Search results for: event injuries
223 Treatment of Neuronal Defects by Bone Marrow Stem Cells Differentiation to Neuronal Cells Cultured on Gelatin-PLGA Scaffolds Coated with Nano-Particles
Authors: Alireza Shams, Ali Zamanian, Atefehe Shamosi, Farnaz Ghorbani
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Introduction: Although the application of a new strategy remains a remarkable challenge for treatment of disabilities due to neuronal defects, progress in Nanomedicine and tissue engineering, suggesting the new medical methods. One of the promising strategies for reconstruction and regeneration of nervous tissue is replacing of lost or damaged cells by specific scaffolds after Compressive, ischemic and traumatic injuries of central nervous system. Furthermore, ultrastructure, composition, and arrangement of tissue scaffolds are effective on cell grafts. We followed implantation and differentiation of mesenchyme stem cells to neural cells on Gelatin Polylactic-co-glycolic acid (PLGA) scaffolds coated with iron nanoparticles. The aim of this study was to evaluate the capability of stem cells to differentiate into motor neuron-like cells under topographical cues and morphogenic factors. Methods and Materials: Bone marrow mesenchymal stem cells (BMMSCs) was obtained by primary cell culturing of adult rat bone marrow got from femur bone by flushing method. BMMSCs were incubated with DMEM/F12 (Gibco), 15% FBS and 100 U/ml pen/strep as media. Then, BMMSCs seeded on Gel/PLGA scaffolds and tissue culture (TCP) polystyrene embedded and incorporated by Fe Nano particles (FeNPs) (Fe3o4 oxide (M w= 270.30 gr/mol.). For neuronal differentiation, 2×10 5 BMMSCs were seeded on Gel/PLGA/FeNPs scaffolds was cultured for 7 days and 0.5 µ mol. Retinoic acid, 100 µ mol. Ascorbic acid,10 ng/ml. Basic fibroblast growth factor (Sigma, USA), 250 μM Iso butyl methyl xanthine, 100 μM 2-mercaptoethanol, and 0.2 % B27 (Invitrogen, USA) added to media. Proliferation of BMMSCs was assessed by using MTT assay for cell survival. The morphology of BMMSCs and scaffolds was investigated by scanning electron microscopy analysis. Expression of neuron-specific markers was studied by immunohistochemistry method. Data were analyzed by analysis of variance, and statistical significance was determined by Turkey’s test. Results: Our results revealed that differentiation and survival of BMMSCs into motor neuron-like cells on Gel/PLGA/FeNPs as a biocompatible and biodegradable scaffolds were better than those cultured in Gel/PLGA in absence of FeNPs and TCP scaffolds. FeNPs had raised physical power but decreased capacity absorption of scaffolds. Well defined oriented pores in scaffolds due to FeNPs may activate differentiation and synchronized cells as a mechanoreceptor. Induction effects of magnetic FeNPs by One way flow of channels in scaffolds help to lead the cells and can facilitate direction of their growth processes. Discussion: Progression of biological properties of BMMSCs and the effects of FeNPs spreading under magnetic field was evaluated in this investigation. In vitro study showed that the Gel/PLGA/FeNPs scaffold provided a suitable structure for motor neuron-like cells differentiation. This could be a promising candidate for enhancing repair and regeneration in neural defects. Dynamic and static magnetic field for inducing and construction of cells can provide better results for further experimental studies.Keywords: differentiation, mesenchymal stem cells, nano particles, neuronal defects, Scaffolds
Procedia PDF Downloads 161222 An Observational Study Assessing the Baseline Communication Behaviors among Healthcare Professionals in an Inpatient Setting in Singapore
Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong
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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.Keywords: healthcare communication, healthcare management, nursing, qualitative observational study
Procedia PDF Downloads 208221 Modelling Flood Events in Botswana (Palapye) for Protecting Roads Structure against Floods
Authors: Thabo M. Bafitlhile, Adewole Oladele
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Botswana has been affected by floods since long ago and is still experiencing this tragic event. Flooding occurs mostly in the North-West, North-East, and parts of Central district due to heavy rainfalls experienced in these areas. The torrential rains destroyed homes, roads, flooded dams, fields and destroyed livestock and livelihoods. Palapye is one area in the central district that has been experiencing floods ever since 1995 when its greatest flood on record occurred. Heavy storms result in floods and inundation; this has been exacerbated by poor and absence of drainage structures. Since floods are a part of nature, they have existed and will to continue to exist, hence more destruction. Furthermore floods and highway plays major role in erosion and destruction of roads structures. Already today, many culverts, trenches, and other drainage facilities lack the capacity to deal with current frequency for extreme flows. Future changes in the pattern of hydro climatic events will have implications for the design and maintenance costs of roads. Increase in rainfall and severe weather events can affect the demand for emergent responses. Therefore flood forecasting and warning is a prerequisite for successful mitigation of flood damage. In flood prone areas like Palapye, preventive measures should be taken to reduce possible adverse effects of floods on the environment including road structures. Therefore this paper attempts to estimate return periods associated with huge storms of different magnitude from recorded historical rainfall depth using statistical method. The method of annual maxima was used to select data sets for the rainfall analysis. In the statistical method, the Type 1 extreme value (Gumbel), Log Normal, Log Pearson 3 distributions were all applied to the annual maximum series for Palapye area to produce IDF curves. The Kolmogorov-Smirnov test and Chi Squared were used to confirm the appropriateness of fitted distributions for the location and the data do fit the distributions used to predict expected frequencies. This will be a beneficial tool for urgent flood forecasting and water resource administration as proper drainage design will be design based on the estimated flood events and will help to reclaim and protect the road structures from adverse impacts of flood.Keywords: drainage, estimate, evaluation, floods, flood forecasting
Procedia PDF Downloads 363220 Manual Wheelchair Propulsion Efficiency on Different Slopes
Authors: A. Boonpratatong, J. Pantong, S. Kiattisaksophon, W. Senavongse
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In this study, an integrated sensing and modeling system for manual wheelchair propulsion measurement and propulsion efficiency calculation was used to indicate the level of overuse. Seven subjects participated in the measurement. On the level surface, the propulsion efficiencies were not different significantly as the riding speed increased. By contrast, the propulsion efficiencies on the 15-degree incline were restricted to around 0.5. The results are supported by previously reported wheeling resistance and propulsion torque relationships implying margin of the overuse. Upper limb musculoskeletal injuries and syndromes in manual wheelchair riders are common, chronic, and may be caused at different levels by the overuse i.e. repetitive riding on steep incline. The qualitative analysis such as the mechanical effectiveness on manual wheeling to establish the relationship between the riding difficulties, mechanical efforts and propulsion outputs is scarce, possibly due to the challenge of simultaneous measurement of those factors in conventional manual wheelchairs and everyday environments. In this study, the integrated sensing and modeling system were used to measure manual wheelchair propulsion efficiency in conventional manual wheelchairs and everyday environments. The sensing unit is comprised of the contact pressure and inertia sensors which are portable and universal. Four healthy male and three healthy female subjects participated in the measurement on level and 15-degree incline surface. Subjects were asked to perform manual wheelchair ridings with three different self-selected speeds on level surface and only preferred speed on the 15-degree incline. Five trials were performed in each condition. The kinematic data of the subject’s dominant hand and a spoke and the trunk of the wheelchair were collected through the inertia sensors. The compression force applied from the thumb of the dominant hand to the push rim was collected through the contact pressure sensors. The signals from all sensors were recorded synchronously. The subject-selected speeds for slow, preferred and fast riding on level surface and subject-preferred speed on 15-degree incline were recorded. The propulsion efficiency as a ratio between the pushing force in tangential direction to the push rim and the net force as a result of the three-dimensional riding motion were derived by inverse dynamic problem solving in the modeling unit. The intra-subject variability of the riding speed was not different significantly as the self-selected speed increased on the level surface. Since the riding speed on the 15-degree incline was difficult to regulate, the intra-subject variability was not applied. On the level surface, the propulsion efficiencies were not different significantly as the riding speed increased. However, the propulsion efficiencies on the 15-degree incline were restricted to around 0.5 for all subjects on their preferred speed. The results are supported by the previously reported relationship between the wheeling resistance and propulsion torque in which the wheelchair axle torque increased but the muscle activities were not increased when the resistance is high. This implies the margin of dynamic efforts on the relatively high resistance being similar to the margin of the overuse indicated by the restricted propulsion efficiency on the 15-degree incline.Keywords: contact pressure sensor, inertia sensor, integrating sensing and modeling system, manual wheelchair propulsion efficiency, manual wheelchair propulsion measurement, tangential force, resultant force, three-dimensional riding motion
Procedia PDF Downloads 287219 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model
Procedia PDF Downloads 140218 An Econometric Analysis of the Flat Tax Revolution
Authors: Wayne Tarrant, Ethan Petersen
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The concept of a flat tax goes back to at least the Biblical tithe. A progressive income tax was first vociferously espoused in a small, but famous, pamphlet in 1848 (although England had an emergency progressive tax for war costs prior to this). Within a few years many countries had adopted the progressive structure. The flat tax was only reinstated in some small countries and British protectorates until Mart Laar was elected Prime Minister of Estonia in 1992. Since Estonia’s adoption of the flat tax in 1993, many other formerly Communist countries have likewise abandoned progressive income taxes. Economists had expectations of what would happen when a flat tax was enacted, but very little work has been done on actually measuring the effect. With a testbed of 21 countries in this region that currently have a flat tax, much comparison is possible. Several countries have retained progressive taxes, giving an opportunity for contrast. There are also the cases of Czech Republic and Slovakia, which have adopted and later abandoned the flat tax. Further, with over 20 years’ worth of economic history in some flat tax countries, we can begin to do some serious longitudinal study. In this paper we consider many economic variables to determine if there are statistically significant differences from before to after the adoption of a flat tax. We consider unemployment rates, tax receipts, GDP growth, Gini coefficients, and market data where the data are available. Comparisons are made through the use of event studies and time series methods. The results are mixed, but we draw statistically significant conclusions about some effects. We also look at the different implementations of the flat tax. In some countries there are equal income and corporate tax rates. In others the income tax has a lower rate, while in others the reverse is true. Each of these sends a clear message to individuals and corporations. The policy makers surely have a desired effect in mind. We group countries with similar policies, try to determine if the intended effect actually occurred, and then report the results. This is a work in progress, and we welcome the suggestion of variables to consider. Further, some of the data from before the fall of the Iron Curtain are suspect. Since there are new ruling regimes in these countries, the methods of computing different statistical measures has changed. Although we first look at the raw data as reported, we also attempt to account for these changes. We show which data seem to be fictional and suggest ways to infer the needed statistics from other data. These results are reported beside those on the reported data. Since there is debate about taxation structure, this paper can help inform policymakers of change the flat tax has caused in other countries. The work shows some strengths and weaknesses of a flat tax structure. Moreover, it provides beginnings of a scientific analysis of the flat tax in practice rather than having discussion based solely upon theory and conjecture.Keywords: flat tax, financial markets, GDP, unemployment rate, Gini coefficient
Procedia PDF Downloads 333217 Time of Week Intensity Estimation from Interval Censored Data with Application to Police Patrol Planning
Authors: Jiahao Tian, Michael D. Porter
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Law enforcement agencies are tasked with crime prevention and crime reduction under limited resources. Having an accurate temporal estimate of the crime rate would be valuable to achieve such a goal. However, estimation is usually complicated by the interval-censored nature of crime data. We cast the problem of intensity estimation as a Poisson regression using an EM algorithm to estimate the parameters. Two special penalties are added that provide smoothness over the time of day and day of the week. This approach presented here provides accurate intensity estimates and can also uncover day-of-week clusters that share the same intensity patterns. Anticipating where and when crimes might occur is a key element to successful policing strategies. However, this task is complicated by the presence of interval-censored data. The censored data refers to the type of data that the event time is only known to lie within an interval instead of being observed exactly. This type of data is prevailing in the field of criminology because of the absence of victims for certain types of crime. Despite its importance, the research in temporal analysis of crime has lagged behind the spatial component. Inspired by the success of solving crime-related problems with a statistical approach, we propose a statistical model for the temporal intensity estimation of crime with censored data. The model is built on Poisson regression and has special penalty terms added to the likelihood. An EM algorithm was derived to obtain maximum likelihood estimates, and the resulting model shows superior performance to the competing model. Our research is in line with the smart policing initiative (SPI) proposed by the Bureau Justice of Assistance (BJA) as an effort to support law enforcement agencies in building evidence-based, data-driven law enforcement tactics. The goal is to identify strategic approaches that are effective in crime prevention and reduction. In our case, we allow agencies to deploy their resources for a relatively short period of time to achieve the maximum level of crime reduction. By analyzing a particular area within cities where data are available, our proposed approach could not only provide an accurate estimate of intensities for the time unit considered but a time-variation crime incidence pattern. Both will be helpful in the allocation of limited resources by either improving the existing patrol plan with the understanding of the discovery of the day of week cluster or supporting extra resources available.Keywords: cluster detection, EM algorithm, interval censoring, intensity estimation
Procedia PDF Downloads 62216 A Design Research Methodology for Light and Stretchable Electrical Thermal Warm-Up Sportswear to Enhance the Performance of Athletes against Harsh Environment
Authors: Chenxiao Yang, Li Li
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In this decade, the sportswear market rapidly expanded while numerous sports brands are conducting fierce competitions to hold their market shares and trying to act as a leader in professional competition sports areas to set the trends. Thus, various advancing sports equipment is being deeply explored to improving athletes’ performance in fierce competitions. Although there is plenty protective equipment such as cuff, running legging, etc., on the market, there is still blank in the field of sportswear during prerace warm-up this important time gap, especially for those competitions host in cold environment. Because there is always time gaps between warm-up and race due to event logistics or unexpected weather factors. Athletes will be exposed to chilly condition for an unpredictable long period of time. As a consequence, the effects of warm-up will be negated, and the competition performance will be degraded. However, reviewing the current market, there is none effective sports equipment provided to help athletes against this harsh environment or the rare existing products are so blocky or heavy to restrict the actions. An ideal thermal-protective sportswear should be light, flexible, comfort and aesthetic at the same time. Therefore, this design research adopted the textile circular knitting methodology to integrate soft silver-coated conductive yarns (ab. SCCYs), elastic nylon yarn and polyester yarn to develop the proposed electrical, thermal sportswear, with the strengths aforementioned. Meanwhile, the relationship between heating performance, stretch load, and energy consumption were investigated. Further, a simulation model was established to ensure providing sufficient warm and flexibility at lower energy cost and with an optimized production, parameter determined. The proposed circular knitting technology and simulation model can be directly applied to instruct prototype developments to cater different target consumers’ needs and ensure prototypes’’ safety. On the other hand, high R&D investment and time consumption can be saved. Further, two prototypes: a kneecap and an elbow guard, were developed to facilitate the transformation of research technology into an industrial application and to give a hint on the blur future blueprint.Keywords: cold environment, silver-coated conductive yarn, electrical thermal textile, stretchable
Procedia PDF Downloads 266215 Seismic Impact and Design on Buried Pipelines
Authors: T. Schmitt, J. Rosin, C. Butenweg
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Seismic design of buried pipeline systems for energy and water supply is not only important for plant and operational safety, but in particular for the maintenance of supply infrastructure after an earthquake. Past earthquakes have shown the vulnerability of pipeline systems. After the Kobe earthquake in Japan in 1995 for instance, in some regions the water supply was interrupted for almost two months. The present paper shows special issues of the seismic wave impacts on buried pipelines, describes calculation methods, proposes approaches and gives calculation examples. Buried pipelines are exposed to different effects of seismic impacts. This paper regards the effects of transient displacement differences and resulting tensions within the pipeline due to the wave propagation of the earthquake. Other effects are permanent displacements due to fault rupture displacements at the surface, soil liquefaction, landslides and seismic soil compaction. The presented model can also be used to calculate fault rupture induced displacements. Based on a three-dimensional Finite Element Model parameter studies are performed to show the influence of several parameters such as incoming wave angle, wave velocity, soil depth and selected displacement time histories. In the computer model, the interaction between the pipeline and the surrounding soil is modeled with non-linear soil springs. A propagating wave is simulated affecting the pipeline punctually independently in time and space. The resulting stresses mainly are caused by displacement differences of neighboring pipeline segments and by soil-structure interaction. The calculation examples focus on pipeline bends as the most critical parts. Special attention is given to the calculation of long-distance heat pipeline systems. Here, in regular distances expansion bends are arranged to ensure movements of the pipeline due to high temperature. Such expansion bends are usually designed with small bending radii, which in the event of an earthquake lead to high bending stresses at the cross-section of the pipeline. Therefore, Karman's elasticity factors, as well as the stress intensity factors for curved pipe sections, must be taken into account. The seismic verification of the pipeline for wave propagation in the soil can be achieved by observing normative strain criteria. Finally, an interpretation of the results and recommendations are given taking into account the most critical parameters.Keywords: buried pipeline, earthquake, seismic impact, transient displacement
Procedia PDF Downloads 181214 Microplastics in the Seine River Catchment: Results and Lessons from a Pluriannual Research Programme
Authors: Bruno Tassin, Robin Treilles, Cleo Stratmann, Minh Trang Nguyen, Sam Azimi, Vincent Rocher, Rachid Dris, Johnny Gasperi
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Microplastics (<5mm) in the environment and in hydro systems is one of the major present environmental issues. Over the last five years a research programme was conducted in order to assess the behavior of microplastics in the Seine river catchment, in a Man-Land-Sea continuum approach. Results show that microplastic concentration varies at the seasonal scale, but also at much smaller scales, during flood events and with tides in the estuary for instance. Moreover, microplastic sampling and characterization issues emerged throughout this work. The Seine river is a 750km long river flowing in Northwestern France. It crosses the Paris megacity (12 millions inhabitants) and reaches the English Channel after a 170 km long estuary. This site is a very relevant one to assess the effect of anthropogenic pollution as the mean river flow is low (mean flow around 350m³/s) while the human presence and activities are very intense. Monthly monitoring of the microplastic concentration took place over a 19-month period and showed significant temporal variations at all sampling stations but no significant upstream-downstream increase, indicating a possible major sink to the sediment. At the scale of a major flood event (winter and spring 2018), microplastic concentration shows an evolution similar to the well-known suspended solids concentration, with an increase during the increase of the flow and a decrease during the decrease of the flow. Assessing the position of the concentration peak in relation to the flow peak was unfortunately impossible. In the estuary, concentrations vary with time in connection with tides movements and in the water column in relation to the salinity and the turbidity. Although major gains of knowledge on the microplastic dynamics in the Seine river have been obtained over the last years, major gaps remain to deal mostly with the interaction with the dynamics of the suspended solids, the selling processes in the water column and the resuspension by navigation or shear stress increase. Moreover, the development of efficient chemical characterization techniques during the 5 year period of this pluriannual research programme led to the improvement of the sampling techniques in order to access smaller microplastics (>10µm) as well as larger but rare ones (>500µm).Keywords: microplastics, Paris megacity, seine river, suspended solids
Procedia PDF Downloads 196213 Microsimulation of Potential Crashes as a Road Safety Indicator
Authors: Vittorio Astarita, Giuseppe Guido, Vincenzo Pasquale Giofre, Alessandro Vitale
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Traffic microsimulation has been used extensively to evaluate consequences of different traffic planning and control policies in terms of travel time delays, queues, pollutant emissions, and every other common measured performance while at the same time traffic safety has not been considered in common traffic microsimulation packages as a measure of performance for different traffic scenarios. Vehicle conflict techniques that were introduced at intersections in the early traffic researches carried out at the General Motor laboratory in the USA and in the Swedish traffic conflict manual have been applied to vehicles trajectories simulated in microscopic traffic simulators. The concept is that microsimulation can be used as a base for calculating the number of conflicts that will define the safety level of a traffic scenario. This allows engineers to identify unsafe road traffic maneuvers and helps in finding the right countermeasures that can improve safety. Unfortunately, most commonly used indicators do not consider conflicts between single vehicles and roadside obstacles and barriers. A great number of vehicle crashes take place with roadside objects or obstacles. Only some recent proposed indicators have been trying to address this issue. This paper introduces a new procedure based on the simulation of potential crash events for the evaluation of safety levels in microsimulation traffic scenarios, which takes into account also potential crashes with roadside objects and barriers. The procedure can be used to define new conflict indicators. The proposed simulation procedure generates with the random perturbation of vehicle trajectories a set of potential crashes which can be evaluated accurately in terms of DeltaV, the energy of the impact, and/or expected number of injuries or casualties. The procedure can also be applied to real trajectories giving birth to new surrogate safety performance indicators, which can be considered as “simulation-based”. The methodology and a specific safety performance indicator are described and applied to a simulated test traffic scenario. Results indicate that the procedure is able to evaluate safety levels both at the intersection level and in the presence of roadside obstacles. The procedure produces results that are expressed in the same unity of measure for both vehicle to vehicle and vehicle to roadside object conflicts. The total energy for a square meter of all generated crash can be used and is shown on the map, for the test network, after the application of a threshold to evidence the most dangerous points. Without any detailed calibration of the microsimulation model and without any calibration of the parameters of the procedure (standard values have been used), it is possible to identify dangerous points. A preliminary sensitivity analysis has shown that results are not dependent on the different energy thresholds and different parameters of the procedure. This paper introduces a specific new procedure and the implementation in the form of a software package that is able to assess road safety, also considering potential conflicts with roadside objects. Some of the principles that are at the base of this specific model are discussed. The procedure can be applied on common microsimulation packages once vehicle trajectories and the positions of roadside barriers and obstacles are known. The procedure has many calibration parameters and research efforts will have to be devoted to make confrontations with real crash data in order to obtain the best parameters that have the potential of giving an accurate evaluation of the risk of any traffic scenario.Keywords: road safety, traffic, traffic safety, traffic simulation
Procedia PDF Downloads 130212 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments
Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis
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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.Keywords: chronic, older person, aged care, emergency department
Procedia PDF Downloads 228211 Estimating Affected Croplands and Potential Crop Yield Loss of an Individual Farmer Due to Floods
Authors: Shima Nabinejad, Holger Schüttrumpf
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Farmers who are living in flood-prone areas such as coasts are exposed to storm surges increased due to climate change. Crop cultivation is the most important economic activity of farmers, and in the time of flooding, agricultural lands are subject to inundation. Additionally, overflow saline water causes more severe damage outcomes than riverine flooding. Agricultural crops are more vulnerable to salinity than other land uses for which the economic damages may continue for a number of years even after flooding and affect farmers’ decision-making for the following year. Therefore, it is essential to assess what extent the agricultural areas are flooded and how much the associated flood damage to each individual farmer is. To address these questions, we integrated farmers’ decision-making at farm-scale with flood risk management. The integrated model includes identification of hazard scenarios, failure analysis of structural measures, derivation of hydraulic parameters for the inundated areas and analysis of the economic damages experienced by each farmer. The present study has two aims; firstly, it attempts to investigate the flooded cropland and potential crop damages for the whole area. Secondly, it compares them among farmers’ field for three flood scenarios, which differ in breach locations of the flood protection structure. To achieve its goal, the spatial distribution of fields and cultivated crops of farmers were fed into the flood risk model, and a 100-year storm surge hydrograph was selected as the flood event. The study area was Pellworm Island that is located in the German Wadden Sea National Park and surrounded by North Sea. Due to high salt content in seawater of North Sea, crops cultivated in the agricultural areas of Pellworm Island are 100% destroyed by storm surges which were taken into account in developing of depth-damage curve for analysis of consequences. As a result, inundated croplands and economic damages to crops were estimated in the whole Island which was further compared for six selected farmers under three flood scenarios. The results demonstrate the significance and the flexibility of the proposed model in flood risk assessment of flood-prone areas by integrating flood risk management and decision-making.Keywords: crop damages, flood risk analysis, individual farmer, inundated cropland, Pellworm Island, storm surges
Procedia PDF Downloads 254210 Lean Implementation in a Nurse Practitioner Led Pediatric Primary Care Clinic: A Case Study
Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller
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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.Keywords: ambulatory care, lean, pediatric primary care, system efficiency
Procedia PDF Downloads 296209 Mild Auditory Perception and Cognitive Impairment in mid-Trimester Pregnancy
Authors: Tahamina Begum, Wan Nor Azlen Wan Mohamad, Faruque Reza, Wan Rosilawati Wan Rosli
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To assess auditory perception and cognitive function during pregnancy is necessary as the pregnant women need extra effort for attention mainly for their executive function to maintain their quality of life. This study aimed to investigate neural correlates of cognitive and behavioral processing during mid trimester pregnancy. Event-Related Potentials (ERPs) were studied by using 128-sensor net and PAS or COWA (controlled Oral Word Association), WCST (Wisconsin Card Sorting Test), RAVLTIM (Rey Auditory Verbal and Learning Test: immediate or interference recall, delayed recall (RAVLT DR) and total score (RAVLT TS) were tested for neuropsychology assessment. In total 18 subjects were recruited (n= 9 in each group; control and pregnant group). All participants of the pregnant group were within 16-27 (mid trimester) weeks gestation. Age and education matched control healthy subjects were recruited in the control group. Participants were given a standardized test of auditory cognitive function as auditory oddball paradigm during ERP study. In this paradigm, two different auditory stimuli (standard and target stimuli) were used where subjects counted silently only target stimuli with giving attention by ignoring standard stimuli. Mean differences between target and standard stimuli were compared across groups. N100 (auditory sensory ERP component) and P300 (auditory cognitive ERP component) were recorded at T3, T4, T5, T6, Cz and Pz electrode sites. An equal number of electrodes showed non-significantly shorter amplitude of N100 component (except significantly shorter at T3, P= 0.05) and non-significant longer latencies (except significantly longer latency at T5, P= 0.008) of N100 component in pregnant group comparing control. In case of P300 component, maximum electrode sites showed non-significantly higher amplitudes and equal number of sites showed non-significant shorter latencies in pregnant group comparing control. Neuropsychology results revealed the non-significant higher score of PAS, lower score of WCST, lower score of RAVLTIM and RAVLTDR in pregnant group comparing control. The results of N100 component and RAVLT scores concluded that auditory perception is mildly impaired and P300 component proved very mild cognitive dysfunction with good executive functions in second trimester of pregnancy.Keywords: auditory perception, pregnancy, stimuli, trimester
Procedia PDF Downloads 376208 Floods Hazards and Emergency Respond in Negara Brunei Darussalam
Authors: Hj Mohd Sidek bin Hj Mohd Yusof
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More than 1.5 billion people around the world are adversely affected by floods. Floods account for about a third of all natural catastrophes, cause more than half of all fatalities and are responsible for a third of overall economic loss around the world. Giving advanced warning of impending disasters can reduce or even avoid the number of deaths, social and economic hardships that are so commonly reported after the event. Integrated catchment management recognizes that it is not practical or viable to provide structural measures that will keep floodwater away from the community and their property. Non-structural measures are therefore required to assist the community to cope when flooding occurs which exceeds the capacity of the structural measures. Non-structural measures may need to be used to influence the way land is used or buildings are constructed, or they may be used to improve the community’s preparedness and response to flooding. The development and implementation of non-structural measures may be guided and encouraged by policy and legislation, or through voluntary action by the community based on knowledge gained from public education programs. There is a range of non-structural measures that can be used for flood hazard mitigation which can be the use measures includes policies and rules applied by government to regulate the kinds of activities that are carried out in various flood-prone areas, including minimum floor levels and the type of development approved. Voluntary actions taken by the authorities and by the community living and working on the flood plain to lessen flooding effects on themselves and their properties including monitoring land use changes, monitoring and investigating the effects of bush / forest clearing in the catchment and providing relevant flood related information to the community. Response modification measures may include: flood warning system, flood education, community awareness and readiness, evacuation arrangements and recovery plan. A Civil Defense Emergency Management needs to be established for Brunei Darussalam in order to plan, co-ordinate and undertake flood emergency management. This responsibility may be taken by the Ministry of Home Affairs, Brunei Darussalam who is already responsible for Fire Fighting and Rescue services. Several pieces of legislation and planning instruments are in place to assist flood management, particularly: flood warning system, flood education Community awareness and readiness, evacuation arrangements and recovery plan.Keywords: RTB, radio television brunei, DDMC, district disaster management center, FIR, flood incidence report, PWD, public works department
Procedia PDF Downloads 252207 An Integrated Geophysical Investigation for Earthen Dam Inspection: A Case Study of Huai Phueng Dam, Udon Thani, Northeastern Thailand
Authors: Noppadol Poomvises, Prateep Pakdeerod, Anchalee Kongsuk
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In the middle of September 2017, a tropical storm named ‘DOKSURI’ swept through Udon Thani, Northeastern Thailand. The storm dumped heavy rain for many hours and caused large amount of water flowing into Huai Phueng reservoir. Level of impounding water increased rapidly, and the extra water flowed over a service spillway, morning-glory type constructed by concrete material for about 50 years ago. Subsequently, a sinkhole was formed on the dam crest and five points of water piping were found on downstream slope closely to spillway. Three techniques of geophysical investigation were carried out to inspect cause of failures; Electrical Resistivity Imaging (ERI), Multichannel Analysis of Surface Wave (MASW), and Ground Penetrating Radar (GPR), respectively. Result of ERI clearly shows evidence of overtop event and heterogeneity around spillway that implied possibility of previous shape of sinkhole around the pipe. The shear wave velocity of subsurface soil measured by MASW can numerically convert to undrained shear strength of impervious clay core. Result of GPR clearly reveals partial settlements of freeboard zone at top part of the dam and also shaping new refilled material to plug the sinkhole back to the condition it should be. In addition, the GPR image is a main answer to confirm that there are not any sinkholes in the survey lines, only that found on top of the spillway. Integrity interpretation of the three results together with several evidences observed during a field walk-through and data from drilled holes can be interpreted that there are four main causes in this account. The first cause is too much water flowing over the spillway. Second, the water attacking morning glory spillway creates cracks upon concrete contact where the spillway is cross-cut to the center of the dam. Third, high velocity of water inside the concrete pipe sucking fine particle of embankment material down via those cracks and flushing out to the river channel. Lastly, loss of clay material of the dam into the concrete pipe creates the sinkhole at the crest. However, in case of failure by piping, it is possible that they can be formed both by backward erosion (internal erosion along or into embedded structure of spillway walls) and also by excess saturated water of downstream material.Keywords: dam inspection, GPR, MASW, resistivity
Procedia PDF Downloads 236206 Radiomics: Approach to Enable Early Diagnosis of Non-Specific Breast Nodules in Contrast-Enhanced Magnetic Resonance Imaging
Authors: N. D'Amico, E. Grossi, B. Colombo, F. Rigiroli, M. Buscema, D. Fazzini, G. Cornalba, S. Papa
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Purpose: To characterize, through a radiomic approach, the nature of nodules considered non-specific by expert radiologists, recognized in magnetic resonance mammography (MRm) with T1-weighted (T1w) sequences with paramagnetic contrast. Material and Methods: 47 cases out of 1200 undergoing MRm, in which the MRm assessment gave uncertain classification (non-specific nodules), were admitted to the study. The clinical outcome of the non-specific nodules was later found through follow-up or further exams (biopsy), finding 35 benign and 12 malignant. All MR Images were acquired at 1.5T, a first basal T1w sequence and then four T1w acquisitions after the paramagnetic contrast injection. After a manual segmentation of the lesions, done by a radiologist, and the extraction of 150 radiomic features (30 features per 5 subsequent times) a machine learning (ML) approach was used. An evolutionary algorithm (TWIST system based on KNN algorithm) was used to subdivide the dataset into training and validation test and to select features yielding the maximal amount of information. After this pre-processing, different machine learning systems were applied to develop a predictive model based on a training-testing crossover procedure. 10 cases with a benign nodule (follow-up older than 5 years) and 18 with an evident malignant tumor (clear malignant histological exam) were added to the dataset in order to allow the ML system to better learn from data. Results: NaiveBayes algorithm working on 79 features selected by a TWIST system, resulted to be the best performing ML system with a sensitivity of 96% and a specificity of 78% and a global accuracy of 87% (average values of two training-testing procedures ab-ba). The results showed that in the subset of 47 non-specific nodules, the algorithm predicted the outcome of 45 nodules which an expert radiologist could not identify. Conclusion: In this pilot study we identified a radiomic approach allowing ML systems to perform well in the diagnosis of a non-specific nodule at MR mammography. This algorithm could be a great support for the early diagnosis of malignant breast tumor, in the event the radiologist is not able to identify the kind of lesion and reduces the necessity for long follow-up. Clinical Relevance: This machine learning algorithm could be essential to support the radiologist in early diagnosis of non-specific nodules, in order to avoid strenuous follow-up and painful biopsy for the patient.Keywords: breast, machine learning, MRI, radiomics
Procedia PDF Downloads 262205 Game On: Unlocking the Educational Potential of Games and Entertainment in Online Learning
Authors: Colleen Cleveland, W. Adam Baldowski
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In the dynamic realm of online education, the integration of games and entertainment has emerged as a powerful strategy to captivate learners, drive active participation, and cultivate meaningful learning experiences. This abstract presents an overview of the upcoming conference, "Game On," dedicated to exploring the transformative impact of gamification, interactive simulations, and multimedia content in the digital learning landscape. Introduction: The conference aims to blur the traditional boundaries between education and entertainment, inspiring learners of diverse ages and backgrounds to actively engage in their online learning journeys. By leveraging the captivating elements of games and entertainment, educators can enhance motivation, retention, and deep understanding among virtual classroom participants. Conference Highlights: Commencing with an exploration of theoretical foundations drawing from educational psychology, instructional design, and the latest pedagogical research, participants will gain valuable insights into the ways gamified elements elevate the quality of online education. Attendees can expect interactive sessions, workshops, and case studies showcasing best practices and innovative strategies, including game-based assessments and virtual reality simulations. Inclusivity and Diversity: The conference places a strong emphasis on inclusivity, accessibility, and diversity in the integration of games and entertainment for educational purposes. Discussions will revolve around accommodating diverse learning styles, overcoming potential challenges, and ensuring equitable access to engaging educational content for all learners. Educational Transformation: Educators, instructional designers, and e-learning professionals attending "Game On" will acquire practical techniques to elevate the quality of their online courses. The conference promises a stimulating and informative exploration of blending education with entertainment, unlocking the untapped potential of games and entertainment in online education. Conclusion: "Game On" invites participants to embark on a journey that transforms online education by harnessing the power of entertainment. This event promises to be a cornerstone in the evolution of virtual learning, offering valuable insights for those seeking to create a more engaging and effective online educational experience. Join us as we explore new horizons, pushing the boundaries of online education through the fusion of games and entertainment.Keywords: online education, games, entertainment, psychology, therapy, pop culture
Procedia PDF Downloads 44204 Comparisons of Drop Jump and Countermovement Jump Performance for Male Basketball Players with and without Low-Dye Taping Application
Authors: Chung Yan Natalia Yeung, Man Kit Indy Ho, Kin Yu Stan Chan, Ho Pui Kipper Lam, Man Wah Genie Tong, Tze Chung Jim Luk
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Excessive foot pronation is a well-known risk factor of knee and foot injuries such as patellofemoral pain, patellar and Achilles tendinopathy, and plantar fasciitis. Low-Dye taping (LDT) application is not uncommon for basketball players to control excessive foot pronation for pain control and injury prevention. The primary potential benefits of using LDT include providing additional supports to medial longitudinal arch and restricting the excessive midfoot and subtalar motion in weight-bearing activities such as running and landing. Meanwhile, restrictions provided by the rigid tape may also potentially limit functional joint movements and sports performance. Coaches and athletes need to weigh the potential benefits and harmful effects before making a decision if applying LDT technique is worthwhile or not. However, the influence of using LDT on basketball-related performance such as explosive and reactive strength is not well understood. Therefore, the purpose of this study was to investigate the change of drop jump (DJ) and countermovement jump (CMJ) performance before and after LDT application for collegiate male basketball players. In this within-subject crossover study, 12 healthy male basketball players (age: 21.7 ± 2.5 years) with at least 3-year regular basketball training experience were recruited. Navicular drop (ND) test was adopted as the screening and only those with excessive pronation (ND ≥ 10mm) were included. Participants with recent lower limb injury history were excluded. Recruited subjects were required to perform both ND, DJ (on a platform of 40cm height) and CMJ (without arms swing) tests in series during taped and non-taped conditions in the counterbalanced order. Reactive strength index (RSI) was calculated by using the flight time divided by the ground contact time measured. For DJ and CMJ tests, the best of three trials was used for analysis. The difference between taped and non-taped conditions for each test was further calculated through standardized effect ± 90% confidence intervals (CI) with clinical magnitude-based inference (MBI). Paired samples T-test showed significant decrease in ND (-4.68 ± 1.44mm; 95% CI: -3.77, -5.60; p < 0.05) while MBI demonstrated most likely beneficial and large effect (standardize effect: -1.59 ± 0.27) in LDT condition. For DJ test, significant increase in both flight time (25.25 ± 29.96ms; 95% CI: 6.22, 44.28; p < 0.05) and RSI (0.22 ± 0.22; 95% CI: 0.08, 0.36; p < 0.05) were observed. In taped condition, MBI showed very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.49) in flight time, possibly beneficial and small effect (standardized effect: -0.26 ± 0.29) in ground contact time and very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.42) in RSI. No significant difference in CMJ was observed (95% CI: -2.73, 2.08; p > 0.05). For basketball players with pes planus, applying LDT could substantially support the foot by elevating the navicular height and potentially provide acute beneficial effects in reactive strength performance. Meanwhile, no significant harmful effect on CMJ was observed. Basketball players may consider applying LDT before the game or training to enhance the reactive strength performance. However since the observed effects in this study could not generalize to other players without excessive foot pronation, further studies on players with normal foot arch or navicular height are recommended.Keywords: flight time, pes planus, pronated foot, reactive strength index
Procedia PDF Downloads 148203 Startup Ecosystem in India: Development and Impact
Authors: Soham Chakraborty
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This article examines the development of start-up culture in India, its development as well as related impact on the Indian society. Another vibrant synonym of start-up in the present century can be starting afresh. Startups have become the new flavor of this decade. A startup ecosystem is formed by mainly the new generation in the making. A startup ecosystem involves a variety of elements without which a startup can never prosper, they are—ideas, inventions, innovations as well as authentic research in the field into which one is interested, mentors, advisors, funding bodies, service provider organizations, angel, venture and so on. The culture of startup is quiet nascent but rampant in India. This is largely due to the widespread of media as a medium through which the newfangled entrepreneurs can spread their word of mouth far and wide. Different kinds of media such as Television, Radio, Internet, Print media and so on, act as the weapon to any startup company in India. The article explores how there is a sudden shift in the growing Indian economy due to the rise of startup ecosystem. There are various reasons, which are the result of the growing success of startup in India, firstly, entrepreneurs are building up startup ideas on the basis of various international startup but giving them a pinch of Indian flavor; secondly, business models are framed based on the current problems that people face in the modern century; thirdly, balance between social and technological entrepreneurs and lastly, quality of mentorship. The Government of India boasts startup as a flagship initiative. Bunch full of benefits and assistance was declared in an event named as 'Start Up India, Stand Up India' on 16th January 2016 by the current Prime Minister of India Mr. Narendra Modi. One of the biggest boon that increasing startups are creating in the society is the proliferation of self-employment. Noted Startups which are thriving in India are like OYO, Where’s The Food (WTF), TVF Pitchers, Flipkart and so on are examples of India is getting covered up by various innovative startups. The deep impact can be felt by each Indian after a few years as various governmental and non-governmental policies and agendas are helping in the sprawling up of startups and have mushroom growth in India. The impact of startup uprising in India is also possible due to increasing globalization which is leading to the eradication of national borders, thereby creating the environment to enlarge one’s business model. To conclude, this article points out on the correlation between rising startup in Indian market and its increasing developmental benefits for the people at large. Internationally, various business portals are tagging India to be the world’s fastest growing startup ecosystem.Keywords: business, ecosystem, entrepreneurs, media, globalization, startup
Procedia PDF Downloads 262202 An Overview of PFAS Treatment Technologies with an In-Depth Analysis of Two Case Studies
Authors: Arul Ayyaswami, Vidhya Ramalingam
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Per- and polyfluoroalkyl substances (PFAS) have emerged as a significant environmental concern due to their ubiquity and persistence in the environment. Their chemical characteristics and adverse effects on human health demands more effective and sustainable solutions in remediation of the PFAS. The work presented here encompasses an overview of treatment technologies with two case studies that utilize effective approaches in addressing PFAS contaminated media. Currently the options for treatment of PFAS compounds include Activated carbon adsorption, Ion Exchange, Membrane Filtration, Advanced oxidation processes, Electrochemical treatment, and Precipitation and Coagulation. In the first case study, a pilot study application of colloidal activated carbon (CAC) was completed to address PFAS from aqueous film-forming foam (AFFF) used to extinguish a large fire. The pilot study was used to demonstrate the effectiveness of a CAC in situ permeable reactive barrier (PRB) in effectively stopping the migration of PFOS and PFOA, moving from the source area at high concentrations. Before the CAC PRB installation, an injection test using - fluorescein dye was conducted to determine the primary fracture-induced groundwater flow pathways. A straddle packer injection delivery system was used to isolate discrete intervals and gain resolution over the 70 feet saturated zone targeted for treatment. Flow rates were adjusted, and aquifer responses were recorded for each interval. The results from the injection test were used to design the pilot test injection plan using CAC PRB. Following the CAC PRB application, the combined initial concentration 91,400 ng/L of PFOS and PFOA were reduced to approximately 70 ng/L (99.9% reduction), after only one month following the injection event. The results demonstrate the remedy's effectiveness to quickly and safely contain high concentrations of PFAS in fractured bedrock, reducing the risk to downgradient receptors. The second study involves developing a reductive defluorination treatment process using UV and electron acceptor. This experiment indicates a significant potential in treatment of PFAS contaminated waste media such as landfill leachates. The technology also shows a promising way of tacking these contaminants without the need for secondary waste disposal or any additional pre-treatments.Keywords: per- and polyfluoroalkyl substances (PFAS), colloidal activated carbon (CAC), destructive PFAS treatment technology, aqueous film-forming foam (AFFF)
Procedia PDF Downloads 54201 Brand Positioning in Iran: A Case Study of the Professional Soccer League
Authors: Homeira Asadi Kavan, Seyed Nasrollah Sajjadi, Mehrzade Hamidi, Hossein Rajabi, Mahdi Bigdely
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Positioning strategies of a sports brand can create a unique impression in the minds of the fans, sponsors, and other stakeholders. In order to influence potential customer's perception in an effective and positive way, a brands positioning strategy must be unique, credible, and relevant. Many sports clubs in Iran have been struggling to implement and achieve brand positioning accomplishments, due to different reasons such as lack of experience, scarcity of experts in the sports branding, and lack of related researches in this field. This study will provide a comprehensive theoretical framework and action plan for sport managers and marketers to design and implement effective brand positioning and to enable them to be distinguishable from competing brands and sports clubs. The study instrument is interviews with sports marketing and brand experts who have been working in this industry for a minimum of 20 years. Qualitative data analysis was performed using Atlast.ti text mining software version 7 and Open, axial and selective coding were employed to uncover and systematically analyze important and complex phenomena and elements. The findings show 199 effective elements in positioning strategies in Iran Professional Soccer League. These elements are categorized into 23 concepts and sub-categories as follows: Structural prerequisites, Strategic management prerequisites, Commercial prerequisites, Major external prerequisites, Brand personality, Club symbols, Emotional aspects, Event aspects, Fans’ strategies, Marketing information strategies, Marketing management strategies, Empowerment strategies, Executive management strategies, League context, Fans’ background, Market context, Club’s organizational context, Support context, Major contexts, Political-Legal elements, Economic factors, Social factors, and Technological factors. Eventually, the study model was developed by 6 main dimensions of Causal prerequisites, Axial Phenomenon (brand position), Strategies, Context Factors, Interfering Factors, and Consequences. Based on the findings, practical recommendations and strategies are suggested that can help club managers and marketers in developing and improving their respective sport clubs, brand positioning, and activities.Keywords: brand positioning, soccer club, sport marketing, Iran professional soccer league, brand strategy
Procedia PDF Downloads 125200 Velma-ARC’s Rehabilitation of Repentant Cybercriminals in Nigeria
Authors: Umukoro Omonigho Simon, Ashaolu David ‘Diya, Aroyewun-Olaleye Temitope Folashade
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The VELMA Action to Reduce Cybercrime (ARC) is an initiative, the first of its kind in Nigeria, designed to identify, rehabilitate and empower repentant cybercrime offenders popularly known as ‘yahoo boys’ in Nigerian parlance. Velma ARC provides social inclusion boot camps with the goal of rehabilitating cybercriminals via psychotherapeutic interventions, improving their IT skills, and empowering them to make constructive contributions to society. This report highlights the psychological interventions provided for participants of the maiden edition of the Velma ARC boot camp and presents the outcomes of these interventions. The boot camp was set up in a hotel premises which was booked solely for the 1 month event. The participants were selected and invited via the Velma online recruitment portal based on an objective double-blind selection process from a pool of potential participants who signified interest via the registration portal. The participants were first taken through psychological profiling (personality, symptomology and psychopathology) before the individual and group sessions began. They were profiled using the Minnesota Multiphasic Personality Inventory -2- Restructured Form (MMPI-2-RF), the latest version of its series. Individual psychotherapy sessions were conducted for all participants based on what was interpreted on their profiles. Focus group discussion was held later to discuss a movie titled ‘catch me if you can’ directed by Steven Spielberg, featuring Leonardo De Caprio and Tom Hanks. The movie was based on the true life story of Frank Abagnale, who was a notorious scammer and con artist in his youthful years. Emergent themes from the movie were discussed as psycho-educative parameters for the participants. The overall evaluation of outcomes from the VELMA ARC rehabilitation boot camp stemmed from a disaggregated assessment of observed changes which are summarized in the final report of the clinical psychologist and was detailed enough to infer genuine repentance and positive change in attitude towards cybercrime among the participants. Follow up services were incorporated to validate initial observations. This gives credence to the potency of the psycho-educative intervention provided during the Velma ARC boot camp. It was recommended that support and collaborations from the government and other agencies/individuals would assist the VELMA foundation in expanding the scope and quality of the Velma ARC initiative as an additional requirement for cybercrime offenders following incarceration.Keywords: Velma-ARC, cybercrime offenders, rehabilitation, Nigeria
Procedia PDF Downloads 142199 On Early Verb Acquisition in Chinese-Speaking Children
Authors: Yating Mu
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Young children acquire native language with amazing rapidity. After noticing this interesting phenomenon, lots of linguistics, as well as psychologists, devote themselves to exploring the best explanations. Thus researches on first language acquisition emerged. Early lexical development is an important branch of children’s FLA (first language acquisition). Verb, the most significant class of lexicon, the most grammatically complex syntactic category or word type, is not only the core of exploring syntactic structures of language but also plays a key role in analyzing semantic features. Obviously, early verb development must have great impacts on children’s early lexical acquisition. Most scholars conclude that verbs, in general, are very difficult to learn because the problem in verb learning might be more about mapping a specific verb onto an action or event than about learning the underlying relational concepts that the verb or relational term encodes. However, the previous researches on early verb development mainly focus on the argument about whether there is a noun-bias or verb-bias in children’s early productive vocabulary. There are few researches on general characteristics of children’s early verbs concerning both semantic and syntactic aspects, not mentioning a general survey on Chinese-speaking children’s verb acquisition. Therefore, the author attempts to examine the general conditions and characteristics of Chinese-speaking children’s early productive verbs, based on data from a longitudinal study on three Chinese-speaking children. In order to present an overall picture of Chinese verb development, both semantic and syntactic aspects will be focused in the present study. As for semantic analysis, a classification method is adopted first. Verb category is a sophisticated class in Mandarin, so it is quite necessary to divide it into small sub-types, thus making the research much easier. By making a reasonable classification of eight verb classes on basis of semantic features, the research aims at finding out whether there exist any universal rules in Chinese-speaking children’s verb development. With regard to the syntactic aspect of verb category, a debate between nativist account and usage-based approach has lasted for quite a long time. By analyzing the longitudinal Mandarin data, the author attempts to find out whether the usage-based theory can fully explain characteristics in Chinese verb development. To sum up, this thesis attempts to apply the descriptive research method to investigate the acquisition and the usage of Chinese-speaking children’s early verbs, on purpose of providing a new perspective in investigating semantic and syntactic features of early verb acquisition.Keywords: Chinese-speaking children, early verb acquisition, verb classes, verb grammatical structures
Procedia PDF Downloads 359198 Pluripotent Stem Cells as Therapeutic Tools for Limbal Stem Cell Deficiencies and Drug Testing
Authors: Aberdam Edith, Sangari Linda, Petit Isabelle, Aberdam Daniel
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Background and Rationale: Transparent avascularised cornea is essential for normal vision and depends on limbal stem cells (LSC) that reside between the cornea and the conjunctiva. Ocular burns or injuries may destroy the limbus, causing limbal stem cell deficiency (LSCD). The cornea becomes vascularised by invaded conjunctival cells, the stroma is scarring, resulting in corneal opacity and loss of vision. Grafted autologous limbus or cultivated autologous LCS can restore the vision, unless the two eyes are affected. Alternative cellular sources have been tested in the last decades, including oral mucosa or hair follicle epithelial cells. However, only partial success has been achieved by the use of these cells since they were not able to uniformly commit into corneal epithelial cells. Human pluripotent stem cells (iPSC) display both unlimited growth capacity and ability to differentiate into any cell type. Our goal was to design a standardized and reproducible protocol to produce transplantable autologous LSC from patients through cell reprogramming technology. Methodology: First, keratinocyte primary culture was established from a small number of plucked hair follicles of healthy donors. The resulting epithelial cells were reprogrammed into induced pluripotent stem cells (iPSCs) and further differentiate into corneal epithelial cells (CEC), according to a robust protocol that recapitulates the main step of corneal embryonic development. qRT-PCR analysis and immunofluorescent staining during the course of differentiation confirm the expression of stage specific markers of corneal embryonic lineage. First appear ectodermal progenitor-specific cytokeratins K8/K18, followed at day 7 by limbal-specific PAX6, TP63 and cytokeratins K5/K14. At day 15, K3/K12+-corneal cells are present. To amplify the iPSC-derived LSC (named COiPSC), intact small epithelial colonies were detached and cultivated in limbal cell-specific medium. In that culture conditions, the COiPSC can be frozen and thaw at any passage, while retaining their corneal characteristics for at least eight passages. To evaluate the potential of COiPSC as an alternative ocular toxicity model, COiPSC were treated at passage P0 to P4 with increasing amounts of SDS and Benzalkonium. Cell proliferation and apoptosis of treated cells was compared to LSC and the SV40-immortalized human corneal epithelial cell line (HCE) routinely used by cosmetological industrials. Of note, HCE are more resistant to toxicity than LSC. At P0, COiPSC were systematically more resistant to chemical toxicity than LSC and even to HCE. Remarkably, this behavior changed with passage since COiPSC at P2 became identical to LSC and thus closer to physiology than HCE. Comparative transcriptome analysis confirmed that COiPSC from P2 are similar to a mixture of LSC and CEC. Finally, by organotypic reconstitution assay, we demonstrated the ability of COiPSC to produce a 3D corneal epithelium on a stromal equivalent made of keratocytes. Conclusion: COiPSC could become valuable for two main applications: (1) an alternative robust tool to perform, in a reproducible and physiological manner, toxicity assays for cosmetic products and pharmacological tests of drugs. (2). COiPSC could become an alternative autologous source for cornea transplantation for LSCD.Keywords: Limbal stem cell deficiency, iPSC, cornea, limbal stem cells
Procedia PDF Downloads 404197 A Computational Framework for Load Mediated Patellar Ligaments Damage at the Tropocollagen Level
Authors: Fadi Al Khatib, Raouf Mbarki, Malek Adouni
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In various sport and recreational activities, the patellofemoral joint undergoes large forces and moments while accommodating the significant knee joint movement. In doing so, this joint is commonly the source of anterior knee pain related to instability in normal patellar tracking and excessive pressure syndrome. One well-observed explanation of the instability of the normal patellar tracking is the patellofemoral ligaments and patellar tendon damage. Improved knowledge of the damage mechanism mediating ligaments and tendon injuries can be a great help not only in rehabilitation and prevention procedures but also in the design of better reconstruction systems in the management of knee joint disorders. This damage mechanism, specifically due to excessive mechanical loading, has been linked to the micro level of the fibred structure precisely to the tropocollagen molecules and their connection density. We argue defining a clear frame starting from the bottom (micro level) to up (macro level) in the hierarchies of the soft tissue may elucidate the essential underpinning on the state of the ligaments damage. To do so, in this study a multiscale fibril reinforced hyper elastoplastic Finite Element model that accounts for the synergy between molecular and continuum syntheses was developed to determine the short-term stresses/strains patellofemoral ligaments and tendon response. The plasticity of the proposed model is associated only with the uniaxial deformation of the collagen fibril. The yield strength of the fibril is a function of the cross-link density between tropocollagen molecules, defined here by a density function. This function obtained through a Coarse-graining procedure linking nanoscale collagen features and the tissue level materials properties using molecular dynamics simulations. The hierarchies of the soft tissues were implemented using the rule of mixtures. Thereafter, the model was calibrated using a statistical calibration procedure. The model then implemented into a real structure of patellofemoral ligaments and patellar tendon (OpenKnee) and simulated under realistic loading conditions. With the calibrated material parameters the calculated axial stress lies well with the experimental measurement with a coefficient of determination (R2) equal to 0.91 and 0.92 for the patellofemoral ligaments and the patellar tendon respectively. The ‘best’ prediction of the yielding strength and strain as compared with the reported experimental data yielded when the cross-link density between the tropocollagen molecule of the fibril equal to 5.5 ± 0.5 (patellofemoral ligaments) and 12 (patellar tendon). Damage initiation of the patellofemoral ligaments was located at the femoral insertions while the damage of the patellar tendon happened in the middle of the structure. These predicted finding showed a meaningful correlation between the cross-link density of the tropocollagen molecules and the stiffness of the connective tissues of the extensor mechanism. Also, damage initiation and propagation were documented with this model, which were in satisfactory agreement with earlier observation. To the best of our knowledge, this is the first attempt to model ligaments from the bottom up, predicted depending to the tropocollagen cross-link density. This approach appears more meaningful towards a realistic simulation of a damaging process or repair attempt compared with certain published studies.Keywords: tropocollagen, multiscale model, fibrils, knee ligaments
Procedia PDF Downloads 126196 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error
Authors: Sau Kam Adeline Chan
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World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error
Procedia PDF Downloads 146195 When the Lights Go Down in the Delivery Room: Lessons From a Ransomware Attack
Authors: Rinat Gabbay-Benziv, Merav Ben-Natan, Ariel Roguin, Benyamine Abbou, Anna Ofir, Adi Klein, Dikla Dahan-Shriki, Mordechai Hallak, Boris Kessel, Mickey Dudkiewicz
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Introduction: Over recent decades, technology has become integral to healthcare, with electronic health records and advanced medical equipment now standard. However, this reliance has made healthcare systems increasingly vulnerable to ransomware attacks. On October 13, 2021, Hillel Yaffe Medical Center experienced a severe ransomware attack that disrupted all IT systems, including electronic health records, laboratory services, and staff communications. The attack, carried out by the group DeepBlueMagic, utilized advanced encryption to lock the hospital's systems and demanded a ransom. This incident caused significant operational and patient care challenges, particularly impacting the obstetrics department. Objective: The objective is to describe the challenges facing the obstetric division following a cyberattack and discuss ways of preparing for and overcoming another one. Methods: A retrospective descriptive study was conducted in a mid-sized medical center. Division activities, including the number of deliveries, cesarean sections, emergency room visits, admissions, maternal-fetal medicine department occupancy, and ambulatory encounters, from 2 weeks before the attack to 8 weeks following it (a total of 11 weeks), were compared with the retrospective period in 2019 (pre-COVID-19). In addition, we present the challenges and adaptation measures taken at the division and hospital levels leading up to the resumption of full division activity. Results: On the day of the cyberattack, critical decisions were made. The media announced the event, calling on patients not to come to our hospital. Also, all elective activities other than cesarean deliveries were stopped. The number of deliveries, admissions, and both emergency room and ambulatory clinic visits decreased by 5%–10% overall for 11 weeks, reflecting the decrease in division activity. Nevertheless, in all stations, there were sufficient activities and adaptation measures to ensure patient safety, decision-making, and workflow of patients were accounted for. Conclusions: The risk of ransomware cyberattacks is growing. Healthcare systems at all levels should recognize this threat and have protocols for dealing with them once they occur.Keywords: ransomware attack, healthcare cybersecurity, obstetrics challenges, IT system disruption
Procedia PDF Downloads 11194 R Statistical Software Applied in Reliability Analysis: Case Study of Diesel Generator Fans
Authors: Jelena Vucicevic
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Reliability analysis represents a very important task in different areas of work. In any industry, this is crucial for maintenance, efficiency, safety and monetary costs. There are ways to calculate reliability, unreliability, failure density and failure rate. This paper will try to introduce another way of calculating reliability by using R statistical software. R is a free software environment for statistical computing and graphics. It compiles and runs on a wide variety of UNIX platforms, Windows and MacOS. The R programming environment is a widely used open source system for statistical analysis and statistical programming. It includes thousands of functions for the implementation of both standard and new statistical methods. R does not limit user only to operation related only to these functions. This program has many benefits over other similar programs: it is free and, as an open source, constantly updated; it has built-in help system; the R language is easy to extend with user-written functions. The significance of the work is calculation of time to failure or reliability in a new way, using statistic. Another advantage of this calculation is that there is no need for technical details and it can be implemented in any part for which we need to know time to fail in order to have appropriate maintenance, but also to maximize usage and minimize costs. In this case, calculations have been made on diesel generator fans but the same principle can be applied to any other part. The data for this paper came from a field engineering study of the time to failure of diesel generator fans. The ultimate goal was to decide whether or not to replace the working fans with a higher quality fan to prevent future failures. Seventy generators were studied. For each one, the number of hours of running time from its first being put into service until fan failure or until the end of the study (whichever came first) was recorded. Dataset consists of two variables: hours and status. Hours show the time of each fan working and status shows the event: 1- failed, 0- censored data. Censored data represent cases when we cannot track the specific case, so it could fail or success. Gaining the result by using R was easy and quick. The program will take into consideration censored data and include this into the results. This is not so easy in hand calculation. For the purpose of the paper results from R program have been compared to hand calculations in two different cases: censored data taken as a failure and censored data taken as a success. In all three cases, results are significantly different. If user decides to use the R for further calculations, it will give more precise results with work on censored data than the hand calculation.Keywords: censored data, R statistical software, reliability analysis, time to failure
Procedia PDF Downloads 396