Search results for: previous enclaves
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2946

Search results for: previous enclaves

2826 Advanced Model for Calculation of the Neutral Axis Shifting and the Wall Thickness Distribution in Rotary Draw Bending Processes

Authors: B. Engel, H. Hassan

Abstract:

Rotary draw bending is a method which is being used in tube forming. In the tube bending process, the neutral axis moves towards the inner arc and the wall thickness distribution changes for tube’s cross section. Thinning takes place in the outer arc of the tube (extrados) due to the stretching of the material, whereas thickening occurs in the inner arc of the tube (intrados) due to the comparison of the material. The calculations of the wall thickness distribution, neutral axis shifting, and strain distribution have not been accurate enough, so far. The previous model (the geometrical model) describes the neutral axis shifting and wall thickness distribution. The geometrical of the tube, bending radius and bending angle are considered in the geometrical model, while the influence of the material properties of the tube forming are ignored. The advanced model is a modification of the previous model using material properties that depends on the correction factor. The correction factor is a purely empirically determined factor. The advanced model was compared with the Finite element simulation (FE simulation) using a different bending factor (Bf=bending radius/ diameter of the tube), wall thickness (Wf=diameter of the tube/ wall thickness), and material properties (strain hardening exponent). Finite element model of rotary draw bending has been performed in PAM-TUBE program (version: 2012). Results from the advanced model resemble the FE simulation and the experimental test.

Keywords: rotary draw bending, material properties, neutral axis shifting, wall thickness distribution

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2825 Influence of Synergistic/Antagonistic Mixtures of Oligomeric Stabilizers on the Biodegradation of γ-Sterilized Polyolefins

Authors: Sameh A. S. Thabit Alariqi

Abstract:

Our previous studies aimed to investigate the biodegradation of γ-sterilized polyolefins in composting and microbial culture environments at different doses and γ-dose rates. It was concluded from the previous studies that the pretreatment of γ-irradiation can accelerate the biodegradation of neat polymer matrix in biotic conditions significantly. A similar work was carried out to study the stabilization of γ-sterilized polyolefins using different mixtures of stabilizers which are approved for food-contact applications. Ethylene-propylene (EP) copolymer has been melt-mixed with hindered amine stabilizers (HAS), phenolic antioxidants and hydroperoxide decomposers. Results were discussed by comparing the stabilizing efficiency, combination and consumption of stabilizers and the synergistic and antagonistic effects was explained through the interaction between the stabilizers. In this attempt, we have aimed to study the influence of the synergistic and antagonistic mixtures of oligomeric stabilizers on the biodegradation of the γ-irradiated polyolefins in composting and microbial culture. Neat and stabilized films of EP copolymer irradiated under γ-radiation and incubated in compost and fungal culture environments. The changes in functional groups, surface morphology, mechanical properties and intrinsic viscosity in polymer chains were characterized by FT-IR spectroscopy, SEM, instron, and viscometric measurements respectively. Results were discussed by comparing the effect of different stabilizers, stabilizers mixtures on the biodegradation of the γ-irradiated polyolefins. It was found that the biodegradation significantly depends on the components of stabilization system, mobility, interaction, and consumption of stabilizers.

Keywords: biodegradation, γ-irradiation, polyolefins, stabilization

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2824 Factors Associated with Mammography Screening Behaviors: A Cross-Sectional Descriptive Study of Egyptian Women

Authors: Salwa Hagag Abdelaziz, Naglaa Fathy Youssef, Nadia Abdellatif Hassan, Rasha Wesam Abdelrahman

Abstract:

Breast cancer is considered as a substantial health concern and practicing mammography screening [MS] is important in minimizing its related morbidity. So it is essential to have a better understanding of breast cancer screening behaviors of women and factors that influence utilization of them. The aim of this study is to identify the factors that are linked to MS behaviors among the Egyptian women. A cross-sectional descriptive design was carried out to provide a snapshot of the factors that are linked to MS behaviors. A convenience sample of 311 women was utilized and all eligible participants admitted to the Women Imaging Unit who are 40 years of age or above, coming for mammography assessment, not pregnant or breast feeding and who accepted to participate in the study were included. A structured questionnaire was developed by the researchers and contains three parts; Socio-demographic data; Motivating factors associated with MS; and association between MS and model of behavior change. The analyzed data indicated that most of the participated women (66.6 %) belonged to the age group of 40-49.A high proportion of participants (58.1%) of group having previous MS influenced by their neighbors to practice MS, whereas 32.7 % in group not having previous MS were influenced by family members which indicated significant differences (P <0.05). Doctors and media are shown to be the least influence of others to practice MS. Women with intention to have a future mammogram had higher OR (1.404) for practicing MS compared with women with no intention. Further studies are needed to examine the relation between Trans-theoretical Model [TTM] and practicing MS.

Keywords: breast cancer, mammography, screening behaviors, morbidity

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2823 Language Learning Strategies to Improve English Speaking Skills among High School Students: A Case Study at Vo Minh Duc High School in Binh Duong Province, Viet Nam

Authors: Du T. Tran, Quyen T. L. Hoang

Abstract:

The role of language learning strategies in second language acquisition has received increased attention across several disciplines in recent years. Language learning strategies have been shown to occur in many studies over the passing years with the aim of improving the efficiency of language learning. Following previous studies, this study endeavors to scrutinize language learning strategies employed by the students at Vo Minh Duc high school and the effect of motivation on students’ learning strategy choices. The responses are examined quantitatively and qualitatively to enhance their validity and reliability. Data are collected from 342 students’ responses to the questionnaire, interviews with ten teachers and fifteen students, and classroom observations. The findings reveal that students’ motivation has an enormous impact on the choice of language learning strategies. The results simultaneously show that students use many language learning strategies to enhance their communicative competence, but the most frequently used ones are cognitive and affective ones. Significant correlations among types of learning strategies and the influence of motivation on the choices of language learning strategies were consistent with previous studies. The study’s results are expected to be beneficial to teachers of English and students in terms of narrowing the gap between the students' language learning strategies and their teaching methodologies preferences and sketching out the best strategies to enhance students’ speaking skills. The implications of these findings and the importance of viewing learners holistically are discussed, and recommendations are made for ongoing research.

Keywords: learning strategies, speaking skills, memorization strategies, cognitive strategies, affective strategies

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2822 The Role of the Child's Previous Inventory in Verb Overgeneralization in Spanish Child Language: A Case Study

Authors: Mary Rosa Espinosa-Ochoa

Abstract:

The study of overgeneralization in inflectional morphology provides evidence for understanding how a child's mind works when applying linguistic patterns in a novel way. High-frequency inflectional forms in the input cause inappropriate use in contexts related to lower-frequency forms. Children learn verbs as lexical items and new forms develop only gradually, around their second year: most of the utterances that children produce are closely related to what they have previously produced. Spanish has a complex verbal system that inflects for person, mood, and tense. Approximately 200 verbs are irregular, and bare roots always require an inflected form, which represents a challenge for the memory. The aim of this research is to investigate i) what kinds of overgeneralization errors children make in verb production, ii) to what extent these errors are related to verb forms previously produced, and iii) whether the overgeneralized verb components are also frequent in children’s linguistic inventory. It consists of a high-density longitudinal study of a middle-class girl (1;11,24-2;02,24) from Mexico City, whose utterances were recorded almost daily for three months to compile a unique corpus in the Spanish language. Of the 358 types of inflected verbs produced by the child, 9.11% are overgeneralizations. Not only are inflected forms (verbal and pronominal clitics) overgeneralized, but also verbal roots. Each of the forms can be traced to previous utterances, and they show that the child is detecting morphological patterns. Neither verbal roots nor inflected forms are associated with high frequency patterns in her own speech. For example, the child alternates the bare roots of an irregular verb, cáye-te* and cáiga-te* (“fall down”), to express the imperative of the verb cá-e-te (fall down.IMPERATIVE-PRONOMINAL.CLITIC), although cay-ó (PAST.PERF.3SG) is the most frequent form of her previous complete inventory, and the combined frequency of caer (INF), cae (PRES.INDICATIVE.3SG), and caes (PRES.INDICATIVE.2SG) is the same as that of as caiga (PRES.SUBJ.1SG and 3SG). These results provide evidence that a) two forms of the same verb compete in the child’s memory, and b) although the child uses her own inventory to create new forms, these forms are not necessarily frequent in her memory storage, which means that her mind is more sensitive to external stimuli. Language acquisition is a developing process, given the sensitivity of the human mind to linguistic interaction with the outside world.

Keywords: inflection, morphology, child language acquisition, Spanish

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2821 Mixed Integer Programming-Based One-Class Classification Method for Process Monitoring

Authors: Younghoon Kim, Seoung Bum Kim

Abstract:

One-class classification plays an important role in detecting outlier and abnormality from normal observations. In the previous research, several attempts were made to extend the scope of application of the one-class classification techniques to statistical process control problems. For most previous approaches, such as support vector data description (SVDD) control chart, the design of the control limits is commonly based on the assumption that the proportion of abnormal observations is approximately equal to an expected Type I error rate in Phase I process. Because of the limitation of the one-class classification techniques based on convex optimization, we cannot make the proportion of abnormal observations exactly equal to expected Type I error rate: controlling Type I error rate requires to optimize constraints with integer decision variables, but convex optimization cannot satisfy the requirement. This limitation would be undesirable in theoretical and practical perspective to construct effective control charts. In this work, to address the limitation of previous approaches, we propose the one-class classification algorithm based on the mixed integer programming technique, which can solve problems formulated with continuous and integer decision variables. The proposed method minimizes the radius of a spherically shaped boundary subject to the number of normal data to be equal to a constant value specified by users. By modifying this constant value, users can exactly control the proportion of normal data described by the spherically shaped boundary. Thus, the proportion of abnormal observations can be made theoretically equal to an expected Type I error rate in Phase I process. Moreover, analogous to SVDD, the boundary can be made to describe complex structures by using some kernel functions. New multivariate control chart applying the effectiveness of the algorithm is proposed. This chart uses a monitoring statistic to characterize the degree of being an abnormal point as obtained through the proposed one-class classification. The control limit of the proposed chart is established by the radius of the boundary. The usefulness of the proposed method was demonstrated through experiments with simulated and real process data from a thin film transistor-liquid crystal display.

Keywords: control chart, mixed integer programming, one-class classification, support vector data description

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2820 Developmental Trajectories and Predictors of Adolescent Depression: A Short Term Study

Authors: Hyang Lim, Sungwon Choi

Abstract:

Many previous studies in area of adolescents' depression have used a longitudinal design. The previous studies have found that the developmental trajectory of them is only one. But it needs to be examined whether the trajectory is applied to all adolescents. Some factors in their home and/or school have an effect on adolescents' depression and more likely to be specific groups. The present study was a longitudinal study aimed to identify the trajectories and to explore the predictors of adolescents' depression. The study used Korean Children and Youth Panel Survey (KCYPS) data. In this study, 2,351 second and third-year of middle school and first of high school students' data was analyzed by using semi-parametric group modeling (SGM). There were 5 trajectory groups for adolescents; low depressed stables, low depressed risers, moderately depressed decreases, moderately depressed stables, severe depressed decreases. The predictors of adolescents' depression were parental abuse, parental neglect, annual family income, parental academic background, friendship at school, and teacher-student relationship at school. All predictors had the significant difference across trajectory group profile for adolescents. The findings of the present study recommend to promote the socioeconomic status and to train social skill for the interpersonal relationship at the home and school. And the results suggest that the proper prevention programs for each group in the middle adolescents that target selected factors may be helpful in reducing the level of depression.

Keywords: adolescent, depression, KCYPS, school life, semi-parametric group-based modeling

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2819 Exploring Attitudes and Experiences of the Cervical Screening Programme in Brighton, United Kingdom

Authors: Kirsty Biggs, Peter Larsen-Disney

Abstract:

Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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2818 A Randomized Controlled Intervention Study of the Effect of Music Training on Mathematical and Working Memory Performances

Authors: Ingo Roden, Stefana Lupu, Mara Krone, Jasmin Chantah, Gunter Kreutz, Stephan Bongard, Dietmar Grube

Abstract:

The present experimental study examined the effects of music and math training on mathematical skills and visuospatial working memory capacity in kindergarten children. For this purpose, N = 54 children (mean age: 5.46 years; SD = .29) were randomly assigned to three groups. Children in the music group (n = 18) received weekly sessions of 60 min music training over a period of eight weeks, whereas children in the math group (n = 18) received the same amount of training focusing on mathematical basic skills, such as numeracy skills, quantity comparison, and counting objectives. The third group of children (n = 18) served as waiting controls. The groups were matched for sex, age, IQ and previous music experiences at baseline. Pre-Post intervention measurements revealed a significant interaction effect of group x time, showing that children in both music and math groups significantly improved their early numeracy skills, whereas children in the control group did not. No significant differences between groups were observed for the visuospatial working memory performances. These results confirm and extend previous findings on transfer effects of music training on mathematical abilities and visuospatial working memory capacity. They show that music and math interventions are similarly effective to enhance children’s mathematical skills. More research is necessary to establish, whether cognitive transfer effects arising from music interventions might facilitate children’s transition from kindergarten to first-grade.

Keywords: music training, mathematical skills, working memory, transfer

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2817 Spirometric Reference Values in 236,606 Healthy, Non-Smoking Chinese Aged 4–90 Years

Authors: Jiashu Shen

Abstract:

Objectives: Spirometry is a basic reference for health evaluation which is widely used in clinical. Previous reference of spirometry is not applicable because of drastic changes of social and natural circumstance in China. A new reference values for the spirometry of the Chinese population is extremely needed. Method: Spirometric reference value was established using the statistical modeling method Generalized Additive Models for Location, Scale and Shape for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and maximal mid-expiratory flow (MMEF). Results: Data from 236,606 healthy non-smokers aged 4–90 years was collected from the MJ Health Check database. Spirometry equations for FEV1, FVC, MMEF, and FEV1/FVC were established, including the predicted values and lower limits of normal (LLNs) by sex. The predictive equations that were developed for the spirometric results elaborated the relationship between spirometry and age, and they eliminated the effects of height as a variable. Most previous predictive equations for Chinese spirometry were significantly overestimated (to be exact, with mean differences of 22.21% in FEV1 and 31.39% in FVC for males, along with differences of 26.93% in FEV1 and 35.76% in FVC for females) or underestimated (with mean differences of -5.81% in MMEF and -14.56% in FEV1/FVC for males, along with a difference of -14.54% in FEV1/FVC for females) the results of lung function measurements as found in this study. Through cross-validation, our equations were established as having good fit, and the means of the measured value and the estimated value were compared, with good results. Conclusions: Our study updates the spirometric reference equations for Chinese people of all ages and provides comprehensive values for both physical examination and clinical diagnosis.

Keywords: Chinese, GAMLSS model, reference values, spirometry

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2816 The Performance Improvement of Solar Aided Power Generation System by Introducing the Second Solar Field

Authors: Junjie Wu, Hongjuan Hou, Eric Hu, Yongping Yang

Abstract:

Solar aided power generation (SAPG) technology has been proven as an efficient way to make use of solar energy for power generation purpose. In an SAPG plant, a solar field consisting of parabolic solar collectors is normally used to supply the solar heat in order to displace the high pressure/temperature extraction steam. To understand the performance of such a SAPG plant, a new simulation model was developed by the authors recently, in which the boiler was treated, as a series of heat exchangers unlike other previous models. Through the simulations using the new model, it was found the outlet properties of reheated steam, e.g. temperature, would decrease due to the introduction of the solar heat. The changes make the (lower stage) turbines work under off-design condition. As a result, the whole plant’s performance may not be optimal. In this paper, the second solar filed was proposed to increase the inlet temperature of steam to be reheated, in order to bring the outlet temperature of reheated steam back to the designed condition. A 600MW SAPG plant was simulated as a case study using the new model to understand the impact of the second solar field on the plant performance. It was found in the study, the 2nd solar field would improve the plant’s performance in terms of cycle efficiency and solar-to-electricity efficiency by 1.91% and 6.01%. The solar-generated electricity produced by per aperture area under the design condition was 187.96W/m2, which was 26.14% higher than the previous design.

Keywords: solar-aided power generation system, off-design performance, coal-saving performance, boiler modelling, integration schemes

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2815 A Study of Tactics in the Dissident Urban Form

Authors: Probuddha Mukhopadhyay

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The infiltration of key elements to the civil structure is foraying its way to reclaim, what is its own. The reclamation of lives and spaces, once challenged, becomes a consistent process of ingress, disguised as parallels to the moving city, disperses into discourses often unheard of and conveniently forgotten. In this age of 'hyper'-urbanization, there are solutions suggested to a plethora of issues faced by citizens, in improving their standards of living. Problems are ancillary to proposals that emerge out of the underlying disorders of the townscape. These interventions result in the formulation of urban policies, to consolidate and optimize, to regularize and to streamline resources. Policy and practice are processes where the politics in policies define the way in which urban solutions are prescribed. Social constraints, that formulate the various cycles of order and disorders within the urban realm, are the stigmas for such interventions. There is often a direct relation of policy to place, no matter how people-centric it may seem to be projected. How we live our lives depends on where we live our lives - a relative statement for urban problems, varies from city to city. Communal compositions, welfare, crisis, socio-economic balance, need for management are the generic roots for urban policy formulation. However, in reality, the gentry administering its environmentalism is the criterion, that shapes and defines the values and expanse of such policies. In relation to the psycho-spatial characteristic of urban spheres with respect to the other side of this game, there have been instances, where the associational values have been reshaped by interests. The public domain reclaimed for exclusivity, thus creating fortified neighborhoods. Here, the citizen cumulative is often drifted by proposals that would over time deplete such landscapes of the city. It is the organized rebellion that in turn formulates further inward looking enclaves of latent aggression. In recent times, it has been observed that the unbalanced division of power and the implied processes of regulating the weak, stem the rebellion who respond in kits and parts. This is a phenomenon that mimics the guerilla warfare tactics, in order to have systems straightened out, either by manipulations or by force. This is the form of the city determined by the various forms insinuated by the state of city wide decisions. This study is an attempt at understanding the way in which development is interpreted by the state and the civil society and the role that community driven processes undertake to reinstate their claims to the city. This is a charter of consolidated patterns of negotiations that tend to counter policies. The research encompasses a study of various contested settlements in two cities of India- Mumbai and Kolkata, tackling dissent through spatial order. The study has been carried out to identify systems - formal and informal, catering to the most challenged interests of the people with respect to their habitat, a model to counter the top-down authoritative framework challenging the legitimacy of such settlements.

Keywords: urban design, insurgence, tactical urbanism, urban governance, civil society, state

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2814 Description of Anthracotheriidae Remains from the Middle and Upper Siwaliks of Punjab, Pakistan

Authors: Abdul M. Khan, Ayesha Iqbal

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In this paper, new dental remains of Merycopotamus (Anthracotheriidae) are described. The specimens were collected during field work by the authors from the well dated fossiliferous locality 'Hasnot' belonging to the Dhok Pathan Formation, and from 'Tatrot' village belonging to Tatrot Formation of the Potwar Plateau, Pakistan. The stratigraphic age of the Neogene deposits around Hasnot is 7 - 5 Ma; whereas the age of the Tatrot Formation is from 3.4 - 2.6 Ma. The newly discovered material when compared with the previous records of the genus Merycopotamus from the Siwaliks led us to identify all the three reported species of this genus from the Siwaliks of Pakistan. As the sample comprises only the dental remains so the identification of the specimens is solely based upon the morpho-metric analysis. The occlusal pattern of the upper molar in Merycopotamus dissimilis is different from Merycopotamus medioximus and Merycopotamus nanus in having a mesostyle fully divided, forming two prominent cusps, while mesostyle in M. medioximus is partly divided and small lateral crests are present on the mesostyle. A continuous loop like mesostyle is present in Merycopotamus nanus. The entoconid fold is present in Merycopotamus dissimilis on the lower molars whereas it is absent in Merycopotamus medioximus and Merycopotamus nanus. The hypoconulid in M. dissimilis is relatively simple but a loop like hypoconulid is present in M. medioximus and M. nanus. The results of the present findings are in line with the previous records of the genus Merycopotamus, with M. nanus, M. medioximus and M. dissimilis in the Late Miocene – Early Pliocene Dhok Pathan Formation, and M. dissimilis in the Late Pliocene Tatrot sediments of Pakistan.

Keywords: Dhok Pathan, late miocene, merycopotamus, pliocene, Tatrot

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2813 The Facilitatory Effect of Phonological Priming on Visual Word Recognition in Arabic as a Function of Lexicality and Overlap Positions

Authors: Ali Al Moussaoui

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An experiment was designed to assess the performance of 24 Lebanese adults (mean age 29:5 years) in a lexical decision making (LDM) task to find out how the facilitatory effect of phonological priming (PP) affects the speed of visual word recognition in Arabic as lexicality (wordhood) and phonological overlap positions (POP) vary. The experiment falls in line with previous research on phonological priming in the light of the cohort theory and in relation to visual word recognition. The experiment also departs from the research on the Arabic language in which the importance of the consonantal root as a distinct morphological unit is confirmed. Based on previous research, it is hypothesized that (1) PP has a facilitating effect in LDM with words but not with nonwords and (2) final phonological overlap between the prime and the target is more facilitatory than initial overlap. An LDM task was programmed on PsychoPy application. Participants had to decide if a target (e.g., bayn ‘between’) preceded by a prime (e.g., bayt ‘house’) is a word or not. There were 4 conditions: no PP (NP), nonwords priming nonwords (NN), nonwords priming words (NW), and words priming words (WW). The conditions were simultaneously controlled for word length, wordhood, and POP. The interstimulus interval was 700 ms. Within the PP conditions, POP was controlled for in which there were 3 overlap positions between the primes and the targets: initial (e.g., asad ‘lion’ and asaf ‘sorrow’), final (e.g., kattab ‘cause to write’ 2sg-mas and rattab ‘organize’ 2sg-mas), or two-segmented (e.g., namle ‘ant’ and naħle ‘bee’). There were 96 trials, 24 in each condition, using a within-subject design. The results show that concerning (1), the highest average reaction time (RT) is that in NN, followed firstly by NW and finally by WW. There is statistical significance only between the pairs NN-NW and NN-WW. Regarding (2), the shortest RT is that in the two-segmented overlap condition, followed by the final POP in the first place and the initial POP in the last place. The difference between the two-segmented and the initial overlap is significant, while other pairwise comparisons are not. Based on these results, PP emerges as a facilitatory phenomenon that is highly sensitive to lexicality and POP. While PP can have a facilitating effect under lexicality, it shows no facilitation in its absence, which intersects with several previous findings. Participants are found to be more sensitive to the final phonological overlap than the initial overlap, which also coincides with a body of earlier literature. The results contradict the cohort theory’s stress on the onset overlap position and, instead, give more weight to final overlap, and even heavier weight to the two-segmented one. In conclusion, this study confirms the facilitating effect of PP with words but not when stimuli (at least the primes and at most both the primes and targets) are nonwords. It also shows that the two-segmented priming is the most influential in LDM in Arabic.

Keywords: lexicality, phonological overlap positions, phonological priming, visual word recognition

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2812 User-Perceived Quality Factors for Certification Model of Web-Based System

Authors: Jamaiah H. Yahaya, Aziz Deraman, Abdul Razak Hamdan, Yusmadi Yah Jusoh

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One of the most essential issues in software products is to maintain it relevancy to the dynamics of the user’s requirements and expectation. Many studies have been carried out in quality aspect of software products to overcome these problems. Previous software quality assessment models and metrics have been introduced with strengths and limitations. In order to enhance the assurance and buoyancy of the software products, certification models have been introduced and developed. From our previous experiences in certification exercises and case studies collaborating with several agencies in Malaysia, the requirements for user based software certification approach is identified and demanded. The emergence of social network applications, the new development approach such as agile method and other varieties of software in the market have led to the domination of users over the software. As software become more accessible to the public through internet applications, users are becoming more critical in the quality of the services provided by the software. There are several categories of users in web-based systems with different interests and perspectives. The classifications and metrics are identified through brain storming approach with includes researchers, users and experts in this area. The new paradigm in software quality assessment is the main focus in our research. This paper discusses the classifications of users in web-based software system assessment and their associated factors and metrics for quality measurement. The quality model is derived based on IEEE structure and FCM model. The developments are beneficial and valuable to overcome the constraints and improve the application of software certification model in future.

Keywords: software certification model, user centric approach, software quality factors, metrics and measurements, web-based system

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2811 Transformer Fault Diagnostic Predicting Model Using Support Vector Machine with Gradient Decent Optimization

Authors: R. O. Osaseri, A. R. Usiobaifo

Abstract:

The power transformer which is responsible for the voltage transformation is of great relevance in the power system and oil-immerse transformer is widely used all over the world. A prompt and proper maintenance of the transformer is of utmost importance. The dissolved gasses content in power transformer, oil is of enormous importance in detecting incipient fault of the transformer. There is a need for accurate prediction of the incipient fault in transformer oil in order to facilitate the prompt maintenance and reducing the cost and error minimization. Study on fault prediction and diagnostic has been the center of many researchers and many previous works have been reported on the use of artificial intelligence to predict incipient failure of transformer faults. In this study machine learning technique was employed by using gradient decent algorithms and Support Vector Machine (SVM) in predicting incipient fault diagnosis of transformer. The method focuses on creating a system that improves its performance on previous result and historical data. The system design approach is basically in two phases; training and testing phase. The gradient decent algorithm is trained with a training dataset while the learned algorithm is applied to a set of new data. This two dataset is used to prove the accuracy of the proposed model. In this study a transformer fault diagnostic model based on Support Vector Machine (SVM) and gradient decent algorithms has been presented with a satisfactory diagnostic capability with high percentage in predicting incipient failure of transformer faults than existing diagnostic methods.

Keywords: diagnostic model, gradient decent, machine learning, support vector machine (SVM), transformer fault

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2810 Rising STI Prevalence among MSM Clients in Calabar, Nigeria: A Call to Action

Authors: Ugoh Kelechi Melford, Anene O.

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Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

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2809 Visual Servoing for Quadrotor UAV Target Tracking: Effects of Target Information Sharing

Authors: Jason R. King, Hugh H. T. Liu

Abstract:

This research presents simulation and experimental work in the visual servoing of a quadrotor Unmanned Aerial Vehicle (UAV) to stabilize overtop of a moving target. Most previous work in the field assumes static or slow-moving, unpredictable targets. In this experiment, the target is assumed to be a friendly ground robot moving freely on a horizontal plane, which shares information with the UAV. This information includes velocity and acceleration information of the ground target to aid the quadrotor in its tracking task. The quadrotor is assumed to have a downward-facing camera which is fixed to the frame of the quadrotor. Only onboard sensing for the quadrotor is utilized for the experiment, with a VICON motion capture system in place used only to measure ground truth and evaluate the performance of the controller. The experimental platform consists of an ArDrone 2.0 and a Create Roomba, communicating using Robot Operating System (ROS). The addition of the target’s information is demonstrated to help the quadrotor in its tracking task using simulations of the dynamic model of a quadrotor in Matlab Simulink. A nested PID control loop is utilized for inner-loop control the quadrotor, similar to previous works at the Flight Systems and Controls Laboratory (FSC) at the University of Toronto Institute for Aerospace Studies (UTIAS). Experiments are performed with ground truth provided by an indoor motion capture system, and the results are analyzed. It is demonstrated that a velocity controller which incorporates the additional information is able to perform better than the controllers which do not have access to the target’s information.

Keywords: quadrotor, target tracking, unmanned aerial vehicle, UAV, UAS, visual servoing

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2808 Bio-Guided of Active New Alkaloids from Alstonia Brassi Toxicity Antitumour Activity in Silico and Molecular Modeling

Authors: Mesbah Khaled, Bouraoui Ouissal, Benkiniouar Rachid, Belkhiri Lotfi

Abstract:

Alstonia, which are tropical plants with a wide geographical distribution, have been divided into different sections by different authors based on previous studies of several species within the genus. Monachino divides Alstonia into 5 sections, while Pichon divides it into 3 sections. Several plants belonging to this genus, such as Alstonia brassii, have been used in traditional folk medicine to treat ailments such as fever, malaria and dysentery]. Previous studies focusing on the chemical composition of these plants have successfully identified indol alkaloids with cytotoxic, anti-diabetic and anti-inflammatory properties. The newly discovered monomers are structurally similar to the backbones of picralin, affinisin and macrolin. On the other hand, all recently isolated dimeric compounds have a macrolin moiety. In this study, a computational analysis was performed on a series of novel molecules, including both monomeric and dimeric compounds with different structural frameworks. This investigation represents the first computational study of these molecules using an in silico approach incorporating 2D-QSAR data. The analysis involved various computational techniques, including 2D-QSAR modelling, molecular docking studies and subsequent validation by molecular dynamics simulation and assessment of ADMET properties. The chemical composition was identified by 1D and 2D NMR. Eight new alkaloids were isolated, 5 monomers and 3 dimers. In this section, we focus on the biological activity of 4 new alkaloids belonging to two different skeletons, the affinisine skeleton.

Keywords: affinisine, talcarpine, macroline, cytotoxicity, alkaloids

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2807 Rt. Side Sleeping Position Prevents Sudden Infant Death Syndrome

Authors: Othman Salim Hussein Al-Fleesy

Abstract:

Background: Studies showed that sudden infant death syndrome (SIDS) has association with sleeping positions. Up-to-date no study explained how could they prevent it? Objectives: 1-To determine which sleeping position is certainly safe one to prevent SIDS. 2-To establish criteria for suggesting definition and making diagnosis for SIDS. 3-To discuss the controversy surrounding SUND, ALTE, NM, as compared to SIDS. Method: This literature review was built on a previous literature. Articles were obtained randomly according to their availability to the author. For the purpose of this work an easy approach was built by modeling an overview on SIDS topic after clarifying the misconception and misinterpretation of a number of controversial issues in regard to SIDS such as: asphyxia, sudden unexpected death among adults (Bangungut or Pokkuri), apparent life threatening event (ALTE), Nightmare, and comparing the findings with the literature review results..By this unique method we got a clue for prevention of Sudden Infant Death Syndrome. Results: The revision revealed with no doubt that no study before have studied right-side sleeping position at all. The author determined right side as the only safe position to preventing SIDS. A new definition for SIDS is suggested. The author postulated a Right side position hypothesis (Alfleesy hypothesis) which is a testable hypothesis in front of all researchers for further study . Conclusion: Our results contradict totally all previous studies and recommendations. We recommended strongly the right side position only for sleeping to prevent SIDS. New definition is suggested and a new hypothesis is postulated.

Keywords: SIDS, ALTE, nightmare, forensic sciences

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2806 Investigating the Association between Escherichia Coli Infection and Breast Cancer Incidence: A Retrospective Analysis and Literature Review

Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

Abstract:

Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

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2805 A Pilot Study Exploring Dog Owners’ Perceptions on Volunteering With Their Dogs in Animal-Assisted Therapy Program in Singapore

Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

Abstract:

In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

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2804 Analytical Study and Conservation Processes of a Wooden Coffin of Middel Kingdom, Ancient Egypt

Authors: Mohamed Ahmed Abd El Kader

Abstract:

This paper describes the conservation processes of an Ancient Egyptian wooden coffin dating back to the Middle Kingdom, ancient Egypt, using several scientific and analytical methods in order to provide a deeper understanding of the deterioration status and a greater awareness of how well preserved the object is. Visual observation and 2D Programs, as well as Optical Microscopy (OM), Environmental scanning Electron Microscopy (ESEM), X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) were used in our study. The identification of wood species and the composition of the pigments and previous restoration materials were made. The coffin was previously conserved and stored in improper conditions, which led to its further deterioration; the surface of the lid dust, which obscured the decorations as well as all necessary restoration work was promptly carried out as soon as the coffin was transferred from the display hall from the Egyptian Museum to the Wood Conservation Laboratory of the Grand Egyptian Museum-Conservation Center (GEM-CC). The analyses provided detailed information concerning the original materials and the materials added during the previous treatment interventions, which was considered when applying the conservation plan. Conservation procedures have been applied with high accuracy to conserve the coffin including cleaning, consolidation of fragile painted layers, and the wooden boards forming the sides of the coffin were reassembled in their original positions. The materials and methods that were applied were extremely effective in stability and reinforcement of the coffin without harmfulness to the original materials and the coffin was successfully conserved and ready to display in the Grand Egyptian Museum (GEM).

Keywords: coffin, middle kingdom, deterioration, 2d program

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2803 Cultural Works Interacting with the Generational Aesthetic Gap between Gen X and Gen Z in China: A Qualitative Study

Authors: Qianyu Zhang

Abstract:

The spread of digital technology in China has worsened the generation gap and intergenerational competition for cultural and aesthetic discourse. Meanwhile, the increased accessibility of cultural works has encouraged the sharing and inheritance of collective cultural memories between generations. However, not each cultural work can engage positively with efforts to bridge intergenerational aesthetic differences. This study argues that in contemporary China, where new media and the Internet are widely available, featured cultural works have more potential to help enhance the cultural aesthetic consensus among different generations, thus becoming an effective countermeasure to narrow the intergenerational aesthetic rift and cultural discontinuity. Specifically, the generational aesthetic gap is expected to be bridged or improved through the shared appreciation or consumption of cultural works that meet certain conditions by several generations. In-depth interviews of Gen X and Gen Z (N=15, respectively) in China uncovered their preferences and commonalities for cultural works and shared experiences in appreciating them. Results demonstrate that both generations’ shared appreciation of cultural work is a necessary but insufficient condition for its effective response to the generational aesthetic gap. Coding analysis rendered six dimensions that cultural works with the potential to bridge the intergenerational aesthetic divide should satisfy simultaneously: genre, theme, content, elements, quality, and accessibility. Cultural works that engage multiple senses/ compound realistic, domestic and contemporary cultural memories/ contain the narrative of family life and nationalism/ include more elements familiar to the previous generation/ are superb-produced and unaffected/ are more accessible better promote intergenerational aesthetic exchange and value recognition. Moreover, compared to the dilemma of the previous generation facing the aesthetic gap, the later generation plays a crucial role in bridging the generational aesthetic divide.

Keywords: cultural works, generation gap, generation X, generation Z, cultural memory

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2802 Parametric Study for Optimal Design of Hybrid Bridge Joint

Authors: Bongsik Park, Jae Hyun Park, Jae-Yeol Cho

Abstract:

Mixed structure, which is a kind of hybrid system, is incorporating steel beam and prestressed concrete beam. Hybrid bridge adopting mixed structure have some merits. Main span length can be made longer by using steel as main span material. In case of cable-stayed bridge having asymmetric span length, negative reaction at side span can be restrained without extra restraining devices by using weight difference between main span material and side span material. However angle of refraction might happen because of rigidity difference between materials and stress concentration also might happen because of abnormal loading transmission at joint in the hybrid bridge. Therefore the joint might be a weak point of the structural system and it needs to pay attention to design of the joint. However, design codes and standards about the joint in the hybrid-bridge have not been established so the joint designs in most of construction cases have been very conservative or followed previous design without extra verification. In this study parametric study using finite element analysis for optimal design of hybrid bridge joint is conducted. Before parametric study, finite element analysis was conducted based on previous experimental data and it is verified that analysis result approximated experimental data. Based on the finite element analysis results, parametric study was conducted. The parameters were selected as those have influences on joint behavior. Based on the parametric study results, optimal design of hybrid bridge joint has been determined.

Keywords: parametric study, optimal design, hybrid bridge, finite element analysis

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2801 First Aid Awareness Campaign for Two Undergraduate Nursing Cohorts

Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

Abstract:

Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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2800 Impact of International Student Mobility on European and Global Identity: A Case Study of Switzerland

Authors: Karina Oborune

Abstract:

International student mobility involves a unique spatio-temporal context and exploring the various aspects of mobile students’ experience can lead to new findings within identity studies. The previous studies have mainly focused on student mobility within Europe and its impact on European identity arguing that students who participate in intra-European mobility already feel European before exchange. Contrary to previous studies, in this paper student mobility is analyzed from different point of view. In order to see whether a true Europeanization of identities is taking place, it is necessary to contrast European identity with alternative supranational identity which could similarly result from student mobility and in particular a global identity. Besides, in the paper there is explored whether geographical constellation (host country continental location during mobility- Europe vs. outside of Europe) plays a role. Based on newly developed model of multicultural, social and socio-demographic variables there is argued that after intra-European mobility only global identity of students could be increased (H1), but the mobility to countries outside of Europe causes changes in European identity (H2). The quantitative study (survey, n=1440, 22 higher education institutions, experimental group of former and future/potential mobile students and control group of non-mobile students) was held in Switzerland where is equally high number of students who participate in intra-European and outside of Europe mobility. The results of multivariate linear regression showed that students who participate in exchange in Europe increase their European identity due to having close friends from Europe, as well as due to length of the mobility experience had impact, but students who participate in exchange outside of Europe increase their global identity due to having close friends from outside of Europe and proficiency in foreign languages.

Keywords: student mobility, European identity, global identity, global identity

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2799 Mathematics Anxiety among Secondary Level Students in Nepal: Classroom Environment Perspective

Authors: Krishna Chandra Paudel

Abstract:

This paper explores the association between the perceived classroom environment and mathematics learning and test anxiety among secondary level students in Nepal. Categorizing the students in three dominant variables- gender, ethnicity and previous schooling, and selecting sample students with respect to higher mathematics anxiety from five heterogeneous classes, the research explores disparities in student's mathematics cognition and reveals nexus between classroom environment and mathematics learning and test anxiety. This research incorporates social learning theory and social development theory as interpretive tool for analyzing themes through qualitative data. Focussing on the interviews with highly mathematics learning anxious students, the study sheds light on how mathematics anxiety among the targeted students is interlinked with multiple factors. The research basically exposes the students’ lack of mathematical passion, their association with other students and participation in classroom learning, asymmetrical content and their lack of preparedness for the tests as caustic factors behind such anxieties. The study further reveals that students’ lack of foundational knowledge and complexity of mathematical content have jointly contributed to mathematics anxiety. Admitting learning as a reciprocal experience, the study points out that the students’ gender, ethnicity and disparities in previous schooling in the context of Nepal has very insignificant impact on students’ mathematics anxiety. It finally recommends that the students who get trapped into the vicious cycle of mathematics anxiety require positive and supportive classroom environment along with inspiring comments/compliments and symmetrical course contents.

Keywords: anxiety, asymmetry, cognition, habitus, pedagogy, preparedness

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2798 Simulating the Dynamics of E-waste Production from Mobile Phone: Model Development and Case Study of Rwanda

Authors: Rutebuka Evariste, Zhang Lixiao

Abstract:

Mobile phone sales and stocks showed an exponential growth in the past years globally and the number of mobile phones produced each year was surpassing one billion in 2007, this soaring growth of related e-waste deserves sufficient attentions paid to it regionally and globally as long as 40% of its total weight is made from metallic which 12 elements are identified to be highly hazardous and 12 are less harmful. Different research and methods have been used to estimate the obsolete mobile phones but none has developed a dynamic model and handle the discrepancy resulting from improper approach and error in the input data. The study aim was to develop a comprehensive dynamic system model for simulating the dynamism of e-waste production from mobile phone regardless the country or region and prevail over the previous errors. The logistic model method combined with STELLA program has been used to carry out this study. Then the simulation for Rwanda has been conducted and compared with others countries’ results as model testing and validation. Rwanda is about 1.5 million obsoletes mobile phone with 125 tons of waste in 2014 with e-waste production peak in 2017. It is expected to be 4.17 million obsoletes with 351.97 tons by 2020 along with environmental impact intensity of 21times to 2005. Thus, it is concluded through the model testing and validation that the present dynamic model is competent and able deal with mobile phone e-waste production the fact that it has responded to the previous studies questions from Czech Republic, Iran, and China.

Keywords: carrying capacity, dematerialization, logistic model, mobile phone, obsolescence, similarity, Stella, system dynamics

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2797 Trends in All-Cause Mortality and Inpatient and Outpatient Visits for Ambulatory Care Sensitive Conditions during the First Year of the COVID-19 Pandemic: A Population-Based Study

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

Abstract:

The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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