Search results for: customer knowledge management

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

Procedia PDF Downloads 170

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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Authors: N. N. Lingaraju, A. Sathish, K. N. Geetha, C. A. Srinivasamurthy, S. Bhaskar

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Studies on spent wash utilization as a nutrient source through 'Effect of distillery spentwash application on soil properties and yield of maize (Zea may L.) and finger millet (Eleusine coracana (L.) G)' was carried out in Malavalli Taluk, Mandya District, Karnataka State, India. The study was conducted in fourteen different locations of Malavalli (12) and Maddur taluk (2) involving maize and finger millet as a test crop. The spentwash was characterized for various parameters like pH, EC, total NPK, Na, Ca, Mg, SO₄, Fe, Zn, Cu, Mn and Cl content. It was observed from the results that the pH was slightly alkaline (7.45), EC was excess (23.3 dS m⁻¹), total NPK was 0.12, 0.02, and 1.31 percent respectively, Na, Ca, Mg and SO₄ concentration was 664, 1305, 745 and 618 (mg L⁻¹) respectively, total solid content was quite high (6.7%), Fe, Zn, Cu, Mn, values were 23.5, 5.70, 3.64, 4.0 mg L⁻¹, respectively. The crops were grown by adopting different crop management practices after application of spentwash at 100 m³ ha⁻¹ to the identified farmer fields. Soil samples were drawn at three stages i.e., before sowing of crop, during crop growth stage and after harvest of the crop at 2 depths (0-30 and 30-60 cm) and analyzed for pH, EC, available K and Na parameters by adopting standard procedures. The soil analysis showed slightly acidic reaction (5.93), normal EC (0.43 dS m⁻¹), medium available potassium (267 kg ha⁻¹) before application of spentwash. Application of spentwash has enhanced pH level of soil towards neutral (6.97), EC 0.25 dS m⁻¹, available K2O to 376 kg ha⁻¹ and sodium content of 0.73 C mol (P+) kg⁻¹ during the crop growth stage. After harvest of the crops soil analysis data indicated a decrease in pH to 6.28, EC of 0.22 dS m⁻¹, available K₂O to 316 kg ha⁻¹ and Na 0.52 C mol (P⁺) kg⁻¹ compared with crop growth stage. The study showed that, there will be enhancement of potassium levels if the spentwash is applied once to dryland. The yields of both the crops were quantified and found to be in the range of 35.65 to 65.55 q ha⁻¹ and increased yield to the extent of 13.36-22.36 percent as compared to control field (11.36-22.33 q ha⁻¹) in maize crop. Also, finger millet yield was increased with the spentwash application to the extent of 14.21-20.49 percent (9.5-17.73 q ha⁻¹) higher over farmers practice (8.15-14.15 q ha⁻¹).

Keywords: distillery spentwash, finger millet, maize, waste water

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Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

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Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

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Authors: Arifur Rahman, Ardeshir Amirkhani, Honghua Hu, Mark Molloy, Karen Vickery

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Introduction and Objectives: Staphylococcus aureus and coagulase-negative staphylococci comprises approximately 65% of infections associated with medical devices and are well known for their biofilm formatting ability. Biofilm-related infections are extremely difficult to eradicate owing to their high tolerance to antibiotics and host immune defences. Currently, there is no efficient method for early biofilm detection. A better understanding to enable detection of biofilm specific proteins in vitro and in vivo can be achieved by studying planktonic and different growth phases of biofilms using a proteome analysis approach. Our goal was to construct a reference map of planktonic and biofilm associated proteins of S. aureus. Methods: S. aureus reference strain (ATCC 25923) was used to grow 24 hours planktonic, 3-day wet biofilm (3DWB), and 12-day wet biofilm (12DWB). Bacteria were grown in tryptic soy broth (TSB) liquid medium. Planktonic growth was used late logarithmic bacteria, and the Centres for Disease Control (CDC) biofilm reactor was used to grow 3 days, and 12-day hydrated biofilms, respectively. Samples were subjected to reduction, alkylation and digestion steps prior to Multiplex labelling using Tandem Mass Tag (TMT) 10-plex reagent (Thermo Fisher Scientific). The labelled samples were pooled and fractionated by high pH RP-HPLC which followed by loading of the fractions on a nanoflow UPLC system (Eksigent UPLC system, AB SCIEX). Mass spectrometry (MS) data were collected on an Orbitrap Elite (Thermo Fisher Scientific) Mass Spectrometer. Protein identification and relative quantitation of protein levels were performed using Proteome Discoverer (version 1.3, Thermo Fisher Scientific). After the extraction of protein ratios with Proteome Discoverer, additional processing, and statistical analysis was done using the TMTPrePro R package. Results and Discussion: The present study showed that a considerable proteomic difference exists among planktonic and biofilms from S. aureus. We identified 1636 total extracellular secreted proteins, of which 350 and 137 proteins of 3DWB and 12DWB showed significant abundance variation from planktonic preparation, respectively. Of these, simultaneous up-regulation in between 3DWB and 12DWB proteins such as extracellular matrix-binding protein ebh, enolase, transketolase, triosephosphate isomerase, chaperonin, peptidase, pyruvate kinase, hydrolase, aminotransferase, ribosomal protein, acetyl-CoA acetyltransferase, DNA gyrase subunit A, glycine glycyltransferase and others we found in this biofilm producer. On the contrary, simultaneous down-regulation in between 3DWB and 12DWB proteins such as alpha and delta-hemolysin, lipoteichoic acid synthase, enterotoxin I, serine protease, lipase, clumping factor B, regulatory protein Spx, phosphoglucomutase, and others also we found in this biofilm producer. In addition, we also identified a big percentage of hypothetical proteins including unique proteins. Therefore, a comprehensive knowledge of planktonic and biofilm associated proteins identified by S. aureus will provide a basis for future studies on the development of vaccines and diagnostic biomarkers. Conclusions: In this study, we constructed an initial reference map of planktonic and various growth phase of biofilm associated proteins which might be helpful to diagnose biofilm associated infections.

Keywords: bacterial biofilms, CDC bioreactor, S. aureus, mass spectrometry, TMT

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Authors: Sunday Nathaniel Obasi, Chiamak Chinasa Obasi

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Soil characterization and classification provide the basic information necessary to create a functional evaluation and soil classification schemes. Fertility capability classification (FCC) on the other hand is a technical system that groups the soils according to kinds of problems they present for management of soil physical and chemical properties. This research was carried out in Ebonyi state, southeastern Nigeria, which is an agrarian state and a leading rice producing part of southeastern Nigeria. In order to maximize the soil and enhance the productivity of rice in Ebonyi soils, soil classification, and fertility classification information need to be supplied. The state was grouped into three locations according to their agricultural zones namely; Ebonyi north, Ebonyi central and Ebonyi south representing Abakaliki, Ikwo and Ivo locations respectively. Major rice growing areas of the soils were located and two profile pits were sunk in each of the studied zones from which soils were characterized, classified and fertility capability classification (FCC) developed. Soil classification was done using United State Department of Agriculture (USDA) Soil Taxonomy and correlated with World Reference Base for soil resources. Results obtained classified Abakaliki 1 and Abakaliki 2 as Typic Fluvaquents (Ochric Fluvisols). Ikwo 1 was classified as Vertic Eutrudepts (Eutric Vertisols) while Ikwo 2 was classified as Typic Eutrudepts (Eutric Cambisols). Ivo 1 and Ivo 2 were both classified as Aquic Eutrudepts (Gleyic Leptosols). Fertility capability classification (FCC) revealed that all studied soils had mostly loamy topsoils and subsoils except Ikwo 1 with clayey topsoil. Limitations encountered in the studied soils include; dryness (d), low ECEC (e), low nutrient capital reserve (k) and water logging/ anaerobic condition (gley). Thus, FCC classifications were Ldek for Abakaliki 1 and 2, Ckv for Ikwo 1, LCk for Ikwo 2 while Ivo 1 and 2 were Legk and Lgk respectively.

Keywords: soil classification, soil fertility, limitations, modifiers, Southeastern Nigeria

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Authors: David Ahiamadia, Ramilan Thiagarajah, Peter Tozer

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In Sub Saharan Africa, farm typologies have been used as a practical way to address heterogeneity among farming systems which is mostly done by grouping farms into subsets with similar characteristics. Due to the complexity in farming systems among farm households, it is not possible to formulate policy recommendations for individual farmers. As a result, this study employs a multivariate statistical approach using Principal Component Analysis (PCA) coupled with cluster analysis to reduce heterogeneity in a 615-household data set from the Africa Rising Baseline Evaluation Survey for 25 farming communities in Northern Ghana. Variables selected for the study were mostly socio-economic, production potential, production intensity, production orientation, crop diversity, food security, resource endowments, and climate risk variables. To avoid making some individuals in the subpopulation worse off when aclimate risk intervention is broadly implemented, the findings of the study also account for diversity in climate risk perception among the different farm types identified and their response strategies towards climate risk. The climate risk variables used in this study involve the most severeclimate shock types perceived by the household, household response to climate shock type, and reason for crop failure (i.e., maize, rice, and groundnut). Eventually, four farm types, each with an adequate level of homogeneity in climate risk perception and response strategies, were identified. Farm type 1 and 3 were wealthy with a lower degree of climate risk perception compared to farm type 2 and 4. Also, relatively wealthy farmers used asset liquidation as a climate risk management strategy, whereas poor farmers resorted to engaging in spiritual activities such as prayers, sacrifices, and divine consultations.

Keywords: smallholder, households, climate risk, variables, typologies

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Authors: Marian Mihalik, Kornel Csach, Martin Kovalik, Matúš Mihalik, Martina Kubovčíková, Maria Zentková, Martin Vavra, Vladimír Girman, Jaroslav Briančin, Marija Perovic, Marija Boškovic, Magdalena Fitta, Robert Pelka

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Current nanomaterials for use in biomedicine are based mainly on iron oxides and on present knowledge on magnetic nanostructures. Manganites can represent another material which can be used optionally. Manganites and their unique electronic properties have been extensively studied in the last decades not only due to fundamental interest but to possible applications of colossal magnetoresistance, magnetocaloric effect, and ferroelectric properties. It was found that the oxygen-reduction reaction on perovskite oxide is intimately connected with metal ion e.g., orbital occupation. The effect of oxygen deviation from the stoichiometric composition on crystal structure was studied very carefully by many authors on LaMnO₃. Depending on oxygen content, the crystal structure changes from orthorhombic one to rhombohedric for oxygen content 3.1. In the case of hole-doped manganites, the change from the orthorhombic crystal structure, which is typical for La1-xCaxMnO3 based manganites, to the rhombohedric crystal structure (La1-xMxMnO₃ where M = K, Ag, and Sr based materials) results in an enormous increase of the Curie temperature. In our paper, we study the effect of oxygen content on crystal structure, thermal, and magnetic properties (including magnetocaloric effect) of La1-xAgxMnO₃nano particle system. The content of oxygen in samples was tuned by heat treatment in different thermal regimes and in various environment (air, oxygen, argon). Water nanosuspensions based on La0.80Ag0.15MnO₃ magnetic particles with the Curie temperature of about 43oC were prepared by two different approaches. First, by using a laboratory circulation mill for milling of powder in the presence of sodium dodecyl sulphate (SDS) and subsequent centrifugation. Second nanosuspension was prepared using an agate bowl, etching in citric acid and HNO3, ultrasound homogeniser, centrifugation, and dextran 40 kDA or 15 kDA as surfactant. Electrostatic stabilisation obtained by the first approach did not offer long term kinetic and aggregation colloidal stability and was unable to compensate for attractive forces between particles under a magnetic field. By the second approach, we prepared suspension oversaturated by dextran 40 kDA for steric stabilisation, with evidence of the presence of superparamagnetic behaviour. Low concentration of nanoparticles and not ideal coverage of nanoparticles impacting the stability of ferrofluids was the disadvantage of this approach. Strong steric stabilisation was observable at alcaic conditions under pH = ~10. Application of dextran 15 kDA leads to relatively stable ferrofluid with pH around physiological conditions, but desegregation of powder by HNO₃ was not effective enough, and the average size of fragments was to large of about 150 nm, and we did not see any signature of superparamagnetic behaviour. The prepared ferrofluids were characterised by scanning and transition microscope method, thermogravimetry, magnetization, and AC susceptibility measurements. Specific Absorption Rate measurements were undertaken on powder as well on ferrofluids in order to estimate the potential application of La₀.₈₀Ag₀.₁₅MnO₃ magnetic particles based ferrofluid for hyperthermia. Our complex study contains an investigation of biocompatibility and potential biohazard of this material.

Keywords: manganites, magnetic nanoparticles, oxygen content, magnetic phase transition, magnetocaloric effect, ferrofluid, hyperthermia

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Authors: Logan Carmichael

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As the world’s governments seek to increasingly digitize their service provisions, there exists a subsequent and fully valid concern about the security underpinning these digital governance provisions. Estonia, a small and innovative Baltic nation, has been refining both its digital governance structure and cybersecurity mechanisms for over three decades and has been praised as global ‘best practice’ in both fields. However, the security of the Estonian digital governance system has been ever-evolving and significantly shaped by cybersecurity crises. This paper examines said crises – 2007 cyberattacks on Estonian government, banks, and news media; the 2017 e-ID crisis; the ongoing COVID-19 pandemic; and the 2022 Russian invasion of Ukraine – and how governance decision-making following these crises has shaped the cybersecurity of the digital governance structure in Estonia. This paper employs a blended constructivist and historical institutionalist theoretical approach as a useful means to view governance and decision-making in the wake of cybersecurity incidents affecting the Estonian digital governance structure. Together, these theoretical groundings frame the topics of cybersecurity and digital governance in an Estonian context through a lens of ideation and experience, as well as institutional path dependencies over time and cybersecurity crises as critical junctures to study. Furthermore, this paper takes a qualitative approach, employing discourse analysis, policy analysis, and elite interviewing of Estonian officials involved in digital governance and cybersecurity in order to glean nuanced perspectives into the processes that followed these four crises. Ultimately, the results of this paper will offer insight into how governments undertake policy-driven change following cybersecurity crises to ensure sufficient security of their digitized service provisions. This paper’s findings are informative not only in continued decision-making in the Estonian system but also in other states currently implementing a digital governance structure, for which security mechanisms are of the utmost importance.

Keywords: cybersecurity, digital governance, Estonia, crisis management, governance in crisis

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

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Authors: Peifang Hsieh

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The prevention of child abuse has aroused serious concerns in Taiwan because of the disparity between the increasing amount of reported child abuse cases that doubled over the past decade and the scarcity of social workers. New Taipei city, with the most population in Taiwan and over 70% of its 4 million citizens are migrant families in which the needs of children can be easily neglected due to insufficient support from relatives and communities, sees urgency for a social support system, by preemptively identifying and outreaching high-risk families of child abuse, so as to offer timely assistance and preventive measure to safeguard the welfare of the children. Big data analysis is the inspiration. As it was clear that high-risk families of child abuse have certain characteristics in common, New Taipei city decides to consolidate detailed background information data from departments of social affairs, education, labor, and health (for example considering status of parents’ employment, health, and if they are imprisoned, fugitives or under substance abuse), to cross-reference for accurate and prompt identification of the high-risk families in need. 'The Service Center for High-Risk Families' (SCHF) was established to integrate data cross-departmentally. By utilizing the machine learning 'random forest method' to build a risk prediction model which can early detect families that may very likely to have child abuse occurrence, the SCHF marks high-risk families red, yellow, or green to indicate the urgency for intervention, so as to those families concerned can be provided timely services. The accuracy and recall rates of the above model were 80% and 65%. This prediction model can not only improve the child abuse prevention process by helping social workers differentiate the risk level of newly reported cases, which may further reduce their major workload significantly but also can be referenced for future policy-making.

Keywords: child abuse, high-risk families, big data analysis, risk prediction model

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Authors: Francisco J. Ortega, Claudia Roman, Moisés García-Morales, Francisco J. Navarro

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Asphaltic bitumen has been largely used in both industrial and civil engineering, mostly in pavement construction and roofing membrane manufacture. However, bitumen as such is greatly susceptible to temperature variations, and dramatically changes its in-service behavior from a viscoelastic liquid, at medium-high temperatures, to a brittle solid at low temperatures. Bitumen modification prevents these problems and imparts improved performance. Isocyanates like polymeric MDI (mixture of 4,4′-diphenylmethane di-isocyanate, 2,4’ and 2,2’ isomers, and higher homologues) have shown to remarkably enhance bitumen properties at the highest in-service temperatures expected. This comes from the reaction between the –NCO pendant groups of the oligomer and the most polar groups of asphaltenes and resins in bitumen. In addition, oxygen diffusion and/or UV radiation may provoke bitumen hardening and ageing. With the purpose of minimizing these effects, nano-layered-silicates (nanoclays) are increasingly being added to bitumen formulations. Montmorillonites, a type of naturally occurring mineral, may produce a nanometer scale dispersion which improves bitumen thermal, mechanical and barrier properties. In order to increase their lipophilicity, these nanoclays are normally treated so that organic cations substitute the inorganic cations located in their intergallery spacing. In the present work, the combined effect of polymeric MDI and the commercial montmorillonite Cloisite® 20A was evaluated. A selected bitumen with penetration within the range 160/220 was modified with 10 wt.% Cloisite® 20A and 2 wt.% polymeric MDI, and the resulting ternary composites were characterized by linear rheology, X-ray diffraction (XRD) and Atomic Force Microscopy (AFM). The rheological tests evidenced a notable solid-like behavior at the highest temperatures studied when bitumen was just loaded with 10 wt.% Cloisite® 20A and high-shear blended for 20 minutes. However, if polymeric MDI was involved, the sequence of addition exerted a decisive control on the linear rheology of the final ternary composites. Hence, in bitumen/Cloisite® 20A/polymeric MDI formulations, the previous solid-like behavior disappeared. By contrast, an inversion in the order of addition (bitumen/polymeric MDI/ Cloisite® 20A) enhanced further the solid-like behavior imparted by the nanoclay. In order to gain a better understanding of the factors that govern the linear rheology of these ternary composites, a morphological and microstructural characterization based on XRD and AFM was conducted. XRD demonstrated the existence of clay stacks intercalated by bitumen molecules to some degree. However, the XRD technique cannot provide detailed information on the extent of nanoclay delamination, unless the entire fraction has effectively been fully delaminated (situation in which no peak is observed). Furthermore, XRD was unable to provide precise knowledge neither about the spatial distribution of the intercalated/exfoliated platelets nor about the presence of other structures at larger length scales. In contrast, AFM proved its power at providing conclusive information on the morphology of the composites at the nanometer scale and at revealing the structural modification that yielded the rheological properties observed. It was concluded that high-shear blending brought about a nanoclay-reinforced network. As for the bitumen/Cloisite® 20A/polymeric MDI formulations, the solid-like behavior was destroyed as a result of the agglomeration of the nanoclay platelets promoted by chemical reactions.

Keywords: Atomic Force Microscopy, bitumen, composite, isocyanate, montmorillonite.

Procedia PDF Downloads 257

Authors: Yousef Alqaryouti, Mariam Al Suwaidi, Raed Mohmood AlKhuwaildi, Hind Kolthoum, Issa Youssef, Mohammed Al Imam

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The UAE has experienced rapid economic growth due to its mature oil production industry, leading to a surge in urbanization and infrastructure development in the construction sector. Sustainable development practices are becoming increasingly important, and the UAE government has taken proactive measures to promote them, including the introduction of sustainable building codes, energy-efficient technologies, and renewable energy sources. Initiatives such as the Masdar City project and the Emirates Green Building Council further demonstrate the government's commitment to a cleaner and healthier environment. By adopting sustainable practices, the UAE can reduce its carbon footprint, lessen its reliance on fossil fuels, and achieve cost savings in the long run. The purpose of this paper is to conduct a thorough review of the current state of sustainability in the construction industry of the UAE. Our research methodology includes a local market survey and qualitative observational analysis of executed housing construction projects by the Mohammed Bin Rashid Housing Establishment. The market survey assesses eleven different challenging factors that affect sustainable construction project delivery. The qualitative observational research is based on data collected from three projects, including construction progress, bill of quantity, and construction program. The study concludes that addressing these challenges requires a collaborative team approach, incentivized contracts, traditional project management practices, an integrated project team, and an increase in sustainability awareness among stakeholders. The recommendations proposed in this study aim to promote and improve the application of sustainability in the UAE's construction industry for the future.

Keywords: sustainability, construction, challenges, opportunities, case study, market survey

Procedia PDF Downloads 52

Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Guo Rui, Cao Xinhu

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In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

Procedia PDF Downloads 122

Authors: Ashneel Ajay Singh, Naoki Suzuki, Kazumi Sakuramoto, Swastika Roshni, Paras Nath, Alok Kalla

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Albacore tuna (Thunnus alalunga) is one of the commercially important species of tuna in the North Pacific region. Despite the long history of albacore fisheries in the Pacific, its ecological characteristics are not sufficiently understood. The effects of changing climate on numerous commercially and ecologically important fish species including albacore tuna have been documented over the past decades. The objective of this study was to explore and elucidate the relationship of environmental variables with the stock parameters of albacore tuna. The relationship of the North Pacific albacore tuna recruitment (R), spawning stock biomass (SSB) and recruits per spawning biomass (RPS) from 1970 to 2012 with the environmental factors of sea surface temperature (SST), Pacific decadal oscillation (PDO), El Niño southern oscillation (ENSO) and Pacific warm pool index (PWI) was construed. SST and PDO were used as independent variables with SSB to construct stock reproduction models for R and RPS as they showed most significant relationship with the dependent variables. ENSO and PWI were excluded due to collinearity effects with SST and PDO. Model selections were based on R2 values, Akaike Information Criterion (AIC) and significant parameter estimates at p<0.05. Models with single independent variables of SST, PDO, ENSO and PWI were also constructed to illuminate their individual effect on albacore R and RPS. From the results it can be said that SST and PDO resulted in the most significant models for reproducing North Pacific albacore tuna R and RPS time series. SST has the highest impact on albacore R and RPS when comparing models with single environmental variables. It is important for fishery managers and decision makers to incorporate the findings into their albacore tuna management plans for the North Pacific Oceanic region.

Keywords: Albacore tuna, El Niño southern oscillation, Pacific decadal oscillation, sea surface temperature

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Authors: Taimaz Larimian, Negin Sadeghi

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Very little is known about the impacts of urban security on the level of social sustainability within the cities of developing countries. Urban security is still struggling to find its position in the social sustainability agenda, despite the significant role of safety and security on different aspects of peoples’ lives. This paper argues that urban safety and security should be better integrated within the social sustainability framework. With this aim, this study investigates the hypothesized relationship between social sustainability and Crime Prevention through Environmental Design (CPTED) approach at the neighborhood scale. This study proposes a model of key influential dimensions of CPTED analyzed into localized factors and sub-factors. These factors are then prioritized using pairwise comparison logic and fuzzy group Analytic Hierarchy Process (AHP) method in order to determine the relative importance of each factor on achieving social sustainability. The proposed model then investigates social sustainability in six case study neighborhoods of Isfahan city based on residents’ perceptions of safety within their neighborhood. Mixed method of data collection is used by using a self-administered questionnaire to explore the residents’ perceptions of social sustainability in their area of residency followed by an on-site observation to measure the CPTED construct. In all, 150 respondents from selected neighborhoods were involved in this research. The model indicates that CPTED approach has a significant direct influence on increasing social sustainability in neighborhood scale. According to the findings, among different dimensions of CPTED, ‘activity support’ and ‘image/ management’ have the most influence on people’s feeling of safety within studied areas. This model represents a useful designing tool in achieving urban safety and security during the development of more socially sustainable and user-friendly urban areas.

Keywords: crime prevention through environmental design (CPTED), developing countries, fuzzy analytic hierarchy process (FAHP), social sustainability

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Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

Procedia PDF Downloads 137

Authors: Amar Ramesh Wayal

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Marathi cinema, an integral part of India’s diverse film industry, has significantly evolved in its storytelling and aesthetics, with the Tamasha genre being central to this evolution. Tamasha, a traditional form of Marathi theatre, features vibrant dance and music, especially the rhythmic and often suggestive musical genre, lavani. It gained cinematic prominence in the 1960s with Anant Mane’s Sangtye Aika (1959), which brought and popularized Tamasha to the silver screen, and V. Shantaram’s Pinjra (1972), an iconic Tamasha drama. Despite early success, Tamasha films declined in popularity until Natarang (2010) revitalized interest in this traditional form. This study examines the relevance and evolution of the Tamasha genre in Marathi cinema through contemporary films like Ek Hota Vidushak by Jabbar Patel (1992), Natarang (2010) by Ravi Jadhav, and Tamasha Live (2022) by Sanjay Jadhav. The selection of the films is based on their significant roles in the evolution of the Tamasha in Marathi cinema. Ek Hota Vidushak explores socio-political themes through Tamasha, Natarang depicts the struggles and emotional depth of Tamasha performers, and Tamasha Live integrates traditional Tamasha into modern cinema. By analysing films from different periods, this study highlights the genre’s reinterpretation and adaptation over time. The study employs a qualitative approach, utilizing textual analysis and cultural critique to examine the portrayal and evolution of Tamasha in selected films. It aims to illuminate the complex relationship between tradition and modernity in Marathi cinema through Foucauldian discourse analysis and Pierre Bourdieu’s concept of “vernacular habitus,” which refers to local, indigenous cultural spaces that shape people’s perceptions and expressions. By analyzing these films, the study seeks to understand how traditional cultural forms are integrated into contemporary cinematic narratives. However, this method has limitations, such as subjectivity in interpretation and the need for extensive contextual knowledge. Qualitative research can be subject to researcher bias, affecting analysis and conclusions. To mitigate this, this study maintains rigorous reflexivity and transparency regarding the researcher’s positionality. Furthermore, findings from specific film analyses may not be universally applicable to all Tamasha films or broader Marathi cinema. To enhance the study’s robustness, future research could incorporate comparative or quantitative data to complement qualitative insights. Despite these challenges, qualitative research is crucial for exploring cultural artifacts and their significance within specific contexts. By triangulating qualitative findings with diverse perspectives and acknowledging limitations, this study aims to provide a nuanced understanding of how Tamasha cinema preserves and revitalizes Maharashtra’s folk traditions while adapting them to contemporary contexts. Analyzing films by Jabbar Patel, Ravi Jadhav, and Sanjay Jadhav shows how these filmmakers balance traditional aesthetics with modern storytelling, bridging historical continuity with contemporary relevance. This study offers insights into how indigenous traditions like Tamasha continue to shape and define cinematic narratives in Maharashtra.

Keywords: Marathi cinema, Tamasha genre, vernacular habitus, discourse analysis, cultural evolution

Procedia PDF Downloads 29

Authors: Zinhle Cindi, Collet Dandara, Mpiko Ntsekhe, Edson Makambwa, Miguel Larceda

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Background: Warfarin is the most commonly used drug in the management of thromboembolic disease. However, there is a huge variability in the time, number of doses or starting doses for patients to achieve the required international normalised ratio (INR) which is compounded by a narrow therapeutic index. Many genetic-association studies have reported on European and Asian populations which have led to the designing of specific algorithms that are now being used to assist in warfarin dosing. However, very few or no studies have looked at the pharmacogenetics of warfarin in African populations, yet, huge differences in dosage requirements to reach the same INR have been observed. Objective: We set out to investigate the distribution of 3 SNPs CYP4F2 c.1347C > T, VKORC1 g.-1639G > A and VKORC1 c.1173C > T among South African Mixed Ancestry (MA) and Black African patients. Methods: DNA was extracted from 383 participants and subsequently genotyped using PCR/RFLP for the CYP4F2 c.1347 (V433M) (rs2108622), VKORC1 g.-1639 (rs9923231) and VKORC1 c.1173 (rs9934438) SNPs. Results: Comparing the Black and MA groups, significant differences were observed in the distribution of the following genotypes; CYP4F2 c.1347C/T (23% vs. 39% p=0.03). All VKORC1 g.-1639G > A genotypes (p < 0.006) and all VKORC1 c.1173C > T genotypes (p < 0.007). Conclusion: CYP4F2 c.1347T (V433M) reduces CYP4F2 protein levels and therefore expected to affect the amount of warfarin needed to block vitamin k recycling. The VKORC1 g-1639A variant alters transcriptional regulation therefore affecting the function of vitamin k epoxide reductase in vitamin k production. The VKORC1 c.1173T variant reduces the enzyme activity of VKORC1 consequently enhancing the effectiveness of warfarin. These are preliminary results; more genetic characterization is required to understand all the genetic determinants affecting how patients respond to warfarin.

Keywords: algorithms, pharmacogenetics, thromboembolic disease, warfarin

Procedia PDF Downloads 254

Authors: Mark Joseph Quinto, Roan Beronilla, Guiller Damian, Eliza Camaso, Ronaldo Alberto

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Forest inventories are essential to assess the composition, structure and distribution of forest vegetation that can be used as baseline information for management decisions. Classical forest inventory is labor intensive and time-consuming and sometimes even dangerous. The use of Light Detection and Ranging (LiDAR) in forest inventory would improve and overcome these restrictions. This study was conducted to determine the possibility of using LiDAR derived data in extracting high accuracy forest biophysical parameters and as a non-destructive method for forest status analysis of San Manual, Pangasinan. Forest resources extraction was carried out using LAS tools, GIS, Envi and .bat scripts with the available LiDAR data. The process includes the generation of derivatives such as Digital Terrain Model (DTM), Canopy Height Model (CHM) and Canopy Cover Model (CCM) in .bat scripts followed by the generation of 17 composite bands to be used in the extraction of forest classification covers using ENVI 4.8 and GIS software. The Diameter in Breast Height (DBH), Above Ground Biomass (AGB) and Carbon Stock (CS) were estimated for each classified forest cover and Tree Count Extraction was carried out using GIS. Subsequently, field validation was conducted for accuracy assessment. Results showed that the forest of San Manuel has 73% Forest Cover, which is relatively much higher as compared to the 10% canopy cover requirement. On the extracted canopy height, 80% of the tree’s height ranges from 12 m to 17 m. CS of the three forest covers based on the AGB were: 20819.59 kg/20x20 m for closed broadleaf, 8609.82 kg/20x20 m for broadleaf plantation and 15545.57 kg/20x20m for open broadleaf. Average tree counts for the tree forest plantation was 413 trees/ha. As such, the forest of San Manuel has high percent forest cover and high CS.

Keywords: carbon stock, forest inventory, LiDAR, tree count

Procedia PDF Downloads 381

Authors: Dilshad Ali Mohammed, Ziyad Nayef Shamsulddin Aldoski, Millet Salim Mohammed

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The increase in levels of traffic congestion along urban signalized arterials needs efficient traffic management. The application of traffic signal coordination can improve the traffic operation and safety for a series of signalized intersection along the arterials. The objective of this study is to evaluate the benefits achievable through actuated traffic signal coordination and make a comparison in control delay against the same signalized intersection in case of being isolated. To accomplish this purpose, a series of eight signalized intersections located on two major arterials in Duhok City was chosen for conducting the study. Traffic data (traffic volumes, link and approach speeds, and passenger car equivalent) were collected at peak hours. Various methods had been used for collecting data such as video recording technique, moving vehicle method and manual methods. Geometric and signalization data were also collected for the purpose of the study. The coupling index had been calculated to check the coordination attainability, and then time space diagrams were constructed representing one-way coordination for the intersections on Barzani and Zakho Streets, and others represented two-way coordination for the intersections on Zakho Street with accepted progression bandwidth efficiency. The results of this study show great progression bandwidth of 54 seconds for east direction coordination and 17 seconds for west direction coordination on Barzani Street under suggested controlled speed of 60 kph agreeable with the present data. For Zakho Street, the progression bandwidth is 19 seconds for east direction coordination and 18 seconds for west direction coordination under suggested controlled speed of 40 kph. The results show that traffic signal coordination had led to high reduction in intersection control delays on both arterials.

Keywords: bandwidth, congestion, coordination, traffic, signals, streets

Procedia PDF Downloads 300

Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 envisages 'smart' manufacturing and services, taking the automation of the 3rd Industrial Revolution to the autonomy of the 4th Industrial Revolution. Powered by innovations in technology and business models, this disruptive transformation is revitalising industry by integrating silos across and beyond value chains. Motivated by the challenges faced by SMEs and Startups in understanding and adopting Industry 4.0, this paper aims to analyse the concept of Growth Poles and evaluate the possibility of its application to Innovation Clusters that strive to propel Industry 4.0 adoption and capacity building. The proposed paper applies qualitative research methodologies including focus groups and survey questionnaires to identify the various factors that affect formation and development of Innovation Clusters. Employing content analysis, the interaction between SMEs and other ecosystem players in such clusters is studied. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position these cluster-based growth poles at the forefront of industrial renaissance. Motivated by this argument, and based on the results of the qualitative research, a roadmap will be proposed to position Innovation Clusters as Growth Poles and effective ecosystems to support Industry 4.0 adoption in a region in the medium to long term. This paper will contribute to the current understanding of the role of Innovation Clusters in capacity building. Relevant management and policy implications stem from the analysis. Furthermore, the findings will be helpful for academicians and policymakers alike, who can leverage an ‘innovation cluster policy’ to enable Industry 4.0 Growth Poles in their regions.

Keywords: digital transformation, fourth industrial revolution, growth poles, industry 4.0, innovation clusters, innovation policy, SMEs and startups

Procedia PDF Downloads 227

Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

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Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

Procedia PDF Downloads 90

Authors: Dionysios Kakaroumpas, Jesseka Farago, Stephen Webber

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Athletes and spectators depend on the tennis ranking system to represent the truest caliber of athletic prowess; a careful look at the current ranking system though, reveals its main weakness: it undermines expectations of fans and players. Our study proposes several key changes to the existing ranking formula that provide a fair and accurate approach to measure player performance. The study proposes a modification of the system to value: participation, continued advancement, and overall achievement. The new ranking formula facilitates closing the trust gap, encouraging competition equality, engaging the fan base, attracting investment, and promoting tennis involvement worldwide. To probe the crux of our main contention we performed week-by-week comparisons between results procured from the current and proposed formulae. After performing this rigorous case-study of top players of each gender, the findings strongly indicated that there is identifiable inflation in the ranks and enhanced the conviction that the current system should be updated. The new system is accompanied by a web-based software package freely available to anyone involved or interested in tennis rankings. The software package is designed to automatically calculate new player rankings based on a responsive, multi-faceted formula that also generates projected point scenarios and provides separate rankings for the three different court surfaces. By taking a critical look at the current tennis ranking system with consideration to the perspective of fans, players, and businesses involved, an upgrade is in order for it to maintain the balance of trust between fans and the evaluation process. In closure, this proposed solution increases fair play competition, eliminates rank inflation, and better engages fans, players, and sponsors by bringing in a new era of professional tennis.

Keywords: measurement and evaluation, rules and regulations, sports management and marketing, tennis ranking system

Procedia PDF Downloads 265

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

Procedia PDF Downloads 64

Authors: A. K. Asekunowo, A O. T. Asafa, O. O. Okoh, O. T. Asekun, O. B. Familoni

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Background: Acalypha godseffiana is an important plant used both as an ornamental and herbs; its leaves are employed in management of diseases such as diabetics in Eastern Nigeria. Aim: The correlations of the polyphenolic compounds in the hypoglycemic potential of different extracts of leaves of A. godseffiana and their safety profile on cell lines were investigated. Materials and Methods: The phytochemical compositions and antioxidants potentials were determined using adopted methods. An in vitro approach was employed in determining the hypoglycemic potentials of the extracts on α-amylase and α-glucosidase. The Line weaver-Burke plot was used to evaluate the mechanisms of Inhibition mechanisms of the enzymes. Results and Conclusions: Antioxidants results revealed that total antioxidant capacity (TAC) of the acetone extract (IC50: 0.34 mg/mL) showed better activity compared to the standards (silymarine 0.52 mg/mL; gallic acid 0.51 mg/mL). In-vitro hypoglycemic activity of the extracts confirmed that acetone extract demonstrated strong and mild inhibitory potential against α-amylase and α-glucosidase respectively. The observed activity was concentration-dependent with IC50 values of 2.33 and 0.13 mg/mL. The observed hypoglycemic and anti-oxidant potentials of acetone extract A. godseffiana correlate to its high polyphenolic contents which include phenols (133.20 mg gallic acid g-1), flavonoid (350.60 mg quercetin g-1) and tannins (264.67 mg catechin g-1). The mechanisms of action exhibited by acetone extract of A. godseffiana were mixed non-competitive and uncompetitive; which can be attributed to its inhibitory properties on α-amylase and α-glucosidase respectively. This effect would cause reduction in the rate at which starch hydrolyse, boost palliated glucose levels; hence, making acetone extract of A. godseffiana a potential anti-hypoglycemic alternative.

Keywords: Acalypha godeseffiana, acetone extract, anti-hypoglycemia, antioxidant, phytochemicals

Procedia PDF Downloads 260

Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha

Abstract:

Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.

Keywords: human health, risk assessment, risk management, vector-borne diseases

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