Search results for: clinical performance assessment

Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Niti Kammuang-lue, Kritsada On-ai, Phrut Sakulchangsatjatai, Pradit Terdtoon

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The objectives of this paper are to investigate effects of dimensionless numbers on thermal performance of the vertical closed-loop pulsating heat pipe (VCLPHP) and to establish a correlation to predict the thermal performance of the VCLPHP. The CLPHPs were made of long copper capillary tubes with inner diameters of 1.50, 1.78, and 2.16mm and bent into 26 turns. Then, both ends were connected together to form a loop. The evaporator, adiabatic, and condenser sections length were equal to 50 and 150 mm. R123, R141b, acetone, ethanol, and water were chosen as variable working fluids with constant filling ratio of 50% by total volume. Inlet temperature of heating medium and adiabatic section temperature was constantly controlled at 80 and 50oC, respectively. Thermal performance was represented in a term of Kutateladze number (Ku). It can be concluded that when Prandtl number of liquid working fluid (Prl), and Karman number (Ka) increases, thermal performance increases. On contrary, when Bond number (Bo), Jacob number (Ja), and Aspect ratio (Le/Di) increases, thermal performance decreases. Moreover, the correlation to predict more precise thermal performance has been successfully established by analyzing on all dimensionless numbers that have effect on the thermal performance of the VCLPHP.

Keywords: vertical closed-loop pulsating heat pipe, working fluid, thermal performance, dimensionless parameter

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Authors: Ahmad Abubakar Sadiq, Nwohu Ndubuka Mark, Jacob Tsado, Ahmad Adam Asharaf, Agbachi E. Okenna, Enesi E. Yahaya, Ambafi James Garba

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Transmission system performance analysis is vital to proper planning and operations of power systems in the presence of deregulation. Key performance indicators (KPIs) are often used as measure of degree of performance. This paper gives a novel method to determine the transmission efficiency by evaluating the ratio of real power losses incurred from a specified transfer direction. Available Transmission Transfer Efficiency (ATTE) expresses the percentage of real power received resulting from inter-area available power transfer. The Tie line (Rated system path) performance is seen to differ from system wide (Network response) performance and ATTE values obtained are transfer direction specific. The required sending end quantities with specified receiving end ATC and the receiving end power circle diagram are obtained for the tie line analysis. The amount of real power loss load relative to the available transfer capability gives a measure of the transmission grid efficiency.

Keywords: performance, transmission system, real power efficiency, available transfer capability

Procedia PDF Downloads 649

Authors: Zenab Naseem, Sadia Imran

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One of the key solutions to the climate change crisis is to develop renewable energy resources, such as solar and wind power and biogas. This paper explores the socioeconomic and environmental viability of solar energy, based on a case study of the Soan Valley Development Program. Under this project, local farmers were provided solar water pumps at subsidized rates. These have been functional for the last seven years and have gained popularity among the local communities. The study measures the economic viability of using solar energy in agriculture, based on data from 36 households, of which 12 households each use diesel, electric and solar water pumps. Our findings are based on the net present value of each technology type. We also carry out a qualitative assessment of the social impact of solar water pumps relative to diesel and electric pumps. Finally, we conduct an environmental impact assessment, using the lifecycle assessment approach. All three analyses indicate that solar energy is a viable alternative to diesel and electricity.

Keywords: alternative energy sources, pollution control adoption and costs, solar energy pumps, sustainable development

Procedia PDF Downloads 255

Authors: Shoukat Ali, Abdul Qadir Jandga, Amjad Hussain

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Objective: The main purpose of this study is to compare the Percent Depth dose (PDD) and In-plane and cross-plane profiles of Varian Golden beam data to the measured data of 6 and 18 MV photons for the commissioning of Eclipse treatment planning system. Introduction: Commissioning of treatment planning system requires an extensive acquisition of beam data for the clinical use of linear accelerators. Accurate dose delivery require to enter the PDDs, Profiles and dose rate tables for open and wedges fields into treatment planning system, enabling to calculate the MUs and dose distribution. Varian offers a generic set of beam data as a reference data, however not recommend for clinical use. In this study, we compared the generic beam data with the measured beam data to evaluate the reliability of generic beam data to be used for the clinical purpose. Methods and Material: PDDs and Profiles of Open and Wedge fields for different field sizes and at different depths measured as per Varian’s algorithm commissioning guideline. The measurement performed with PTW 3D-scanning water phantom with semi-flex ion chamber and MEPHYSTO software. The online available Varian Golden Beam Data compared with the measured data to evaluate the accuracy of the golden beam data to be used for the commissioning of Eclipse treatment planning system. Results: The deviation between measured vs. golden beam data was in the range of 2% max. In PDDs, the deviation increases more in the deeper depths than the shallower depths. Similarly, profiles have the same trend of increasing deviation at large field sizes and increasing depths. Conclusion: Study shows that the percentage deviation between measured and golden beam data is within the acceptable tolerance and therefore can be used for the commissioning process; however, verification of small subset of acquired data with the golden beam data should be mandatory before clinical use.

Keywords: percent depth dose, flatness, symmetry, golden beam data

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Authors: Gholamhassan Kakha, Mohsen Jami, Daniel Alex Merino Natorce

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Sustainable development refers to the creation of a balance between the development and the environment too; it consists of three key principles namely environment, society and economy. These three parameters are related to each other and the imbalance occurs in each will lead to the disparity of the other parts. Mining is one of the most important tools of the economic growth and social welfare in many countries. Meanwhile, assessment of the environmental impacts has directed to the attention of planners toward the natural environment of the areas surrounded by mines and allowing for monitoring and controlling of the current situation by the designers. In this look upon, a semi-quantitative model using a matrix method is presented for assessing the environmental impacts in the BOOG Granite Mine located in Sistan and Balouchestan, one of the provinces of Iran for determining the effective factors and environmental components. For accomplishing this purpose, the initial data are collected by the experts at the next stage; the effect of the factors affects each environmental component is determined by specifying the qualitative viewpoints. Based on the results, factors including air quality, ecology, human health and safety along with the environmental damages resulted from mining activities in that area. Finally, the results gained from the assessment of the environmental impact are used to evaluate the sustainability by using Philips mathematical model. The results show that the sustainability of this area is weak, so environmental preventive measures are recommended to reduce the environmental damages to its components.

Keywords: sustainable development, environmental impacts' assessment, BOOG granite, Philips mathematical model

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Authors: S. Forughi, A. De Zoysa, S. Bhati

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The present study focuses on the environmental performance of the companies in the electricity-producing sector and its relationship with their financial performance. We will review the major studies that examined the relationship between the environmental and financial performance of firms in various industries. While the classical economic debates consider the environmental friendly activities costly and harmful to a firm’s profitability, it is claimed that firms will be rewarded with higher profitability in long run through the investments in environmental friendly activities. In this context, prior studies have examined the relationship between the environmental and financial performance of firms operating in different industry sectors. Our study will employ an environmental indicator to increase the accuracy of the results and be employed as an independent variable in our developed econometric model to evaluate the impact of the financial performance of the firms on their environmental friendly activities in the context of companies operating in the Australian electricity-producing sector. As a result, we expect our methodology to contribute to the literature and the findings of the study will help us to provide recommendations and policy implications to the electricity producers.

Keywords: Australian electricity sector, efficiency measurement, environmental-financial performance interaction, environmental index

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Authors: Doran C. Kalmin

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The descending genicular artery (DGA) perforator free flap provides an alternative to free flap reconstruction based on a review of the literature detailing both anatomical and clinical studies. The descending genicular artery (DGA) supplies skin, muscle, tendon, and bone located around the medial aspect of the knee that has been used in several pioneering reports in reconstructing defects located in various areas throughout the body. After the success of the medial femoral condyle flap in early studies, a small number of studies have been published detailing the use of the DGA in free flap reconstruction. Despite early success in the use of the DGA flap, acceptance within the Plastic and Reconstructive Surgical community has been limited due primarily to anatomical variations of the pedicle. This literature review is aimed at detailing the progression of the DGA perforator free flap and its variations as an alternative and reliable free flap for reconstruction of composite defects with an exploration into both anatomical and clinical studies. A literature review was undertaken, and the progression of the DGA flap is explored from the early review by Acland et al. pioneering the saphenous free flap to exploring modern changes and studies of the anatomy of the DGA. An extensive review of the literature was undertaken that details the anatomy and its variations, approaches to harvesting the flap, the advantages, and disadvantages of the DGA perforator free flap as well as flap outcomes. There are 15 published clinical series of DGA perforator free flaps that incorporate cutaneous, osteoperiosteal, cartilage, osteocutaneous, osteoperiosteal and muscle, osteoperiosteal and subcutaneous and tendocutatenous. The commonest indication for using a DGA free flap was for non-union of bone, particularly that of the scaphoid whereby the medial femoral condyle could be used. In the case series, a success rate of over 90% was established, showing that these early studies have had good success with a wide range of tissue transfers. The greatest limitation is the anatomical variation of the DGA and therefore, the challenges associated with raising the flap. Despite the variation in anatomy and around 10-15% absence of the DGA, the saphenous artery can be used as well as the superior medial genicular artery if the vascular bone is required as part of the flap. Despite only a handful of anatomical and clinical studies describing the DGA perforator free flap, it ultimately provides a reliable flap that can include a variety of composite structure used for reconstruction in almost any area throughout the body. Although it has limitations, it provides a reliable option for free flap reconstruction that can routinely be performed as a single-stage procedure.

Keywords: anatomical study, clinical study, descending genicular artery, literature review, perforator free flap reconstruction

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Authors: Thomas Heffernan, Nick Neave, Colin Hamilton, Gill Case

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Hoarding is the acquisition of and failure to discard possessions, leading to excessive clutter and significant psychological/emotional distress. From a cognitive-behavioural approach, excessive hoarding arises from information-processing deficits, as well as from problems with emotional attachment to possessions and beliefs about the nature of possessions. In terms of information processing, hoarders have shown deficits in executive functions, including working memory, planning, inhibitory control, and cognitive flexibility. However, this previous research is often confounded by co-morbid factors such as anxiety, depression, or obsessive-compulsive disorder. The current study adopted a cognitive-behavioural approach, specifically assessing executive deficits and working memory in a non-clinical sample of hoarders, compared with non-hoarders. In this study, a non-clinical sample of 40 hoarders and 73 non-hoarders (defined by The Savings Inventory-Revised) completed the Adult Executive Functioning Inventory, which measures working memory and inhibition, Dysexecutive Questionnaire-Revised, which measures general executive function and the Hospital Anxiety and Depression Scale, which measures mood. The participant sample was made up of unpaid young adult volunteers who were undergraduate students and who completed the questionnaires on a university campus. The results revealed that, after observing no differences between hoarders and non-hoarders on age, sex, and mood, hoarders reported significantly more deficits in inhibitory control and general executive function when compared with non-hoarders. There was no between-group difference on general working memory. This suggests that non-clinical hoarders have a specific difficulty with inhibition-control, which enables you to resist repeated, unwanted urges. This might explain the hoarder’s inability to resist urges to buy and keep items that are no longer of any practical use. These deficits may be underpinned by general executive function deficiencies.

Keywords: hoarding, memory, executive, deficits

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Authors: Hesham Abd Elkhalek, Sherif M. Hafez, Yasser M. El Fahham

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Allocating limited budget to maintain bridge networks and selecting effective maintenance strategies for each bridge represent challenging tasks for maintenance managers and decision makers. In Egypt, bridges are continuously deteriorating. In many cases, maintenance works are performed due to user complaints. The objective of this paper is to develop a practical and reliable framework to manage the maintenance, repair, and rehabilitation (MR&R) activities of Bridges network considering performance and budget limits. The model solves an optimization problem that maximizes the average condition of the entire network given the limited available budget using Genetic Algorithm (GA). The framework contains bridge inventory, condition assessment, repair cost calculation, deterioration prediction, and maintenance optimization. The developed model takes into account multiple parameters including serviceability requirements, budget allocation, element importance on structural safety and serviceability, bridge impact on network, and traffic. A questionnaire is conducted to complete the research scope. The proposed model is implemented in software, which provides a friendly user interface. The framework provides a multi-year maintenance plan for the entire network for up to five years. A case study of ten bridges is presented to validate and test the proposed model with data collected from Transportation Authorities in Egypt. Different scenarios are presented. The results are reasonable, feasible and within acceptable domain.

Keywords: bridge management systems (BMS), cost optimization condition assessment, fund allocation, Markov chain

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Authors: Joanna Maj

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Awe inspiring is the idea that emotions could be present in human-machine interactions, both on the human side as well as the machine side. Human factors present intriguing components and are examined in detail while discussing this controversial topic. Mood, attention, memory, performance, assessment, causes of emotion, and neurological responses are analyzed as components of the interaction. Problems in computer-based technology, revenge of the system on its users and design, and applications comprise a major part of all descriptions and examples throughout this paper. It also allows for critical thinking while challenging intriguing questions regarding future directions in research, dealing with emotion in human-machine interactions.

Keywords: biocomputing, biomedical engineering, emotions, human-machine interaction, interfaces

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Authors: Akalu Banbeta, Emmanuel Lesaffre, Reynaldo Martina, Joost Van Rosmalen

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Including data from previous studies (historical data) in the analysis of the current study may reduce the sample size requirement and/or increase the power of analysis. The most common example is incorporating historical control data in the analysis of a current clinical trial. However, this only applies when the historical control dataare similar enough to the current control data. Recently, several Bayesian approaches for incorporating historical data have been proposed, such as the meta-analytic-predictive (MAP) prior and the modified power prior (MPP) both for single control as well as for multiple historical control arms. Here, we examine the performance of the MAP and the MPP approaches for the analysis of (over-dispersed) count data. To this end, we propose a computational method for the MPP approach for the Poisson and the negative binomial models. We conducted an extensive simulation study to assess the performance of Bayesian approaches. Additionally, we illustrate our approaches on an overactive bladder data set. For similar data across the control arms, the MPP approach outperformed the MAP approach with respect to thestatistical power. When the means across the control arms are different, the MPP yielded a slightly inflated type I error (TIE) rate, whereas the MAP did not. In contrast, when the dispersion parameters are different, the MAP gave an inflated TIE rate, whereas the MPP did not.We conclude that the MPP approach is more promising than the MAP approach for incorporating historical count data.

Keywords: count data, meta-analytic prior, negative binomial, poisson

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Authors: S. Shujan, A. T. Rupasinghe, N. L. Gunawardena

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Numerous studies have determined that there is a direct correlation between the successful interviewee and the nonverbal behavioral patterns of that person during the interview. In this study, we focus on formations of interview questions in such a way that, it gets an opportunity for assessing interviewee through the answers using the nonverbal behavioral cues. From all the nonverbal behavioral factors we have identified, in this study priority is given to the ‘facial expression variations’ with the assistance of facial expression analytics tool; this research proposes a novel approach in question formation for the assessment of interviewees in ‘Software Industry’.

Keywords: assessments, hirability, interviews, non-verbal behaviour patterns, question formation

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Authors: S. Cencek, A. Markun

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Noise assessment methods are regularly used in scope of Environmental Impact Assessments for planned projects to assess (predict) the expected noise emissions of these projects. Different noise assessment methods could be used. In recent years, we had an opportunity to collaborate in some noise assessment procedures where noise assessments of different laboratories have been performed simultaneously. We identified some significant differences in noise assessment results between laboratories in Slovenia. We estimate that despite good input Georeferenced Data to set up acoustic model exists in Slovenia; there is no clear consensus on methods for predictive noise methods for planned projects. We analyzed input data, methods and results of predictive noise methods for two planned industrial projects, both were done independently by two laboratories. We also analyzed the data, methods and results of two interlaboratory collaborative noise models for two existing noise sources (railway and motorway). In cases of predictive noise modelling, the validations of acoustic models were performed by noise measurements of surrounding existing noise sources, but in varying durations. The acoustic characteristics of existing buildings were also not described identically. The planned noise sources were described and digitized differently. Differences in noise assessment results between different laboratories have ranged up to 10 dBA, which considerably exceeds the acceptable uncertainty ranged between 3 to 6 dBA. Contrary to predictive noise modelling, in cases of collaborative noise modelling for two existing noise sources the possibility to perform the validation noise measurements of existing noise sources greatly increased the comparability of noise modelling results. In both cases of collaborative noise modelling for existing motorway and railway, the modelling results of different laboratories were comparable. Differences in noise modeling results between different laboratories were below 5 dBA, which was acceptable uncertainty set up by interlaboratory noise modelling organizer. The lessons learned from the study were: 1) Predictive noise calculation using formulae from International standard SIST ISO 9613-2: 1997 is not an appropriate method to predict noise emissions of planned projects since due to complexity of procedure they are not used strictly, 2) The noise measurements are important tools to minimize noise assessment errors of planned projects and should be in cases of predictive noise modelling performed at least for validation of acoustic model, 3) National guidelines should be made on the appropriate data, methods, noise source digitalization, validation of acoustic model etc. in order to unify the predictive noise models and their results in scope of Environmental Impact Assessments for planned projects.

Keywords: environmental noise assessment, predictive noise modelling, spatial planning, noise measurements, national guidelines

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Mohamed H. Sorour, Hayam F. Shaalan, Heba A. Hani, Eman S. Sayed

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Ion exchange adsorption has a long standing history of success for seawater softening and selective ion removal from saline sources. Strong, weak and mixed types ion exchange systems could be designed and optimized for target separation. In this paper, different types of adsorbents comprising zeolite 13X and kaolin, in addition to, poly acrylate/zeolite (AZ), poly acrylate/kaolin (AK) and stand-alone poly acrylate (A) hydrogel types were prepared via microwave (M) and ultrasonic (U) irradiation techniques. They were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). The developed adsorbents were evaluated on bench scale level and based on assessment results, a composite bed has been formulated for performance evaluation in pilot scale column investigations. Owing to the hydrogel nature of the partially crosslinked poly acrylate, the developed adsorbents manifested a swelling capacity of about 50 g/g. The pilot trials have been carried out using magnesium enriched Red Seawater to simulate Red Seawater desalination brine. Batch studies indicated varying uptake efficiencies, where Mg adsorption decreases according to the following prepared hydrogel types AU>AM>AKM>AKU>AZM>AZU, being 108, 107, 78, 69, 66 and 63 mg/g, respectively. Composite bed adsorbent tested in the up-flow mode column studies indicated good performance for Mg uptake. For an operating cycle of 12 h, the maximum uptake during the loading cycle approached 92.5-100 mg/g, which is comparable to the performance of some commercial resins. Different regenerants have been explored to maximize regeneration and minimize the quantity of regenerants including 15% NaCl, 0.1 M HCl and sodium carbonate. Best results were obtained by acidified sodium chloride solution. In conclusion, developed cation exchange adsorbents comprising clay or zeolite support indicated adequate performance for Mg recovery under saline environment. Column design operated at the up-flow mode (approaching expanded bed) is appropriate for such type of separation. Preliminary cost indicators for Mg recovery via ion exchange have been developed and analyzed.

Keywords: batch and dynamic magnesium separation, seawater, polyacrylate hydrogel, cost evaluation

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Authors: M. Reza Hashemi, Chris Small, Scott Hayward

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The Northeast Coast of the US faces damaging effects of coastal flooding and winds due to Atlantic tropical and extratropical storms each year. Historically, several large storm events have produced substantial levels of damage to the region; most notably of which were the Great Atlantic Hurricane of 1938, Hurricane Carol, Hurricane Bob, and recently Hurricane Sandy (2012). The objective of this study was to develop an integrated modeling system that could be used as a forecasting/hindcasting tool to evaluate and communicate the risk coastal communities face from these coastal storms. This modeling system utilizes the ADvanced CIRCulation (ADCIRC) model for storm surge predictions and the Simulating Waves Nearshore (SWAN) model for the wave environment. These models were coupled, passing information to each other and computing over the same unstructured domain, allowing for the most accurate representation of the physical storm processes. The coupled SWAN-ADCIRC model was validated and has been set up to perform real-time forecast simulations (as well as hindcast). Modeled storm parameters were then passed to a coastal risk assessment tool. This tool, which is generic and universally applicable, generates spatial structural damage estimate maps on an individual structure basis for an area of interest. The required inputs for the coastal risk model included a detailed information about the individual structures, inundation levels, and wave heights for the selected region. Additionally, calculation of wind damage to structures was incorporated. The integrated coastal risk assessment system was then tested and applied to Charlestown, a small vulnerable coastal town along the southern shore of Rhode Island. The modeling system was applied to Hurricane Sandy and a synthetic storm. In both storm cases, effect of natural dunes on coastal risk was investigated. The resulting damage maps for the area (Charlestown) clearly showed that the dune eroded scenarios affected more structures, and increased the estimated damage. The system was also tested in forecast mode for a large Nor’Easters: Stella (March 2017). The results showed a good performance of the coupled model in forecast mode when compared to observations. Finally, a nearshore model XBeach was then nested within this regional grid (ADCIRC-SWAN) to simulate nearshore sediment transport processes and coastal erosion. Hurricane Irene (2011) was used to validate XBeach, on the basis of a unique beach profile dataset at the region. XBeach showed a relatively good performance, being able to estimate eroded volumes along the beach transects with a mean error of 16%. The validated model was then used to analyze the effectiveness of several erosion mitigation methods that were recommended in a recent study of coastal erosion in New England: beach nourishment, coastal bank (engineered core), and submerged breakwater as well as artificial surfing reef. It was shown that beach nourishment and coastal banks perform better to mitigate shoreline retreat and coastal erosion.

Keywords: ADCIRC, coastal flooding, storm surge, coastal risk assessment, living shorelines

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Fahad Alam

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Work stress directly affects job performance, specifically in a worse environment. Consequently, a social provision plays a crucial part for enhancement. Therefore, the current research investigates the direct and moderating effect between religious activities, sustainability and peer support on job performance at hospitals in Khyber PakhtunKhwa (KPK), Pakistan. Both primary and secondary data are collected through 261 questionnaires of medical employees from four district hospitals in Khyber PakhtunKhwa, Pakistan, in 2018. The analysis was carried out by SPSS16 and SMART PLS3, to test the direct effect of religious activities, sustainability and social support on job performance and the effect of moderating variable 'work environment' on job performance. The finding confirmed that direct and moderating variables play a significant positive effect among religious activities, sustainability and peer support on job performance, the variables help to diminish the strain level or the stress level, consequently helps in the job completed. Affirmative social approaches produce desirable effects on job performance. The research revealed that social provisions are significant triggers for superior practices. Moreover, the results are stimulating because some of the past literature revealed an insignificant correlation between social provision and performance. This study found that there is a significant relationship which persuades health care organizations.

Keywords: job performance, peer’s support, religious activities, sustainability, work environment

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Omer Akkaya, Nurullah Ekmekcı, Muammer Zerenler

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Innovation for businesses means a new product and service and sometimes a new implementation. Total Quality Management is a management philosophy which focus on customer, process and system.There is a certain relationship between principles of Total Quality Management and innovation performance. Main aim of this study is to show how the implementation and principles of Total Quality Management (TQM) affect a firm's innovation performance. Also, this paper discusses positive and negative affects of Total Quality Management on innovation performance and demonstrates some examples.

Keywords: innovation, innovation types, total quality management, principles of total quality management

Procedia PDF Downloads 630

Authors: Neha Gupta

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Landslide vulnerability is considered as the crucial parameter for the assessment of landslide risk. The term vulnerability defined as the damage or degree of elements at risk of different dimensions, i.e., physical, social, economic, and environmental dimensions. Himalaya region is very prone to multi-hazard such as floods, forest fires, earthquakes, and landslides. With the increases in fatalities rates, loss of infrastructure, and economy due to landslide in the Himalaya region, leads to the assessment of vulnerability. In this study, a methodology to measure the combination of vulnerability dimension, i.e., social vulnerability, physical vulnerability, and environmental vulnerability in one framework. A combined result of these vulnerabilities has rarely been carried out. But no such approach was applied in the Indian Scenario. The methodology was applied in an area of east Sikkim Himalaya, India. The physical vulnerability comprises of building footprint layer extracted from remote sensing data and Google Earth imaginary. The social vulnerability was assessed by using population density based on land use. The land use map was derived from a high-resolution satellite image, and for environment vulnerability assessment NDVI, forest, agriculture land, distance from the river were assessed from remote sensing and DEM. The classes of social vulnerability, physical vulnerability, and environment vulnerability were normalized at the scale of 0 (no loss) to 1 (loss) to get the homogenous dataset. Then the Multi-Criteria Analysis (MCA) was used to assign individual weights to each dimension and then integrate it into one frame. The final vulnerability was further classified into four classes from very low to very high.

Keywords: landslide, multi-criteria analysis, MCA, physical vulnerability, social vulnerability

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Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias

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Magnetic Resonance Imaging (MRI) is a vital imaging technique used in both clinical and pre-clinical areas to obtain detailed anatomical and functional information. However, MRI scans can be expensive, time-consuming, and often require the use of anesthetics to keep animals still during the imaging process. Anesthetics are commonly administered to animals undergoing MRI scans to ensure they remain still during the imaging process. However, prolonged or repeated exposure to anesthetics can have adverse effects on animals, including physiological alterations and potential toxicity. Minimizing the duration and frequency of anesthesia is, therefore, crucial for the well-being of research animals. In recent years, various sampling trajectories have been investigated to reduce the number of MRI measurements leading to shorter scanning time and minimizing the duration of animal exposure to the effects of anesthetics. Compressed sensing (CS) and sampling trajectories, such as cartesian, spiral, and radial, have emerged as powerful tools to reduce MRI data while preserving diagnostic quality. This work aims to apply CS and cartesian, spiral, and radial sampling trajectories for the reconstruction of MRI of the abdomen of mice sub-sampled at levels below that defined by the Nyquist theorem. The methodology of this work consists of using a fully sampled reference MRI of a female model C57B1/6 mouse acquired experimentally in a 4.7 Tesla MRI scanner for small animals using Spin Echo pulse sequences. The image is down-sampled by cartesian, radial, and spiral sampling paths and then reconstructed by CS. The quality of the reconstructed images is objectively assessed by three quality assessment techniques RMSE (Root mean square error), PSNR (Peak to Signal Noise Ratio), and SSIM (Structural similarity index measure). The utilization of optimized sampling trajectories and CS technique has demonstrated the potential for a significant reduction of up to 70% of image data acquisition. This result translates into shorter scan times, minimizing the duration and frequency of anesthesia administration and reducing the potential risks associated with it.

Keywords: compressed sensing, magnetic resonance, sampling trajectories, small animals

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Authors: Akeel Noori Almulla Hwaish

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Architectural design is influenced by the actual thermal behaviour of building components, and this in turn depends not only on their steady and periodic thermal characteristics, but also on exposure effects, orientation, surface colour, and climatic fluctuations at the given location. Design data and environmental parameters should be produced in an accurate way for specified locations, so that architects and engineers can confidently apply them in their design calculations that enable precise evaluation of the influence of various parameters relating to each component of the envelope, which indicates overall thermal performance of building. The present paper will be carried out with an objective of thermal behaviour assessment and characteristics of the opaque and transparent parts of one of the very unique components used as a symbolic distinguished element of building envelope, its thermal behaviour under the impact of solar temperatures, and its role in heat exchange related to a specific U-value of specified construction materials alternatives. The research method will consider the specified Hot-Dry weather and new mosque in Baghdad, Iraq as a case study. Also, data will be presented in light of the criteria of indoor thermal comfort in terms of design parameters and thermal assessment for a“model dome”. Design alternatives and considerations of energy conservation, will be discussed as well using comparative computer simulations. Findings will be incorporated to outline the conclusions clarifying the important role of the dome in heat exchange of the whole building envelope for approaching an indoor thermal comfort level and further research in the future.

Keywords: building envelope, sustainable design, dome impact, hot-climates, heat exchange

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

Procedia PDF Downloads 86

Authors: Eman A. Embaby, Amira A. A. Abdallah

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Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30 min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs. 29.07±2.4 years, weight 63.6±7 vs. 60±7.8 kg, and height 162.73±4 vs. 162.8±6 cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5 min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, fatigability, gluteus-medius, LBP, standing, trunk

Procedia PDF Downloads 245

Authors: Phil P. Wagner

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There is an overwhelming amount of athlete-centric information available for sport practitioners in this era of tech and big data, but protocols in athletic rehabilitation remain arbitrary. It is a common assumption that the rate at which tissue heals amongst individuals is the same; yielding protocols that are entirely time-based. Progressing athletes through rehab programs that lack individualization can potentially expose athletes to stimuli they are not prepared for or unnecessarily lengthen their recovery period. A 7-year aggregated and anonymous database was used to develop reliable and valid assessments to measure athletic resilience. Each assessment utilizes force plate technology with proprietary protocols and analysis to provide key thresholds for injury risk and recovery. Using a T score to analyze movement qualities, much like the Z score used for bone density from a Dexa scan, specific prescriptions are provided to mitigate the athlete’s inherent injury risk. In addition to obliging to surgical clearance, practitioners must put in place a clearance protocol guided by standardized assessments and achievement in strength thresholds. In order to truly hold individuals accountable (practitioners, athletic trainers, performance coaches, etc.), success in improving pre-defined key performance indicators must be frequently assessed and analyzed.

Keywords: analytics, athlete rehabilitation, athlete resilience, injury prediction, injury prevention

Procedia PDF Downloads 228

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

Procedia PDF Downloads 118

Authors: Su-Hyun Cho, Chang-U Chae

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Environmental impact assessment techniques have been developed as a result of the worldwide efforts to reduce the environmental impact of global warming. By using the quantification method in the construction industry, it is now possible to manage the greenhouse gas is to systematically evaluate the impact on the environment over the entire construction process. In particular, the proportion of greenhouse gas emissions at the production stage of construction material occupied is high, and efforts are needed in particular in the construction field. In this study, intended for concrete products for the construction materials, by using the LCA evaluation method, we compared the results of environmental impact assessment and carbon emissions of developing products that have been applied low-carbon technologies compared to existing products. As a results, by introducing a raw material of industrial waste, showed carbon reduction. Through a comparison of the carbon emission reduction effect of low-carbon technologies, it is intended to provide academic data for the evaluation of greenhouse gases in the construction sector and the development of low-carbon technologies of the future.

Keywords: CO₂ emissions, CO₂ reduction, ready-mixed concrete, environmental impact assessment

Procedia PDF Downloads 479