Search results for: public health management
5715 A Cohort Study of Early Cardiologist Consultation by Telemedicine on the Critical Non-STEMI Inpatients
Authors: Wisit Wichitkosoom
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Objectives: To find out the more effect of early cardiologist consultation using a simple technology on the diagnosis and early proper management of patients with Non-STEMI at emergency department of district hospitals without cardiologist on site before transferred. Methods: A cohort study was performed in Udonthani general hospital at Udonthani province. From 1 October 2012–30 September 2013 with 892 patients diagnosed with Non-STEMI. All patients mean aged 46.8 years of age who had been transferred because of Non-STEMI diagnosed, over a 12 week period of studied. Patients whose transferred, in addition to receiving proper care, were offered a cardiologist consultation with average time to Udonthani hospital 1.5 hour. The main outcome measure was length of hospital stay, mortality at 3 months, inpatient investigation, and transfer rate to the higher facilitated hospital were also studied. Results: Hospital stay was significantly shorter for those didn’t consult cardiologist (hazard ratio 1.19; approximate 95% CI 1.001 to 1.251; p = 0.039). The 136 cases were transferred to higher facilitated hospital. No statistically significant in overall mortality between the groups (p=0.068). Conclusions: Early cardiologist consultant can reduce length of hospital stay for patients with cardiovascular conditions outside of cardiac center. The new basic technology can apply for the safety patient.Keywords: critical, telemedicine, safety, non STEMI
Procedia PDF Downloads 4135714 Developing the P1-P7 Management and Analysis Software for Thai Child Evaluation (TCE) of Food and Nutrition Status
Authors: S. Damapong, C. Kingkeow, W. Kongnoo, P. Pattapokin, S. Pruenglamphu
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As the presence of Thai children double burden malnutrition, we conducted a project to promote holistic age-appropriate nutrition for Thai children. Researchers developed P1-P7 computer software for managing and analyzing diverse types of collected data. The study objectives were: i) to use software to manage and analyze the collected data, ii) to evaluate the children nutritional status and their caretakers’ nutrition practice to create regulations for improving nutrition. Data were collected by means of questionnaires, called P1-P7. P1, P2 and P5 were for children and caretakers, and others were for institutions. The children nutritional status, height-for-age, weight-for-age, and weight-for-height standards were calculated using Thai child z-score references. Institution evaluations consisted of various standard regulations including the use of our software. The results showed that the software was used in 44 out of 118 communities (37.3%), 57 out of 240 child development centers and nurseries (23.8%), and 105 out of 152 schools (69.1%). No major problems have been reported with the software, although user efficiency can be increased further through additional training. As the result, the P1-P7 software was used to manage and analyze nutritional status, nutrition behavior, and environmental conditions, in order to conduct Thai Child Evaluation (TCE). The software was most widely used in schools. Some aspects of P1-P7’s questionnaires could be modified to increase ease of use and efficiency.Keywords: P1-P7 software, Thai child evaluation, nutritional status, malnutrition
Procedia PDF Downloads 3475713 Financing from Customers for SMEs and Managing Financial Risks: The Role of Customer Relationships
Authors: Yongsheng Guo, Mengyu Lu
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This study investigates how Chinese SMEs manage financial risks in financing from customers from the perspectives of ethics and national culture. A grounded theory approach is adopted to identify the causal conditions, actions/interactions, and consequences. 32 interviews were conducted, and systematic coding methods were used to identify themes and categories. This study found that Chinese ethical principles, including integrity, friendship, and reciprocity, and cultural traits, including collectivism, acquaintance society, and long-term orientation, provide conditions for financing from customers. The SMEs establish trust-based relationships with customers through personal communications and social networks and reduce financial risk through diversification, frequent operations, and enterprise reputations. Both customers and SMEs can get benefits like financial resources and customer experiences. This study creates a theoretical framework that connects the causal conditions, processes, and outcomes, providing a deeper understanding of financing from customers. A resource and process capability theory of SMEs and a customer capital and customer value model are proposed to connect accounting and finance concepts. Suggestions are proposed for the authorities as more guidance and regulations are needed for this informal finance.Keywords: CRM, culture, ethics, SME, risk management
Procedia PDF Downloads 385712 Exoskeleton for Hemiplegic Patients: Mechatronic Approach to Move One Disabled Lower Limb
Authors: Alaoui Hamza, Moutacalli Mohamed Tarik, Chebak Ahmed
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The number of people suffering from hemiplegia is growing each year. This lower limb disability affects all the aspects of their lives by taking away their autonomy. This implicates their close relatives, as well as the health system to provide the necessary care they need. The integration of exoskeletons in the medical field became a promising solution to resolve this issue. This paper presents an exoskeleton designed to help hemiplegic people get back the sensation and ability of normal walking. For this purpose, three step models have been created. The first step allows a simple forward movement of the leg. The second method is designed to overcome some obstacles in the patient path, and finally the third step model gives the patient total control over the device. Each of the control methods was designed to offer a solution to the challenges that the patients may face during the walking process.Keywords: ability of normal walking, exoskeleton, hemiplegic patients, lower limb motion- mechatronics
Procedia PDF Downloads 1475711 Effect of Migraine on Functional Performance and Reported Symptoms in Children with Concussion
Authors: Abdulaziz Alkathiry
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Concussion is a common brain injury that affect physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Migraine has been identified as a common symptom reported after concussion and was tied with worse prognoses. Hence, we aimed to investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. This cross-sectional study involved 35 symptomatic children aged 9 – 17 years recruited within 1 year from their concussion injury at a tertiary balance center. Participants’ symptoms and functional performance were assessed using the post-concussion symptoms scale (PCSS) and the functional gait assessment (FGA) respectively. Concussed children with migraine showed significantly worse symptoms including fatigue, sleeping impairment, difficulty concentrating, and visual problems (P < 0.05). Functional performance didn’t show differences between concussed children with and without migraine. Although concussed children with and without migraine didn’t show any differences on functional performance, worse cognitive symptoms were found in concussed children with migraine. A customized treatment approach is indicated in the presence of migraine for the management of children with concussion. Keywords: Concussion; Migraine; Balance; Post-Concussion Symptoms Scale; Functional Gait AssessmentKeywords: concussion, migraine, post-concussion symptoms scale, functional gait assessment, balance
Procedia PDF Downloads 3375710 Applying Innovation in FP Counselling: Results from A360 Amplify Matasan Matan Arewa Implementation of Counseling for Choice to Improve Contraceptive Adoption and Continuation among Married Adolescent Girls (15-19 years) in Northern Nigeria
Authors: Bulama Alhaji Alhassan, Roselyn Odeh, Rakiya Idris Labaran, Dorcas Yemi Danladi, Faith Ochonu
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Introduction: Contraceptive use has numerous health benefits such as preventing unplanned pregnancies thereby supporting women to achieve their life goals, maintaining the ideal amount of time between pregnancies, lowering the death rate for both mothers and children and generally enhancing the lives of women and children. Despite the numerous advantages of modern contraception and numerous initiatives by the government and development partners to promote its adoption, Nigeria's use of these methods has remained persistently low. Counseling about contraception is essential to providing high-quality treatment ensuring informed choice, and voluntarism for family planning is the key. The goal of the contraceptive counseling approach known as Counseling for Choice (C4C) is to ensure that people have the agency and voice to choose the contraceptive methods that best suit their requirements by altering the way both clients and providers engage in family planning counseling sessions. Aim: To evaluate the effect of counseling for choice on Modern Contraceptive adoption and continuation among married adolescent girls aged 15-19 years in 61 health facilities, within a 6-month period in Northern Nigeria. Methodology: Data from the NDHIS was obtained from selected facilities Pre & Post commencement of C4C intervention from 36 facilities Kaduna and 25 Nasarawa Matasan Matan Arewa (MMA) core implementation states putting into consideration the specific period of initiation of intervention, six months after deployment of the C4C, data was obtained from these facilities for post analysis. Data was analyzed on SPSS using paired sample t-test. Result: C4C resulted to improved access to FP services via increasing contraceptive adoption and continued used by 15% and 27% respectively (p<0.05) in Nasarawa state. While in Kaduna state we observed 11% and 28% improvement in adoption and continued use respectively as well with statistical significance (p<0.05) depicting that the increase is highly correlated (0.99 Nasarawa and 0.75 Kaduna) with the C4C intervention where the provider uses the NORMAL AND 3Ws Rubric to explain to the client in a simplified manner what to do with chosen method, what to expect with her method of adoption and when to return for a refill. Conclusion: In Northern Nigeria, it was observed that most clients discontinue their methods due to bleeding side effect and that was related to lack of appropriate and comprehensive information during counselling about what to expect with the clients method of adoption but with the intervention of the program, through capacity strengthening of PHC providers on counselling skills using the Counselling for Choice, it has helped to improve modern contraceptive uptake among young married women in northern Nigeria.Keywords: continuation, counselling, uptake, adolescent, modern & implementation
Procedia PDF Downloads 675709 Single Cell Rna Sequencing Operating from Benchside to Bedside: An Interesting Entry into Translational Genomics
Authors: Leo Nnamdi Ozurumba-Dwight
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Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq
Procedia PDF Downloads 1735708 An Experiential Learning of Ontology-Based Multi-document Summarization by Removal Summarization Techniques
Authors: Pranjali Avinash Yadav-Deshmukh
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Remarkable development of the Internet along with the new technological innovation, such as high-speed systems and affordable large storage space have led to a tremendous increase in the amount and accessibility to digital records. For any person, studying of all these data is tremendously time intensive, so there is a great need to access effective multi-document summarization (MDS) systems, which can successfully reduce details found in several records into a short, understandable summary or conclusion. For semantic representation of textual details in ontology area, as a theoretical design, our system provides a significant structure. The stability of using the ontology in fixing multi-document summarization problems in the sector of catastrophe control is finding its recommended design. Saliency ranking is usually allocated to each phrase and phrases are rated according to the ranking, then the top rated phrases are chosen as the conclusion. With regards to the conclusion quality, wide tests on a selection of media announcements are appropriate for “Jammu Kashmir Overflow in 2014” records. Ontology centered multi-document summarization methods using “NLP centered extraction” outshine other baselines. Our participation in recommended component is to implement the details removal methods (NLP) to enhance the results.Keywords: disaster management, extraction technique, k-means, multi-document summarization, NLP, ontology, sentence extraction
Procedia PDF Downloads 3785707 Earthquake Vulnerability and Repair Cost Estimation of Masonry Buildings in the Old City Center of Annaba, Algeria
Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente
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The seismic risk mitigation from the perspective of the old buildings stock is truly essential in Algerian urban areas, particularly those located in seismic prone regions, such as Annaba city, and which the old buildings present high levels of degradation associated with no seismic strengthening and/or rehabilitation concerns. In this sense, the present paper approaches the issue of the seismic vulnerability assessment of old masonry building stocks through the adaptation of a simplified methodology developed for a European context area similar to that of Annaba city, Algeria. Therefore, this method is used for the first level of seismic vulnerability assessment of the masonry buildings stock of the old city center of Annaba. This methodology is based on a vulnerability index that is suitable for the evaluation of damage and for the creation of large-scale loss scenarios. Over 380 buildings were evaluated in accordance with the referred methodology and the results obtained were then integrated into a Geographical Information System (GIS) tool. Such results can be used by the Annaba city council for supporting management decisions, based on a global view of the site under analysis, which led to more accurate and faster decisions for the risk mitigation strategies and rehabilitation plans.Keywords: Damage scenarios, masonry buildings, old city center, seismic vulnerability, vulnerability index
Procedia PDF Downloads 4455706 Piezo-Extracted Model Based Chloride/ Carbonation Induced Corrosion Assessment in Reinforced Concrete Structures
Authors: Gupta. Ashok, V. talakokula, S. bhalla
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Rebar corrosion is one of the main causes of damage and premature failure of the reinforced concrete (RC) structures worldwide, causing enormous costs for inspection, maintenance, restoration and replacement. Therefore, early detection of corrosion and timely remedial action on the affected portion can facilitate an optimum utilization of the structure, imparting longevity to it. The recent advent of the electro-mechanical impedance (EMI) technique using piezo sensors (PZT) for structural health monitoring (SHM) has provided a new paradigm to the maintenance engineers to diagnose the onset of the damage at the incipient stage itself. This paper presents a model based approach for corrosion assessment based on the equivalent parameters extracted from the impedance spectrum of concrete-rebar system using the EMI technique via the PZT sensors.Keywords: impedance, electro-mechanical, stiffness, mass, damping, equivalent parameters
Procedia PDF Downloads 5365705 The Moderation Effect of Smart Phone Addiction in Relationship between Self-Leadership and Innovative Behavior
Authors: Gi-Ryun Park, Gye-Wan Moon, Dong-Hoon Yang
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This study aims to explore the positive effects of self-leadership and innovative behavior that'd been proven in the existing researches proactively and understand the regulation effects of smartphone addiction which has recently become an issue in Korea. This study conducted a convenient sampling of college students attending the four colleges located at Daegu. A total of 210 questionnaires in 5-point Likert scale were distributed to college students. Among which, a total of 200 questionnaires were collected for our final analysis data. Both correlation analysis and regression analysis were carried out to verify those questionnaires through SPSS 20.0. As a result, college students' self-leadership had a significantly positive impact on innovative behavior (B= .210, P= .003). In addition, it is found that the relationship between self-leadership and innovative behavior can be adjusted depending on the degree of smartphone addiction in college students (B= .264, P= .000). This study could first understand the negative effects of smartphone addiction and find that if students' self-leadership is improved in terms of self-management and unnecessary use of smartphone is controlled properly, innovative behavior can be improved. In addition, this study is significant in that it attempts to identify a new impact of smartphone addiction with the recent environmental changes, unlike the existing researches that'd been carried out from the perspective of organizational behavior theory.Keywords: innovative behavior, revolutionary behavior, self-leadership, smartphone addiction
Procedia PDF Downloads 2505704 Policy Evaluation of Republic Act 9502 “Universally Accessible Cheaper and Quality Medicines Act of 2008”
Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban
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To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502
Procedia PDF Downloads 385703 Symptom Burden and Quality of Life in Advanced Lung Cancer Patients
Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour
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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.Keywords: quality of life, lung cancer, metastasis, symptoms burden
Procedia PDF Downloads 3755702 Heavy Metal Concentrations in Sediments of Sta. Maria River, Laguna
Authors: Francis Angelo A. Sta. Ana
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Heavy metal pollutants are a major environmental concern in built-up areas in the Philippines. It causes negative effects on aquatic organisms and human health. Heavy metals concentrations of chromium, mercury, lead, copper, arsenic, zinc, cadmium, and nickel were investigated in Sta. Maria river, in Laguna. A total of 16 sediment samples were collected from the river at four stations. Atomic absorption spectroscopy (AAS) was used for element detection. It is found that copper is associated with chromium based on statistical analysis using principal component analysis (PCA). Conduct of Sediment Quality Guideline (SQG) revealed that chromium has high toxicity due to values higher than Sediment Quality Guidelines Probable Effect Level (SQG’s PEL). Copper, Nickel, and Pb fall on average toxicity while others are below PEL and effect range low (ERL).Keywords: heavy metals, pollutants, sediment quality guidelines, atomic absorption spectroscopy
Procedia PDF Downloads 1345701 Analysis of the Impact of Climate Change on Maize (Zea Mays) Yield in Central Ethiopia
Authors: Takele Nemomsa, Girma Mamo, Tesfaye Balemi
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Climate change refers to a change in the state of the climate that can be identified (e.g. using statistical tests) by changes in the mean and/or variance of its properties and that persists for an extended period, typically decades or longer. In Ethiopia; Maize production in relation to climate change at regional and sub- regional scales have not been studied in detail. Thus, this study was aimed to analyse the impact of climate change on maize yield in Ambo Districts, Central Ethiopia. To this effect, weather data, soil data and maize experimental data for Arganne hybrid were used. APSIM software was used to investigate the response of maize (Zea mays) yield to different agronomic management practices using current and future (2020s–2080s) climate data. The climate change projections data which were downscaled using SDSM were used as input of climate data for the impact analysis. Compared to agronomic practices the impact of climate change on Arganne in Central Ethiopia is minute. However, within 2020s-2080s in Ambo area; the yield of Arganne hybrid is projected to reduce by 1.06% to 2.02%, and in 2050s it is projected to reduce by 1.56 While in 2080s; it is projected to increase by 1.03% to 2.07%. Thus, to adapt to the changing climate; farmers should consider increasing plant density and fertilizer rate per hectare.Keywords: APSIM, downscaling, response, SDSM
Procedia PDF Downloads 3745700 Explanation Conceptual Model of the Architectural Form Effect on Structures in Building Aesthetics
Authors: Fatemeh Nejati, Farah Habib, Sayeh Goudarzi
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Architecture and structure have always been closely interrelated so that they should be integrated into a unified, coherent and beautiful universe, while in the contemporary era, both structures and architecture proceed separately. The purpose of architecture is the art of creating form and space and order for human service, and the goal of the structural engineer is the transfer of loads to the structure, too. This research seeks to achieve the goal by looking at the relationship between the form of architecture and structure from its inception to the present day to the Global Identification and Management Plan. Finally, by identifying the main components of the design of the structure in interaction with the architectural form, an effective step is conducted in the Professional training direction and solutions to professionals. Therefore, after reviewing the evolution of structural and architectural coordination in various historical periods as well as how to reach the form of the structure in different times and places, components are required to test the components and present the final theory that one hundred to be tested in this regard. Finally, this research indicates the fact that the form of architecture and structure has an aesthetic link, which is influenced by a number of components that could be edited and has a regular order throughout history that could be regular. The research methodology is analytic, and it is comparative using analytical and matrix diagrams and diagrams and tools for conducting library research and interviewing.Keywords: architecture, structural form, structural and architectural coordination, effective components, aesthetics
Procedia PDF Downloads 2105699 MhAGCN: Multi-Head Attention Graph Convolutional Network for Web Services Classification
Authors: Bing Li, Zhi Li, Yilong Yang
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Web classification can promote the quality of service discovery and management in the service repository. It is widely used to locate developers desired services. Although traditional classification methods based on supervised learning models can achieve classification tasks, developers need to manually mark web services, and the quality of these tags may not be enough to establish an accurate classifier for service classification. With the doubling of the number of web services, the manual tagging method has become unrealistic. In recent years, the attention mechanism has made remarkable progress in the field of deep learning, and its huge potential has been fully demonstrated in various fields. This paper designs a multi-head attention graph convolutional network (MHAGCN) service classification method, which can assign different weights to the neighborhood nodes without complicated matrix operations or relying on understanding the entire graph structure. The framework combines the advantages of the attention mechanism and graph convolutional neural network. It can classify web services through automatic feature extraction. The comprehensive experimental results on a real dataset not only show the superior performance of the proposed model over the existing models but also demonstrate its potentially good interpretability for graph analysis.Keywords: attention mechanism, graph convolutional network, interpretability, service classification, service discovery
Procedia PDF Downloads 1325698 Spatio-Temporal Data Mining with Association Rules for Lake Van
Authors: Tolga Aydin, M. Fatih Alaeddinoğlu
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People, throughout the history, have made estimates and inferences about the future by using their past experiences. Developing information technologies and the improvements in the database management systems make it possible to extract useful information from knowledge in hand for the strategic decisions. Therefore, different methods have been developed. Data mining by association rules learning is one of such methods. Apriori algorithm, one of the well-known association rules learning algorithms, is not commonly used in spatio-temporal data sets. However, it is possible to embed time and space features into the data sets and make Apriori algorithm a suitable data mining technique for learning spatio-temporal association rules. Lake Van, the largest lake of Turkey, is a closed basin. This feature causes the volume of the lake to increase or decrease as a result of change in water amount it holds. In this study, evaporation, humidity, lake altitude, amount of rainfall and temperature parameters recorded in Lake Van region throughout the years are used by the Apriori algorithm and a spatio-temporal data mining application is developed to identify overflows and newly-formed soil regions (underflows) occurring in the coastal parts of Lake Van. Identifying possible reasons of overflows and underflows may be used to alert the experts to take precautions and make the necessary investments.Keywords: apriori algorithm, association rules, data mining, spatio-temporal data
Procedia PDF Downloads 3655697 Combating the Practice of Open Defecation through Appropriate Communication Strategies in Rural India
Authors: Santiagomani Alex Parimalam
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Lack of awareness on the consequences of open defecation and myths and misconceptions related to use of toilets have led to the continued practice of open defecation in India. Government of India initiated a multi-pronged intensive communication campaign against the practice of open defecation in the last few years. The primary vision of this communication campaign was to provide increased demand for toilets and to ensure that all have access to safe sanitation. The campaign strategy included the use of mass media, group and folk media, and interpersonal communication to expedite achieving its objectives. The campaign included the use of various media such as posters, wall writings, slides in cinema theatres, kiosks, pamphlets, newsletters, flip charts and folk media to bring behavioural changes in the communities. The author did a concurrent monitoring and process documentation of the campaigns initiated by the state of Tamilnandu, India between 2013 and 2016 commissioned by UNICEF India. The study was carried out to assess the effectiveness of the communication campaigns in combating the practice of open defecation and promote construction of toilets in the state of Tamilnadu, India. Initial findings revealed the gap in understanding the audience and the use of appropriate media. The first phase of the communication campaign by name as Chi Chi Chollapa (bringing shame concept) also revealed that use of interpersonal communication, group and community media were the most effective strategy in reaching the rural masses. The failure of various other media used especially the print media (poster, handbills, newsletter, kiosks) provides insights as to where the government needs to invest its resources in bringing health-seeking behaviour in the community. The findings shared with the government enabled to strengthen the campaign resulting in improved response. Taking cues from the study, the government understood the potency of the women, school children, youth and community leaders as the effective carriers of the message. The government narrowed down its focus and invested on the voluntary workers (village poverty reduction committee workers VPRCs) in the community. The effectiveness of interpersonal communication and peer education by the credible community worker threw light on the need for localising the content and communicator. From this study, we could derive that only community and group media are preferred by the people in the rural community. Children, youth, women, and credible local leaders are proved to be ambassadors in behaviour change communication. This study discloses the lacunae involved in the communication campaign and points out that the state should have carried out a proper communication need analysis and piloting. The study used a survey method with random sampling. The study used both quantitative and qualitative tools such as interview schedules, in-depth interviews, and focus group discussions in rural areas of Tamilnadu in phases. The findings of the study would provide directions to future campaigns to any campaign concerning health and rural development.Keywords: appropriate, communication, combating, open defecation
Procedia PDF Downloads 1215696 A Turn-on Fluorescent Sensor for Pb(II)
Authors: Ece Kök Yetimoğlu, Soner Çubuk, Neşe Taşci, M. Vezir Kahraman
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Lead(II) is one of the most toxic environmental pollutants in the world, due to its high toxicity and non-biodegradability. Lead exposure causes severe risks to human health such as central brain damages, convulsions, kidney damages, and even death. To determine lead(II) in environmental or biological samples, scientists use atomic absorption spectrometry (AAS), inductively coupled plasma mass spectrometry (ICPMS), fluorescence spectrometry and electrochemical techniques. Among these systems the fluorescence spectrometry and fluorescent chemical sensors have attracted considerable attention because of their good selectivity and high sensitivity. The fluorescent polymers usually contain covalently bonded fluorophores. In this study imidazole based UV cured polymeric film was prepared and designed to act as a fluorescence chemo sensor for lead (II) analysis. The optimum conditions such as influence of pH value and time on the fluorescence intensity of the sensor have also been investigated. The sensor was highly sensitive with a detection limit as low as 1.87 × 10−8 mol L-1 and it was successful in the determination of Pb(II) in water samples.Keywords: fluorescence, lead(II), photopolymerization, polymeric sensor
Procedia PDF Downloads 6665695 Deep Learning Framework for Predicting Bus Travel Times with Multiple Bus Routes: A Single-Step Multi-Station Forecasting Approach
Authors: Muhammad Ahnaf Zahin, Yaw Adu-Gyamfi
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Bus transit is a crucial component of transportation networks, especially in urban areas. Any intelligent transportation system must have accurate real-time information on bus travel times since it minimizes waiting times for passengers at different stations along a route, improves service reliability, and significantly optimizes travel patterns. Bus agencies must enhance the quality of their information service to serve their passengers better and draw in more travelers since people waiting at bus stops are frequently anxious about when the bus will arrive at their starting point and when it will reach their destination. For solving this issue, different models have been developed for predicting bus travel times recently, but most of them are focused on smaller road networks due to their relatively subpar performance in high-density urban areas on a vast network. This paper develops a deep learning-based architecture using a single-step multi-station forecasting approach to predict average bus travel times for numerous routes, stops, and trips on a large-scale network using heterogeneous bus transit data collected from the GTFS database. Over one week, data was gathered from multiple bus routes in Saint Louis, Missouri. In this study, Gated Recurrent Unit (GRU) neural network was followed to predict the mean vehicle travel times for different hours of the day for multiple stations along multiple routes. Historical time steps and prediction horizon were set up to 5 and 1, respectively, which means that five hours of historical average travel time data were used to predict average travel time for the following hour. The spatial and temporal information and the historical average travel times were captured from the dataset for model input parameters. As adjacency matrices for the spatial input parameters, the station distances and sequence numbers were used, and the time of day (hour) was considered for the temporal inputs. Other inputs, including volatility information such as standard deviation and variance of journey durations, were also included in the model to make it more robust. The model's performance was evaluated based on a metric called mean absolute percentage error (MAPE). The observed prediction errors for various routes, trips, and stations remained consistent throughout the day. The results showed that the developed model could predict travel times more accurately during peak traffic hours, having a MAPE of around 14%, and performed less accurately during the latter part of the day. In the context of a complicated transportation network in high-density urban areas, the model showed its applicability for real-time travel time prediction of public transportation and ensured the high quality of the predictions generated by the model.Keywords: gated recurrent unit, mean absolute percentage error, single-step forecasting, travel time prediction.
Procedia PDF Downloads 655694 Assessment of Sleeping Patterns of Saudis with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods Using a Wearable Device and a Questionnaire
Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris
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Background: Quantity and quality of sleep have been reported to be significant risk factors for obesity and development of metabolic disorders such as type 2 diabetes mellitus (T2DM). The relationship between diabetes and sleep quantity was reported to be U-shaped, which means increased or decreased sleeping hours can increase the risk of diabetes. The plasma glucagon levels were found to continuously decrease during night-time sleep in healthy individuals, independently of blood glucose and insulin levels. The disturbance of the circadian rhythm is also important and has been linked with an increased the chance of diabetes incidence. There is a lack of research on sleep patterns on Saudis with T2DM and how this is affected by Ramadan fasting. Aim: To assess the sleeping patterns of Saudis with T2DM (before, during, and after Ramadan), using two different techniques and relate this to their HbA1c levels. Method: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Their sleeping patterns were assessed by a self-administered questionnaire (before, during, and after Ramadan). The assessment included the daily total sleeping hours (DTSH), and total night-time sleeping hours (TNTSH) of the participants. In addition, sleeping patterns of 36 patients, randomly selected from the 82 participants, were further tracked during and after Ramadan by using Fitbit Flex 2™ accelerometer. Blood samples were collected in each period for measuring HbA1c. Results: Questionnaire analysis revealed that the sleeping patterns significantly changed between the periods, with shorter hours during Ramadan (P < 0.001 for DTSH, and P < 0.001 for TNTSH). These findings were confirmed by the Fitbit data, which also indicated significant shorter sleeping hours for the DTSH, and the TNTSH during Ramadan (P < 0.001 and P < 0.001, respectively). Although there were no significant correlations between the questionnaire and Fitbit data, the TNTSH were shorter among the participants in all periods by both techniques. The mean HbA1c significantly varied between periods, with lowest level during Ramadan. Although the statistical tests did not show significant variances in the mean HbA1c between the groups of participants regarding their hours of sleeping, the lowest mean HbA1c was observed in the group of participants who slept for 6-8 hours and had longer night-time sleeping hours. Conclusion: A short sleep duration, and absence of night-time sleep were significantly observed among the majority of the study population during Ramadan, which could suppress the full benefits of Ramadan fasting for diabetic patients. This study showed that there is a good agreement between the findings of the questionnaire and the Fitbit device for evaluating sleeping patterns in a Saudi population. A larger study is needed in the future to investigate the impact of Ramadan fasting on sleep quality and quantity and its relationship with health and disease.Keywords: Diabetes, Fasting, Fitbit, HbA1c, IPAQ, Ramadan, Sleep
Procedia PDF Downloads 1075693 Rating the Importance of Customer Requirements for Green Product Using Analytic Hierarchy Process Methodology
Authors: Lara F. Horani, Shurong Tong
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Identification of customer requirements and their preferences are the starting points in the process of product design. Most of design methodologies focus on traditional requirements. But in the previous decade, the green products and the environment requirements have increasingly attracted the attention with the constant increase in the level of consumer awareness towards environmental problems (such as green-house effect, global warming, pollution and energy crisis, and waste management). Determining the importance weights for the customer requirements is an essential and crucial process. This paper used the analytic hierarchy process (AHP) approach to evaluate and rate the customer requirements for green products. With respect to the ultimate goal of customer satisfaction, surveys are conducted using a five-point scale analysis. With the help of this scale, one can derive the weight vectors. This approach can improve the imprecise ranking of customer requirements inherited from studies based on the conventional AHP. Furthermore, the AHP with extent analysis is simple and easy to implement to prioritize customer requirements. The research is based on collected data through a questionnaire survey conducted over a sample of 160 people belonging to different age, marital status, education and income groups in order to identify the customer preferences for green product requirements.Keywords: analytic hierarchy process (AHP), green product, customer requirements for green design, importance weights for the customer requirements
Procedia PDF Downloads 2395692 A Risk-Based Comprehensive Framework for the Assessment of the Security of Multi-Modal Transport Systems
Authors: Mireille Elhajj, Washington Ochieng, Deeph Chana
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The challenges of the rapid growth in the demand for transport has traditionally been seen within the context of the problems of congestion, air quality, climate change, safety, and affordability. However, there are increasing threats including those related to crime such as cyber-attacks that threaten the security of the transport of people and goods. To the best of the authors’ knowledge, this paper presents for the first time, a comprehensive framework for the assessment of the current and future security issues of multi-modal transport systems. The approach or method proposed is based on a structured framework starting with a detailed specification of the transport asset map (transport system architecture), followed by the identification of vulnerabilities. The asset map and vulnerabilities are used to identify the various approaches for exploitation of the vulnerabilities, leading to the creation of a set of threat scenarios. The threat scenarios are then transformed into risks and their categories, and include insights for their mitigation. The consideration of the mitigation space is holistic and includes the formulation of appropriate policies and tactics and/or technical interventions. The quality of the framework is ensured through a structured and logical process that identifies the stakeholders, reviews the relevant documents including policies and identifies gaps, incorporates targeted surveys to augment the reviews, and uses subject matter experts for validation. The approach to categorising security risks is an extension of the current methods that are typically employed. Specifically, the partitioning of risks into either physical or cyber categories is too limited for developing mitigation policies and tactics/interventions for transport systems where an interplay between physical and cyber processes is very often the norm. This interplay is rapidly taking on increasing significance for security as the emergence of cyber-physical technologies, are shaping the future of all transport modes. Examples include: Connected Autonomous Vehicles (CAVs) in road transport; the European Rail Traffic Management System (ERTMS) in rail transport; Automatic Identification System (AIS) in maritime transport; advanced Communications, Navigation and Surveillance (CNS) technologies in air transport; and the Internet of Things (IoT). The framework adopts a risk categorisation scheme that considers risks as falling within the following threat→impact relationships: Physical→Physical, Cyber→Cyber, Cyber→Physical, and Physical→Cyber). Thus the framework enables a more complete risk picture to be developed for today’s transport systems and, more importantly, is readily extendable to account for emerging trends in the sector that will define future transport systems. The framework facilitates the audit and retro-fitting of mitigations in current transport operations and the analysis of security management options for the next generation of Transport enabling strategic aspirations such as systems with security-by-design and co-design of safety and security to be achieved. An initial application of the framework to transport systems has shown that intra-modal consideration of security measures is sub-optimal and that a holistic and multi-modal approach that also addresses the intersections/transition points of such networks is required as their vulnerability is high. This is in-line with traveler-centric transport service provision, widely accepted as the future of mobility services. In summary, a risk-based framework is proposed for use by the stakeholders to comprehensively and holistically assess the security of transport systems. It requires a detailed understanding of the transport architecture to enable a detailed vulnerabilities analysis to be undertaken, creates threat scenarios and transforms them into risks which form the basis for the formulation of interventions.Keywords: mitigations, risk, transport, security, vulnerabilities
Procedia PDF Downloads 1595691 A Distributed Cryptographically Generated Address Computing Algorithm for Secure Neighbor Discovery Protocol in IPv6
Authors: M. Moslehpour, S. Khorsandi
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Due to shortage in IPv4 addresses, transition to IPv6 has gained significant momentum in recent years. Like Address Resolution Protocol (ARP) in IPv4, Neighbor Discovery Protocol (NDP) provides some functions like address resolution in IPv6. Besides functionality of NDP, it is vulnerable to some attacks. To mitigate these attacks, Internet Protocol Security (IPsec) was introduced, but it was not efficient due to its limitation. Therefore, SEND protocol is proposed to automatic protection of auto-configuration process. It is secure neighbor discovery and address resolution process. To defend against threats on NDP’s integrity and identity, Cryptographically Generated Address (CGA) and asymmetric cryptography are used by SEND. Besides advantages of SEND, its disadvantages like the computation process of CGA algorithm and sequentially of CGA generation algorithm are considerable. In this paper, we parallel this process between network resources in order to improve it. In addition, we compare the CGA generation time in self-computing and distributed-computing process. We focus on the impact of the malicious nodes on the CGA generation time in the network. According to the result, although malicious nodes participate in the generation process, CGA generation time is less than when it is computed in a one-way. By Trust Management System, detecting and insulating malicious nodes is easier.Keywords: NDP, IPsec, SEND, CGA, modifier, malicious node, self-computing, distributed-computing
Procedia PDF Downloads 2765690 Applying of an Adaptive Neuro-Fuzzy Inference System (ANFIS) for Estimation of Flood Hydrographs
Authors: Amir Ahmad Dehghani, Morteza Nabizadeh
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This paper presents the application of an Adaptive Neuro-Fuzzy Inference System (ANFIS) to flood hydrograph modeling of Shahid Rajaee reservoir dam located in Iran. This was carried out using 11 flood hydrographs recorded in Tajan river gauging station. From this dataset, 9 flood hydrographs were chosen to train the model and 2 flood hydrographs to test the model. The different architectures of neuro-fuzzy model according to the membership function and learning algorithm were designed and trained with different epochs. The results were evaluated in comparison with the observed hydrographs and the best structure of model was chosen according the least RMSE in each performance. To evaluate the efficiency of neuro-fuzzy model, various statistical indices such as Nash-Sutcliff and flood peak discharge error criteria were calculated. In this simulation, the coordinates of a flood hydrograph including peak discharge were estimated using the discharge values occurred in the earlier time steps as input values to the neuro-fuzzy model. These results indicate the satisfactory efficiency of neuro-fuzzy model for flood simulating. This performance of the model demonstrates the suitability of the implemented approach to flood management projects.Keywords: adaptive neuro-fuzzy inference system, flood hydrograph, hybrid learning algorithm, Shahid Rajaee reservoir dam
Procedia PDF Downloads 4725689 Mechanistic Analysis of an L-2-Haloacid Dehalogenase (DehL) from Rhizobium Sp. RC1: Computational Approach
Authors: Aliyu Adamu, Fahrul Huyop, Roswanira Abdul Wahab, Mohd Shahir Shamsir
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Halogenated organic compounds occur in huge amount in biosphere. This is attributable to the diverse use of halogen-based compounds in the synthesis of various industrially important products. Halogenated compound is toxic and may persist in the environment, thereby causing serious health and environmental pollution problems. L-2-haloacid dehalogenases (EC 3.8.1.2) catalyse the specific cleavage of carbon-halogen bond in L-isomers of halogenated compounds, which consequently reverse the effects of environmental halogen-associated pollution. To enhance the efficiency and utility of these enzymes, this study investigates the catalytic amino acid residues and the molecular functional mechanism of DehL, by classical molecular dynamic simulations, MM-PBSA and ab initio fragments molecular orbital (FMO) calculations. The results of the study will serve as the basis for the molecular engineering of the enzyme.Keywords: DehL, Functional mechanism, Catalytic residues, L-2-haloacid dehalogenase
Procedia PDF Downloads 3505688 Bystanders' Behavior during Emergencies
Authors: Alan (Avi) Kirschenbaum, Carmit Rapaport
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The behavior of bystanders in emergencies and disasters have been examined for over 50 years. Such acts have been cited as contributing to saving lives in terms of providing first responder help until official emergency units can arrive. Several reasons have been suggested for this type of behavior but most focused on a broad segment of individual psychological decision-making processes. Recent theoretical evidence suggests that the external factors for such bystander decisions, mainly disaster community based social contexts factors, are also important. We aim to test these competing arguments. Specifically, we examine alternative explanatory perspectives by focusing on self-efficacy as a proxy for the accepted individual psychological case and contrast it with potential bystander characteristics of the individual as well factors as embedded in the social context of the disaster community. To do so, we will utilize a random sampling of the population from a field study of an urban community in Israel that experienced five years of continuous terror attacks. The results strongly suggest that self-efficacy, as well as external factors: preparedness and having skills for intervention during emergencies along with gender best, predict potential helping behaviors. These results broaden our view of bystander behavior and open a window for enhancing this phenomenon as another element in disaster and crisis management.Keywords: bystander behavior, disasters emergencies, psychological motivation to help, social context for helping
Procedia PDF Downloads 1195687 Current Status of Ir-192 Brachytherapy in Bangladesh
Authors: M. Safiqul Islam, Md Arafat Hossain Sarkar
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Brachytherapy is one of the most important cancer treatment management systems in radiotherapy department. Brachytherapy treatment is moved into High Dose Rate (HDR) after loader from Low Dose Rate (LDR) after loader due to radiation protection advantage. HDR Brachytherapy is a highly multipurpose system for enhancing cure and achieving palliation in many common cancers disease of developing countries. High-dose rate (HDR) Brachytherapy is a type of internal radiation therapy that delivers radiation from implants placed close to or inside, the tumor(s) in the body. This procedure is very effective at providing localized radiation to the tumor site while minimizing the patient’s whole body dose. Brachytherapy has proven to be a highly successful treatment for cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer. For the time being in our country we have 10 new HDR Remote after loading Brachytherapy. Right now 4 HDR Brachytherapy is already installed and running for patient’s treatment out of 10 HDR Brachytherapy. Ir-192 source is more comfortable than Co-60. In that case people or expert personnel prefer Ir-192 source for different kind of cancer patients. Ir-192 are economically, more flexible and familiar in our country.Keywords: Ir-192, brachytherapy, cancer treatment, prostate, cervix, endometrium, breast, skin, bronchus, esophagus, soft tissue sarcomas
Procedia PDF Downloads 4255686 The Effect of Whole-Body Vertical Rhythm Training on Fatigue, Physical Activity, and Quality of Life to the Middle-Aged and Elderly with Hemodialysis Patients
Authors: Yen-Fen Shen, Meng-Fan Li
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The study aims to investigate the effect of full-body vertical rhythmic training on fatigue, physical activity, and quality of life among middle-aged and elderly hemodialysis patients. The study adopted a quasi-experimental research method and recruited 43 long-term hemodialysis patients from a medical center in northern Taiwan, with 23 and 20 participants in the experimental and control groups, respectively. The experimental group received full-body vertical rhythmic training as an intervention, while the control group received standard hemodialysis care without any intervention. Both groups completed the measurements by using "Fatigue Scale", "Physical Activity Scale" and "Chinese version of the Kidney Disease Quality of Life Questionnaire" before and after the study. The experimental group underwent a 10-minute full-body vertical rhythmic training three times per week, which lasted for eight weeks before receiving regular hemodialysis treatment. The data were analyzed by SPSS 25 software, including descriptive statistics such as frequency distribution, percentages, means, and standard deviations, as well as inferential statistics, including chi-square, independent samples t-test, and paired samples t-test. The study results are summarized as follows: 1. There were no significant differences in demographic variables, fatigue, physical activity, and quality of life between the experimental and control groups in the pre-test. 2. After the intervention of the “full-body vertical rhythmic training,” the experimental group showed significantly better results in the category of "feeling tired and fatigued in the lower back", "physical functioning role limitation", "bodily pain", "social functioning", "mental health", and "impact of kidney disease on life quality." 3. The paired samples t-test results revealed that the control group experienced significant differences between the pre-test and post-test in the categories of feeling tired and fatigued in the lower back, bodily pain, social functioning mental health, and impact of kidney disease on life quality, with scores indicating a decline in life quality. Conversely, the experimental group only showed a significant worsening in bodily pain" and the impact of kidney disease on life quality, with lower change values compared to the control group. Additionally, there was an improvement in the condition of "feeling tired and fatigued in the lower back" for the experimental group. Conclusion: The intervention of the “full-body vertical rhythmic training” had a certain positive effect on the quality of life of the experimental group. While it may not entirely enhance patients' quality of life, it can mitigate the negative impact of kidney disease on certain aspects of the body. The study provides clinical practice, nursing education, and research recommendations based on the results and discusses the limitations of the research.Keywords: hemodialysis, full-body vertical rhythmic training, fatigue, physical activity, quality of life
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