planning and designing commercial activities centers and also presents the impact of ecommerce on the urban fabric, such as division and fragmentation of space, showroom syndrome, reconceptualization of space, etc., in a critical way. The changes are understood by analyzing the e-commerce logistic process. Based on the inferences reach at the conclusion for the need of an integrated approach in the field of planning and designing of public spaces for the sustainable omnichannel retailing. This study was carried out with the following objectives Monitoring the impact of e commerce on the traditional shopping space. Explore the new challenges and opportunities faced by the urban form. Explore how adaptive and inclusive our cities are to the dynamics of transformative changes caused by ecommerce.

Keywords: E-commerce, shopping streets, online environment, offline environment, shopping factors

Procedia PDF Downloads 93
4128 Floristic Diversity, Carbon Stocks and Degradation Factors in Two Sacred Forests in the West Cameroon Region

Authors: Maffo Maffo Nicole Liliane, Mounmeni Kpoumie Hubert, Mbaire Matindje Karl Marx, Zapfack Louis

Abstract:

Sacred forests play a valuable role in conserving local biodiversity and provide numerous ecosystem services in Cameroon. The study was carried out in the sacred forests of Bandrefam and Batoufam (western Cameroon). The aim was to estimate the diversity of woody species, carbon stocks and degradation factors in these sacred forests. The floristic inventory was carried out in plots measuring 25m × 25m for trees with diameters greater than 10 cm and 5m × 5m for trees with diameters less than 10 cm. Carbon stocks were estimated using the non-destructive method and the allometric equations. Data on degradation factors were collected using semi-structured surveys in the Bandrefam and Batoufam neighborhoods. The floristic inventory identified 65 species divided into 57 genera and 30 families in the Bandrefam Sacred Forest and 45 species divided into 42 genera and 27 families in the Batoufam Sacres Forest. The families common to both sacred forests are as follows: Phyllanthaceae, Fabaceae, Moraceae, Lamiaceae, Malvaceae, Rubiaceae, Meliaceae, Anacardiaceae, and Sapindaceae. Three genera are present in both sites. These are: Albizia, Macaranga, Trichillia. In addition, there are 27 species in common between the two sites. The total carbon stock is 469.26 tC/ha at Batoufam and 291.41 tC/ha at Bandrefam. The economic value varies between 15 823 877.05 fcfa at Batoufam and 9 825 530.528 fcfa at Bandrefam. The study shows that despite the sacred nature of these forests, they are subject to degradation factors such as bushfires (35.42 %), the creation of plantations (23.96 %), illegal timber exploitation (21.88 %), young people's lack of interest in the notion of conservation (9.38 %), climate change (7.29 %) and growing urbanization (2.08 %). These factors threaten biodiversity and reduce carbon storage in these forests.

Keywords: sacred forests, degradation factors, carbon stocks, semi-structured surveys

Procedia PDF Downloads 53
4127 Is More Inclusive More Effective? The 'New Style' Public Distribution System in India

Authors: Avinash Kishore, Suman Chakrabarti

Abstract:

In September 2013, the parliament of India enacted the National Food Security Act (NFSA) which entitles two-thirds of India’s population to five kilograms of rice, wheat or coarse cereals per person per month at one to three rupees per kilogram. Five states in India—Andhra Pradesh, Chhattisgarh, Tamil Nadu, Odisha and West Bengal—had already implemented somewhat similar changes in the TPDS a few years earlier using their own budgetary resources. They made rice—coincidentally, all five states are predominantly rice-eating—available in fair price shops to a majority of their population at very low prices (less than Rs.3/kg). This paper tries to account for the changes in household consumption patterns associated with the change in TPDS policy in these states using data from household consumption surveys by the National Sample Survey Organization (NSSO). NSS data show improvement in the coverage of TPDS and average off-take of grains from fair price shops between 2004-05 and 2009-10 across all states of India. However, the increase in coverage and off-take was significantly higher in four out of these five states than in the rest of India. An average household in these states purchased three kilos more rice per month from fair price shops than its counterpart in non-treated states as a result of more generous TPDS policies backed by administrative reforms. The increase in consumption of PDS rice was the highest in Chhattisgarh, the poster state of PDS reforms. Households in Chhattisgarh used money saved on rice to spend more on pulses, edible oil, vegetables and sugar and other non-food items. We also find evidence that making TPDS more inclusive and more generous is not enough unless it is supported by administrative reforms to improve grain delivery and control diversion to open markets.

Keywords: public distribution system, social safety-net, national food security act, diet quality, Chhattisgarh

Procedia PDF Downloads 376
4126 Mycorrhizal Autochthonous Consortium Induced Defense-Related Mechanisms of Olive Trees against Verticillium dahliae

Authors: Hanane Boutaj, Abdelilah Meddich, Said Wahbi, Zainab El Alaoui-Talibi, Allal Douira, Abdelkarim Filali-Maltouf, Cherkaoui El Modafar

Abstract:

The present work aims to investigate the effect of arbuscular mycorrhizal fungi (AMF) in improving the olive tree resistance to Verticillium wilt caused by Verticillium dahliae. Inoculated plants with a mycorrhizal autochthonous consortium 'Rhizolive consortium' and pure strain 'Glomus irregulare' were infected after three months with V. dahliae. The improving of olive tree resistance was determined through disease severity, incidence, and defoliation. On the other hand, the defense mechanisms of olive plants were evaluated through lignin content, phenylalanine ammonia lyase (PAL) activity, and polyphenol content. The results revealed that both AMF significantly (p < 0.05) reduced disease development and the rate of defoliation in infected olive plants. Moreover, the contents of lignin were boosted after mycorrhizal inoculation in both the roots and the stems of olive plants, which remained significantly (p < 0.001) higher after the 90th days of V. dahliae inoculation. PAL activity was increased after V. dahliae inoculation in the stems of 'Rhizolive consortium' treatment that were 17 times higher than those in the roots of olive plants. The polyphenol content in the stems was about twice higher than those in the roots. The reduction of disease severity was accompanied by increased levels of lignin content, PAL activity, and polyphenol content, particularly in the stems of olive plants, indicating the strengthening of the olive plant immune system against V. dahliae.

Keywords: olive tree, Mycorrhizal autochthonous consortium, Glomus irregulare, Verticillium dahliae, defense mechanisms

Procedia PDF Downloads 120
4125 Determination of Soil Loss by Erosion in Different Land Covers Categories and Slope Classes in Bovilla Watershed, Tirana, Albania

Authors: Valmir Baloshi, Fran Gjoka, Nehat Çollaku, Elvin Toromani

Abstract:

As a sediment production mechanism, soil erosion is the main environmental threat to the Bovilla watershed, including the decline of water quality of the Bovilla reservoir that provides drinking water to Tirana city (the capital of Albania). Therefore, an experiment with 25 erosion plots for soil erosion monitoring has been set up since June 2017. The aim was to determine the soil loss on plot and watershed scale in Bovilla watershed (Tirana region) for implementation of soil and water protection measures or payments for ecosystem services (PES) programs. The results of erosion monitoring for the period June 2017 - May 2018 showed that the highest values of surface runoff were noted in bare land of 38829.91 liters on slope of 74% and the lowest values in forest land of 12840.6 liters on slope of 64% while the highest values of soil loss were found in bare land of 595.15 t/ha on slope of 62% and lowest values in forest land of 18.99 t/ha on slope of 64%. These values are much higher than the average rate of soil loss in the European Union (2.46 ton/ha/year). In the same sloping class, the soil loss was reduced from orchard or bare land to the forest land, and in the same category of land use, the soil loss increased with increasing land slope. It is necessary to conduct chemical analyses of sediments to determine the amount of chemical elements leached out of the soil and end up in the reservoir of Bovilla. It is concluded that PES programs should be implemented for rehabilitation of sub-watersheds Ranxe, Vilez and Zall-Bastar of the Bovilla watershed with valuable conservation practices.

Keywords: ANOVA, Bovilla, land cover, slope, soil loss, watershed management

Procedia PDF Downloads 169
4124 Developing Indoor Enhanced Bio Composite Vertical Smart Farming System for Climbing Food Plant

Authors: S. Mokhtar, R. Ibrahim, K. Abdan, A. Rashidi

Abstract:

The population in the world are growing in very fast rate. It is expected that urban growth and development would create serious questions of food production and processing, transport, and consumption. Future smart green city policies are emerging to support new ways of visualizing, organizing and managing the city and its flows towards developing more sustainable cities in ensuring food security while maintaining its biodiversity. This is a survey paper analyzing the feasibility of developing a smart vertical farming system for climbing food plant to meet the need of food consumption in urban cities with an alternative green material. This paper documents our investigation on specific requirement for farming high valued climbing type food plant suitable for vertical farming, development of appropriate biocomposite material composition, and design recommendations for developing a new smart vertical farming system inside urban buildings. Results include determination of suitable specific climbing food plant species and material manufacturing processes for reinforcing natural fiber for biocomposite material. The results are expected to become recommendations for developing alternative structural materials for climbing food plant later on towards the development of the future smart vertical farming system. This paper contributes to supporting urban farming in cities and promotes green materials for preserving the environment. Hence supporting efforts in food security agenda especially for developing nations.

Keywords: biocomposite, natural reinforce fiber, smart farming, vertical farming

Procedia PDF Downloads 170
4123 Synthesis of Highly Efficient Bio-Octane Number Booster Using Nano Au-NiAlZr-Layered Double Hydroxides Catalyst

Authors: Bachir Redouane, Dib Nihel, Bedrane Sumeya, Blanco Ginesa, Calvino José Juan

Abstract:

Furfural, a key biomass-derived platform compound, holds significant potential for biofuel production and the synthesis of high-value intermediates. This study investigates the hydrogenation-condensation reaction of furfural issued from lignocellulosique biomass with isopropyl alcohol to produce isopropylfurfuryl ether (iPFE), a next-generation synfuel with a high-octane number. iPFE’s water stability and resistance to methanol absorption make it a sustainable alternative to conventional gasoline additives, offering comparable performance. The catalyst used in this reaction is based on NiAl layered double hydroxides (LDH), with zirconium incorporated to enhance the distribution and structure of active sites. Gold (Au) was deposited on the NiAlZr-LDH support to improve selectivity and yield. The addition of Zr improved the thermal and mechanical stability of the catalyst, while the Au modification further increased selectivity toward iPFE. Extensive catalytic experiments were conducted to optimize reaction conditions, including temperature, hydrogen pressure, and Au loading, to maximize iPFE yield. The results demonstrate a high conversion rate of furfural, exceeding 90% under optimal conditions, with enhanced selectivity toward iPFE. Moreover, iPFE was shown to have a higher-octane number compared to traditional furfuryl ethers, making it a highly promising candidate for advanced fuel applications.

Keywords: Au-NiAlZr-LDH, biofuels, furfural, green chemistry, hydrogenation, isopropylfurfuryl ether, octane number.

Procedia PDF Downloads 21
4122 Confidence Levels among UK Emergency Medicine Doctors in Performing Emergency Lateral Canthotomy: Should it be a Key Skill in the ED

Authors: Mohanad Moustafa, Julia Sieberer, Rhys Davies

Abstract:

Background: Orbital compartment syndrome (OCS) is a sight-threatening Ophthalmologic emergency caused by rapidly increasing intraorbital pressure. It is usually caused by a retrobulbar hemorrhage as a result of trauma. If not treated in a timely manner, permanent vision loss can occur. Lateral canthotomy and cantholysis are minor procedures that can be performed bedside with equipment available in the emergency department. The aim of the procedure is to release the attachments between the suspensory ligaments of the eye and the bony orbital wall, leading to a decrease in intraorbital pressure and preventing irreversible loss of vision. As most Ophthalmologists across the UK provide non-resident on-call service, this may lead to a delay in the treatment of OCS and stresses the need for Emergency medical staff to be able to provide this sight-saving procedure independently. Aim: To survey current training, experience, and confidence levels among Emergency Medicine doctors in performing emergency lateral canthotomy and to establish whether these variables change the following teaching from experienced ophthalmologists. RESULTS: Most EM registrars had little to no experience in performing lateral canthotomy and cantholysis. The majority of them showed a significant increase in their confidence to perform the procedure following ophthalmic-led teaching. The survey also showed that the registrars felt such training should be added to/part of the EM curriculum. Conclusion: The involvement of Ophthalmologists in the teaching of EM doctors to recognise and treat OCS independently may prevent delays in treatment and reduce the risk of permanent sight loss. This project showed potential in improving patient care and will lead to a National Survey of EM doctors across the UK.

Keywords: lateral canthotomy, retrobulbar hemorrhage, Ophthalmology, orbital compartment syndrome, sight loss, blindness

Procedia PDF Downloads 101
4121 Physiological and Biochemical Based Analysis to Assess the Efficacy of Mulch under Partial Root Zone Drying in Wheat

Authors: Salman Ahmad, Muhammad Aown Sammar Raza, Muhammad Farrukh Saleem, Rashid Iqbal, Muhammad Saqlain Zaheer, Muhammad Usman Aslam, Imran Haider, Muhammad Adnan Nazar, Muhammad Ali

Abstract:

Among the various abiotic stresses, drought stress is one of the most challenging for field crops. Wheat is one of the major staple food of the world, which is highly affected by water deficit stress in the current scenario of climate change. In order to ensure food security by depleting water resources, there is an urgent need to adopt technologies which result in sufficient crop yield with less water consumption. Mulching and partial rootzone drying (PRD) are two important management techniques used for water conservation and to mitigate the negative impacts of drought. The experiment was conducted to screen out the best-suited mulch for wheat under PRD system. Two water application techniques (I1= full irrigation I2= PRD irrigation) and four mulch treatments (M0= un-mulched, M1= black plastic mulch, M2= wheat straw mulch and M4= cotton sticks mulch) were conducted in completely randomized design with four replications. The treatment, black plastic mulch was performed the best than other mulch treatments. For irrigation levels, higher values of growth, physiological and water-related parameters were recorded in control treatment while, quality traits and enzymatic activities were higher under partial root zone drying. The current study concluded that adverse effects of drought on wheat can be significantly mitigated by using mulches but black plastic mulch was best suited for partial rootzone drying irrigation system in wheat.

Keywords: antioxidants, leaf water relations, Mulches, osmolytes, partial root zone drying, photosynthesis

Procedia PDF Downloads 268
4120 Dynamics of Parent to Adolescent Communication on Sexual and Reproductive Health in Sub-Saharan Africa: A Focus on Barriers and Policy Implications

Authors: Douglas Nyathi, Mxolisi Sibanda, Joram Ndlovuu, Thulani Dube, Innocent T. Mahiya

Abstract:

Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast mediato come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.

Keywords: parent, adolecsent, communication, sexual and reproductive health

Procedia PDF Downloads 460
4119 A Survey of Skin Cancer Detection and Classification from Skin Lesion Images Using Deep Learning

Authors: Joseph George, Anne Kotteswara Roa

Abstract:

Skin disease is one of the most common and popular kinds of health issues faced by people nowadays. Skin cancer (SC) is one among them, and its detection relies on the skin biopsy outputs and the expertise of the doctors, but it consumes more time and some inaccurate results. At the early stage, skin cancer detection is a challenging task, and it easily spreads to the whole body and leads to an increase in the mortality rate. Skin cancer is curable when it is detected at an early stage. In order to classify correct and accurate skin cancer, the critical task is skin cancer identification and classification, and it is more based on the cancer disease features such as shape, size, color, symmetry and etc. More similar characteristics are present in many skin diseases; hence it makes it a challenging issue to select important features from a skin cancer dataset images. Hence, the skin cancer diagnostic accuracy is improved by requiring an automated skin cancer detection and classification framework; thereby, the human expert’s scarcity is handled. Recently, the deep learning techniques like Convolutional neural network (CNN), Deep belief neural network (DBN), Artificial neural network (ANN), Recurrent neural network (RNN), and Long and short term memory (LSTM) have been widely used for the identification and classification of skin cancers. This survey reviews different DL techniques for skin cancer identification and classification. The performance metrics such as precision, recall, accuracy, sensitivity, specificity, and F-measures are used to evaluate the effectiveness of SC identification using DL techniques. By using these DL techniques, the classification accuracy increases along with the mitigation of computational complexities and time consumption.

Keywords: skin cancer, deep learning, performance measures, accuracy, datasets

Procedia PDF Downloads 137
4118 3D Numerical Studies and Design Optimization of a Swallowtail Butterfly with Twin Tail

Authors: Arunkumar Balamurugan, G. Soundharya Lakshmi, V. Thenmozhi, M. Jegannath, V. R. Sanal Kumar

Abstract:

Aerodynamics of insects is of topical interest in aeronautical industries due to its wide applications on various types of Micro Air Vehicles (MAVs). Note that the MAVs are having smaller geometric dimensions operate at significantly lower speeds on the order of 10 m/s and their Reynolds numbers range is approximately 1,50,000 or lower. In this paper, numerical study has been carried out to capture the flow physics of a biological inspired Swallowtail Butterfly with fixed wing having twin tail at a flight speed of 10 m/s. Comprehensive numerical simulations have been carried out on swallow butterfly with twin tail flying at a speed of 10 m/s with uniform upper and lower angles of attack in both lateral and longitudinal position for identifying the best wing orientation with better aerodynamic efficiency. Grid system in the computational domain is selected after a detailed grid refinement exercises. Parametric analytical studies have been carried out with different lateral and longitudinal angles of attack for finding the better aerodynamic efficiency at the same flight speed. The results reveal that lift coefficient significantly increases with marginal changes in the longitudinal angle and vice versa. But in the case of drag coefficient the conventional changes have been noticed, viz., drag increases at high longitudinal angles. We observed that the change of twin tail section has a significant impact on the formation of vortices and aerodynamic efficiency of the MAV’s. We concluded that for every lateral angle there is an exact longitudinal orientation for the existence of an aerodynamically efficient flying condition of any MAV. This numerical study is a pointer towards for the design optimization of Twin tail MAVs with flapping wings.

Keywords: aerodynamics of insects, MAV, swallowtail butterfly, twin tail MAV design

Procedia PDF Downloads 397
4117 Impact of Heat Moisture Treatment on the Yield of Resistant Starch and Evaluation of Functional Properties of Modified Mung Bean (Vigna radiate) Starch

Authors: Sreejani Barua, P. P. Srivastav

Abstract:

Formulation of new functional food products for diabetes patients and obsessed people is a challenge for food industries till date. Starch is a certainly happening, ecological, reasonable and profusely obtainable polysaccharide in plant material. In the present scenario, there is a great interest in modifying starch functional properties without destroying its granular structure using different modification techniques. Resistant starch (RS) contains almost zero calories and can control blood glucose level to prevent diabetes. The current study focused on modification of mung bean starch which is a good source of legumes carbohydrate for the production of functional food. Heat moisture treatment (HMT) of mung starch was conducted at moisture content of 10-30%, temperature of 80-120 °C and time of 8-24 h.The content of resistant starch after modification was significantly increased from native starches containing RS 7.6%. The design combinations of HMT had been completed through Central Composite Rotatable Design (CCRD). The effects of HMT process variables on the yield of resistant starch was studied through Rapid Surface Methodology (RSM). The highest increase of resistant starch was found up to 34.39% when treated the native starch with 30% m.c at 120 °C temperature for 24 h.The functional properties of both native and modified mung bean starches showed that there was a reduction in the swelling power and swelling volume of HMT starches. However, the solubility of the HMT starches was higher than that of untreated native starch and also observed change in structural (scanning electron microscopy), X-Ray diffraction (XRD) pattern, blue value and thermal (differential scanning calorimetry) properties. Therefore, replacing native mung bean starch with heat-moisture treated mung bean starch leads to the development of new products with higher resistant starch levels and functional properties.

Keywords: Mung bean starch, heat moisture treatment, functional properties, resistant starch

Procedia PDF Downloads 207
4116 Study of the Effect of the Contra-Rotating Component on the Performance of the Centrifugal Compressor

Authors: Van Thang Nguyen, Amelie Danlos, Richard Paridaens, Farid Bakir

Abstract:

This article presents a study of the effect of a contra-rotating component on the efficiency of centrifugal compressors. A contra-rotating centrifugal compressor (CRCC) is constructed using two independent rotors, rotating in the opposite direction and replacing the single rotor of a conventional centrifugal compressor (REF). To respect the geometrical parameters of the REF one, two rotors of the CRCC are designed, based on a single rotor geometry, using the hub and shroud length ratio parameter of the meridional contour. Firstly, the first rotor is designed by choosing a value of length ratio. Then, the second rotor is calculated to be adapted to the fluid flow of the first rotor according aerodynamics principles. In this study, four values of length ratios 0.3, 0.4, 0.5, and 0.6 are used to create four configurations CF1, CF2, CF3, and CF4 respectively. For comparison purpose, the circumferential velocity at the outlet of the REF and the CRCC are preserved, which means that the single rotor of the REF and the second rotor of the CRCC rotate with the same speed of 16000rpm. The speed of the first rotor in this case is chosen to be equal to the speed of the second rotor. The CFD simulation is conducted to compare the performance of the CRCC and the REF with the same boundary conditions. The results show that the configuration with a higher length ratio gives higher pressure rise. However, its efficiency is lower. An investigation over the entire operating range shows that the CF1 is the best configuration in this case. In addition, the CRCC can improve the pressure rise as well as the efficiency by changing the speed of each rotor independently. The results of changing the first rotor speed show with a 130% speed increase, the pressure ratio rises of 8.7% while the efficiency remains stable at the flow rate of the design operating point.

Keywords: centrifugal compressor, contra-rotating, interaction rotor, vacuum

Procedia PDF Downloads 139
4115 Optimization of Ultrasound Assisted Extraction of Polysaccharides from Plant Waste Materials: Selected Model Material is Hazelnut Skin

Authors: T. Yılmaz, Ş. Tavman

Abstract:

In this study, optimization of ultrasound assisted extraction (UAE) of hemicellulose based polysaccharides from plant waste material has been studied. Selected material is hazelnut skin. Extraction variables for the operation are extraction time, amplitude and application temperature. Optimum conditions have been evaluated depending on responses such as amount of wet crude polysaccharide, total carbohydrate content and dried sample. Pretreated hazelnut skin powders were used for the experiments. 10 grams of samples were suspended in 100 ml water in a jacketed vessel with additional magnetic stirring. Mixture was sonicated by immersing ultrasonic probe processor. After the extraction procedures, ethanol soluble and insoluble sides were separated for further examinations. The obtained experimental data were analyzed by analysis of variance (ANOVA). Second order polynomial models were developed using multiple regression analysis. The individual and interactive effects of applied variables were evaluated by Box Behnken Design. The models developed from the experimental design were predictive and good fit with the experimental data with high correlation coefficient value (R2 more than 0.95). Extracted polysaccharides from hazelnut skin are assumed to be pectic polysaccharides according to the literature survey of Fourier Transform Spectrometry (FTIR) analysis results. No more change can be observed between spectrums of different sonication times. Application of UAE at optimized condition has an important effect on extraction of hemicellulose from plant material by satisfying partial hydrolysis to break the bounds with other components in plant cell wall material. This effect can be summarized by varied intensity of microjets and microstreaming at varied sonication conditions.

Keywords: hazelnut skin, optimization, polysaccharide, ultrasound assisted extraction

Procedia PDF Downloads 334
4114 Effect of Temperature on Investigation of Index Properties of Red Clay Soil

Authors: Birhanu Kassa

Abstract:

The knowledge of temperature effect on index properties and, thus, the understanding of its behavior may be essential for a complete understanding of the various cases of Geotechnical Engineering problems and for conducting meaningful practical research, analysis, and design in tropical regions, such as the Ethiopian environment. The scarcity of the proper geotechnical information on the subsoil makes foundation and engineering works risk able, difficult, and sometimes hazardous. Seasonal variations, environmental effects, terrain challenges, and temperature effects all affect the quality of soil. Simada is a city which is found in south Gondar and it is developing rapidly both in horizontal and vertical construction. Rapid urbanization in the city area has led to an increased interest in the basic properties of soils that are present within the city area. There has been no previous research that looks into the effect of temperature on the investigation of clay soil index qualities in Simada. This work focuses mainly on investigating the Index and some other properties of soil in Simada Town with varying temperatures. To explore the influence of temperature change, samples were collected from various regions of the city, and routine laboratory tests were performed on the collected samples at various temperatures. Disturbed samples were taken at intervals where an average depth of 1.5-2m depths below natural ground level. The standard laboratory tests performed on all twenty-four soil samples were the water content, gradation analysis, Atterberg limits, specific gravity, and compaction test. All specimens were tested at different temperatures (25°C, 35 °C, 45 °C, 65 °C,75 and 105 °C). The variation of the plasticity characteristics of the soils has been determined based on the temperature variation. From the test result, we can conclude that temperature has a significant effect on the index properties of clay soil, in our case, red clay soil.

Keywords: airdried, oven dried, soils index properties, compaction test

Procedia PDF Downloads 48
4113 Working Conditions and Occupational Health: Analyzing the Stressing Factors in Outsourced Employees

Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

Abstract:

In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

Procedia PDF Downloads 111
4112 Nondestructive Acoustic Microcharacterisation of Gamma Irradiation Effects on Sodium Oxide Borate Glass X2Na2O-X2B2O3 by Acoustic Signature

Authors: Ibrahim Al-Suraihy, Abdellaziz Doghmane, Zahia Hadjoub

Abstract:

We discuss in this work the elastic properties by using acoustic microscopes to measure Rayleigh and longitudinal wave velocities in a no radiated and radiated sodium borate glasses X2Na2O-X2B2O3 with 0 ≤ x ≤ 27 (mol %) at microscopic resolution. The acoustic material signatures were first measured, from which the characteristic surface velocities were determined.Longitudinal and shear ultrasonic velocities were measured in a different composition of sodium borate glass samples before and after irradiation with γ-rays. Results showed that the effect due to increasing sodium oxide content on the ultrasonic velocity appeared more clearly than due to γ-radiation. It was found that as Na2O composition increases, longitudinal velocities vary from 3832 to 5636 m/s in irradiated sample and it vary from 4010 to 5836 m/s in high radiated sample by 10 dose whereas shear velocities vary from 2223 to 3269 m/s in irradiated sample and it vary from 2326 m/s in low radiation to 3385 m/s in high radiated sample by 10 dose. The effect of increasing sodium oxide content on ultrasonic velocity was very clear. The increase of velocity was attributed to the gradual increase in the rigidity of glass and hence strengthening of network due to gradual change of boron atoms from the three-fold to the four-fold coordination of oxygen atoms. The ultrasonic velocities data of glass samples have been used to find the elastic modulus. It was found that ultrasonic velocity, elastic modulus and microhardness increase with increasing barium oxide content and increasing γ-radiation dose.

Keywords: mechanical properties X2Na2O-X2B2O3, acoustic signature, SAW velocities, additives, gamma-radiation dose

Procedia PDF Downloads 401
4111 House Facades and Emotions: Exploring the Psychological Impact of Architectural Features

Authors: Nour Tawil, Sandra Weber, Kirsten K. Roessler, Martin Mau, Simone Kuhn

Abstract:

The link between “quality” residential environments and human health and well-being has long been proposed. While the physical properties of a sound environment have been fairly defined, little focus has been given to the psychological impact of architectural elements. Recently, studies have investigated the response to architectural parameters, using measures of physiology, brain activity, and emotion. Results showed different aspects of interest: detailed and open versus blank and closed facades, patterns in perceiving different elements, and a visual bias for capturing faces in buildings. However, in the absence of a consensus on methodologies, the available studies remain unsystematic and face many limitations regarding the underpinning psychological mechanisms. To bridge some of these gaps, an online study was launched to investigate design features that influence the aesthetic judgement and emotional evaluation of house facades, using a well-controlled stimulus set of Canadian houses. A methodical modelling of design features will be performed to extract both high and low level image properties, in addition to segmentation of layout-related features. 300 participants from Canada, Denmark, and Germany will rate the images on twelve psychological dimensions representing appealing aspects of a house. Subjective ratings are expected to correlate with specific architectural elements while controlling for typicality and familiarity, and other individual differences. With the lack of relevant studies, this research aims to identify architectural elements of beneficial qualities that can inform design strategies for optimized residential spaces.

Keywords: architectural elements, emotions, psychological response, residential facades.

Procedia PDF Downloads 235
4110 Genotypic Variation in the Germination Performance and Seed Vigor of Safflower (Carthamus tinctorius L.)

Authors: Mehmet Demir Kaya, Engin Gökhan Kulan, Onur İleri, Süleyman Avcı

Abstract:

Due to variation in seed size, shape and oil content of safflower cultivars, germination and emergence performance have been severely influenced by seed characteristics. This study aimed to determine genotypic variation among safflower genotypes for one thousand seed weight, oil content, germination and seed vigor using electrical conductivity (EC) and cold test. In the study, safflower lines ES37-5, ES38-4, ES43-11, ES55-14 and ES58-11 which were developed by single seed selection method, and Dinçer and Remzibey-05 were used as standard varieties. The genotypes were grown under rainfed conditions in Eskişehir, Turkey with four replications. The seeds of each genotype were subjected to standard germination and emergence test at 25°C for 10 days with four replications and 50 seeds per replicate. Electrical conductivity test was performed at 25°C for 24 h to assess the seed vigor. Also, cold test were applied to each safflower genotype at 10°C for 4 days and 25°C for 6 days. Results showed that oil content of the safflower genotypes were different. The highest oil content was determined in ES43-11 with 36.6% while the lowest was 25.9% in ES38-4. Higher germination and emergence rate were obtained from ES55-14 with 96.5% and 73.0%, respectively. There was no significant difference among the safflower genotypes for EC values. Cold test showed that ES43-11 and ES55-14 gave the maximum germination percentages. It was concluded that genotypic factors except for soil and climatic conditions play an important role for determining seed vigor because safflower genotypes grown at the same condition produced various seed vigor values.

Keywords: Carthamus tinctorius L., germination, emergence, cold test, electrical conductivity

Procedia PDF Downloads 374
4109 Re-Evaluation of Functional Assessment of Anorexia/Cachexia Therapy (Appetite Scale) with Nutritional Intake of Cancer Patients

Authors: Amena Omer Syeda, Harita Shyam

Abstract:

Background: Anorexia a common symptom among patients with prolonged illness leading to anorexia-cachexia syndrome with a prevalence rate of 70%. In order to provide effective health care and better response to treatment, appetite should be assessed on admission and then periodically for earlier nutrition intervention. Functional Assessment of Anorexia/Cachexia Therapy (FAACT) appetite scale is 12 questions, patient-rated, symptom specific measure for appetite, and distress from anorexia. It assigns a score ranging from 0 (worst response) to 4 (best response). Therefore, proposing a total score of ≤24 may be sufficient to make a diagnosis of anorexia. Objectives: To assess the FAACT scale by co-relating the scores with the Nutritional intake and BMI of Cancer Patients. Methods: The FAACT scores of 100 cancer in-patients receiving chemotherapy or radiation as treatment, their 24-hour calorie and protein intake and BMI were recorded. The data was then statistically analyzed. Results: The calorie and protein intake and FAACT scores both showed a significant positive co-relation (p<0.001), inferring that the patients with a FAACT score of ≤24 where not meeting their calorie as well as protein requirements, hence rightly categorizing them as anorexic. The co-relation between BMI and FAACT scores showed a weak co-relation and was not statistically significant (p > 0.05).The FAACT scale thus is not sensitive to distinguish patients being under-weight, normal weight or obese. Conclusion: The FAACT scale helps in providing better palliative and nutritional care as it correctly assessed anorexia /cachexia in cancer patients and co-related significantly with their nutrient intake.

Keywords: appetite, cachexia, cancer, malnutrition

Procedia PDF Downloads 250
4108 Parameter Optimization and Thermal Simulation in Laser Joining of Coach Peel Panels of Dissimilar Materials

Authors: Masoud Mohammadpour, Blair Carlson, Radovan Kovacevic

Abstract:

The quality of laser welded-brazed (LWB) joints were strongly dependent on the main process parameters, therefore the effect of laser power (3.2–4 kW), welding speed (60–80 mm/s) and wire feed rate (70–90 mm/s) on mechanical strength and surface roughness were investigated in this study. The comprehensive optimization process by means of response surface methodology (RSM) and desirability function was used for multi-criteria optimization. The experiments were planned based on Box– Behnken design implementing linear and quadratic polynomial equations for predicting the desired output properties. Finally, validation experiments were conducted on an optimized process condition which exhibited good agreement between the predicted and experimental results. AlSi3Mn1 was selected as the filler material for joining aluminum alloy 6022 and hot-dip galvanized steel in coach peel configuration. The high scanning speed could control the thickness of IMC as thin as 5 µm. The thermal simulations of joining process were conducted by the Finite Element Method (FEM), and results were validated through experimental data. The Fe/Al interfacial thermal history evidenced that the duration of critical temperature range (700–900 °C) in this high scanning speed process was less than 1 s. This short interaction time leads to the formation of reaction-control IMC layer instead of diffusion-control mechanisms.

Keywords: laser welding-brazing, finite element, response surface methodology (RSM), multi-response optimization, cross-beam laser

Procedia PDF Downloads 353
4107 Combustion Improvements by C4/C5 Bio-Alcohol Isomer Blended Fuels Combined with Supercharging and EGR in a Diesel Engine

Authors: Yasufumi Yoshimoto, Enkhjargal Tserenochir, Eiji Kinoshita, Takeshi Otaka

Abstract:

Next generation bio-alcohols produced from non-food based sources like cellulosic biomass are promising renewable energy sources. The present study investigates engine performance, combustion characteristics, and emissions of a small single cylinder direct injection diesel engine fueled by four kinds of next generation bio-alcohol isomer and diesel fuel blends with a constant blending ratio of 3:7 (mass). The tested bio-alcohol isomers here are n-butanol and iso-butanol (C4 alcohol), and n-pentanol and iso-pentanol (C5 alcohol). To obtain simultaneous reductions in NOx and smoke emissions, the experiments employed supercharging combined with EGR (Exhaust Gas Recirculation). The boost pressures were fixed at two conditions, 100 kPa (naturally aspirated operation) and 120 kPa (supercharged operation) provided with a roots blower type supercharger. The EGR rates were varied from 0 to 25% using a cooled EGR technique. The results showed that both with and without supercharging, all the bio-alcohol blended diesel fuels improved the trade-off relation between NOx and smoke emissions at all EGR rates while maintaining good engine performance, when compared with diesel fuel operation. It was also found that regardless of boost pressure and EGR rate, the ignition delays of the tested bio-alcohol isomer blends are in the order of iso-butanol > n-butanol > iso-pentanol > n-pentanol. Overall, it was concluded that, except for the changes in the ignition delays the influence of bio-alcohol isomer blends on the engine performance, combustion characteristics, and emissions are relatively small.

Keywords: alternative fuel, butanol, diesel engine, EGR (Exhaust Gas Recirculation), next generation bio-alcohol isomer blended fuel, pentanol, supercharging

Procedia PDF Downloads 172
4106 Outcomes in New-Onset Diabetic Foot Ulcers Stratified by Etiology

Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

Abstract:

Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

Procedia PDF Downloads 440