Search results for: construction project assessment risk factor

Authors: Jiancheng Zheng

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When metals are released into water from mining activities, they undergo changes chemically, physically and biologically and then may become more mobile and transportable along the waterway from their original sites. Natural colloids, including both organic and inorganic entities, are naturally occurring in any aquatic environment with sizes in the nanometer range. Natural colloids in a water system play an important role, quite often a key role, in binding and transporting compounds. When assessing and evaluating metals in natural waters, their sources, mobility, fate, and distribution patterns in the system are the major concerns from the point of view of assessing environmental contamination and pollution during resource development. There are a few ways to quantify colloids and accordingly study how metals distribute on different sizes of colloids. Current research results show that the presence of colloids can enhance the transport of some heavy metals in water, while heavy metals may also have an influence on the transport of colloids when cations in the water system change colloids and/or the ion strength of the water system changes. Therefore, studies into the relationship between different sizes of colloids and different metals in a water system are necessary and needed as natural colloids in water systems are complex mixtures of both organic and inorganic as well as biological materials. Their stability could be sensitive to changes in their shapes, phases, hardness and functionalities due to coagulation and deposition et al. and chemical, physical, and biological reactions. Because metal contaminants’ adsorption on surfaces of colloids is closely related to colloid properties, it is desired to fraction water samples as soon as possible after a sample is taken in the natural environment in order to avoid changes to water samples during transportation and storage. For this reason, this study carried out groundwater sample processing in the field, using Prep/Scale tangential flow filtration systems with 3-level cartridges (1 kDa, 10 kDa and 100 kDa). Groundwater samples from seven sites at Fort MacMurray, Alberta, Canada, were fractionated during the 2015 field sampling season. All samples were processed within 3 hours after samples were taken. Preliminary results show that although the distribution pattern of metals on colloids may vary with different samples taken from different sites, some elements often tend to larger colloids (such as Fe and Re), some to finer colloids (such as Sb and Zn), while some of them mainly in the dissolved form (such as Mo and Be). This information is useful to evaluate and project the fate and mobility of different metals in the groundwaters and possibly in environmental water systems.

Keywords: metal, colloid, groundwater, mobility, fractionation, sorption

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Authors: K. Masera, A. K. Hossain

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Hardly any neat biodiesel satisfies the European EN14214 standard for compression ignition engine application. To satisfy the EN14214 standard, various additives are doped into biodiesel; however, biodiesel additives might cause other problems such as increase in the particular emission and increased specific fuel consumption. In addition, the additives could be expensive. Considering the increasing level of greenhouse gas GHG emissions and fossil fuel depletion, it is forecasted that the use of biodiesel will be higher in the near future. Hence, the negative aspects of the biodiesel additives will likely to gain much more importance and need to be replaced with better solutions. This study aims to satisfy the European standard EN14214 by blending the biodiesels derived from sustainable feedstocks. Waste Cooking Oil (WCO) and Animal Fat Oil (AFO) are two sustainable feedstocks in the EU (including the UK) for producing biodiesels. In the first stage of the study, these oils were transesterified separately and neat biodiesels (W100 & A100) were produced. Secondly, the biodiesels were blended together in various ratios: 80% WCO biodiesel and 20% AFO biodiesel (W80A20), 60% WCO biodiesel and 40% AFO biodiesel (W60A40), 50% WCO biodiesel and 50% AFO biodiesel (W50A50), 30% WCO biodiesel and 70% AFO biodiesel (W30A70), 10% WCO biodiesel and 90% AFO biodiesel (W10A90). The prepared samples were analysed using Thermo Scientific Trace 1300 Gas Chromatograph and ISQ LT Mass Spectrometer (GC-MS). The GS-MS analysis gave Fatty Acid Methyl Ester (FAME) breakdowns of the fuel samples. It was found that total saturation degree of the samples was linearly increasing (from 15% for W100 to 54% for A100) as the percentage of the AFO biodiesel was increased. Furthermore, it was found that WCO biodiesel was mainly (82%) composed of polyunsaturated FAMEs. Cetane numbers, iodine numbers, calorific values, lower heating values and the densities (at 15 ^oC) of the samples were estimated by using the mass percentages data of the FAMEs. Besides, kinematic viscosities (at 40 °C and 20 °C), densities (at 15 °C), heating values and flash point temperatures of the biomixture samples were measured in the lab. It was found that estimated and measured characterisation results were comparable. The current study concluded that biomixture fuel samples W60A40 and W50A50 were perfectly satisfying the European EN 14214 norms without any need of additives. Investigation on engine performance, exhaust emission and combustion characteristics will be conducted to assess the full feasibility of the proposed biomixture fuels.

Keywords: biodiesel, blending, characterisation, CI engine

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Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias

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

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

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Authors: Ayca Bilginoglu, Belma Turan

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Metabolic syndrome, is associated impaired blood glucose level, insulin resistance, dyslipidemia caused by abdominal obesity. Also, it is related with cardiovascular risk accumulation and cardiomyopathy. The hypothesis of this study was to examine the effect of thiazolidinediones such as pioglitazone which is widely used insulin-sensitizing agents that improve glycemic control, on intracellular Na+ homeostasis in metabolic syndrome-induced cardiomyopathy in male rats. Male Wistar-Albino rats were randomly divided into three groups, namely control (Con, n=7), metabolic syndrome (MetS, n=7) and pioglitazone treated metabolic syndrome group (MetS+PGZ, n=7). Metabolic syndrome was induced by providing drinking water that was 32% sucrose, for 18 weeks. All of the animals were exposed to a 12 h light – 12 h dark cycle. Abdominal obesity and glucose intolerance had measured as a marker of metabolic syndrome. Intracellular Na+ ([Na+]i) is an important modulator of excitation–contraction coupling in heart. [Na+]i at rest and [Na+]i during pacing with electrical field stimulation in 0.2 Hz, 0.8 Hz, 2.0 Hz stimulation frequency were recorded in cardiomyocytes. Also, Na+ channel current (INa) density and I-V curve were measured to understand [Na+]i homeostasis. In results, high sucrose intake, as well as the normal daily diet, significantly increased body mass and blood glucose level of the rats in the metabolic syndrome group as compared with the non-treated control group. In MetS+PZG group, the blood glucose level and body inclined to decrease to the Con group. There was a decrease in INa density and there was a shift both activation and inactivation curve of INa. Pioglitazone reversed the shift to the control side. Basal [Na+]i either MetS and Con group were not significantly different, but there was a significantly increase in [Na+]i in stimulated cardiomyocytes in MetS group. Furthermore, pioglitazone had not effect on basal [Na+]i but it reversed the increase in [Na+]i in stimulated cardiomyocytes to the that of Con group. Results of the present study suggest that pioglitazone has a significant effect on the Na+ homeostasis in the metabolic syndrome induced cardiomyopathy in rats. All animal procedures and experiments were approved by the Animal Ethics Committee of Ankara University Faculty of Medicine (2015-2-37).

Keywords: insulin resistance, intracellular sodium, metabolic syndrome, sodium current

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Authors: Akemi Nasu, Keiko Matsumoto

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Rehabilitation for cancer requires setting up individual goals for each patient and an approach that properly fits the stage of cancer when putting into practice. In order to cope with the daily changes in the patients' condition, the establishment of a good cooperative relationship between the nurses and the physiotherapists, occupational therapists, and speech-language-hearing therapists (therapists) becomes essential. This study will focus on the present situation of the cooperation between nurses and therapists, especially the speech-language-hearing therapists, and aim to elucidate what develops there. A semi-structured interview was conducted targeted at a physical therapist having practical experience in working in collaboration with nurses. The contents of the interview were transcribed and converted to data, and the data was encoded and categorized with sequentially increasing degrees of abstraction to conduct a qualitative explorative factor analysis of the data. When providing ethical explanations, particular care was taken to ensure that participants would not be subjected to any disadvantages as a result of participating in the study. In addition, they were also informed that their privacy would be ensured and that they have the right to decline to participate in the study. In addition, they were also informed that the results of the study would be announced publicly at an applicable nursing academic conference. This study has been approved following application to the ethical committee of the university with which the researchers are affiliated. The survey participant is a female speech-language-hearing therapist in her forties. As a result of the analysis, 6 categories were extracted consisting of 'measures to address appetite and aspiration pneumonia prevention', 'limitation of the care a therapist alone could provide', 'the all-inclusive patient- supportive care provided by nurses', 'expand the beneficial cooperation with nurses', 'providing education for nurses on the swallowing function utilizing videofluoroscopic examination of swallowing', 'enhancement of communication including conferences'. In order to improve the team performance, and for the teamwork competency necessary for the provision of safer care, mutual support is essential. As for the cooperation between nurses and therapists, this survey indicates that the maturing of the cooperation between professionals in order to improve nursing professionals' knowledge and enhance communication will lead to an improvement in the quality of the rehabilitation for cancer.

Keywords: cancer rehabilitation, nurses, speech-language-hearing therapists, interprofessional work

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Authors: Nihar Bheda

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Protecting digital assets such as networks, systems, and data from advanced cyber threats is the aim of Digital Immunity Systems (DIS), which are a subset of cybersecurity. With features like continuous monitoring, coordinated reactions, and long-term adaptation, DIS seeks to mimic biological immunity. This minimizes downtime by automatically identifying and eliminating threats. Traditional security measures, such as firewalls and antivirus software, are insufficient for enterprises, such as healthcare providers, given the rapid evolution of cyber threats. The number of medical record breaches that have occurred in recent years is proof that attackers are finding healthcare data to be an increasingly valuable target. However, obstacles to enhancing security include outdated systems, financial limitations, and a lack of knowledge. DIS is an advancement in cyber defenses designed specifically for healthcare settings. Protection akin to an "immune system" is produced by core capabilities such as anomaly detection, access controls, and policy enforcement. Coordination of responses across IT infrastructure to contain attacks is made possible by automation and orchestration. Massive amounts of data are analyzed by AI and machine learning to find new threats. After an incident, self-healing enables services to resume quickly. The implementation of DIS is consistent with the healthcare industry's urgent requirement for resilient data security in light of evolving risks and strict guidelines. With resilient systems, it can help organizations lower business risk, minimize the effects of breaches, and preserve patient care continuity. DIS will be essential for protecting a variety of environments, including cloud computing and the Internet of medical devices, as healthcare providers quickly adopt new technologies. DIS lowers traditional security overhead for IT departments and offers automated protection, even though it requires an initial investment. In the near future, DIS may prove to be essential for small clinics, blood banks, imaging centers, large hospitals, and other healthcare organizations. Cyber resilience can become attainable for the whole healthcare ecosystem with customized DIS implementations.

Keywords: digital immunity system, cybersecurity, healthcare data, emerging technology

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Authors: Sheelagh Heugh, Michael Upton, Kriya Kalidas, Stephen Breen

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This article aims to create awareness of the opportunities and issues the artificial intelligence (AI) tool GPT-3 (Generative Pre-trained Transformer-3) brings to higher education. Technological disruptors have featured in higher education (HE) since Konrad Klaus developed the first functional programmable automatic digital computer. The flurry of technological advances, such as personal computers, smartphones, the world wide web, search engines, and artificial intelligence (AI), have regularly caused disruption and discourse across the educational landscape around harnessing the change for the good. Accepting AI influences are inevitable; we took mixed methods through participatory action research and evaluation approach. Joining HE communities, reviewing the literature, and conducting our own research around Chat GPT-3, we reviewed our institutional approach to changing our current practices and developing policy linked to assessments and the use of Chat GPT-3. We review the impact of GPT-3, a high-powered natural language processing (NLP) system first seen in 2020 on HE. Historically HE has flexed and adapted with each technological advancement, and the latest debates for educationalists are focusing on the issues around this version of AI which creates natural human language text from prompts and other forms that can generate code and images. This paper explores how Chat GPT-3 affects the current educational landscape: we debate current views around plagiarism, research misconduct, and the credibility of assessment and determine the tool's value in developing skills for the workplace and enhancing critical analysis skills. These questions led us to review our institutional policy and explore the effects on our current assessments and the development of new assessments. Conclusions: After exploring the pros and cons of Chat GTP-3, it is evident that this form of AI cannot be un-invented. Technology needs to be harnessed for positive outcomes in higher education. We have observed that materials developed through AI and potential effects on our development of future assessments and teaching methods. Materials developed through Chat GPT-3 can still aid student learning but lead to redeveloping our institutional policy around plagiarism and academic integrity.

Keywords: artificial intelligence, Chat GPT-3, intellectual property, plagiarism, research misconduct

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Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

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Authors: Shahid Mahmood, Ghulam Mueen-Ud-Din, Farah Naz Akbar, Yousaf Quddoos, Syeda Mahvish Zahra, Wajiha Saeed, Tayyaba Sami Ullah

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Obesity is an epidemic across the globe that affects all the segments of the population. Physical inactivity, passionate consumption of junk food, inadequate water intake and an unhealthy lifestyle are evident among university girls that are ruining their health gravely especially fat accumulation. The study was carried out to investigate the potential etiological factors of obesity development in university girls. The cross sectional study was carried out after approval of the Departmental Review Committee for Ethics (DRCE) as the par Declaration of Helsinki at Institute of Food Science and Nutrition (IFSN), University of Sargodha, Sargodha-Pakistan and Department of Food Science and Home Economics, G. C. Women University, Faisalabad-Pakistan. 400 girls were selected randomly from different departments of both universities. Nutritional status of the volunteers was assessed through approved protocols for demographics, anthropometrics, body composition, energetics, vital signs, clinical signs and symptoms, medical/family history, and dietary intake assessment (FFQ), water intake and physical activity level. The obesity was determined on body fat (%). Alarming and unheeded etiological factors for the development of obesity in girls were explored by the study. About 93 % girls had a sedentary level of physical activity, zealous consumption of junk food (5.31±1.23 servings), drank little water (1.09±0.26 L/day) that consequent high heaps of fat (35.06±3.02 %), measly body water (52.38±3.4 %), poor bone mass (05.14±0.31 Kg), and high BMI (26.68±1.14 Kg/m²) in 34% girls. The malnutrition also depicted by poor vital signs i.e. low body temperature (97.11±0.93 °F), slightly higher blood pressure (124.19±4.08 / 85.25±2.97 mmHg), rapid pulse rate (99.2 ± 6.85 beats/min), reduced blood O₂ saturation (96.53±0.96 %), scanty peak expiratory flow rate (297 ± 15.7 L /min). The outcomes of the research articulated that physical inactivity; extreme intakes of junk food, insufficient water consumption are etiological factors for obesity development among girls which are usually overlooked in Pakistan.

Keywords: informed consent, junk food, obesity, physical inactivity

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Authors: V. E. Messerle, A. L. Mosse, O. A. Lavrichshev, A. N. Nikonchuk, A. B. Ustimenko

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One of the most serious environmental problems today is pollution by biomedical waste (BMW), which in most cases has undesirable properties such as toxicity, carcinogenicity, mutagenicity, fire. Sanitary and hygienic survey of typical solid BMW, made in Belarus, Kazakhstan, Russia and other countries shows that their risk to the environment is significantly higher than that of most chemical wastes. Utilization of toxic BMW requires use of the most universal methods to ensure disinfection and disposal of any of their components. Such technology is a plasma technology of BMW processing. To implement this technology a thermodynamic analysis of the plasma processing of BMW was fulfilled and plasma-box furnace was developed. The studies have been conducted on the example of the processing of bone. To perform thermodynamic calculations software package Terra was used. Calculations were carried out in the temperature range 300 - 3000 K and a pressure of 0.1 MPa. It is shown that the final products do not contain toxic substances. From the organic mass of BMW synthesis gas containing combustible components 77.4-84.6% was basically produced, and mineral part consists mainly of calcium oxide and contains no carbon. Degree of gasification of carbon reaches 100% by the temperature 1250 K. Specific power consumption for BMW processing increases with the temperature throughout its range and reaches 1 kWh/kg. To realize plasma processing of BMW experimental installation with DC plasma torch of 30 kW power was developed. The experiments allowed verifying the thermodynamic calculations. Wastes are packed in boxes weighing 5-7 kg. They are placed in the box furnace. Under the influence of air plasma flame average temperature in the box reaches 1800 OC, the organic part of the waste is gasified and inorganic part of the waste is melted. The resulting synthesis gas is continuously withdrawn from the unit through the cooling and cleaning system. Molten mineral part of the waste is removed from the furnace after it has been stopped. Experimental studies allowed determining operating modes of the plasma box furnace, the exhaust gases was analyzed, samples of condensed products were assembled and their chemical composition was determined. Gas at the outlet of the plasma box furnace has the following composition (vol.%): CO - 63.4, H2 - 6.2, N2 - 29.6, S - 0.8. The total concentration of synthesis gas (CO + H2) is 69.6%, which agrees well with the thermodynamic calculation. Experiments confirmed absence of the toxic substances in the final products.

Keywords: biomedical waste, box furnace, plasma torch, processing, synthesis gas

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Authors: Noriyuki Suyama

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This paper discusses purchasing behavior in retail stores, with a particular focus on the impact of weather changes on customers' purchasing behavior. Weather conditions are one of the factors that greatly affect the management and operation of retail stores. However, there is very little research on the relationship between weather conditions and marketing from an academic perspective, although there is some importance from a practical standpoint and knowledge based on experience. For example, customers are more hesitant to go out when it rains than when it is sunny, and they may postpone purchases or buy only the minimum necessary items even if they do go out. It is not difficult to imagine that weather has a significant impact on consumer behavior. To the best of the authors' knowledge, there have been only a few studies that have delved into the purchasing behavior of individual customers. According to Hirata (2018), the economic impact of weather in the United States is estimated to be 3.4% of GDP, or "$485 billion ± $240 billion per year. However, weather data is not yet fully utilized. Representative industries include transportation-related industries (e.g., airlines, shipping, roads, railroads), leisure-related industries (e.g., leisure facilities, event organizers), energy and infrastructure-related industries (e.g., construction, factories, electricity and gas), agriculture-related industries (e.g., agricultural organizations, producers), and retail-related industries (e.g., retail, food service, convenience stores, etc.). This paper focuses on the retail industry and advances research on weather. The first reason is that, as far as the author has investigated the retail industry, only grocery retailers use temperature, rainfall, wind, weather, and humidity as parameters for their products, and there are very few examples of academic use in other retail industries. Second, according to NBL's "Toward Data Utilization Starting from Consumer Contact Points in the Retail Industry," labor productivity in the retail industry is very low compared to other industries. According to Hirata (2018) mentioned above, improving labor productivity in the retail industry is recognized as a major challenge. On the other hand, according to the "Survey and Research on Measurement Methods for Information Distribution and Accumulation (2013)" by the Ministry of Internal Affairs and Communications, the amount of data accumulated by each industry is extremely large in the retail industry, so new applications are expected by analyzing these data together with weather data. Third, there is currently a wealth of weather-related information available. There are, for example, companies such as WeatherNews, Inc. that make weather information their business and not only disseminate weather information but also disseminate information that supports businesses in various industries. Despite the wide range of influences that weather has on business, the impact of weather has not been a subject of research in the retail industry, where business models need to be imagined, especially from a micro perspective. In this paper, the author discuss the important aspects of the impact of weather on marketing strategies in the non-food retail industry.

Keywords: consumer behavior, weather marketing, marketing science, big data, retail marketing

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Ahmed Ehsanur Rahman, Nazia Binte Ali, Abdullah Nurus Salam Khan, Afrin Iqbal, Mohammad Mehedi Hasan, Salma Morium, Afsana Bhuiyan, Shams El Arifeen

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Violence against women has been treated as a global epidemic which is as fatal as any serious disease or accidents. Like many other low-income countries it is also common in Bangladesh. In spite of existence of a few documented evidences in some other countries, in Bangladesh, domestic violence against women (DVAW) is not considered as a factor for malnutrition in children yet. Hence, the aim of the study was to investigate the association between DVAW and the nutritional status of their under-5 children in the context of slum areas of Chittagong, Bangladesh. A Cross-sectional survey was conducted among 87 women of reproductive age having at least one child under-5 years of age and staying with husband for at least last 1 year in selected slums under Chittagong City Corporation area. Data collection tools were structured questionnaire for the study participants and mid-upper arm circumference (MUAC) to measure the nutritional status of the under-5 children. The data underwent descriptive and regression analysis. Out of 87 respondents, 50 (57.5%) reported to suffer from domestic violence by their husband during last one year. Physical violence was found to be significantly associated with age (p=0.02), age at marriage (p=0.043), wealth score (p=0.000), and with knowledge regarding law (p=0.017). According to the measurement of mid-upper arm circumference (MUAC) 21% children were suffering from severe acute malnutrition (SAM) and the same percentage of children were suffering from moderate acute malnutrition (MAM). However, unadjusted odds ratio suggested that there was negative association with domestic violence and nutritional status. But, the logistic regression confounding for other variable showed significant association with total family income (p=0.006), wealth score (p=0.031), age at marriage (p=0.029) and number of child (p=0.006). Domestic violence against women and under nutrition of the children, both are highly prevalent in Bangladesh. More extensive research should be performed to identify the factors contributing to the high prevalence of domestic violence and malnutrition in urban slums of Bangladesh. Household-based intervention is needed to limit this burning problem. In a nutshell, effective community participation, education and counseling are essential to create awareness among the community.

Keywords: Bangladesh, cross sectional survey, domestic violence against women, nutritional status, under-5 children, urban slums

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Authors: Abdreheman Seid Abdella

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This study examined instructors willingness, self-efficacy beliefs, attitudes and knowledge about provisions of instructional accommodations for students with disabilities in universities. Major concepts used in this study operationally defined and some models of disability were reviewed. Questionnaires were distributed to a total of 181 instructors from four universities and quantitative data was generated. Then to analyze the data, appropriate methods of data analysis were employed. The result indicated that on average instructors had positive willingness, strong self-efficacy beliefs and positive attitudes towards providing instructional accommodations. In addition, the result showed that the majority of participants had moderate level of knowledge about provision of instructional accommodations. Concerning the relationship between instructors background variables and dependent variables, the result revealed that location of university and awareness raising training about Inclusive Education showed statistically significant relationship with all dependent variables (willingness, self-efficacy beliefs, attitudes and knowledge). On the other hand, gender and college/faculty did not show a statistically significant relationship. In addition, it was found that among the inter-correlation of dependent variables, the correlation between attitudes and willingness to provide accommodations was the strongest. Furthermore, using multiple linear regression analysis, this study also indicated that predictor variables like self-efficacy beliefs, attitudes, knowledge and teaching methodology training made statistically significant contribution to predicting the criterion willingness. Predictor variables like willingness and attitudes made statistically significant contribution to predicting self-efficacy beliefs. Predictor variables like willingness, Special Needs Education course and self-efficacy beliefs made statistically significant contribution to predict attitudes. Predictor variables like Special Needs Education courses, the location of university and willingness made statistically significant contribution to predicting knowledge. Finally, using exploratory factor analysis, this study showed that there were four components or factors each that represent the underlying constructs of willingness and self-efficacy beliefs to provide instructional accommodations items, five components for attitudes towards providing accommodations items and three components represent the underlying constructs for knowledge about provisions of instructional accommodations items. Based on the findings, recommendations were made for improving the situation of instructional accommodations in Ethiopian universities.

Keywords: willingness, self-efficacy belief, attitude, knowledge

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Alina Murtishcheva

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The development of an effective system of administrative supervision is a prerequisite for the functioning of local self-government on the basis of the rule of law. Administrative supervision of local self-government is of particular importance in the EU countries due to the influence of integration processes. The central authorities act on the international level; however, subnational authorities also have to implement European legislation in order to strengthen integration. Therefore, the central authority, being the connecting link between supranational and subnational authorities, should bear responsibility, including financial responsibility, for possible mistakes of subnational authorities. Consequently, the state should have sufficient mechanisms of control over local and regional authorities in order to correct their mistakes. At the same time, the control mechanisms do not deny the autonomy of local self-government. The paper analyses models of administrative supervision of local self-government in Ukraine, Poland, Lithuania, Belgium, Great Britain, Italy, and France. The research methods used in this paper are theoretical methods of analysis of scientific literature, constitutions, legal acts, Congress of Local and Regional Authorities of the Council of Europe reports, and constitutional court decisions, as well as comparative and logical analysis. The legislative basis of administrative supervision was scrutinized, and the models of administrative supervision were classified, including a priori control and ex-post control or their combination. The advantages and disadvantages of these models of administrative supervision are analysed. Compliance with Article 8 of the European Charter of Local Self-Government is of great importance for countries achieving common goals and sharing common values. However, countries under study have problems and, in some cases, demonstrate non-compliance with provisions of Article 8. Such non-conformity as the endorsement of a mayor by the Flemish Government in Belgium, supervision with a view to expediency in Great Britain, and the tendency to overuse supervisory power in Poland are analysed. On the basis of research, the tendencies of administrative supervision of local authorities’ activities in selected European countries are described. Several recommendations for Ukraine as a country that had been granted the EU candidate status are formulated. Having emphasised its willingness to become a member of the European community, Ukraine should not only follow the best European practices but also avoid the mistakes of countries that have long-term experience in developing the local self-government institution. This project has received funding from the Research Council of Lithuania (LMTLT), agreement № P-PD-22-194

Keywords: administrative supervision, decentralisation, legality, local authorities, local self-government

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Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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Authors: Mustafa Tahir Ocak, Gülsün Tanyeli

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Georgia became Christian in the 4th century. During the 7th and 8th centuries, Georgia, with its capital at Tiflis, was devastated by Arab invasions from the south and east. Tiflis was abandoned and a new Georgia, with its capital at present-day Ardanuç; in Turkey, was established, based on the provinces of Tao, Klarjeti and Shavsheti. Georgian power revived during the 9th century and the new kings embarked on a notable period of church building, each prince intent on raising memorials to his reign. Georgia was weakened again in the 11th century. First, by Byzantium which now feared the Georgians’ growing power and, second, by the advance of the Seljuk Turks. But defeat did not last long and under David II, ‘the Builder’, Georgian armies recaptured Tiflis in 1122, heralding a second political and cultural renascence. There has been a remarkable increase in the number of monuments in 9th-11th centuries. Kingdom of Georgia’s boundaries have changed lots of times over the centuries, and consequently a considerable number of churches are to be found in other countries, especially in north-eastern provinces of Turkey. Georgian monuments spread to valleys of the Çoruh, Oltu and Tortum rivers in north-east Turkey. These churches have significant role in architectural history. The medieval Georgians and the Armenians had known contacts with Byzantium. Their churches influenced mid-Byzantine architecture and were a factor in the evolution of the Romanesque style in Europe. In the centuries following the inclusion of Tao and Klarjeti within the expanding Ottoman Empire, the monasteries and churches were gradually abandoned with migration of Christian population. Although some of those monuments are in good condition through the conversion of churches to use as mosques, the rest of those monuments are under threat from neglect and lack of maintenance. Many fell into ruin or were plundered for their stone; others were damaged by earthquakes, by treasure hunters. The only hope for the Georgian churches is for them to be recognised as a touristic value in a beautiful region of deep valleys and magnificent mountain scenery. As coeval churches in modern Georgian boundaries, these churches in north-eastern provinces of Turkey have to evaluated by UNESCO. This study aims to create awereness about the conservation of Georgian churches in north-eastern provinces of Turkey as world heritage taking advantages of tourism. Georgian churches as a heritage should be evaluated not only a monument but also cultural landscape. The cultural route is created visiting both churches and the other medieval structures in these regions.

Keywords: Georgian churches, medieval monuments, Tao-Klarjeti, Turkey

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Authors: Ässia Boukhatmi, Roger Nyffenegger

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The expansion of solar energy as a means to address the climate crisis is undisputed, but the increasing number of new photovoltaic (PV) modules being put on the market is simultaneously leading to increased challenges in terms of managing the growing waste stream. Many of the discarded modules are still fully functional but are often damaged by improper handling after disassembly or not properly tested to be considered for a second life. In addition, the collection rate for dismantled PV modules in several European countries is only a fraction of previous projections, partly due to the increased number of illegal exports. The underlying problem for those market imperfections is an insufficient data exchange between the different actors along the PV value chain, as well as the limited traceability of PV panels during their lifetime. As part of the Horizon 2020 project CIRCUSOL, an asset database prototype was developed to tackle the described problems. In an iterative process applying the design science research methodology, different business models, as well as the technical implementation of the database, were established and evaluated. To explore the requirements of different stakeholders for the development of the database, surveys and in-depth interviews were conducted with various representatives of the solar industry. The proposed database prototype maps the entire value chain of PV modules, beginning with the digital product passport, which provides information about materials and components contained in every module. Product-related information can then be expanded with performance data of existing installations. This information forms the basis for the application of data analysis methods to forecast the appropriate end-of-life strategy, as well as the circular economy potential of PV modules, already before they arrive at the recycling facility. The database prototype could already be enriched with data from different data sources along the value chain. From a business model perspective, the database offers opportunities both in the area of reuse as well as with regard to the certification of sustainable modules. Here, participating actors have the opportunity to differentiate their business and exploit new revenue streams. Future research can apply this approach to further industry and product sectors, validate the database prototype in a practical context, and can serve as a basis for standardization efforts to strengthen the circular economy.

Keywords: business model, circular economy, database, design science research, solar industry

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Authors: Agnieszka Feliczak-Guzik, Paulina Szczyglewska, Izabela Nowak

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A catalyst-assisted oxidation reaction is one of the key reactions exploited by various industries. Their conductivity yields essential compounds and intermediates, such as alcohols, epoxides, aldehydes, ketones, and organic acids. Researchers are devoting more and more attention to developing active and selective materials that find application in many catalytic reactions, such as cyclohexene epoxidation. This reaction yields 1,2-epoxycyclohexane and 1,2-diols as the main products. These compounds are widely used as intermediates in the perfume industry and synthesizing drugs and lubricants. Hence, our research aimed to use hierarchical zeolites modified with transition metal ions, e.g., Nb, V, and Ta, in the epoxidation reaction of cyclohexene using microwaveheating. Hierarchical zeolites are materials with secondary porosity, mainly in the mesoporous range, compared to microporous zeolites. In the course of the research, materials based on two commercial zeolites, with Faujasite (FAU) and Zeolite Socony Mobil-5 (ZSM-5) structures, were synthesized and characterized by various techniques, such as X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and low-temperature nitrogen adsorption/desorption isotherms. The materials obtained were then used in a cyclohexene epoxidation reaction, which was carried out as follows: catalyst (0.02 g), cyclohexene (0.1 cm3), acetonitrile (5 cm3) and dihydrogen peroxide (0.085 cm3) were placed in a suitable glass reaction vessel with a magnetic stirrer inside in a microwave reactor. Reactions were carried out at 45° C for 6 h (samples were taken every 1 h). The reaction mixtures were filtered to separate the liquid products from the solid catalyst and then transferred to 1.5 cm3 vials for chromatographic analysis. The test techniques confirmed the acquisition of additional secondary porosity while preserving the structure of the commercial zeolite (XRD and low-temperature nitrogen adsorption/desorption isotherms). The results of the activity of the hierarchical catalyst modified with niobium in the cyclohexene epoxidation reaction indicate that the conversion of cyclohexene, after 6 h of running the process, is about 70%. As the main product of the reaction, 2-cyclohexanediol was obtained (selectivity > 80%). In addition to the mentioned product, adipic acid, cyclohexanol, cyclohex-2-en-1-one, and 1,2-epoxycyclohexane were also obtained. Furthermore, in a blank test, no cyclohexene conversion was obtained after 6 h of reaction. Acknowledgments The work was carried out within the project “Advanced biocomposites for tomorrow’s economy BIOG-NET,” funded by the Foundation for Polish Science from the European Regional Development Fund (POIR.04.04.00-00-1792/18-00.

Keywords: epoxidation, oxidation reactions, hierarchical zeolites, synthesis

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Authors: Aruma Baduge Kithma De Silva

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Haskap (Lonicera caerulea L.), also known as blue honeysuckle, is a newly commercialized berry crop in Canada. Haskap berries are rich in polyphenols, including, anthocyanins, which are known for potential health-promoting properties. Cyanidin-3-O-glucoside (C3G) is the most abundant anthocyanin of haskap berries. The compound C3G has the ability to reduce the risk of type 2 diabetes (T2D), which has become an increasingly common health issue around the world. The T2D is characterized as a metabolic disorder of hyperglycemia and insulin resistance. It has been demonstrated that C3G has anti-diabetic effects through several ways, including inhibition of dipeptidyl peptidase-4 (DPP-4), reduction of gluconeogenesis, improvement in insulin sensitivity, and inhibition of activities of carbohydrate hydrolyzing enzymes, including α-amylase and α-glucosidase. The goal of this study was to investigate the influence of variety and harvests maturity of haskap on C3G, other fruit quality characteristics and anti-diabetic activities of haskap berries using in vitro studies. The polyphenols present in four commercially grown haskap cultivars, Aurora, Rebecca, Larissa, and Evie harvested at five harvesting dates (H1-H5) apart from 2-3 days, were extracted separately. High-performance liquid chromatography electrospray ionization mass spectrometry (HPLC-ESI-MS) analyzes of polyphenols revealed that haskap berries contain predominantly anthocyanins, flavonols, flavan-3-ols, and phenolic acids. The compound C3G was the most prominent anthocyanin, which is available in approximately 79% of total anthocyanin in four cultivars. The Larissa at H5 contained the highest C3G content. The antioxidant capacity of Evie at H5 was greater than other cultivars. Furthermore, Larissa H5 showed the greatest inhibition of carbohydrate hydrolyzing enzymes including alpha-glucosidase and alpha-amylase. In conclusion, the haskap variety and harvesting date influenced the polyphenol composition and biological properties. The variety Larissa, at H5 harvesting date, contained the highest polyphenol content and the ability of inhibition of the carbohydrate hydrolyzing enzyme as well as DPP4 enzyme in order to reduce type 2 diabetes.

Keywords: anthocyanin, Haskap, type 2 diabetes, polyphenol

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Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi

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Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.

Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths

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Authors: Stephanie Yun Yu Law

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Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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Authors: Sangeet Anand

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Body art and tattooing have long been practiced as a form of self-expression for centuries, and this study studies and analyzes the pertinence of tattoo culture in our everyday lives and ancient past. Individuals of different cultures represent ideas, practices, and elements of their cultures through symbolic representation. These symbols come in all shapes and sizes and can be as simple as the makeup you put on every day to something more permanent such as a tattoo. In the long run, these individuals who choose to display art on their bodies are seeking to express their individuality. In addition, these visuals are ultimately a reflection of our own appropriate cultures deem as beautiful, important, and powerful to the human eye. They make us known to the world and give us a plausible identity in an ever-changing world. We have lived through and seen a rise in hippie culture today. This type of bodily decoration displayed by this fad has made it seem as though body art is a visual language that is relatively new. But quite to the contrary, it is not. Through cultural symbolic exploration, we can answer key questions to ideas that have been raised for centuries. Through careful, in-depth interviews, this study takes a broad subject matter-art, and symbolism-and culminates it into a deeper philosophical connection between the world and its past. The basic methodologies used in this sociocultural study include interview questionnaires and textual analysis, which encompass a subject and interviewer as well as source material. The major findings of this study contain a distinct connection between cultural heritage and the day-to-day likings of an individual. The participant that was studied during this project demonstrated a clear passion for hobbies that were practiced even by her ancestors. We can conclude, through these findings, that there is a deeper cultural connection between modern day humans, the first humans, and the surrounding environments. Our symbols today are a direct reflection of the elements of nature that our human ancestors were exposed to, and, through cultural acceptance, we can adorn ourselves with these representations to help others identify our pasts. Body art embraces the different aspects of different cultures and holds significance, tells stories, and persists, even as the human population rapidly integrates. With this pattern, our human descendents will continue to represent their cultures and identities in the future. Body art is an integral element in understanding how and why people identify with certain aspects of life over others and broaden the scope for conducting more analysis cross-culturally.

Keywords: natural, symbolism, tattoo, terrestrial

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Authors: Pisut Boonkaew, Jatuporn Thongsri

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In hard disk drive manufacturing industry, the process of reducing an unnecessary part and qualifying the quality of part before assembling is important. Thus, clamp was designed and fabricated as a fixture for holding in testing process. Basically, testing by trial and error consumes a long time to improve. Consequently, the simulation was brought to improve the part and reduce the time taken. The problem is the present clamp has a low life expectancy because of the critical stress that occurred. Hence, the simulation was brought to study the behavior of stress and compressive force to improve the clamp expectancy with all probability of designs which are present up to 27 designs, which excluding the repeated designs. The probability was calculated followed by the full fractional rules of six sigma methodology which was provided correctly. The six sigma methodology is a well-structured method for improving quality level by detecting and reducing the variability of the process. Therefore, the defective will be decreased while the process capability increasing. This research focuses on the methodology of stress and fatigue reduction while compressive force still remains in the acceptable range that has been set by the company. In the simulation, ANSYS simulates the 3D CAD with the same condition during the experiment. Then the force at each distance started from 0.01 to 0.1 mm will be recorded. The setting in ANSYS was verified by mesh convergence methodology and compared the percentage error with the experimental result; the error must not exceed the acceptable range. Therefore, the improved process focuses on degree, radius, and length that will reduce stress and still remain in the acceptable force number. Therefore, the fatigue analysis will be brought as the next process in order to guarantee that the lifetime will be extended by simulating through ANSYS simulation program. Not only to simulate it, but also to confirm the setting by comparing with the actual clamp in order to observe the different of fatigue between both designs. This brings the life time improvement up to 57% compared with the actual clamp in the manufacturing. This study provides a precise and trustable setting enough to be set as a reference methodology for the future design. Because of the combination and adaptation from the six sigma method, finite element, fatigue and linear regressive analysis that lead to accurate calculation, this project will able to save up to 60 million dollars annually.

Keywords: clamp, finite element analysis, structural, six sigma, linear regressive analysis, fatigue analysis, probability

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Thiago Ribeiro de Alencar, Jacyro Gramulia Junior, Patricia Teixeira Leite

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The area of the electricity sector that deals with energy needs by the hydroelectric in a coordinated manner is called Operation Planning of Hydrothermal Power Systems (OPHPS). The purpose of this is to find a political operative to provide electrical power to the system in a given period, with reliability and minimal cost. Therefore, it is necessary to determine an optimal schedule of generation for each hydroelectric, each range, so that the system meets the demand reliably, avoiding rationing in years of severe drought, and that minimizes the expected cost of operation during the planning, defining an appropriate strategy for thermal complementation. Several optimization algorithms specifically applied to this problem have been developed and are used. Although providing solutions to various problems encountered, these algorithms have some weaknesses, difficulties in convergence, simplification of the original formulation of the problem, or owing to the complexity of the objective function. An alternative to these challenges is the development of techniques for simulation optimization and more sophisticated and reliable, it can assist the planning of the operation. Thus, this paper presents the development of a computational tool, namely Hydro-IA for solving optimization problem identified and to provide the User an easy handling. Adopted as intelligent optimization technique is Genetic Algorithm (GA) and programming language is Java. First made the modeling of the chromosomes, then implemented the function assessment of the problem and the operators involved, and finally the drafting of the graphical interfaces for access to the User. The results with the Genetic Algorithms were compared with the optimization technique nonlinear programming (NLP). Tests were conducted with seven hydroelectric plants interconnected hydraulically with historical stream flow from 1953 to 1955. The results of comparison between the GA and NLP techniques shows that the cost of operating the GA becomes increasingly smaller than the NLP when the number of hydroelectric plants interconnected increases. The program has managed to relate a coherent performance in problem resolution without the need for simplification of the calculations together with the ease of manipulating the parameters of simulation and visualization of output results.

Keywords: energy, optimization, hydrothermal power systems, artificial intelligence and genetic algorithms

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Authors: Nawaf Al Khashram, Graham Arnold, Weijie Wang

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Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—The aim of this study is to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: age group, gait analysis, kinematics, normal children

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Authors: Bita Rabbani, Hossein Chiti, Faranak Sharifi, Saeedeh Mazloomzadeh

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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity, are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as changes in diet and physical activity, on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels of elementary, middle, and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers, and parents, changes in food services, and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles, and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software version 16.0. Results: Overall, 589 individuals (252 male, 337 female) entered the case group, and 803 individuals (344 male, 459 female) entered the control group. After two years of intervention, mean waist circumference (63.8 ± 10.9) and diastolic BP (63.8 ± 10.4) were significantly lower; however, mean systolic BP (10.1.0 ± 12.5), food score (25.0 ± 5.0) and drinking score (12.1 ± 2.3) were higher in the intervention group (p<0.001). Comparing components of metabolic syndrome between the second year and at time of recruitment within the intervention group showed that although number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are two major components of metabolic syndrome, are much higher in our study than in other regions of country. However, interventions for modification of diet and increase in physical activity are effective in lowering their prevalence.

Keywords: metabolic syndrome, obesity, life style, nutrition, hypertension

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Authors: Raymond K. Jonkers

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The present study investigated approaches and techniques to enhance strategic management governance and decision making within the framework of a performance-based balanced scorecard. The review of best practices from strategic, program, process, and systems engineering management provided for a holistic approach toward effective outcome-based capability management. One technique, based on factorial experimental design methods, was used to develop an empirical model. This model predicted the degree of capability effectiveness and is dependent on controlled system input variables and their weightings. These variables represent business performance measures, captured within a strategic balanced scorecard. The weighting of these measures enhances the ability to quantify causal relationships within balanced scorecard strategy maps. The focus in this study was on the performance of tangible assets within the scorecard rather than the traditional approach of assessing performance of intangible assets such as knowledge and technology. Tangible assets are represented in this study as physical systems, which may be thought of as being aboard a ship or within a production facility. The measures assigned to these systems include project funding for upgrades against demand, system certifications achieved against those required, preventive maintenance to corrective maintenance ratios, and material support personnel capacity against that required for supporting respective systems. The resultant scorecard is viewed as complimentary to the traditional balanced scorecard for program and performance management. The benefits from these scorecards are realized through the quantified state of operational capabilities or outcomes. These capabilities are also weighted in terms of priority for each distinct system measure and aggregated and visualized in terms of overall state of capabilities achieved. This study proposes the use of interactive controls within the scorecard as a technique to enhance development of alternative solutions in decision making. These interactive controls include those for assigning capability priorities and for adjusting system performance measures, thus providing for what-if scenarios and options in strategic decision-making. In this holistic approach to capability management, several cross functional processes were highlighted as relevant amongst the different management disciplines. In terms of assessing an organization’s ability to adopt this approach, consideration was given to the P3M3 management maturity model.

Keywords: management, systems, performance, scorecard

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Authors: Fangliang Chen, Yihe Huang, Tejav Deganyar, Anselm Boehm, Hamid Batoul

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With growing population density and further urbanization, the average noise level in cities is increasing. Excessive noise is not only annoying but also leads to a negative impact on human health. To deal with the increasing city noise, environmental regulations bring up higher standards on acoustic comfort in buildings by mitigating the noise transmission from building envelope exterior to interior. Framed window, door and façade systems are the leading choice for modern fenestration construction, which provides demonstrated quality of weathering reliability, environmental efficiency, and installation ease. The overall sound insulation of such systems depends both on glasses and frames, where glass usually covers the majority of the exposed surfaces, thus it is the main source of sound energy transmission. While frames in modern façade systems become slimmer for aesthetic appearance, which contribute to a minimal percentage of exposed surfaces. Nevertheless, frames might provide substantial transmission paths for sound travels through because of much less mass crossing the path, thus becoming more critical in limiting the acoustic performance of the whole system. There are various methodologies and numerical programs that can accurately predict the acoustic performance of either glasses or frames. However, due to the vast variance of size and dimension between frame and glass in the same system, there is no satisfactory theoretical approach or affordable simulation tool in current practice to access the over acoustic performance of a whole façade system. For this reason, laboratory test turns out to be the only reliable source. However, laboratory test is very time consuming and high costly, moreover different lab might provide slightly different test results because of varieties of test chambers, sample mounting, and test operations, which significantly constrains the early phase design of framed façade systems. To address this dilemma, this study provides an effective analytical methodology to predict the acoustic performance of framed façade systems, based on vast amount of acoustic test results on glass, frame and the whole façade system consist of both. Further test results validate the current model is able to accurately predict the overall sound transmission loss of a framed system as long as the acoustic behavior of the frame is available. Though the presented methodology is mainly developed from façade systems with aluminum frames, it can be easily extended to systems with frames of other materials such as steel, PVC or wood.

Keywords: city noise, building facades, sound mitigation, sound transmission loss, framed façade system

Procedia PDF Downloads 40