Search results for: risk reduction behavior

Authors: Kauser Jahan, Jason Halvorsen, Kara Banks, Kara Natoli, Elizabeth McWeeney, Brittany LeMasney, Nicole Caramanna, Justin Hillman, Christopher Hauske, Meghan Sparks

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The Virtual Engineers on Wheels (ViEW) is a revised version of our established mobile K-12 outreach program Engineers on Wheels in order to address the pandemic. The Virtual Engineers on Wheels' (VIEW) goal has stayed the same as in prior years: to provide K-12 students and educators with the necessary resources to peak interest in the expanding fields of engineering. With these trying times, the Virtual Engineers on Wheels outreach has adapted its medium of instruction to be more seamless with the online approach to teaching and outreach. In the midst of COVID-19, providing a safe transfer of information has become a constraint for research. The focus has become how to uphold a level of quality instruction without diminishing the safety of those involved by promoting proper health practices and giving hope to students as well as their families. Furthermore, ViEW has created resources on effective strategies that minimize risk factors of COVID-19 and inform families that there is still a promising future ahead. To obtain these goals while still maintaining true to the hands-on learning that is so crucial to young minds, the approach is online video lectures followed by experiments within different engineering disciplines. ViEW has created a comprehensive website that students can leverage to explore the different fields of study. One of the experiments entails teaching about drone usage and how it might play a factor in the future of unmanned deliveries. Some of the other experiments focus on the differences in mask materials and their effectiveness, as well as their environmental outlook. Having students perform from home enables them a safe environment to learn at their own pace while still providing quality instruction that would normally be achieved in the classroom. Contact information is readily available on the website to provide interested parties with a means to ask their inquiries. As it currently stands, the interest in engineering/STEM-related fields is underrepresented from women and certain minority groups. So alongside the desire to grow interest, helping balance the scales is one of the main priorities of VIEW. In previous years, VIEW surveyed students before and after instruction to see if their perception of engineering has changed. In general, it is the understanding that being exposed to engineering/STEM at a young age increases the chances that it will be pursued later in life.

Keywords: STEM, engineering outreach, teaching pedagogy, pandemic

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Authors: Divyansh Goel, Varun Jain

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Classical economics works on the principle that people are rational and analytical in their decision making and their choices fall in line with the most suitable option according to the dominant strategy in a standard game theory model. This model has failed at many occasions in estimating the behavior and dealings of rational people, giving proof of some other underlying heuristics and cognitive biases at work. This paper probes into the study of these factors, which fall under the umbrella of behavioral economics and through their medium explore the solution to a problem which a lot of nations presently face. There has long been a wide disparity in the number of people holding favorable views on organ donation and the actual number of people signing up for the same. This paper, in its entirety, is an attempt to shape the public policy which leads to an increase the number of organ donations that take place and close the gap in the statistics of the people who believe in signing up for organ donation and the ones who actually do. The key assumption here is that in cases of cognitive dissonance, where people have an inconsistency due to conflicting views, people have a tendency to go with the default choice. This tendency is a well-documented cognitive bias known as the status quo bias. The research in this project involves an assay of mandated choice models of organ donation with two case studies. The first of an opt-in system of Germany (where people have to explicitly sign up for organ donation) and the second of an opt-out system of Austria (every citizen at the time of their birth is an organ donor and has to explicitly sign up for refusal). Additionally, there has also been presented a detailed analysis of the experiment performed by Eric J. Johnson and Daniel G. Goldstein. Their research as well as many other independent experiments such as that by Tsvetelina Yordanova of the University of Sofia, both of which yield similar results. The conclusion being that the general population has by and large no rigid stand on organ donation and are gullible to status quo bias, which in turn can determine whether a large majority of people will consent to organ donation or not. Thus, in our paper, we throw light on how governments can use status quo bias to drive positive social change by making policies in which everyone by default is marked an organ donor, which will, in turn, save the lives of people who succumb on organ transplantation waitlists and save the economy countless hours of economic productivity.

Keywords: behavioral economics, game theory, organ donation, status quo bias

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Authors: Justine Kiiza, Xu Jiafang

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The world’s demand for energy is increasing rapidly due to population growth and a reduction in shallow conventional oil and gas reservoirs, resorting to deeper and mostly unconventional reserves like shale oil and gas. Most shale formations contain a large amount of expansive sodium montmorillonite (Na-Mnt), due to high water adsorption, hydration, and when the drilling fluid filtrate enters the formation with high Mnt content, the wellbore wall can be unstable due to hydration and swelling, resulting to shrinkage, sticking, balling, time wasting etc., and well collapse in extreme cases causing complex downhole accidents and high well costs. Recently, polyamines like 1, 6 – hexane diamine (HEDA) have been used as typical drilling fluid shale inhibitors to minimize and/or cab clay mineral swelling and maintain the wellbore stability. However, their application is limited to shallow drilling due to their sensitivity to elevated temperature and pressure. Inorganic potassium salts i.e., KCl, have long been applied for restriction of shale formation hydration expansion in deep wells, but their use is limited due to toxicity. Understanding the adsorption behaviour of HEDA on Na-Mnt surfaces in present of organo-salts, organic K-salts e.g., HCO₂K - main component of organo-salt drilling fluid, is of great significance in explaining the inhibitory performance of polyamine inhibitors. Molecular dynamic simulations (MD) were applied to investigate the influence of HCO₂K and KCl on the adsorption mechanism of HEDA on the Na-Mnt surface. Simulation results showed that adsorption configurations of HEDA are mainly by terminal amine groups with a flat-lying alkyl hydrophobic chain. Its interaction with the clay surface decreased the H-bond number between H₂O-clay and neutralized the negative charge of the Mnt surface, thus weakening the surface hydration ability of Na-Mnt. The introduction of HCO₂K greatly improved inhibition ability, coordination of interlayer ions with H₂O as they were replaced by K+, and H₂O-HCOO- coordination reduced H₂O-Mnt interactions, mobility and transport capability of H₂O molecules were more decreased. While KCl showed little ability and also caused more hydration with time, HCO₂K can be used as an alternative for offshore drilling instead of toxic KCl, with a maximum concentration noted in this study as 1.65 wt%. This study provides a theoretical elucidation for the inhibition mechanism and adsorption characteristics of HEDA inhibitor on Na-Mnt surfaces in the presence of K+-salts and may provide more insight into the evaluation, selection, and molecular design of new clay-swelling high-performance WBDF systems used in oil and gas complex offshore drilling well sections.

Keywords: shale, hydration, inhibition, polyamines, organo-salts, simulation

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Authors: Juan C. Martínez-Alfaro, Aracely Zúñiga, Fernando Ruíz-Zarate

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In recent years, the Katahdin sheep breeds have been one of the breeds with greater acceptance by sheep farmers in southwestern Mexico. The Hair Sheep breeds from tropical latitudes (16° to 21° North Latitude) show low estrus activity from January to May. By contrast, these breeds of sheep exhibit high estrus activity from August to December. However, the reproductive management of Hair Sheep crossbred is very limited, independently of the socioeconomic levels of sheep farmers. Thus, in crossbred of Hair Sheep, occurrence of lambing is greater in autumn (84%) than spring (16%). In this sense, the aim of this study was to determine the lambing in Crossbred of Katahdin sheep during different seasons of the year. The Hypothesis was that in crossbred of Katahdin sheep, the lambing period has a behavior seasonal in the Southwestern Mexico. The study design consisted in evaluating the lambing proportion in one herds of Katahdin ewes crossbred during one year (October 1st, 2015 to October 1st, 2016). The study was realized in a farm located in the municipality of Jiquipilas, in the State of Chiapas, Mexico (16° North Latitude). A total of 40 female sheep homogeneous in terms of physical condition, age and physiological state were selected; and they were fed in grazing continuous, mainly with Africa star grass (Cynodon lemfuensis) and they are provided with water and mineral salts ad libitum; during the dry season, the ewes were supplemented with a diet of maize and sorghum, and the reproductive management was continuous mating. The lambing proportion was analyzed by chi-squared test, using SAS statistical software. The proportion of Katahdin ewes crossbred that lambed during the study period was high (100%; 40/40), the prolificacy was 1.42 (lamb/lambing). The proportion of lambing was higher (P<0.05) in autumn (67.5%; 27/40), than winter, spring and summer (32.5%; 13/40; 0%; 0/40; 0%; 0/40; respectively). The proportion of lambing was greater (P<0.05) in November (50%; 20/40), compared to October, December and January (2.5%; 1/40; 27.5%; 11/40; 20%; 8/40, respectively). The results are consistent with the fact that in the Hair Sheep Breeds, the lambing appears behave seasonally. The most important finding is that the lambing period in the crossbred of Katahdin Sheep is similar to the crossbred of Hair Sheep in tropical regions of Mexico. Therefore, the period of greater sexual activity occurs in the spring season. In conclusion, the period of lambing in crossbred of Katahdin ewes appears behave seasonally. Further researches to assess the ovarian activity in different breeds of Hair Ewes are under assessment.

Keywords: Katahdin ewes, lambing, prolificacy, seasonality

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Authors: Rinat Gabbay-Benziv, Merav Ben-Natan, Ariel Roguin, Benyamine Abbou, Anna Ofir, Adi Klein, Dikla Dahan-Shriki, Mordechai Hallak, Boris Kessel, Mickey Dudkiewicz

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Introduction: Over recent decades, technology has become integral to healthcare, with electronic health records and advanced medical equipment now standard. However, this reliance has made healthcare systems increasingly vulnerable to ransomware attacks. On October 13, 2021, Hillel Yaffe Medical Center experienced a severe ransomware attack that disrupted all IT systems, including electronic health records, laboratory services, and staff communications. The attack, carried out by the group DeepBlueMagic, utilized advanced encryption to lock the hospital's systems and demanded a ransom. This incident caused significant operational and patient care challenges, particularly impacting the obstetrics department. Objective: The objective is to describe the challenges facing the obstetric division following a cyberattack and discuss ways of preparing for and overcoming another one. Methods: A retrospective descriptive study was conducted in a mid-sized medical center. Division activities, including the number of deliveries, cesarean sections, emergency room visits, admissions, maternal-fetal medicine department occupancy, and ambulatory encounters, from 2 weeks before the attack to 8 weeks following it (a total of 11 weeks), were compared with the retrospective period in 2019 (pre-COVID-19). In addition, we present the challenges and adaptation measures taken at the division and hospital levels leading up to the resumption of full division activity. Results: On the day of the cyberattack, critical decisions were made. The media announced the event, calling on patients not to come to our hospital. Also, all elective activities other than cesarean deliveries were stopped. The number of deliveries, admissions, and both emergency room and ambulatory clinic visits decreased by 5%–10% overall for 11 weeks, reflecting the decrease in division activity. Nevertheless, in all stations, there were sufficient activities and adaptation measures to ensure patient safety, decision-making, and workflow of patients were accounted for. Conclusions: The risk of ransomware cyberattacks is growing. Healthcare systems at all levels should recognize this threat and have protocols for dealing with them once they occur.

Keywords: ransomware attack, healthcare cybersecurity, obstetrics challenges, IT system disruption

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Authors: Abebe Taye

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The interest in enhancing the performance of all-solid-state batteries featuring lithium metal anodes as a potential alternative to traditional lithium-ion batteries has prompted exploration into new avenues. A promising strategy involves transforming lithium-ion batteries into hybrid configurations by integrating lithium-ion and lithium-metal solid-state components. This study is focused on achieving stable lithium deposition and advancing the electrochemical capabilities of solid-state lithium hybrid batteries with anodes by incorporating mesocarbon microbeads (MCMBs) blended with silver nanoparticles. To achieve this, mesocarbon microbeads (MCMBs) blended with silver nanoparticles are coated on stainless-steel current collectors. These samples undergo a battery of analyses employing diverse techniques. Surface morphology is studied through scanning electron microscopy (SEM). The electrochemical behavior of the coated samples is evaluated in both half-cell and full-cell setups utilizing an argyrodite-type sulfide electrolyte. The stability of MCMBs in the electrolyte is assessed using electrochemical impedance spectroscopy (EIS). Additional insights into the composition are gleaned through X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and energy-dispersive X-ray spectroscopy (EDS). At an ultra-low N/P ratio of 0.26, stability is upheld for over 100 charge/discharge cycles in half-cells. When applied in a full-cell configuration, the hybrid anode preserves 60.1% of its capacity after 80 cycles at 0.3 C under a low N/P ratio of 0.45. In sharp contrast, the capacity retention of the cell using untreated MCMBs declines to 20.2% after a mere 60 cycles. The introduction of mesocarbon microbeads (MCMBs) combined with silver nanoparticles into the hybrid anode of solid-state lithium batteries substantially elevates their stability and electrochemical performance. This approach ensures consistent lithium deposition and removal, mitigating dendrite growth and the accumulation of inactive lithium. The findings from this investigation hold significant value in elevating the reversibility and energy density of lithium-ion batteries, thereby making noteworthy contributions to the advancement of more efficient energy storage systems.

Keywords: MCMB, lithium metal, hybrid anode, silver nanoparticle, cycling stability

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Authors: Pomila Sharma

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Rajasthan is among regions with greatest climate sensitivity and lowest adaptive capabilities. In many parts of the Rajasthan surface water which can be highly turbid and contaminated with fecal coliform bacteria is used for drinking purposes. The majority rely almost exclusively upon traditional sources of highly turbid and untreated pathogenic surface water for their domestic water needs. In many parts of rural areas of Rajasthan, it is still difficult to obtain clean water, especially remote habitations with no groundwater due to quality issues or depletion and limited feasibility to connect with surface water schemes due to low density of population in these areas to justify large infrastructure investment. The most viable sources are rain water harvesting, community managed open wells, private wells, ponds and small-scale irrigation reservoirs have often been the main traditional sources of rural drinking water. Turbidity is conventionally removed by treating the water with expensive chemicals. This study has to investigate the use of crushed seeds from the tree Moringa oleifera (drumstick) as a natural alternative to conventional coagulant chemicals. The use of Moringa oleifera seed powder can produce potable water of higher quality than the original source. Moringa oleifera a native species of northern India, the tree is now grown extensively throughout the tropics and found in many countries of Africa, Asia & South America. The seeds of tree contains significant quantities of low molecular weight, water soluble proteins which carries the positive charge when the crushed seeds are added to water. This protein binds in raw water with negatively charged turbid water with bacteria, clay, algae, etc. Under proper mixing, these particles make flocks, which may be left to settle by gravity or be removed by filtration. Using Moringa oleifera as a replacement coagulation in such surface sources of arid and semi-arid areas can meet the need for water purification in remote places of Rajasthan state of India. The present study accesses to find out laboratory based investigation of the effect of seeds of Moringa tree on its coagulation effectiveness (purification) using turbid water samples of surface source of the Rajasthan state. In this study, moringa seed powder showed that filtering with seed powder may diminish water pollution and bacterial counts. Results showed Moringa oleifera seeds coagulate 90-95% of turbidity and color efficiently leading to an aesthetically clear supernatant & reduced about 85-90% of bacterial load reduction in samples.

Keywords: bacterial load, coagulant, turbidity, water purification

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Authors: Jamal Ahmad

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The Sanctuary of the Kafirs is a sanctified place for the people of Kalash which contain the sacred remains of their culture. The existence of the cultural Sanctuary is not limited up to boundaries of culture but its canopy also contain the spiritual attachments in terms of religion, rituals, introspections, myths, customs and living standards. Culture is the manifestation of the human intellectual achievement in a qualitative phenomenon of a place. The ethnic people of Hindu Kush (Kalash) are an indigenous group that practices Animism. They believe in Animistic Symbology i-e the material universe has high spiritual power. The Animism in their living standard comes from the high spiritualized and sacred sacrifices of animals goats, sheep etc. in their festivals which is the symbol of purity. Similarly certain cultural and religious phenomena make its behavior, its living pattern, its fairy tales, its birth and even its death unique. The scattered and the vanishing fragments of the Kafiristan, demands the phenomenal solution which molds all these factors into preserving standards. It demands a place of belief where, their unique culture, religion, festivals and life style make a sincere base for future existence, and such phenomena of place will consciously or unconsciously molds these ideas into building fabric. The Sanctuary contains ancient vandalized cemetery, the qaliq* the mujnatikeen*, the jastaks*, dewadoor* an amphitheater for dancing and ritual performances, an herbal garden and a profile sanctuary of the blood line of Kalash. The Case-Analysis provokes a new architecture of place, as the Phenomenological Architecture, which requires a place and phenomenon to take place. The Animistic Symbology and Phenomenology both are the part of their life but needs to reveal its hidden meaning and existence i-e (The Balamain, the alpine meadows, the sacred river). The Architectural work is strengthened by the philosophies of Animism and Phenomenology which make it easy to understand. The Scope of work is to reincarnate the ethical boundaries between the neighboring tribes and the Kafirs, by a series of dwellings, cultural and religious communal buildings and spaces, gardens and streets layout under the umbrella of ethical beliefs of Kalash community. So we conclude to build the Sanctuary of the Kafirs, in Bamboret valley of Kalash.

Keywords: Qaliq, Mujnatikeen, Dewadoor, Jastaks

Procedia PDF Downloads 334

Authors: G. Andreutti, G. Saccone, D. Lucariello, C. Pirozzi, S. Franchitti, R. Borrelli, C. Toscano, P. Caso, G. Ferraro, C. Pascarella

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The reduction of greenhouse gases and pollution emissions is a worldwide environmental issue. The amount of CO₂ released by an aircraft is associated with the amount of fuel burned, so the improvement of engine thermo-mechanical efficiency and specific fuel consumption is a significant technological driver for aviation. Moreover, with the prospect that avgas will be phased out, an engine able to use more available and cheaper fuels is an evident advantage. An advanced aeronautical Diesel engine, because of its high efficiency and ability to use widely available and low-cost jet and diesel fuels, is a promising solution to achieve a more fuel-efficient aircraft. On the other hand, a Diesel engine has generally a higher overall weight, if compared with a gasoline one of same power performances. Fixing the MTOW, Max Take-Off Weight, and the operational payload, this extra-weight reduces the aircraft fuel fraction, partially vinifying the associated benefits. Therefore, an effort in weight saving manufacturing technologies is likely desirable. In this work, in order to achieve the mentioned goals, innovative Electron Beam Melting – EBM, Additive Manufacturing – AM technologies were applied to a two-stroke, common rail, GF56 Diesel engine, developed by the CMD Company for aeronautic applications. For this purpose, a consortium of academic, research and industrial partners, including CMD Company, Italian Aerospace Research Centre – CIRA, University of Naples Federico II and the University of Salerno carried out a technological project, funded by the Italian Minister of Education and Research – MIUR. The project aimed to optimize the baseline engine in order to improve its performance and increase its airworthiness features. This project was focused on the definition, design, development, and application of enabling technologies for performance improvement of GF56. Weight saving of this engine was pursued through the application of EBM-AM technologies and in particular using Arcam AB A2X machine, available at CIRA. The 3D printer processes titanium alloy micro-powders and it was employed to realize new connecting rods of the GF56 engine with an additive-oriented design approach. After a preliminary investigation of EBM process parameters and a thermo-mechanical characterization of titanium alloy samples, additive manufactured, innovative connecting rods were fabricated. These engine elements were structurally verified, topologically optimized, 3D printed and suitably post-processed. Finally, the overall performance improvement, on a typical General Aviation aircraft, was estimated, substituting the conventional engine with the optimized GF56 propulsion system.

Keywords: aeronautic propulsion, additive manufacturing, performance improvement, weight saving, piston engine

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Authors: Mubarack Ahmed, Gabriele Gradoni, Stephen C. Creagh, Gregor Tanner

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High-frequency cables commonly connect modern devices and sensors. Interestingly, the proportion of electric components is rising fast in an attempt to achieve lighter and greener devices. Modelling the propagation of signals through these cable networks in the presence of parameter uncertainty is a daunting task. In this work, we study the response of high-frequency cable networks using both Transmission Line and Quantum Graph (QG) theories. We have successfully compared the two theories in terms of reflection spectra using measurements on real, lossy cables. We have derived a generalisation of the vertex scattering matrix to include non-uniform networks – networks of cables with different characteristic impedances and propagation constants. The QG model implicitly takes into account the pseudo-chaotic behavior, at the vertices, of the propagating electric signal. We have successfully compared the asymptotic growth of eigenvalues of the Laplacian with the predictions of Weyl law. We investigate the nearest-neighbour level-spacing distribution of the resonances and compare our results with the predictions of Random Matrix Theory (RMT). To achieve this, we will compare our graphs with the generalisation of Wigner distribution for open systems. The problem of scattering from networks of cables can also provide an analogue model for wireless communication in highly reverberant environments. In this context, we provide a preliminary analysis of the statistics of communication capacity for communication across cable networks, whose eventual aim is to enable detailed laboratory testing of information transfer rates using software defined radio. We specialise this analysis in particular for the case of MIMO (Multiple-Input Multiple-Output) protocols. We have successfully validated our QG model with both TL model and laboratory measurements. The growth of Eigenvalues compares well with Weyl’s law and the level-spacing distribution agrees so well RMT predictions. The results we achieved in the MIMO application compares favourably with the prediction of a parallel on-going research (sponsored by NEMF21.)

Keywords: eigenvalues, multiple-input multiple-output, quantum graph, random matrix theory, transmission line

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Authors: Zoliana Bawitlung, P. C. Rohmingliana, L. Z. Chhangte, Remlal Siama, Hming Chungnunga, Vanram Lawma, L. Hnamte, B. K. Sahoo, B. K. Sapra, J. Malsawma

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Mizoram state has the highest lung cancer incidence rate in India due to its high-level consumption of tobacco and its products which is supplemented by the food habits. While smoking is mainly responsible for this incidence, the effect of inhalation of indoor radon gas cannot be discarded as the hazardous nature of this radioactive gas and its progenies on human population have been well-established worldwide where the radiation damage to bronchial cells eventually can be the second leading cause of lung cancer next to smoking. It is also known that the effect of radiation, however, small may be the concentration, cannot be neglected as they can bring about the risk of cancer incidence. Hence, estimation of indoor radon concentration is important to give a useful reference against radiation effects as well as establishing its safety measures and to create a baseline for further case-control studies. The indoor radon/thoron concentrations in Mizoram had been measured in 41 dwellings selected on the basis of spot gamma background radiation and construction type of the houses during 2015-2016. The dwellings were monitored for one year, in 4 months cycles to indicate seasonal variations, for the indoor concentration of radon gas and its progenies, outdoor gamma dose, and indoor gamma dose respectively. A time-integrated method using Solid State Nuclear Track Detector (SSNTD) based single entry pin-hole dosimeters were used for measurement of indoor Radon/Thoron concentration. Gamma dose measurements for indoor as well as outdoor were carried out using Geiger Muller survey meters. Seasonal variation of indoor radon/ thoron concentration was monitored. The results show that the annual average radon concentrations varied from 54.07 – 144.72 Bq/m³ with an average of 90.20 Bq/m³ and the annual average thoron concentration varied from 17.39 – 54.19 Bq/m³ with an average of 35.91 Bq/m³ which are below the permissible limit. The spot survey of gamma background radiation level varies between 9 to 24 µR/h inside and outside the dwellings throughout Mizoram which are all within acceptable limits. From the above results, there is no direct indication that radon/thoron is responsible for the high lung cancer incidence in the area. In order to find epidemiological evidence of natural radiations to high cancer incidence in the area, one may need to conduct a case-control study which is beyond this scope. However, the derived data of measurement will provide baseline data for further studies.

Keywords: background gamma radiation, indoor radon/thoron, lung cancer, seasonal variation

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Authors: Spencer Liu, William Chan, Marlena Komatz, Tommy Ramos, Mark Trentalange, Faye Rim, Dae Kim, Mary Kelly, Samuel Schuessler, Roberta Stack, Justas Lauzadis, Kathryn DelPizzo, Seth Waldman, Alexandra Sideris

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Background & Significance: The increasing prevalence of cannabis use in the United States has important safety considerations in the perioperative setting, as chronic or heavy preoperative cannabis use may increase the risk of intraoperative complications, postoperative nausea and vomiting (PONV), increased postoperative pain levels, and acute side effects associated with cannabis use cessation. In this retrospective chart review study, we sought to determine the prevalence of self-reported cannabis use in the past 5-years at a single institution in New York City. We hypothesized that there is an increasing prevalence of preoperative self-reported cannabis use among adult and adolescent patients undergoing orthopedic surgery. Methods: After IRB approval for this retrospective study, surgical cases performed on patients 12 years of age and older at the hospital’s main campus and two ambulatory surgery centers between January 1st, 2018, and December 31st, 2023, with preoperatively self-disclosed cannabis use entered in the social history intake form were identified using the tool SlicerDicer in Epic. Case and patient characteristics were extracted, and trends in utilization over time were assessed by the Cochran-Armitage trend test. Results: Overall, the prevalence of self-reported cannabis use increased from 6.6% in 2018 to 10.6% in 2023. By age group, the prevalence of self-reported cannabis use among adolescents remained consistently low (2018: 2.6%, 2023: 2.6%) but increased with significant evidence for a linear trend (p < 0.05) within every adult age group. Among adults, patients who were 18-24 years old (2018: 18%, 2023: 20.5%) and 25-34 years old (2018: 15.9%, 2023: 24.2%) had the highest prevalences of disclosure, whereas patients who were 75 years of age or older had the lowest prevalence of disclosure (2018: 1.9%, 2023: 4.6%). Patients who were 25-34 years old had the highest percent difference in disclosure rates of 8.3%, which corresponded to a 52.2% increase from 2018 to 2023. The adult age group with the highest percent change was patients who were 75 years of age or older, with a difference of 2.7%, which corresponded to a 142.1% increase from 2018 to 2023. Conclusions: These trends in preoperative self-reported cannabis use among patients undergoing orthopedic surgery have important implications for perioperative care and clinical outcomes. Efforts are underway to refine and standardize cannabis use data capture at our institution.

Keywords: orthopedic surgery, cannabis, postoperative pain, postoperative nausea

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Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

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Authors: Ercan Kızılay, Mustafa Demi̇rel, Selçuk Coşkun

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Railway signaling systems consist of vital products that regulate railway traffic and provide safe route arrangements and maneuvers of trains. SIL 4 signal lamps are produced by many manufacturers today. There is a need for systems that enable these signal lamps to be controlled by commands from the interlocking. These systems should act as fail-safe and give error indications to the interlocking system when an unexpected situation occurs for the safe operation of railway systems from the RAMS perspective. In the past, driving and proving the lamp in relay-based systems was typically done via signaling relays. Today, the proving of lamps is done by comparing the current values read over the return circuit, the lower and upper threshold values. The purpose is an analog electronic object controller with the possibility of easy integration with vital systems and the signal lamp itself. During the study, the EN50126 standard approach was considered, and the concept, definition, risk analysis, requirements, architecture, design, and prototyping were performed throughout this study. FMEA (Failure Modes and Effects Analysis) and FTA (Fault Tree) Analysis) have been used for safety analysis in accordance with EN 50129. Concerning these analyzes, the 1oo2D reactive fail-safe hardware design of a controller has been researched. Electromagnetic compatibility (EMC) effects on the functional safety of equipment, insulation coordination, and over-voltage protection were discussed during hardware design according to EN 50124 and EN 50122 standards. As vital equipment for railway signaling, railway signal object controllers should be developed according to EN 50126 and EN 50129 standards which identify the steps and requirements of the development in accordance with the SIL 4(Safety Integrity Level) target. In conclusion of this study, an analog railway signal object controller, which takes command from the interlocking system, is processed in driver cards. Driver cards arrange the voltage level according to desired visibility by means of semiconductors. Additionally, prover cards evaluate the current upper and lower thresholds. Evaluated values are processed via logic gates which are composed as 1oo2D by means of analog electronic technologies. This logic evaluates the voltage level of the lamp and mitigates the risks of undue dimming.

Keywords: object controller, railway electronic, analog electronic, safety, railway signal

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Authors: Katarzyna Wyka, Dana Sylvan, JoAnn Difede

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Background and significance: The following disaster, population-based screening programs are routinely established to assess physical and psychological consequences of exposure. These data sets are highly skewed as only a small percentage of trauma-exposed individuals develop health issues. Commonly used statistical methodology in post-disaster mental health generally involves population-averaged models. Such models aim to capture the overall response to the disaster and its aftermath; however, they may not be sensitive enough to accommodate population heterogeneity in symptomatology, such as post-traumatic stress or depressive symptoms. Methods: We use an archival longitudinal data set from Weill-Cornell 9/11 Mental Health Screening Program established following the World Trade Center (WTC) terrorist attacks in New York in 2001. Participants are rescue and recovery workers who participated in the site cleanup and restoration (n=2960). The main outcome is the post-traumatic stress symptoms (PTSD) severity score assessed via clinician interviews (CAPS). For a detailed understanding of response to the disaster and its aftermath, we are adapting quantile regression methodology with particular focus on predictors of extreme distress and resilience to trauma. Results: The response variable was defined as the quantile of the CAPS score for each individual under two different scenarios specifying the unconditional quantiles based on: 1) clinically meaningful CAPS cutoff values and 2) CAPS distribution in the population. We present graphical summaries of the differential effects. For instance, we found that the effect of the WTC exposures, namely seeing bodies and feeling that life was in danger during rescue/recovery work was associated with very high PTSD symptoms. A similar effect was apparent in individuals with prior psychiatric history. Differential effects were also present for age and education level of the individuals. Conclusion: We evaluate the utility of quantile regression in disaster research in contrast to the commonly used population-averaged models. We focused on assessing the distribution of risk factors for post-traumatic stress symptoms across quantiles. This innovative approach provides a comprehensive understanding of the relationship between dependent and independent variables and could be used for developing tailored training programs and response plans for different vulnerability groups.

Keywords: disaster workers, post traumatic stress, PTSD, quantile regression

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Authors: Robertson Freeman

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The prime objective of this research is to examine income inequality and its effects on household livelihoods in Parker Paint. Many researchers failed to address the potential threat of income inequality on diverse household livelihood indicators, including health, food, housing, transport and many others. They examine and generalize the effects of income differentials on household livelihoods by addressing one indicator of livelihood security. This research fills the loopholes of previous research by examining the effects of income inequality and how it affects the livelihoods of households, taking into consideration livelihood indicators including health, food security, and transport. The researcher employed the mixed research method to analyze the distribution of income and solicit opinions of household heads on the effects of their monthly income on their livelihoods. Age and sex structure, household composition, type of employment and educational status influence income inequality. The level of income, Lorenz curve and the Gini coefficient was mutually employed to calculate and determine the level of income inequality. One hundred eighty-two representing 96% of household heads are employed while 8, representing 4%, are unemployed. However, out of a total number of 182 employed, representing 96%, 27 people representing 14%, are employed in the formal private sector, while 110, representing 58%, are employed in the private informal sector. Monthly average income, savings, investments and unexpected circumstances affect the livelihood of households. Infrastructural development and wellbeing should be pursued by reducing expenditure earmarked in other sectors and channeling the funds towards the provision of household needs. One of the potent tools for consolidating household livelihoods is to initiate livelihood empowerment programs. Government and private sector agencies should establish more health insurance schemes, providing mosquito nets, immunization services, public transport, as well as embarking on feeding programs, especially in the remote areas of Parker paint. To climax the research findings, self-employment, entrepreneurship and the general private sector employment is a transparent double-edged sword. If employed in the private sector, there is the likelihood to increase one’s income. However, this also induces the income gap between the rich and poor since many people are exploited by affluence, thereby relegating the poor from the wealth hierarchy. Age and sex structure, as well as type of employment, should not be overlooked since they all play fundamental roles in influencing income inequality. Savings and investments seem to play a positive role in reducing income inequality. However, savings and investment in this research affect livelihoods negatively. It behooves mankind to strive and work hard to the best of ability in earning sufficient income and embracing measures to retain his financial strength. In so doing, people will be able to provide basic household needs, celebrate the reduction in unemployment and dependence and finally ensure sustainable livelihoods.

Keywords: income, inequality, livelihood, pakerpaint

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Authors: Piyush Hajela

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Public spaces in Indian market places are vibrant, colorful and carry latent dimensions that make them attractive and popular gathering spaces. These markets satisfy the household needs of the people and also their social, cultural and traditional aspirations. Going to a market place for shopping in India is a great source of entertainment for the people. They would love to spend as much time as possible and stay for longer durations than otherwise required. It is this desire of the people that generates public spaces. Much of these public spaces emerge as squares, plazas, corners of varied shapes and sizes at different locations, and yet provide a conducive environment. Such public spaces grow organically and are discovered by the people themselves. Indian markets serve people of different culture, religion, caste, age, gender which keeps them alive all the year round. Indian is a diverse country and this diversity is reflected clearly in the market places. They hold the people together and promote harmony across cultures. Free access to these market places makes them magnets for social interaction. Public spaces are spread across a city and more or less have established their existence and prominence in a social set up. While few of them are created, others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The paper aims at identifying these freely accessible public spaces and the dimensions within it that make these public spaces hold the people for significant duration of time. The dimensions present shall be judged through collective response of human senses in form of safety, comfort and so on through the expressions of the participants. The aim therefore would be to trace the freely accessible public spaces emerged in Indian markets and evaluate them for human response and behavior. The hierarchy of market places in the city of Bhopal is well established as, city center level, sub city-center level, community level, local and convenient level market places. While many city-centers are still referred to as the old or traditional or the core area of the city, the others are part of the planned city. These different levels of market places are studied for emerged public spaces. These emerged public spaces are then documented in detail for unveiling the dimensions they offer through, photographs, visual observations, questionnaires and response of the participants of these public spaces.

Keywords: human comfort, enclosure, safety, social interaction

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Authors: Halina Veloso e Zarate, Manuela Triggianese

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The urban challenges posed by rapid population growth, climate adaptation, and sustainable living have compelled Dutch cities to reimagine their built environment and transportation systems. As a pivotal contributor to CO₂ emissions, the transportation sector in the Netherlands demands innovative solutions for transitioning to low-carbon mobility. This study investigates the potential of transit oriented development (TOD) as a strategy for achieving carbon reduction and sustainable urban transformation. Focusing on the Lombardijen station area in Rotterdam, which is targeted for significant densification, this paper presents a design-oriented exploration of a low-carbon transport node. By employing a research-by-design methodology, this study delves into multifaceted factors and scales, aiming to propose future scenarios for Lombardijen. Drawing from a synthesis of existing literature, applied research, and practical insights, a robust design framework emerges. To inform this framework, governmental data concerning the built environment and material embodied carbon are harnessed. However, the restricted access to crucial datasets, such as property ownership information from the cadastre and embodied carbon data from De Nationale Milieudatabase, underscores the need for improved data accessibility, especially during the concept design phase. The findings of this research contribute fundamental insights not only to the Lombardijen case but also to TOD studies across Rotterdam's 13 nodes and similar global contexts. Spatial data related to property ownership facilitated the identification of potential densification sites, underscoring its importance for informed urban design decisions. Additionally, the paper highlights the disparity between the essential role of embodied carbon data in environmental assessments for building permits and its limited accessibility due to proprietary barriers. Although this study lays the groundwork for sustainable urbanization through TOD-based design, it acknowledges an area of future research worthy of exploration: the socio-economic dimension. Given the complex socio-economic challenges inherent in the Lombardijen area, extending beyond spatial constraints, a comprehensive approach demands integration of mobility infrastructure expansion, land-use diversification, programmatic enhancements, and climate adaptation. While the paper adopts a TOD lens, it refrains from an in-depth examination of issues concerning equity and inclusivity, opening doors for subsequent research to address these aspects crucial for holistic urban development.

Keywords: Rotterdam zuid, transport oriented development, carbon emissions, low-carbon design, cross-scale design, data-supported design

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Authors: Edvard Kokanyan, Narine Babajanyan, Ninel Kokanyan, Marco Bazzan

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Lithium niobate (LN) crystals, renowned for their exceptional nonlinear optical, electro-optical, piezoelectric, and photorefractive properties, stand as foundational materials in diverse fields of study and application. While they have long been utilized in frequency converters of laser radiation, electro-optical modulators, and holographic information recording media, LN crystals doped with rare earth ions represent a compelling frontier for modern compact devices. These materials exhibit immense potential as key components in infrared lasers, optical sensors, self-cooling systems, and radiation balanced laser setups. In this study, we present the successful synthesis of Ho-doped lithium niobate (LN:Ho) thin films on sapphire substrates employing the Sol-Gel technique. The films exhibit a strong crystallographic orientation along the perpendicular direction to the substrate surface, with X-ray diffraction analysis confirming the predominant alignment of the film's "c" axis, notably evidenced by the intense (006) reflection peak. Further characterization through Raman spectroscopy, employing a confocal Raman microscope (LabRAM HR Evolution) with exciting wavelengths of 532 nm and 785 nm, unraveled intriguing insights. Under excitation with a 785 nm laser, Raman scattering obeyed selection rules, while employing a 532 nm laser unveiled additional forbidden lines reminiscent of behaviors observed in bulk LN:Ho crystals. These supplementary lines were attributed to luminescence induced by excitation at 532 nm. Leveraging data from anti-Stokes Raman lines facilitated the disentanglement of luminescence spectra from the investigated samples. Surface scanning affirmed the uniformity of both structure and luminescence across the thin films. Notably, despite the robust orientation of the "c" axis perpendicular to the substrate surface, Raman signals indicated a stochastic distribution of "a" and "b" axes, validating the mosaic structure of the films along the mentioned axis. This study offers valuable insights into the structural properties of Ho-doped lithium niobate thin films, with the observed luminescence behavior holding significant promise for potential applications in optoelectronic devices.

Keywords: lithium niobate, Sol-Gel, luminescence, Raman spectroscopy

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Authors: Ivana Čavlina Tomašević, Višnjica Vučetić, Maja Telišman Prtenjak, Barbara Malečić

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The Split wildfire on the mid-Adriatic Coast in July 2017 is one of the most severe wildfires in Croatian history, given the size and unexpected fire behavior, and it is used in this research as a case study to run the Weather Research and Forecasting Spread Fire (WRF SFIRE) model. This coupled fire-atmosphere model was successfully run for the first time ever for one Croatian wildfire case. Verification of coupled simulations was possible by using the detailed reconstruction of the Split wildfire. Specifically, precise information on ignition time and location, together with mapped fire progressions and spotting within the first 30 hours of the wildfire, was used for both – to initialize simulations and to evaluate the model’s ability to simulate fire’s propagation and final fire scar. The preliminary simulations were obtained using high-resolution vegetation and topography data for the fire area, additionally interpolated to fire grid spacing at 33.3 m. The results demonstrated that the WRF SFIRE model has the ability to work with real data from Croatia and produce adequate results for forecasting fire spread. As the model in its setup has the ability to include and exclude the energy fluxes between the fire and the atmosphere, this was used to investigate possible fire-atmosphere interactions during the Split wildfire. Finally, successfully coupled simulations provided the first numerical evidence that a wildfire from the Adriatic coast region can modify the dynamical structure of the surrounding atmosphere, which agrees with observations from fire grounds. This study has demonstrated that the WRF SFIRE model has the potential for operational application in Croatia with more accurate fire predictions in the future, which could be accomplished by inserting the higher-resolution input data into the model without interpolation. Possible uses for fire management in Croatia include prediction of fire spread and intensity that may vary under changing weather conditions, available fuels and topography, planning effective and safe deployment of ground and aerial firefighting forces, preventing wildland-urban interface fires, effective planning of evacuation routes etc. In addition, the WRF SFIRE model results from this research demonstrated that the model is important for fire weather research and education purposes in order to better understand this hazardous phenomenon that occurs in Croatia.

Keywords: meteorology, agrometeorology, fire weather, wildfires, couple fire-atmosphere model

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Authors: Arianna Vedaschi

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This paper addresses the relationship between freedom of expression, national security and radicalization. Is it still possible to talk about a balance between the first two elements? Or, due to the intrusion of the third, is it more appropriate to consider freedom of expression as “permanently disfigured” by securitarian concerns? In this study, both the legislative and the judicial level are taken into account and the comparative method is employed in order to provide the reader with a complete framework of relevant issues and a workable set of solutions. The analysis moves from the finding according to which the tension between free speech and national security has become a major issue in democratic countries, whose very essence is continuously endangered by the ever-changing and multi-faceted threat of international terrorism. In particular, a change in terrorist groups’ recruiting pattern, attracting more and more people by way of a cutting-edge communicative strategy, often employing sophisticated technology as a radicalization tool, has called on law-makers to modify their approach to dangerous speech. While traditional constitutional and criminal law used to punish speech only if it explicitly and directly incited the commission of a criminal action (“cause-effect” model), so-called glorification offences – punishing mere ideological support for terrorism, often on the web – are becoming commonplace in the comparative scenario. Although this is direct, and even somehow understandable, consequence of the impending terrorist menace, this research shows many problematic issues connected to such a preventive approach. First, from a predominantly theoretical point of view, this trend negatively impacts on the already blurred line between permissible and prohibited speech. Second, from a pragmatic point of view, such legislative tools are not always suitable to keep up with ongoing developments of both terrorist groups and their use of technology. In other words, there is a risk that such measures become outdated even before their application. Indeed, it seems hard to still talk about a proper balance: what was previously clearly perceived as a balancing of values (freedom of speech v. public security) has turned, in many cases, into a hierarchy with security at its apex. In light of these findings, this paper concludes that such a complex issue would perhaps be better dealt with through a combination of policies: not only criminalizing ‘terrorist speech,’ which should be relegated to a last resort tool, but acting at an even earlier stage, i.e., trying to prevent dangerous speech itself. This might be done by promoting social cohesion and the inclusion of minorities, so as to reduce the probability of people considering terrorist groups as a “viable option” to deal with the lack of identification within their social contexts.

Keywords: radicalization, free speech, international terrorism, national security

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Authors: Sezer Kefeli, Sertaç Arslan

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Supercavitation is a pressure dependent process which gives opportunity to eliminate the wetted surface effects on the underwater vehicle due to the differences of viscosity and velocity effects between liquid (freestream) and gas phase. Cavitation process occurs depending on rapid pressure drop or temperature rising in liquid phase. In this paper, pressure based cavitation is investigated due to the fact that is encountered in the underwater world, generally. Basically, this vapor-filled pressure based cavities are unstable and harmful for any underwater vehicle because these cavities (bubbles or voids) lead to intense shock waves while collapsing. On the other hand, supercavitation is a desired and stabilized phenomena than general pressure based cavitation. Supercavitation phenomena offers the idea of minimizing form drag, and thus supercavitating vehicles are revived. When proper circumstances are set up, which are either increasing the operating speed of the underwater vehicle or decreasing the pressure difference between free stream and artificial pressure, the continuity of the supercavitation is obtainable. There are 2 types of supercavitation to obtain stable and continuous supercavitation, and these are called as natural and artificial supercavitation. In order to generate natural supercavitation, various mechanical structures are discovered, which are called as cavitators. In literature, a lot of cavitator types are studied either experimentally or numerically on a CFD platforms with intent to observe natural supercavitation since the 1900s. In this paper, firstly, experimental results are obtained, and trend lines are generated based on supercavitation parameters in terms of cavitation number (), form drag coefficientC_D, dimensionless cavity diameter (d_m/d_c), and length (L_c/d_c). After that, natural cavitation verification studies are carried out for disk and cone shape cavitators. In addition, supercavitation parameters are numerically analyzed at different operating conditions, and CFD results are fitted into trend lines of experimental results. The aims of this paper are to generate one generally accepted drag coefficient equation for disk and cone cavitators at different cavitator half angle and investigation of the supercavitation parameters with respect to cavitation number. Moreover, 165 CFD analysis are performed at different cavitation numbers on FLUENT version 21R2. Five different cavitator types are modeled on SCDM with respect tocavitator’s half angles. After that, CFD database is generated depending on numerical results, and new trend lines are generated based on supercavitation parameters. These trend lines are compared with experimental results. Finally, the generally accepted drag coefficient equation and equations of supercavitation parameters are generated.

Keywords: cavity envelope, CFD, high speed underwater vehicles, supercavitation, supercavitating flows, supercavitation parameters, drag reduction, viscous force elimination, natural cavitation verification

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Authors: Henry Kiptum Yatich, Ronald Chepkilot, Aquilars Mutuku Kalio

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Studies on energy management have focused on environmental conservation, reduction in production and operation expenses. However, transferring gains of energy management practices to competitive advantage is importance to manufacturers in Kenya. Success in managing competitive advantage arises out of a firm’s ability in identifying and implementing actions that can give the company an edge over its rivals. Manufacturing firms in Kenya are the highest consumers of both electricity and petroleum products. In this regard, the study posits that transfer of the gains of energy management practices to competitive advantage is imperative. The study was carried in Nairobi and its environs, which hosts the largest number of manufacturers. The study objectives were; to determine the level of implementing energy management regulations on sustaining competitive advantage, to determine the level of implementing company energy management policy on competitive advantage, to examine the level of implementing energy efficient technology on sustaining competitive advantage, and to assess the percentage energy expenditure on sustaining competitive advantage among manufacturing firms. The study adopted a survey research design, with a study population of 145,987. A sample of 384 respondents was selected randomly from 21 proportionately selected firms. Structured questionnaires were used to collect data. Data analysis was done using descriptive statistics (mean and standard deviations) and inferential statistics (correlation, regression, and T-test). Data is presented using tables and diagrams. The study found that Energy Management Regulations, Company Energy Management Policies, and Energy Expenses are significant predictors of Competitive Advantage (CA). However, Energy Efficient Technology as a component of Energy Management Practices did not have a significant relationship with Competitive Advantage. The study revealed that the level of awareness in the sector stood at 49.3%. Energy Expenses in the sector stood at an average of 10.53% of the firm’s total revenue. The study showed that gains from energy efficiency practices can be transferred to competitive strategies so as to improve firm competitiveness. The study recommends that manufacturing firms should consider energy management practices as part of its strategic agenda in assessing and reviewing their energy management practices as possible strategies for sustaining competitiveness. The government agencies such as Energy Regulatory Commission, the Ministry of Energy and Petroleum, and Kenya Association of Manufacturers should enforce the energy management regulations 2012, and with enhanced stakeholder involvement and sensitization so as promote sustenance of firm competitiveness. Government support in providing incentives and rebates for acquisition of energy efficient technologies should be pursued. From the study limitation, future experimental and longitudinal studies need to be carried out. It should be noted that energy management practices yield enormous benefits to all stakeholders and that the practice should not be considered a competitive tool but rather as a universal practice.

Keywords: energy, efficiency, management, guidelines, policy, technology, competitive advantage

Procedia PDF Downloads 384

Authors: Anu Shrestha, Krassi Rumchev, Ben Mullins, Yun Zhao, Linda Selvey

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Cycling is often promoted as a means of reducing vehicular congestion, noise and greenhouse gas and air pollutant emissions in urban areas. It is also indorsed as a healthy means of transportation in terms of reducing the risk of developing a range of physical and psychological conditions. However, people who cycle regularly may not be aware that they can become exposed to high levels of Vehicular Air Pollutants (VAP) emitted by nearby traffics and therefore experience adverse health effects as a result. The study will highlight the present scenario of ambient air pollution level in different cycling routes in Perth and also highlight significant contribution to the understanding of health risks that cyclist may face from exposure to particulate air pollution. Methodology: This research was conducted in Perth, Western Austral and consisted of two groups of cyclists cycling near high (2 routes) and low (two routes) vehicular traffic roads, at high and low levels of exertion, during the cold and warm seasons. A sample size of 123 regular cyclists who cycled at least 80 km/week, aged 20-55, and non-smoker were selected for this study. There were altogether 100 male and 23 female who were asked to choose one or more routes among four different routes, and each participant cycled the route for warm or cold or both seasons. Cyclist who reported cardiovascular and other chronic health conditions (excluding asthma) were not invited into the study. Exposures to selected air pollutants were assessed by undertaking background and personal measurements alone with the measurement of heart and breathe rate of each participant. Finding: According to the preliminary study findings, the cyclists who used cycling route close to high traffic route were exposed to higher levels of measured air pollutants Nitrogen Oxide (NO₂) =0.12 ppm, sulfur dioxide (SO₂)=0.06 ppm and carbon monoxide (CO)=0.25 PPM compared to those who cycled away from busy roads. However, we measured high concentrations of particulate air pollution near one of the low traffic route which we associate with the close proximity to ferry station. Concluding Statement: As a conclusion, we recommend that cycling routes should be selected away from high traffic routes. If possible, we should also consider that if the cycling route is surrounded by the dense populated infrastructures, it can trap the pollutants and always facilitate in increasing inhalation of particle count among the cyclists.

Keywords: air pollution, carbon monoxide, cyclists' health, nitrogen dioxide, nitrogen oxide, respirable particulate matters

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Authors: Oliver Chunho Ma, Tszying Chang

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Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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Authors: Anietie J. Atangwho, Udeme E. Asibong, Item J. Atangwho, Ndifreke E. Udonwa

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Diabesity, a syndrome where diabetes and obesity occur simultaneously in a single patient, has emerged as a recent challenge to the medical world and is already at epidemic proportion in some countries. Therefore, this study aimed to determine the prevalence of diabesity among adult patients attending the General Outpatient clinic of three healthcare facilities in Calabar in a bid to improve healthcare delivery to patients at risk. A cross-sectional descriptive study design was employed using a mixed method approach that comprised quantitative and qualitative components i.e., Focused Group Discussion (FGD) and Key Informant Interview (KII). One hundred and ninety (190) participants aged 18 to 72 years and body mass index (BMI) ≥ 30kg/m2 were recruited as the study population for the quantitative study using systematic random sampling technique and analysed using SPSS version 25. The qualitative component performed 4 FGDs and 3 KIIs. Results of sociodemographic variables showed respondents aged 35 – 44 as highest in number (37.3%). Of this number, 83.7% were females, 76.8% married, and 3.7% earned USD1,110.00 monthly. Whereas majority of the participants (65.8 %) were within class 1 obesity, only 38% considered themselves obese. Diabesity occurrence was found to be 12.6% (i.e. BMI ≥ 30 to 45.2kg/m2 vs FBS ≥ 7.0 – 14.8mmo/l), with 38% of them being previously undiagnosed. About 48.4 % of the respondents ate two meals only per day; with 90.5% eating between meals. Snacking was predominant, mostly pastries (67.9%), with 58.9% taking cola drinks alongside. Sixty-one percent participated in one form of exercise or the other, with walking/trekking as the most common; 34.4 % had no regular exercise schedule. Only about 39.5% of the participants spent less than an hour on devices like phone, television, and laptops. Additionally, previously known and newly diagnosed hypertensive patients were 27.9% and 7.2%, respectively. Qualitative assessment with KII and FGDs showed eating unhealthy diets and lack of exercise as major factors responsible for diabesity. The bivariate analysis revealed significant association between diabesity with marital status and hypertension (p = 0.007 and p = 0.005, respectively). Also, positive association with diabesity were eating snacking (p = 0.017) and number of times a respondent snacks per day (p = 0.035). Overall, the study has revealed the occurrence of diabesity in Calabar at 12.6 % of the study population, with 38 % of them previously undiagnosed; it identified unhealthy diets and lack of exercise as causative factors as well as hypertension as snacking associatory indicators of diabesity.

Keywords: diabesity, obesity, diabetes, unhealthy diet

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Susana Gonçalves, Joana Lencart, Anabela Gregório Dias

Abstract:

Introduction: In combination with chemotherapy, Total Body Irradiation (TBI) is most used as part of the conditioning regimen prior to allogeneic hematopoietic stem cell transplantation. Conventional TBI techniques have a long application time but non-conformality of beam-application with the inability to individually spare organs at risk. Our institution’s intention is to start using Volumetric Modulated Arc Therapy (VMAT) techniques to increase homogeneity of delivered radiation. As a first approach, a dosimetric plan was performed on a computed tomography (CT) scan of a Rando Alderson antropomorfic phantom (head and torso), using a set of six arcs distributed along the phantom. However, a full body anthropomorphic phantom is essential to carry out technique validation and implementation. Our aim is to define the physical and chemical characteristics and the ideal manufacturing procedure of upper and lower limbs to our anthropomorphic phantom, for later validate TBI using VMAT. Materials and Methods: To study the better fit between our phantom and limbs, a CT scan of Rando Alderson anthropomorphic phantom was acquired. CT was performed on GE Healthcare equipment (model Optima CT580 W), with slice thickness of 2.5 mm. This CT was also used to access the electronic density of soft tissue and bone through Hounsfield units (HU) analysis. Results: CT images were analyzed and measures were made for the ideal upper and lower limbs. Upper limbs should be build under the following measures: 43cm length and 7cm diameter (next to the shoulder section). Lower limbs should be build under the following measures: 79cm length and 16.5cm diameter (next to the thigh section). As expected, soft tissue and bone have very different electronic density. This is important to choose and analyze different materials to better represent soft tissue and bone characteristics. The approximate HU values of the soft tissue and for bone shall be 35HU and 250HU, respectively. Conclusion: At the moment, several compounds are being developed based on different types of resins and additives in order to be able to control and mimic the various constituent densities of the tissues. Concurrently, several manufacturing techniques are being explored to make it possible to produce the upper and lower limbs in a simple and non-expensive way, in order to finally carry out a systematic and appropriate study of the total body irradiation. This preliminary study was a good starting point to demonstrate the feasibility of TBI with VMAT.

Keywords: TBI, VMAT, anthropomorphic phantom, tissue equivalent materials

Procedia PDF Downloads 80

Authors: Jessica Cecchinelli, Amer Ali

Abstract:

The continuing growth in road traffic and the resultant impact on the level of pollution and safety especially in urban areas have led local and national authorities to reduce traffic speed and flow in major towns and cities. Various boroughs of London have recently reduced the in-city speed limit from 30mph to 20mph mainly to calm traffic, improve safety and reduce noise and vibration. This paper reports the detailed field measurements using noise sensor and analyser and the corresponding theoretical calculations and analysis of the noise levels on a number of roads in the central London Borough of Camden where speed limit was reduced from 30mph to 20mph in all roads except the major routes of the ‘Transport for London (TfL)’. The measurements, which included the key noise levels and scales at residential streets and main roads, were conducted during weekdays and weekends normal and rush hours. The theoretical calculations were done according to the UK procedure ‘Calculation of Road Traffic Noise 1988’ and with conversion to the European L-day, L-evening, L-night, and L-den and other important levels. The current study also includes comparable data and analysis from previously measured noise in the Borough of Camden and other boroughs of central London. Classified traffic flow and speed on the roads concerned were observed and used in the calculation part of the study. Relevant data and description of the weather condition are reported. The paper also reports a field survey in the form of face-to-face interview questionnaires, which was carried out in parallel with the field measurement of noise, in order to ascertain the opinions and views of local residents and workers in the reduced speed zones of 20mph. The main findings are that the reduction in speed had reduced the noise pollution on the studied zones and that the measured and calculated noise levels for each speed zone are closely matched. Among the other findings was that of the field survey of the opinions and views of the local residents and workers in the reduced speed 20mph zones who supported the scheme and felt that it had improved the quality of life in their areas giving a sense of calmness and safety particularly for families with children, the elderly, and encouraged pedestrians and cyclists. The key conclusions are that lowering the speed limit in built-up areas would not just reduce the number of serious accidents but it would also reduce the noise pollution and promote clean modes of transport particularly walking and cycling. The details of the site observations and the corresponding calculations together with critical comparative analysis and relevant conclusions will be reported in the full version of the paper.

Keywords: noise calculation, noise field measurement, road traffic noise, speed limit in london, survey of people satisfaction

Procedia PDF Downloads 424