Search results for: median duration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2002

Search results for: median duration

352 Re-Examining the Distinction between Odour Nuisance and Health Impact: A Community’s Campaign against Landfill Gas Exposure in Shongweni, South Africa

Authors: Colin David La Grange, Lisa Frost Ramsay

Abstract:

Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.

Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation

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351 On the Weightlessness of Vowel Lengthening: Insights from Arabic Dialect of Yemen and Contribution to Psychoneurolinguistics

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Montaha Al Yaari, Ayman Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

Abstract:

Introduction: It is well established that lengthening (longer duration) is considered one of the correlates of lexical and phrasal prominence. However, it is unexplored whether the scope of vowel lengthening in the Arabic dialect of Yemen (ADY) is differently affected by educated and/or uneducated speakers from different dialectal backgrounds. Specifically, the research aims to examine whether or not linguistic background acquired through different educational channels makes a difference in the speech of the speaker and how that is reflected in related psychoneurolinguistic impairments. Methods: For the above mentioned purpose, we conducted an articulatory experiment wherein a set of words from ADY were examined in the dialectal speech of thousand and seven hundred Yemeni educated and uneducated speakers aged 19-61 years growing up in five regions of the country: Northern, southern, eastern, western and central and were, accordingly, assigned into five dialectal groups. A seven-minute video clip was shown to the participants, who have been asked to spontaneously describe the scene they had just watched before the researchers linguistically and statistically analyzed recordings to weigh vowel lengthening in the speech of the participants. Results: The results show that vowels (monophthongs and diphthongs) are lengthened by all participants. Unexpectedly, educated and uneducated speakers from northern and central dialects lengthen vowels. Compared with uneducated speakers from the same dialect, educated speakers lengthen fewer vowels in their dialectal speech. Conclusions: These findings support the notion that extensive exposure to dialects on account of standard language can cause changes to the patterns of dialects themselves, and this can be seen in the speech of educated and uneducated speakers of these dialects. Further research is needed to clarify the phonemic distinctive features and frequency of lengthening in other open class systems (i.e., nouns, adjectives, and adverbs). Phonetic and phonological report measures are needed as well as validation of existing measures for assessing phonemic vowel length in the Arabic population in general and Arabic individuals with voice, speech, and language impairments in particular.

Keywords: vowel lengthening, Arabic dialect of Yemen, phonetics, phonology, impairment, distinctive features

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350 Investigation of Poly P-Dioxanone as Promising Biodegradable Polymer for Short-Term Medical Application

Authors: Stefanie Ficht, Lukas Schübel, Magdalena Kleybolte, Markus Eblenkamp, Jana Steger, Dirk Wilhelm, Petra Mela

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Although 3D printing as transformative technology has become of increasing interest in the medical field and the demand for biodegradable polymers has developed to a considerable extent, there are only a few additively manufactured, biodegradable implants on the market. Additionally, the sterilization of such implants and its side effects on degradation have still not been sufficiently studied. Within this work, thermosensitive poly p-dioxanone (PPDO) samples were printed with fused filament fabrication (FFF) and investigated. Subsequently, H₂O₂ plasma and gamma radiation were used as low-temperature sterilization techniques and compared among each other and the control group (no sterilization). In order to assess the effect of different sterilization on the degradation behavior of PPDO, the samples were immersed in phosphate-buffered solution (PBS) over 28 days, and surface morphology, thermal properties, molecular weight, inherent viscosity, and mechanical properties were examined at regular time intervals. The study demonstrates that PPDO was printed with great success and that thermal properties, molecular weight (Mw), and inherent viscosity (IV) were not significantly affected by the printing process itself. H₂O₂ plasma sterilization did not significantly harm the thermosensitive polymer, while gamma radiation lowered IV and Mw statistically significantly compared to the control group (p < 0.001). During immersion in PBS, a decrease in Mw and mechanical strength occurred for all samples. However, gamma sterilized samples were affected to a much higher extent compared to the two other sample groups both in final values and timeline. This was confirmed by scanning electron microscopy showing no changes of surface morphology of (non-sterilized) control samples, first microcracks appearing on plasma sterilized samples after two weeks while being present on gamma sterilized samples already immediately after radiation to then further deteriorate over immersion duration. To conclude, we demonstrated that FFF and H₂O₂ plasma sterilization are well suited for processing thermosensitive, biodegradable polymers used for the development of innovative short-term medical applications.

Keywords: additive manufacturing, sterilization, biodegradable, thermosensitive, medical application

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349 Improving the Constructability of Highway Design Plans

Authors: R. Edward Minchin Jr.

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The U.S. Federal Highway Administration (FHWA) Every Day Counts Program (EDC) has resulted in state DOTs putting evermore emphasis on speeding up the delivery of highway and bridge construction projects for use by the driving public. This has resulted in an increase in the use of alternative construction delivery systems such as design-build (D-B), construction manager at-risk (CMR) or construction manager/general contractor (CM/GC), and adding alternative technical concepts (ATCs) to traditional design-bid-build (DBB) contracts. ATCs have exhibited great potential for delivering substantial benefits like cost savings, increased constructability, and quicker project delivery. Previous research has found that knowledge of project constructability was lacking in state Department of Transportation (DOT) planning, programming, and environmental staffs. Many agencies have therefore relied on a set of ‘acceptable’ design solutions over the years of working with their local resource agencies. The result is that the permitting process for several government agencies has become increasingly restrictive with the result that the DOTs and their industry partners lose the ability to innovate after a permit is approved. The intent of this paper is to report on the research team’s progress in this ongoing effort furnish the United States government with a uniform set of guidelines for the application of constructability reviews during all phases of project development and delivery. The research uses surveys and interviews to determine which states have implemented formal programs to ensure that the constructor is furnished with a set of contract documents that affords said constructor with the best possible opportunity to successfully construct the project with the highest quality standards, within the contract duration and without exceeding the construction budget. Once these states are identified, workshops are held all over the nation, resulting in the team learning the best current practices and giving the team the ability to recommend new practices that will improve the process. The plan is for the FHWA to encourage or require state DOTs to use these practices on all federally funded highway and bridge construction projects. The project deliverable is a Guidebook for FHWA to use in disseminating the recommended practices to the states.

Keywords: alternative construction delivery, alternative technical concepts, constructability, construction design plans

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348 Urban Logistics Dynamics: A User-Centric Approach to Traffic Modelling and Kinetic Parameter Analysis

Authors: Emilienne Lardy, Eric Ballot, Mariam Lafkihi

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Efficient urban logistics requires a comprehensive understanding of traffic dynamics, particularly as it pertains to kinetic parameters influencing energy consumption and trip duration estimations. While real-time traffic information is increasingly accessible, current high-precision forecasting services embedded in route planning often function as opaque 'black boxes' for users. These services, typically relying on AI-processed counting data, fall short in accommodating open design parameters essential for management studies, notably within Supply Chain Management. This work revisits the modelling of traffic conditions in the context of city logistics, emphasizing its significance from the user’s point of view, with two focuses. Firstly, the focus is not on the vehicle flow but on the vehicles themselves and the impact of the traffic conditions on their driving behaviour. This means opening the range of studied indicators beyond vehicle speed, to describe extensively the kinetic and dynamic aspects of the driving behaviour. To achieve this, we leverage the Art. Kinema parameters are designed to characterize driving cycles. Secondly, this study examines how the driving context (i.e., exogenous factors to the traffic flow) determines the mentioned driving behaviour. Specifically, we explore how accurately the kinetic behaviour of a vehicle can be predicted based on a limited set of exogenous factors, such as time, day, road type, orientation, slope, and weather conditions. To answer this question, statistical analysis was conducted on real-world driving data, which includes high-frequency measurements of vehicle speed. A Factor Analysis and a Generalized Linear Model have been established to link kinetic parameters with independent categorical contextual variables. The results include an assessment of the adjustment quality and the robustness of the models, as well as an overview of the model’s outputs.

Keywords: factor analysis, generalised linear model, real world driving data, traffic congestion, urban logistics, vehicle kinematics

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347 Analysis of Structural Modeling on Digital English Learning Strategy Use

Authors: Gyoomi Kim, Jiyoung Bae

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The purpose of this study was to propose a framework that verifies the structural relationships among students’ use of digital English learning strategy (DELS), affective domains, and their individual variables. The study developed a hypothetical model based on previous studies on language learning strategy use as well as digital language learning. The participants were 720 Korean high school students and 430 university students. The instrument was a self-response questionnaire that contained 70 question items based on Oxford’s SILL (Strategy Inventory for Language Learning) as well as the previous studies on language learning strategies in digital learning environment in order to measure DELS and affective domains. The collected data were analyzed through structural equation modeling (SEM). This study used quantitative data analysis procedures: Explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). Firstly, the EFA was conducted in order to verify the hypothetical model; the factor analysis was conducted preferentially to identify the underlying relationships between measured variables of DELS and the affective domain in the EFA process. The hypothetical model was established with six indicators of learning strategies (memory, cognitive, compensation, metacognitive, affective, and social strategies) under the latent variable of the use of DELS. In addition, the model included four indicators (self-confidence, interests, self-regulation, and attitude toward digital learning) under the latent variable of learners’ affective domain. Secondly, the CFA was used to determine the suitability of data and research models, so all data from the present study was used to assess model fits. Lastly, the model also included individual learner factors as covariates and five constructs selected were learners’ gender, the level of English proficiency, the duration of English learning, the period of using digital devices, and previous experience of digital English learning. The results verified from SEM analysis proposed a theoretical model that showed the structural relationships between Korean students’ use of DELS and their affective domains. Therefore, the results of this study help ESL/EFL teachers understand how learners use and develop appropriate learning strategies in digital learning contexts. The pedagogical implication and suggestions for the further study will be also presented.

Keywords: Digital English Learning Strategy, DELS, individual variables, learners' affective domains, Structural Equation Modeling, SEM

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346 Changes in the Lives of Families Having a Child with Cancer

Authors: Ilknur Kahriman, Hacer Kobya Bulut, Birsel C. Demirbag

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Introduction and Aim: One of the most challenging aspects of being parents of a child diagnosed with cancer is to balance their normal family life with the child's health needs and treatment requirements. Cancer covers an important part of family life and gets ahead of other matters. Families mostly feel that everything has changed in their lives with the cancer diagnosis and are obliged to make a number of adjustments in their lives. Their normal family life suddenly begins to include treatments, hospital appointments and hospitalizations. This study is a descriptive research conducted to determine the changes in the lives of families who had a child with cancer. Methods: This study was carried out with 65 families having children diagnosed with cancer in 0-17 age group at outpatient pediatric oncology clinic and polyclinic of a university hospital in Trabzon. Data were collected through survey method from August to November, 2015. In the analysis of the data, numbers, percentage and chi-square test were used. Findings: It was found out that the average age of mothers was 35.33 years, most of them were primary school graduates (44.6%) and housewives (89.2%) and the average age of fathers was 39.30 years, most of them were high school graduates (29.2%) and self-employed (43.8% ). The majority of their children were boys and their average age was 7.74 years and 77% had Acute lymphocytic leukemia (ALL) diagnosis. 87.5% of the mothers who had a child with cancer had increased fears in their lives, 84.4% had increased workload at home, 82.8% had more stressful life and 82.8% felt themselves physically tired. The mothers indicated that their healthy children could not do the social activities they had used to do before (56.5%), they no longer fed their healthy children with the food they loved eating so that the sick child did not aspire (52.3%) and their healthy children were more furious than before (53.2%). As for the fathers, the fundamental change they had was increased workload at home (82.3%), had more stressful life (80.6%) and could no longer allocate time to the activities they had been interested in and done before (77.8%). There was not a significant difference between the sick children gender and the changes in their parents lives. The communication between the mothers and their healthy children were determined to be positively affected in the families in which the sick child's disease duration was under 12 months (X2 = 6.452, p = 0.011). Conclusion: This study showed that parents having a child with cancer had more workload at home, had more stressful lives, could not allocate time to social activities, had increased fears, felt themselves tired and their healthy children became more furious and their social activities reduced.

Keywords: child, cancer, changes in lives, family

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345 Tick Induced Facial Nerve Paresis: A Narrative Review

Authors: Jemma Porrett

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Background: We present a literature review examining the research surrounding tick paralysis resulting in facial nerve palsy. A case of an intra-aural paralysis tick bite resulting in unilateral facial nerve palsy is also discussed. Methods: A novel case of otoacariasis with associated ipsilateral facial nerve involvement is presented. Additionally, we conducted a review of the literature, and we searched the MEDLINE and EMBASE databases for relevant literature published between 1915 and 2020. Utilising the following keywords; 'Ixodes', 'Facial paralysis', 'Tick bite', and 'Australia', 18 articles were deemed relevant to this study. Results: Eighteen articles included in the review comprised a total of 48 patients. Patients' ages ranged from one year to 84 years of age. Ten studies estimated the possible duration between a tick bite and facial nerve palsy, averaging 8.9 days. Forty-one patients presented with a single tick within the external auditory canal, three had a single tick located on the temple or forehead region, three had post-auricular ticks, and one patient had a remarkable 44 ticks removed from the face, scalp, neck, back, and limbs. A complete ipsilateral facial nerve palsy was present in 45 patients, notably, in 16 patients, this occurred following tick removal. House-Brackmann classification was utilised in 7 patients; four patients with grade 4, one patient with grade three, and two patients with grade 2 facial nerve palsy. Thirty-eight patients had complete recovery of facial palsy. Thirteen studies were analysed for time to recovery, with an average time of 19 days. Six patients had partial recovery at the time of follow-up. One article reported improvement in facial nerve palsy at 24 hours, but no further follow-up was reported. One patient was lost to follow up, and one article failed to mention any resolution of facial nerve palsy. One patient died from respiratory arrest following generalized paralysis. Conclusions: Tick paralysis is a severe but preventable disease. Careful examination of the face, scalp, and external auditory canal should be conducted in patients presenting with otalgia and facial nerve palsy, particularly in tropical areas, to exclude the possibility of tick infestation.

Keywords: facial nerve palsy, tick bite, intra-aural, Australia

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344 Cost Overruns in Mega Projects: Project Progress Prediction with Probabilistic Methods

Authors: Yasaman Ashrafi, Stephen Kajewski, Annastiina Silvennoinen, Madhav Nepal

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Mega projects either in construction, urban development or energy sectors are one of the key drivers that build the foundation of wealth and modern civilizations in regions and nations. Such projects require economic justification and substantial capital investment, often derived from individual and corporate investors as well as governments. Cost overruns and time delays in these mega projects demands a new approach to more accurately predict project costs and establish realistic financial plans. The significance of this paper is that the cost efficiency of megaprojects will improve and decrease cost overruns. This research will assist Project Managers (PMs) to make timely and appropriate decisions about both cost and outcomes of ongoing projects. This research, therefore, examines the oil and gas industry where most mega projects apply the classic methods of Cost Performance Index (CPI) and Schedule Performance Index (SPI) and rely on project data to forecast cost and time. Because these projects are always overrun in cost and time even at the early phase of the project, the probabilistic methods of Monte Carlo Simulation (MCS) and Bayesian Adaptive Forecasting method were used to predict project cost at completion of projects. The current theoretical and mathematical models which forecast the total expected cost and project completion date, during the execution phase of an ongoing project will be evaluated. Earned Value Management (EVM) method is unable to predict cost at completion of a project accurately due to the lack of enough detailed project information especially in the early phase of the project. During the project execution phase, the Bayesian adaptive forecasting method incorporates predictions into the actual performance data from earned value management and revises pre-project cost estimates, making full use of the available information. The outcome of this research is to improve the accuracy of both cost prediction and final duration. This research will provide a warning method to identify when current project performance deviates from planned performance and crates an unacceptable gap between preliminary planning and actual performance. This warning method will support project managers to take corrective actions on time.

Keywords: cost forecasting, earned value management, project control, project management, risk analysis, simulation

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343 Early Age Behavior of Wind Turbine Gravity Foundations

Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

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The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

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342 Effect of Motor Imagery of Truncal Exercises on Trunk Function and Balance in Early Stroke: A Randomized Controlled Trial

Authors: Elsa Reethu, S. Karthik Babu, N. Syed

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Background: Studies in the past focused on the additional benefits of action observation in improving upper and lower limb functions and improving activities of daily living when administered along with conventional therapy. Nevertheless, there is a paucity of literature proving the effects of motor imagery of truncal exercise in improving trunk control in patients with stroke. Aims/purpose: To study the effect of motor imagery of truncal exercises on trunk function and balance in early stroke. Methods: A total of 24 patients were included in the study. 12 were included in the experimental group and 12 were included in control group Trunk function was measured using Trunk Control Test (TCT), Trunk Impairment Scale Verheyden (TIS Verheyden) and Trunk Impairment Scale Fujiwara (TIS Fujiwara). The balance was assessed using Brunel Balance Assessment (BBA) and Tinetti POMA. For the experimental group, each session was for 30 minutes of physical exercises and 15 minutes of motor imagery, once a day, six times a week for 3 weeks and prior to the exercise session, patients viewed a video tape of all the trunk exercises to be performed for 15minutes. The control group practiced the trunk exercises alone for the same duration. Measurements were taken before, after and 4 weeks after intervention. Results: The effect of treatment in motor imagery group showed better improvement when compared with control group when measured after 3 weeks on values of static sitting balance, dynamic balance, total TIS (Verheyden) score, BBA, Tinetti balance and gait with a large effect size of 0.86, 1.99, 1.69, 1.06, 1.63 and 0.97 respectively. The moderate effect size was seen in values of TIS Fujiwara (0.58) and small effect size was seen on TCT (0.12) and TIS coordination component (0.13).at the end of 4 weeks after intervention, the large effect size was identified on values of dynamic balance (2.06), total TIS score (1.59) and Tinetti balance (1.24). The moderate effect size was observed on BBA (0.62) and Tinetti gait (0.72). Conclusion: Trunk motor imagery is effective in improving trunk function and balance in patients with stroke and has a carryover effect in the aspects of mobility. The therapy gain that was observed during the time of discharge was seen to be maintained at the follow-up levels.

Keywords: stroke, trunk rehabilitation, trunk function, balance, motor imagery

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341 The Conundrum of Marital Rape in Malawi: The Past, the Present and the Future

Authors: Esther Gumboh

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While the definition of rape has evolved over the years and now differs from one jurisdiction to another, at the heart of the offence remains the absence of consent on the part of the victim. In simple terms, rape consists in non-consensual sexual intercourse. Therefore, the core issue is whether the accused acted with the consent of the victim. Once it is established that the act was consensual, a conviction of rape cannot be secured. Traditionally, rape within marriage was impossible because it was understood that a woman gave irrevocable consent to sex with her husband throughout the duration of the marriage. This position has since changed in most jurisdictions. Indeed, Malawian law now recognises the offence of marital rape. This is a victory for women’s rights and gender equality. Curiously, however, the definition of marital rape endorsed differs from the standard understanding of rape as non-consensual sex. Instead, the law has introduced the concept of unreasonableness of the refusal to engage in sex as a defence to an accused. This is an alarming position that undermines the protection sought to be derived from the criminalisation of rape within marriage. Moreover, in the Malawian context where rape remains an offence only men can commit against women, the current legal framework for marital rape perpetuates the societal misnomer that a married woman gives a once-off consent to sexual intercourse by virtue of marriage. This takes us back to the old common law position which many countries have moved away from. The present definition of marital rape under Malawian law also sits at odd with the nature of rape that is applicable to all other instances of non-consensual sexual intercourse. Consequently, the law fails to protect married women from unwanted sexual relations at the hands of their husbands. This paper critically examines the criminalisation of marital rape in Malawi. It commences with a historical account of the conceptualisation of rape and then looks at judgments that rejected the validity of marital rape. The discussion then moves to the debates that preceded the criminalisation of marital rape in Malawi and how the Law Commission reasoned to finally make a recommendation in its favour. Against this background, the paper analyses the legal framework for marital rape and what this means for the elements of the offence and defences that may be raised by an accused. In the final analysis, this contribution recommends that there is need to amend the definition of marital rape. Better still, the law should simply state that the fact of marriage is not a defence to a charge of rape, or, in other words, that there is no marital rape exemption. This would automatically mean that husbands are subjected to the same criminal law principles as their unmarried counterparts when it comes to non-consensual sexual intercourse with their wives.

Keywords: criminal law, gender, Malawi, marital rape, rape, sexual intercourse

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340 Active Filtration of Phosphorus in Ca-Rich Hydrated Oil Shale Ash Filters: The Effect of Organic Loading and Form of Precipitated Phosphatic Material

Authors: Päärn Paiste, Margit Kõiv, Riho Mõtlep, Kalle Kirsimäe

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For small-scale wastewater management, the treatment wetlands (TWs) as a low cost alternative to conventional treatment facilities, can be used. However, P removal capacity of TW systems is usually problematic. P removal in TWs is mainly dependent on the physico–chemical and hydrological properties of the filter material. Highest P removal efficiency has been shown trough Ca-phosphate precipitation (i.e. active filtration) in Ca-rich alkaline filter materials, e.g. industrial by-products like hydrated oil shale ash (HOSA), metallurgical slags. In this contribution we report preliminary results of a full-scale TW system using HOSA material for P removal for a municipal wastewater at Nõo site, Estonia. The main goals of this ongoing project are to evaluate: a) the long-term P removal efficiency of HOSA using real waste water; b) the effect of high organic loading rate; c) variable P-loading effects on the P removal mechanism (adsorption/direct precipitation); and d) the form and composition of phosphate precipitates. Onsite full-scale experiment with two concurrent filter systems for treatment of municipal wastewater was established in September 2013. System’s pretreatment steps include septic tank (2 m2) and vertical down-flow LECA filters (3 m2 each), followed by horizontal subsurface HOSA filters (effective volume 8 m3 each). Overall organic and hydraulic loading rates of both systems are the same. However, the first system is operated in a stable hydraulic loading regime and the second in variable loading regime that imitates the wastewater production in an average household. Piezometers for water and perforated sample containers for filter material sampling were incorporated inside the filter beds to allow for continuous in-situ monitoring. During the 18 months of operation the median removal efficiency (inflow to outflow) of both systems were over 99% for TP, 93% for COD and 57% for TN. However, we observed significant differences in the samples collected in different points inside the filter systems. In both systems, we observed development of preferred flow paths and zones with high and low loadings. The filters show formation and a gradual advance of a “dead” zone along the flow path (zone with saturated filter material characterized by ineffective removal rates), which develops more rapidly in the system working under variable loading regime. The formation of the “dead” zone is accompanied by the growth of organic substances on the filter material particles that evidently inhibit the P removal. Phase analysis of used filter materials using X-ray diffraction method reveals formation of minor amounts of amorphous Ca-phosphate precipitates. This finding is supported by ATR-FTIR and SEM-EDS measurements, which also reveal Ca-phosphate and authigenic carbonate precipitation. Our first experimental results demonstrate that organic pollution and loading regime significantly affect the performance of hydrated ash filters. The material analyses also show that P is incorporated into a carbonate substituted hydroxyapatite phase.

Keywords: active filtration, apatite, hydrated oil shale ash, organic pollution, phosphorus

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339 Perception of Nursing Students’ Engagement With Emergency Remote Learning During COVID 19 Pandemic

Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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338 Cardio-respiratory Rehabilitation in Patients With Chronic or Post-acute Cardiomyopathy and COPD

Authors: Ledi Neçaj

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Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

Procedia PDF Downloads 82
337 In-Vitro Evaluation of the Long-Term Stability of PEDOT:PSS Coated Microelectrodes for Chronic Recording and Electrical Stimulation

Authors: A. Schander, T. Tessmann, H. Stemmann, S. Strokov, A. Kreiter, W. Lang

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For the chronic application of neural prostheses and other brain-computer interfaces, long-term stable microelectrodes for electrical stimulation are essential. In recent years many developments were done to investigate different appropriate materials for these electrodes. One of these materials is the electrical conductive polymer poly(3,4-ethylenedioxythiophene) (PEDOT), which has lower impedance and higher charge injection capacity compared to noble metals like gold and platinum. However the long-term stability of this polymer is still unclear. Thus this paper reports on the in-vitro evaluation of the long-term stability of PEDOT coated gold microelectrodes. For this purpose a highly flexible electrocorticography (ECoG) electrode array, based on the polymer polyimide, is used. This array consists of circular gold electrodes with a diameter of 560 µm (0.25 mm2). In total 25 electrodes of this array were coated simultaneously with the polymer PEDOT:PSS in a cleanroom environment using a galvanostatic electropolymerization process. After the coating the array is additionally sterilized using a steam sterilization process (121°C, 1 bar, 20.5 min) to simulate autoclaving prior to the implantation of such an electrode array. The long-term measurements were performed in phosphate-buffered saline solution (PBS, pH 7.4) at the constant body temperature of 37°C. For the in-vitro electrical stimulation a one channel bipolar current stimulator is used. The stimulation protocol consists of a bipolar current amplitude of 5 mA (cathodal phase first), a pulse duration of 100 µs per phase, a pulse pause of 50 µs and a frequency of 1 kHz. A PEDOT:PSS coated gold electrode with an area of 1 cm2 serves as the counter electrode. The electrical stimulation is performed continuously with a total amount of 86.4 million bipolar current pulses per day. The condition of the PEDOT coated electrodes is monitored in between with electrical impedance spectroscopy measurements. The results of this study demonstrate that the PEDOT coated electrodes are stable for more than 3.6 billion bipolar current pulses. Also the unstimulated electrodes show currently no degradation after the time period of 5 months. These results indicate an appropriate long-term stability of this electrode coating for chronic recording and electrical stimulation. The long-term measurements are still continuing to investigate the life limit of this electrode coating.

Keywords: chronic recording, electrical stimulation, long-term stability, microelectrodes, PEDOT

Procedia PDF Downloads 576
336 Change of Epidemiological Characteristics and Disease Burden of Varicella Due to Implementation of Mass Immunization Program in Taiwan from 2000 to 2012

Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

Procedia PDF Downloads 390
335 Early Initiation of Breastfeeding and Its Determinants among Non-Caesarean Deliveries at Primary and Secondary Health Facilities: A Case Observational Study

Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

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Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

Procedia PDF Downloads 142
334 Familiarity with Engineering Project Management And Their Duties In Projects

Authors: Mokhtar Nikgoo

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Today's industrial world has undergone tremendous changes in certain periods. These changes are called environmental changes. And they have a direct impact on organizations and bodies. Therefore, the importance of knowing these changes is clear. This importance has caused the manufacturing organizations to move towards multiple products and constantly change and expand their system. This research tries to show how the organization moves in this category by defining the basic steps of implementing a project. One of the most important features of a hard-to-order production organization is the definition of different production projects from different customers. Therefore, the lack of sufficient understanding of the type of work causes the project to be defined for the organization in question, and the managers of the organization (in every organizational level) are constantly involved with different projects. In the implementation of the production project of the aforementioned organizations, directing the facilities and people of the organization towards the implementation of the project is of particular importance. Therefore, it is felt necessary to define the project manager and his basic duties. Considering the importance of this topic, the project chapter deals with project management and its importance and examines all the different issues in that category from the perspective of implementation. A project includes certain activities of the organization that require the use of different resources and all the activities of the organization in order to implement the project with defined facilities and at the designated times. Project management is planning, organizing and controlling the organization's resources for a short-term goal that has been created for short-term and medium-term goals and objectives. Project management has the important task of centering and integrating (coordinating) task and line managers. In other words, project management requires having a strong and appropriate relationship with the internal people of the system to carry out the assigned activities and must have a general and technical knowledge related to various activities in the project environment. It seems that everything with project management in It is communication. One of the characteristics of production organizations under the order is the relationship between the customer (customers) and the organization until the completion of the defined project. Due to the nature of the work, it is necessary for a person to establish this relationship between the client and the organization's people and to establish this relationship in such a way that it does not cause a lack of coordination in the organization's activities. Therefore, project management has a very important role at this stage, because the relationship between the client and his organization will be any problems and problems and points of view that the client has, he must inform the management so that he can implement the cases with its analysis and special processes. To be transferred to other departments and line managers.

Keywords: project management, crisis management, project delays bill, project duration

Procedia PDF Downloads 38
333 Development of an Instrument for Measurement of Thermal Conductivity and Thermal Diffusivity of Tropical Fruit Juice

Authors: T. Ewetumo, K. D. Adedayo, Festus Ben

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Knowledge of the thermal properties of foods is of fundamental importance in the food industry to establish the design of processing equipment. However, for tropical fruit juice, there is very little information in literature, seriously hampering processing procedures. This research work describes the development of an instrument for automated thermal conductivity and thermal diffusivity measurement of tropical fruit juice using a transient thermal probe technique based on line heat principle. The system consists of two thermocouple sensors, constant current source, heater, thermocouple amplifier, microcontroller, microSD card shield and intelligent liquid crystal. A fixed distance of 6.50mm was maintained between the two probes. When heat is applied, the temperature rise at the heater probe measured with time at time interval of 4s for 240s. The measuring element conforms as closely as possible to an infinite line source of heat in an infinite fluid. Under these conditions, thermal conductivity and thermal diffusivity are simultaneously measured, with thermal conductivity determined from the slope of a plot of the temperature rise of the heating element against the logarithm of time while thermal diffusivity was determined from the time it took the sample to attain a peak temperature and the time duration over a fixed diffusivity distance. A constant current source was designed to apply a power input of 16.33W/m to the probe throughout the experiment. The thermal probe was interfaced with a digital display and data logger by using an application program written in C++. Calibration of the instrument was done by determining the thermal properties of distilled water. Error due to convection was avoided by adding 1.5% agar to the water. The instrument has been used for measurement of thermal properties of banana, orange and watermelon. Thermal conductivity values of 0.593, 0.598, 0.586 W/m^o C and thermal diffusivity values of 1.053 ×〖10〗^(-7), 1.086 ×〖10〗^(-7), and 0.959 ×〖10〗^(-7) 〖m/s〗^2 were obtained for banana, orange and water melon respectively. Measured values were stored in a microSD card. The instrument performed very well as it measured the thermal conductivity and thermal diffusivity of the tropical fruit juice samples with statistical analysis (ANOVA) showing no significant difference (p>0.05) between the literature standards and estimated averages of each sample investigated with the developed instrument.

Keywords: thermal conductivity, thermal diffusivity, tropical fruit juice, diffusion equation

Procedia PDF Downloads 338
332 Triploid Rainbow Trout (Oncorhynchus mykiss) for Better Aquaculture and Ecological Risk Management

Authors: N. N. Pandey, Raghvendra Singh, Biju S. Kamlam, Bipin K. Vishwakarma, Preetam Kala

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The rainbow trout (Oncorhynchus mykiss) is an exotic salmonid fish, well known for its fast growth, tremendous ability to thrive in diverse conditions, delicious flesh and hard fighting nature in Europe and other countries. Rainbow trout farming has a great potential for its contribution to the mainstream economy of Himalayan states in India and other temperate countries. These characteristics establish them as one of the most widely introduced and cultured fish across the globe, and its farming is also prominent in the cold water regions of India. Nevertheless, genetic fatigue, slow growth, early maturity, and low productivity are limiting the expansion of trout production. Moreover, farms adjacent to natural streams or other water sources are subject to escape of domesticated rainbow trout into the wild, which is a serious environmental concern as the escaped fish is subject to contaminate and disrupt the receiving ecosystem. A decline in production traits due to early maturity prolongs the culture duration and affects the profit margin of rainbow trout farms in India. A viable strategy that could overcome these farming constraints in large scale operation is the production of triploid fish that are sterile and more heterozygous. For better triploidy induction rate (TR), heat shock at 28°C for 10 minutes and pressure shock 9500 psi pressure for 5 minutes is applied to green eggs with 90-100% of triploidy success and 72-80% survival upto swim-up fry stage. There is 20% better growth in aquaculture with triploids rainbow trout over diploids. As compared to wild diploid fish, larger sized and fitter triploid rainbow trout in natural waters attract to trout anglers, and support the development of recreational fisheries by state fisheries departments without the risk of contaminating existing gene pools and disrupting local fish diversity. Overall, enhancement of productivity in rainbow trout farms and trout production in coldwater regions, development of lucrative trout angling and better ecological management is feasible with triploid rainbow trout.

Keywords: rainbow trout, triploids fish, heat shock, pressure shock, trout angling

Procedia PDF Downloads 116
331 Kinetic Energy Recovery System Using Spring

Authors: Mayuresh Thombre, Prajyot Borkar, Mangirish Bhobe

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New advancement of technology and never satisfying demands of the civilization are putting huge pressure on the natural fuel resources and these resources are at a constant threat to its sustainability. To get the best out of the automobile, the optimum balance between performance and fuel economy is important. In the present state of art, either of the above two aspects are taken into mind while designing and development process which puts the other in the loss as increase in fuel economy leads to decrement in performance and vice-versa. In-depth observation of the vehicle dynamics apparently shows that large amount of energy is lost during braking and likewise large amount of fuel is consumed to reclaim the initial state, this leads to lower fuel efficiency to gain the same performance. Current use of Kinetic Energy Recovery System is only limited to sports vehicles only because of the higher cost of this system. They are also temporary in nature as power can be squeezed only during a small time duration and use of superior parts leads to high cost, which results on concentration on performance only and neglecting the fuel economy. In this paper Kinetic Energy Recovery System for storing the power and then using the same while accelerating has been discussed. The major storing element in this system is a Flat Spiral Spring that will store energy by compression and torsion. The use of spring ensure the permanent storage of energy until used by the driver unlike present mechanical regeneration system in which the energy stored decreases with time and is eventually lost. A combination of internal gears and spur gears will be used in order to make the energy release uniform which will lead to safe usage. The system can be used to improve the fuel efficiency by assisting in overcoming the vehicle’s inertia after braking or to provide instant acceleration whenever required by the driver. The performance characteristics of the system including response time, mechanical efficiency and overall increase in efficiency are demonstrated. This technology makes the KERS (Kinetic Energy Recovery System) more flexible and economical allowing specific application while at the same time increasing the time frame and ease of usage.

Keywords: electric control unit, energy, mechanical KERS, planetary gear system, power, smart braking, spiral spring

Procedia PDF Downloads 191
330 The Analgesic Impact of Adding Intrathecal Ketamine to Spinal Anaesthesia for Hip or Knee Arthroplasty: A Clinical Audit

Authors: Carl Ashworth, Matthys Campher

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Spinal anaesthesia has been identified as the “gold standard” for primary elective total hip and knee arthroplasty, which is most commonly performed using longer-acting local anaesthetics, such as hyperbaric bupivacaine, to prolong the duration of anaesthesia and analgesia suitable for these procedures. Ketamine is known to have local anaesthetic effects with potent analgesic properties and has been evaluated as a sole anaesthetic agent via intrathecal administration; however, the use of intrathecal ketamine as an adjunct to intrathecal hyperbaric bupivacaine, morphine, and fentanyl has not been extensively studied. The objective of this study was to identify the potential analgesic effects of the addition of intrathecal ketamine to spinal anaesthesia and to compare the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine. The medical records of patients who underwent elective hip- or knee arthroplasty under spinal anaesthesia performed by an individual anaesthetist with either intrathecal hyperbaric bupivacaine, morphine and fentanyl or intrathecal hyperbaric bupivacaine, morphine, fentanyl and ketamine between June 4, 2020, and June 4, 2022, were retrospectively reviewed. These encounters were reviewed and analyzed from a perioperative pain perspective, with the primary outcome measure as the oral morphine equivalent (OME) usage in the 48 hours post-spinal anaesthesia, and secondary outcome measures including time to breakthrough analgesia, self-reported pain scores at rest and during movement at 24 and 48 hours after surgery, adverse effects of analgesia, complications, and length of stay. There were 26 patients identified who underwent TKR between June 4, 2020, and June 4, 2022, and 25 patients who underwent THR with the same conditions. It was identified that patients who underwent traditional spinal anaesthesia with the addition of ketamine for elective hip- or knee arthroplasty had a lower mean total OME in the 48 hours immediately post-spinal anaesthesia yet had a shorter time to breakthrough analgesia administration. The proposed mechanism of action for intrathecal ketamine as an additive to traditional spinal anaesthesia for elective hip- or knee arthroplasty is that it may prolong and attenuate the analgesic effect of traditional spinal anaesthesia. There were no significant differences identified in comparing the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine.

Keywords: anaesthesia, spinal, intra-thecal, ketamine, spinal-morphine, bupivacaine

Procedia PDF Downloads 43
329 Handy EKG: Low-Cost ECG For Primary Care Screening In Developing Countries

Authors: Jhiamluka Zservando Solano Velasquez, Raul Palma, Alejandro Calderon, Servio Paguada, Erick Marin, Kellyn Funes, Hana Sandoval, Oscar Hernandez

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Background: Screening cardiac conditions in primary care in developing countries can be challenging, and Honduras is not the exception. One of the main limitations is the underfunding of the Healthcare System in general, causing conventional ECG acquisition to become a secondary priority. Objective: Development of a low-cost ECG to improve screening of arrhythmias in primary care and communication with a specialist in secondary and tertiary care. Methods: Design a portable, pocket-size low-cost 3 lead ECG (Handy EKG). The device is autonomous and has Wi-Fi/Bluetooth connectivity options. A mobile app was designed which can access online servers with machine learning, a subset of artificial intelligence to learn from the data and aid clinicians in their interpretation of readings. Additionally, the device would use the online servers to transfer patient’s data and readings to a specialist in secondary and tertiary care. 50 randomized patients volunteer to participate to test the device. The patients had no previous cardiac-related conditions, and readings were taken. One reading was performed with the conventional ECG and 3 readings with the Handy EKG using different lead positions. This project was possible thanks to the funding provided by the National Autonomous University of Honduras. Results: Preliminary results show that the Handy EKG performs readings of the cardiac activity similar to those of a conventional electrocardiograph in lead I, II, and III depending on the position of the leads at a lower cost. The wave and segment duration, amplitude, and morphology of the readings were similar to the conventional ECG, and interpretation was possible to conclude whether there was an arrhythmia or not. Two cases of prolonged PR segment were found in both ECG device readings. Conclusion: Using a Frugal innovation approach can allow lower income countries to develop innovative medical devices such as the Handy EKG to fulfill unmet needs at lower prices without compromising effectiveness, safety, and quality. The Handy EKG provides a solution for primary care screening at a much lower cost and allows for convenient storage of the readings in online servers where clinical data of patients can then be accessed remotely by Cardiology specialists.

Keywords: low-cost hardware, portable electrocardiograph, prototype, remote healthcare

Procedia PDF Downloads 170
328 Leveraging xAPI in a Corporate e-Learning Environment to Facilitate the Tracking, Modelling, and Predictive Analysis of Learner Behaviour

Authors: Libor Zachoval, Daire O Broin, Oisin Cawley

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E-learning platforms, such as Blackboard have two major shortcomings: limited data capture as a result of the limitations of SCORM (Shareable Content Object Reference Model), and lack of incorporation of Artificial Intelligence (AI) and machine learning algorithms which could lead to better course adaptations. With the recent development of Experience Application Programming Interface (xAPI), a large amount of additional types of data can be captured and that opens a window of possibilities from which online education can benefit. In a corporate setting, where companies invest billions on the learning and development of their employees, some learner behaviours can be troublesome for they can hinder the knowledge development of a learner. Behaviours that hinder the knowledge development also raise ambiguity about learner’s knowledge mastery, specifically those related to gaming the system. Furthermore, a company receives little benefit from their investment if employees are passing courses without possessing the required knowledge and potential compliance risks may arise. Using xAPI and rules derived from a state-of-the-art review, we identified three learner behaviours, primarily related to guessing, in a corporate compliance course. The identified behaviours are: trying each option for a question, specifically for multiple-choice questions; selecting a single option for all the questions on the test; and continuously repeating tests upon failing as opposed to going over the learning material. These behaviours were detected on learners who repeated the test at least 4 times before passing the course. These findings suggest that gauging the mastery of a learner from multiple-choice questions test scores alone is a naive approach. Thus, next steps will consider the incorporation of additional data points, knowledge estimation models to model knowledge mastery of a learner more accurately, and analysis of the data for correlations between knowledge development and identified learner behaviours. Additional work could explore how learner behaviours could be utilised to make changes to a course. For example, course content may require modifications (certain sections of learning material may be shown to not be helpful to many learners to master the learning outcomes aimed at) or course design (such as the type and duration of feedback).

Keywords: artificial intelligence, corporate e-learning environment, knowledge maintenance, xAPI

Procedia PDF Downloads 110
327 Identifying Diabetic Retinopathy Complication by Predictive Techniques in Indian Type 2 Diabetes Mellitus Patients

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

Procedia PDF Downloads 170
326 Intellectual Property Rights Reforms and the Quality of Exported Goods

Authors: Gideon Ndubuisi

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It is widely acknowledged that the quality of a country’s export matters more decisively than the quantity it exports. Hence, understanding the drivers of exported goods’ quality is a relevant policy question. Among other things, product quality upgrading is a considerable cost uncertainty venture that can be undertaken by an entrepreneur. Once a product is successfully upgraded, however, others can imitate the product, and hence, the returns to the pioneer entrepreneur are socialized. Along with this line, a government policy such as intellectual property rights (IPRs) protection which lessens the non-appropriability problem and incentivizes cost discovery investments becomes both a panacea in addressing the market failure and a sine qua non for an entrepreneur to engage in product quality upgrading. In addendum, product quality upgrading involves complex tasks which often require a lot of knowledge and technology sharing beyond the bounds of the firm thereby creating rooms for knowledge spillovers and imitations. Without an institution that protects upstream suppliers of knowledge and technology, technology masking occurs which bids up marginal production cost and product quality fall. Despite these clear associations between IPRs and product quality upgrading, the surging literature on the drivers of the quality of exported goods has proceeded almost in isolation of IPRs protection as a determinant. Consequently, the current study uses a difference-in-difference method to evaluate the effects of IPRs reforms on the quality of exported goods in 16 developing countries over the sample periods of 1984-2000. The study finds weak evidence that IPRs reforms increase the quality of all exported goods. When the industries are sorted into high and low-patent sensitive industries, however, we find strong indicative evidence that IPRs reform increases the quality of exported goods in high-patent sensitive sectors both in absolute terms and relative to the low-patent sensitive sectors in the post-reform period. We also obtain strong indicative evidence that it brought the quality of exported goods in the high-patent sensitive sectors closer to the quality frontier. Accounting for time-duration effects, these observed effects grow over time. The results are also largely consistent when we consider the sophistication and complexity of exported goods rather than just quality upgrades.

Keywords: exports, export quality, export sophistication, intellectual property rights

Procedia PDF Downloads 111
325 Engineering Analysis for Fire Safety Using Computational Fluid Dynamic (CFD)

Authors: Munirajulu M, Srikanth Modem

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A large cricket stadium with the capacity to accommodate several thousands of spectators has the seating arena consisting of a two-tier arrangement with an upper and a lower bowl and an intermediate concourse podium level for pedestrian movement to access the bowls. The uniqueness of the stadium is that spectators can have an unobstructed view from all around the podium towards the field of play. Upper and lower bowls are connected by stairs. The stairs landing is a precast slab supported by cantilevered steel beams. These steel beams are fixed to precast columns supporting the stadium structure. The stair slabs are precast concrete supported on a landing slab and cantilevered steel beams. During an event of a fire at podium level between two staircases, fire resistance of steel beams is very critical to life safety. If the steel beam loses its strength due to lack of fire resistance, it will be weak in supporting stair slabs and may lead to a hazard in evacuating occupants from the upper bowl to the lower bowl. In this study, to ascertain fire rating and life safety, a performance-based design using CFD analysis is used to evaluate the steel beams' fire resistance. A fire size of 3.5 MW (convective heat output of fire) with a wind speed of 2.57 m/s is considered for fire and smoke simulation. CFD results show that the smoke temperature near the staircase/ around the staircase does not exceed 1500 C for the fire duration considered. The surface temperature of cantilevered steel beams is found to be less than or equal to 1500 C. Since this temperature is much less than the critical failure temperature of steel (5200 C), it is concluded that the design of structural steel supports on the staircase is adequate and does not need additional fire protection such as fire-resistant coating. CFD analysis provided an engineering basis for the performance-based design of steel structural elements and an opportunity to optimize fire protection requirements. Thus, performance-based design using CFD modeling and simulation of fire and smoke is an innovative way to evaluate fire rating requirements, ascertain life safety and optimize the design with regard to fire protection on structural steel elements.

Keywords: fire resistance, life safety, performance-based design, CFD analysis

Procedia PDF Downloads 179
324 Ameliorative Effect of Curcuma Longa against Arsenic Induced Reproductive Toxicity in Charles Foster Rats

Authors: Shazia Naheed Akhter, Rekha Kumari

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An estimated 70 million population are exposed to arsenic poisoning in India in recent times. Arsenic contamination in the groundwater has caused serious health hazards among the exposed population. In Bihar, the first district was Bhojpur, where arsenic causing health issues were reported in 2002. Presently, there are 18 districts that are reported arsenic poisoning in the groundwater. The exposed population is firstly diseased with various symptoms such as skin manifestations, loss of appetite, constipation, hormonal disorders, etc. The long duration exposure has led to cause infertility in the male subjects. The present study thus aims to develop the antidote against arsenic-induced male reproductive toxicity in animal models. The study was carried out on Charles Foster Rats after the approval from Institutional Animal Ethics Committee. A total of n=18 rats (12 weeks old) of an average weight of 160 ± 20 g were used for the study. The study group included n=6 control and n= 12 treated with sodium arsenite orally at the dose of 8mg/Kg b.w daily for 40 days. The n= 6 animals were dissected and the rest n=6 was administered orally with Curcuma longa rhizome ethanolic extract at the dose of 600mg/Kg b.w per day for 40 days. At the end of the entire experiment, all the animals were dissected out and their reproductive organs were taken out, especially epididymis for sperm counts, sperm motility, sperm mortality, sperm morphology. The blood samples were collected for the hormonal assay (testosterone and luteinizing hormone), as well as for hematological and biochemical analysis. The study showed a high magnitude of degeneration in the reproductive organs of the rats in the arsenic-treated group. There were degenerative fluctuations in the sperm counts, sperm motility, sperm mortality, sperm morphology and in the hormonal parameters, as well as in the hematological and biochemical parameters in the arsenic-treated rats. But, after the administration of Curcuma longa, there was significant amelioration in all these parameters. Therefore, the present study shows that Curcuma longa plays a vital role to combat arsenic-induced male reproductive toxicity.

Keywords: sodium arsenite, Charles foster rats, ethanolic rhizome extract of curcuma longa, male reproductive toxicity, amelioration

Procedia PDF Downloads 209
323 Diffusion MRI: Clinical Application in Radiotherapy Planning of Intracranial Pathology

Authors: Pomozova Kseniia, Gorlachev Gennadiy, Chernyaev Aleksandr, Golanov Andrey

Abstract:

In clinical practice, and especially in stereotactic radiosurgery planning, the significance of diffusion-weighted imaging (DWI) is growing. This makes the existence of software capable of quickly processing and reliably visualizing diffusion data, as well as equipped with tools for their analysis in terms of different tasks. We are developing the «MRDiffusionImaging» software on the standard C++ language. The subject part has been moved to separate class libraries and can be used on various platforms. The user interface is Windows WPF (Windows Presentation Foundation), which is a technology for managing Windows applications with access to all components of the .NET 5 or .NET Framework platform ecosystem. One of the important features is the use of a declarative markup language, XAML (eXtensible Application Markup Language), with which you can conveniently create, initialize and set properties of objects with hierarchical relationships. Graphics are generated using the DirectX environment. The MRDiffusionImaging software package has been implemented for processing diffusion magnetic resonance imaging (dMRI), which allows loading and viewing images sorted by series. An algorithm for "masking" dMRI series based on T2-weighted images was developed using a deformable surface model to exclude tissues that are not related to the area of interest from the analysis. An algorithm of distortion correction using deformable image registration based on autocorrelation of local structure has been developed. Maximum voxel dimension was 1,03 ± 0,12 mm. In an elementary brain's volume, the diffusion tensor is geometrically interpreted using an ellipsoid, which is an isosurface of the probability density of a molecule's diffusion. For the first time, non-parametric intensity distributions, neighborhood correlations, and inhomogeneities are combined in one segmentation of white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) algorithm. A tool for calculating the coefficient of average diffusion and fractional anisotropy has been created, on the basis of which it is possible to build quantitative maps for solving various clinical problems. Functionality has been created that allows clustering and segmenting images to individualize the clinical volume of radiation treatment and further assess the response (Median Dice Score = 0.963 ± 0,137). White matter tracts of the brain were visualized using two algorithms: deterministic (fiber assignment by continuous tracking) and probabilistic using the Hough transform. The proposed algorithms test candidate curves in the voxel, assigning to each one a score computed from the diffusion data, and then selects the curves with the highest scores as the potential anatomical connections. White matter fibers were visualized using a Hough transform tractography algorithm. In the context of functional radiosurgery, it is possible to reduce the irradiation volume of the internal capsule receiving 12 Gy from 0,402 cc to 0,254 cc. The «MRDiffusionImaging» will improve the efficiency and accuracy of diagnostics and stereotactic radiotherapy of intracranial pathology. We develop software with integrated, intuitive support for processing, analysis, and inclusion in the process of radiotherapy planning and evaluating its results.

Keywords: diffusion-weighted imaging, medical imaging, stereotactic radiosurgery, tractography

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