Search results for: heart rate index
9950 Reduction of Physician's Radiation Dose during Cardiac Catheterization Procedures Using Lead-Free Sterile Radiation Shields
Authors: Mohammad O. Diab, Sahera A. Saleh, Mustapha M. Dichari, Nijez Aloulou, Omar Hamoui, Feras Chehade
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This study sought to evaluate the efficiency of lead-free sterile radiation shield (Radionex) in the reduction of physician's exposure dose during interventional cardiology procedures. Cardiac catheterization procedures are often associated with high radiation doses and high levels of secondary radiation emitted by the patient's body. This study compares physician exposure dose rate during cardiac catheterization procedures done through the femoral artery with sterile radiation shielding to same procedures made without the shielding. The mean operator radiation dose rate without using the shield was found to be 18.4µSv/min compared to a mean dose rate of 5.1 µSv/min when using the shield, rendering a reduction of 72.5% of radiation received by the physician. Sterile radiation shielding is consequently an effective addition to a cardiac catheterization lab radiation protection system.Keywords: cardiac catheterization, physician exposure dose, sterile radiation shielding, lead-free sterile radiation shields
Procedia PDF Downloads 5139949 The Sustainability of Farm Forestry Management in Bulukumba Regency, South Sulawesi, Indonesia
Authors: Nuraeni, Suryanti, Saida, Annas Boceng
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Farm forestry is a forest where farmers or landowners do cultivation and farming activities on their land. This study aims to determine the dimensions of sustainable development of farm forestry and to analyze the leverage factors to improve the sustainability status of farm forestry management in Bulukumba Regency. This research was conducted in Kajang District, Bulukumba Regency. The analysis of the sustainability of farm forestry management applied Multi-Dimensional Scaling (MDS), a modification of the Rapid Appraisal of The Status of Farming (RAPFARM). The index value of farm forestry sustainability was by 62.01% for ecological dimension, 51.54% for economic dimension, 61.00% for the social and cultural dimension, and 63.24% for legal and institutional dimension with sustainable enough category status. Meanwhile, the index value for the technology and infrastructure was by 47.16% of less sustainable category status. The result of leverage analysis of attributes for the dimensions of ecological, economic, social and cultural, legal and institutional as well as infrastructure and technology afforded twenty-two (22) leverage sensitive factors that influence the sustainability of farm forestry.Keywords: farm forestry, South Sulawesi, management, sustainability
Procedia PDF Downloads 3679948 Hybrid Model for Measuring the Hedge Strategy in Exchange Risk in Information Technology Industry
Authors: Yi-Hsien Wang, Fu-Ju Yang, Hwa-Rong Shen, Rui-Lin Tseng
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The business is notably related to the market risk according to the increase of liberalization of financial markets. Hence, the company usually utilized high financial leverage of derivatives to hedge the risk. When the company choose different hedging instruments to face a variety of exchange rate risk, we employ the Multinomial Logistic-AHP to analyze the impact of various derivatives. Hence, the research summarized the literature on relevant factors affecting managers selected exchange rate hedging instruments, using Multinomial Logistic Model and and further integrate AHP. Using Experts’ Questionnaires can test multi-level selection and hedging effect of different hedging instruments in order to calculate the hedging instruments and the multi-level factors of weights to understand the gap between the empirical results and practical operation. Finally, the Multinomial Logistic-AHP Model will sort the weights to analyze. The research findings can be a basis reference for investors in decision-making.Keywords: exchange rate risk, derivatives, hedge, multinomial logistic-AHP
Procedia PDF Downloads 4429947 Designing Inventory System with Constrained by Reducing Ordering Cost, Lead Time and Lost Sale Rate and Considering Random Disturbance in Ordering Quantity
Authors: Arezoo Heidary, Abolfazl Mirzazadeh, Aref Gholami-Qadikolaei
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In the business environment it is very common that a lot received may not be equal to quantity ordered. in this work, a random disturbance in a received quantity is considered. It is assumed a maximum allowable limit for storage space and inventory investment.The impact of lead time and ordering cost reductions once they act dependently is also investigated. Further, considering a mixture of back order and lost sales for allowable shortage system, the effect of investment on reducing lost sale rate is analyzed. For the proposed control system, a Lagrangian method is applied in order to solve the problem and an algorithmic procedure is utilized to achieve optimal solution with the global minimum expected cost. Finally, proves on concavity and convexity of the model in the decision variables are shown.Keywords: stochastic inventory system, lead time, ordering cost, lost sale rate, inventory constraints, random disturbance
Procedia PDF Downloads 4199946 Association of the Time in Targeted Blood Glucose Range of 3.9–10 Mmol/L with the Mortality of Critically Ill Patients with or without Diabetes
Authors: Guo Yu, Haoming Ma, Peiru Zhou
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BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality
Procedia PDF Downloads 2229945 Bit Error Rate Performance of MIMO Systems for Wireless Communications
Authors: E. Ghayoula, M. Haj Taieb, A. Bouallegue, J. Y. Chouinard, R. Ghayoula
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This paper evaluates the bit error rate (BER) performance of MIMO systems for wireless communication. MIMO uses multiple transmitting antennas, multiple receiving antennas and the space-time block codes to provide diversity. MIMO transmits signal encoded by space-time block (STBC) encoder through different transmitting antennas. These signals arrive at the receiver at slightly different times. Spatially separated multiple receiving antennas are employed to provide diversity reception to combat the effect of fading in the channel. This paper presents a detailed study of diversity coding for MIMO systems. STBC techniques are implemented and simulation results in terms of the BER performance with varying number of MIMO transmitting and receiving antennas are presented. Our results show how increasing the number of both transmit and receive antenna improves system performance and reduces the bit error rate.Keywords: MIMO systems, diversity, BER, MRRC, SIMO, MISO, STBC, alamouti, SNR
Procedia PDF Downloads 4909944 The Prevalence of Obesity among a Huge Sample of 5-20 Years Old Jordanian Children and Adolescents Based on CDC Criteria
Authors: Walid Al-Qerem, Ruba Zumot
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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.Keywords: CDC, obesity, childhood, Jordan
Procedia PDF Downloads 579943 The Optimization of Immobilization Conditions for Biohydrogen Production from Palm Industry Wastewater
Authors: A. W. Zularisam, Sveta Thakur, Lakhveer Singh, Mimi Sakinah Abdul Munaim
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Clostridium sp. LS2 was immobilised by entrapment in polyethylene glycol (PEG) gel beads to improve the biohydrogen production rate from palm oil mill effluent (POME). We sought to explore and optimise the hydrogen production capability of the immobilised cells by studying the conditions for cell immobilisation, including PEG concentration, cell loading and curing times, as well as the effects of temperature and K2HPO4 (500–2000 mg/L), NiCl2 (0.1–5.0 mg/L), FeCl2 (100–400 mg/L) MgSO4 (50–200 mg/L) concentrations on hydrogen production rate. The results showed that by optimising the PEG concentration (10% w/v), initial biomass (2.2 g dry weight), curing time (80 min) and temperature (37 °C), as well as the concentrations of K2HPO4 (2000 mg/L), NiCl2 (1 mg/L), FeCl2 (300 mg/L) and MgSO4 (100 mg/L), a maximum hydrogen production rate of 7.3 L/L-POME/day and a yield of 0.31 L H2/g chemical oxygen demand were obtained during continuous operation. We believe that this process may be potentially expanded for sustained and large-scale hydrogen production.Keywords: hydrogen, polyethylene glycol, immobilised cell, fermentation, palm oil mill effluent
Procedia PDF Downloads 2719942 Association between Dental Caries and Asthma among 12-15 Years Old School Children Studying in Karachi, Pakistan: A Cross Sectional Study
Authors: Wajeeha Zahid, Shafquat Rozi, Farhan Raza, Masood Kadir
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Background: Dental caries affects the overall health and well-being of children. Findings from various international studies regarding the association of dental caries with asthma are inconsistent. With the increasing burden of caries and childhood asthma, it becomes imperative for an underdeveloped country like Pakistan where resources are limited to identify whether there is a relationship between the two. This study aims to identify an association between dental caries and asthma. Methods: A cross-sectional study was conducted on 544 children aged 12-15 years recruited from five private schools in Karachi. Information on asthma was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The questionnaire addressed questions regarding child’s demographics, physician diagnoses of asthma, type of medication administered, family history of asthma and allergies, dietary habits and oral hygiene behavior. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth) index The data was analyzed using Cox proportional Hazard algorithm and crude and adjusted prevalence ratios with 95% CI were reported. Results: This study comprises of 306 (56.3%) boys and 238 (43.8%) girls. The mean age of children was 13.2 ± (0.05) years. The total number of children with carious teeth (DMFT > 0) were 166/544 (30.5%), and the decayed component contributed largely (22.8%) to the DMFT score. The prevalence of physician’s diagnosed asthma was 13%. This study identified almost 7% asthmatic children using the internationally validated International Study of Asthma and Allergies in Childhood (ISAAC) tool and 8 children with childhood asthma were identified by parent interviews. Overall prevalence of asthma was 109/544 (20%). The prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. The adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.59-1.29). After adjusting for carious food intake, age, oral hygiene index and dentist visit, the association between asthma and dental caries turned out to be non-significant. Conclusion: There was no association between asthma and dental caries among children who participated in this study.Keywords: asthma, caries, children, school-based
Procedia PDF Downloads 2469941 Investigation of Delivery of Triple Play Service in GE-PON Fiber to the Home Network
Authors: Anurag Sharma, Dinesh Kumar, Rahul Malhotra, Manoj Kumar
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Fiber based access networks can deliver performance that can support the increasing demands for high speed connections. One of the new technologies that have emerged in recent years is Passive Optical Networks. This paper is targeted to show the simultaneous delivery of triple play service (data, voice and video). The comparative investigation and suitability of various data rates is presented. It is demonstrated that as we increase the data rate, number of users to be accommodated decreases due to increase in bit error rate.Keywords: BER, PON, TDMPON, GPON, CWDM, OLT, ONT
Procedia PDF Downloads 7339940 Utilization Of Medical Plants Tetrastigma glabratum (Blume) Planch from Mount Prau in the Blumah, Central Java
Authors: A. Lianah, B. Peter Sopade, C. Krisantini
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Walikadep/Tetrastigma glabratum (Blume) Planch is a traditional herb that has been used by people of Blumah village; it is believed to have a stimulant effect and ailments for many illnesses. Our survey demonstrated that the people of Blumah village has exploited walikadep from Protected Forest of Mount Prau. More than 10% of 448 households at Blumah village have used walikadep as traditional herb or jamu. Part of the walikadep plants used is the liquid extract of the stem. The population of walikadep is getting scarce and it is rarely found now. The objectives of this study are to examine the stimulant effect of walikadep, to measure growth and exploitation rate of walikadep, and to find ways to effectively propagate the plants, as well as identifying the impact on the environment through field experiments and explorative survey. Stimulant effect was tested using open-field and hole-board test. Data were collected through field observation and experiment, and data were analysed using lab test and Anova. Rate of exploitation and plant growth was measured using Regression analysis; comparison of plant growth in-situ and ex-situ used descriptive analysis. The environmental impact was measured by population structure vegetation analysis method by Shannon Weinner. The study revealed that the walikadep exudates did not have a stimulant effect. Exploitation of walikadep and the long time required to reach harvestable size resulted in the scarcity of the plant in the natural habitat. Plant growth was faster in-situ than ex-situ; and fast growth was obtained from middle part cuttings treated with vermicompost. Biodiversity index after exploitation was higher than before exploitation, possibly due to the toxic and allellopathic effect (phenolics) of the plant. Based on these findings, further research is needed to examine the toxic effects of the leave and stem extract of walikadep and their allelopathic effects. We recommend that people of Blumah village to stop using walikadep as the stimulant. The local people, village government in the regional and central levels, and perhutani should do an integrated efforts to conserve walikadep through Pengamanan Terpadu Konservasi Walikadep Lestari (PTKWL) program, so this population of this plant in the natural habitat can be maintained.Keywords: utilization, medical plants, traditional, Tetastigma glabratum
Procedia PDF Downloads 2809939 Inflation and Unemployment Rates as Indicators of the Transition European Union Countries Monetary Policy Orientation
Authors: Elza Jurun, Damir Piplica, Tea Poklepović
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Numerous studies carried out in the developed western democratic countries have shown that the ideological framework of the governing party has a significant influence on the monetary policy. The executive authority consisting of a left-wing party gives a higher weight to unemployment suppression and central bank implements a more expansionary monetary policy. On the other hand, right-wing governing party considers the monetary stability to be more important than unemployment suppression and in such a political framework the main macroeconomic objective becomes the inflation rate reduction. The political framework conditions in the transition countries which are new European Union (EU) members are still highly specific in relation to the other EU member countries. In the focus of this paper is the question whether the same monetary policy principles are valid in these transitional countries as well as they apply in developed western democratic EU member countries. The data base consists of inflation rate and unemployment rate for 11 transitional EU member countries covering the period from 2001 to 2012. The essential information for each of these 11 countries and for each year of the observed period is right or left political orientation of the ruling party. In this paper we use t-statistics to test our hypothesis that there are differences in inflation and unemployment between right and left political orientation of the governing party. To explore the influence of different countries, through years and different political orientations descriptive statistics is used. Inflation and unemployment should be strongly negatively correlated through time, which is tested using Pearson correlation coefficient. Regarding the fact whether the governing authority is consisted from left or right politically oriented parties, monetary authorities will adjust its policy setting the higher priority on lower inflation or unemployment reduction.Keywords: inflation rate, monetary policy orientation, transition EU countries, unemployment rate
Procedia PDF Downloads 4409938 Experimental Study of CO₂ Hydrate Formation in Presence of Different Promotors
Authors: Samaneh Soroush, Tommy Golczynski, Tony Spratt
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One of the new technologies for CO₂ capture, storage, and utilization (CCSU) is forming clathrate hydrate. This technology has some unknowns and challenges that make it difficult to apply in the real world. The low formation rate is one of the main difficulties of CO₂ hydrate. In this work, the effect of different promotors on the hydrate formation rate has been studied. Two surfactants, sodium dodecyl sulfate (SDS), tetra-n-butylammonium bromide (TBAB), and cyclopentane (CP) as a thermodynamic promotor and their combination have been used for the experiments. The results showed that the SDS is a powerful kinetic promotor and its combination with CP helps to convert more CO₂ to hydrate in a short time.Keywords: carbon capture, carbon dioxide, hydrate, promotor
Procedia PDF Downloads 2559937 Investigating the Aerosol Load of Eastern Mediterranean Basin with Sentinel-5p Satellite
Authors: Deniz Yurtoğlu
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Aerosols directly affect the radiative balance of the earth by absorbing and/or scattering the sun rays reaching the atmosphere and indirectly affect the balance by acting as a nucleus in cloud formation. The composition, physical, and chemical properties of aerosols vary depending on their sources and the time spent in the atmosphere. The Eastern Mediterranean Basin has a high aerosol load that is formed from different sources; such as anthropogenic activities, desert dust outbreaks, and the spray of sea salt; and the area is subjected to atmospheric transport from other locations on the earth. This region, which includes the deserts of Africa, the Middle East, and the Mediterranean sea, is one of the most affected areas by climate change due to its location and the chemistry of the atmosphere. This study aims to investigate the spatiotemporal deviation of aerosol load in the Eastern Mediterranean Basin between the years 2018-2022 with the help of a new pioneer satellite of ESA (European Space Agency), Sentinel-5P. The TROPOMI (The TROPOspheric Monitoring Instrument) traveling on this low-Earth orbiting satellite is a UV (Ultraviolet)-sensing spectrometer with a resolution of 5.5 km x 3.5 km, which can make measurements even in a cloud-covered atmosphere. By using Absorbing Aerosol Index data produced by this spectrometer and special scripts written in Python language that transforms this data into images, it was seen that the majority of the aerosol load in the Eastern Mediterranean Basin is sourced from desert dust and anthropogenic activities. After retrieving the daily data, which was separated from the NaN values, seasonal analyses match with the normal aerosol variations expected, which are high in warm seasons and lower in cold seasons. Monthly analyses showed that in four years, there was an increase in the amount of Absorbing Aerosol Index in spring and winter by 92.27% (2019-2021) and 39.81% (2019-2022), respectively. On the other hand, in the summer and autumn seasons, a decrease has been observed by 20.99% (2018-2021) and 0.94% (2018-2021), respectively. The overall variation of the mean absorbing aerosol index from TROPOMI between April 2018 to April 2022 reflects a decrease of 115.87% by annual mean from 0.228 to -0.036. However, when the data is analyzed by the annual mean values of the years which have the data from January to December, meaning from 2019 to 2021, there was an increase of 57.82% increase (0.108-0.171). This result can be interpreted as the effect of climate change on the aerosol load and also, more specifically, the effect of forest fires that happened in the summer months of 2021.Keywords: aerosols, eastern mediterranean basin, sentinel-5p, tropomi, aerosol index, remote sensing
Procedia PDF Downloads 679936 Increased Availability and Accessibility of Family Planning Services: An Approach Leading to Improved Contraceptive Uptake and Reproductive Behavior of Women Living in Pakistan
Authors: Lutaf Ali, Haris Ahmed, Hina Najmi
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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.Keywords: access, family planning, underserved population, socio-demographic facts
Procedia PDF Downloads 2039935 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children
Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul
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Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.Keywords: children, diabetes, metabolic control, periodontal therapy
Procedia PDF Downloads 1619934 Weed Out the Bad Seeds: The Impact of Strategic Portfolio Management on Patent Quality
Authors: A. Lefebre, M. Willekens, K. Debackere
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Since the 1990s, patent applications have been booming, especially in the field of telecommunications. However, this increase in patent filings has been associated with an (alleged) decrease in patent quality. The plethora of low-quality patents devalues the high-quality ones, thus weakening the incentives for inventors to patent inventions. Despite the rich literature on strategic patenting, previous research has neglected to emphasize the importance of patent portfolio management and its impact on patent quality. In this paper, we compare related patent portfolios vs. nonrelated patents and investigate whether the patent quality and innovativeness differ between the two types. In the analyses, patent quality is proxied by five individual proxies (number of inventors, claims, renewal years, designated states, and grant lag), and these proxies are then aggregated into a quality index. Innovativeness is proxied by two measures: the originality and radicalness index. Results suggest that related patent portfolios have, on average, a lower patent quality compared to nonrelated patents, thus suggesting that firms use them for strategic purposes rather than for the extended protection they could offer. Even upon testing the individual proxies as a dependent variable, we find evidence that related patent portfolios are of lower quality compared to nonrelated patents, although not all results show significant coefficients. Furthermore, these proxies provide evidence of the importance of adding fixed effects to the model. Since prior research has found that these proxies are inherently flawed and never fully capture the concept of patent quality, we have chosen to run the analyses with individual proxies as supplementary analyses; however, we stick with the comprehensive index as our main model. This ensures that the results are not dependent upon one certain proxy but allows for multiple views of the concept. The presence of divisional applications might be linked to the level of innovativeness of the underlying invention. It could be the case that the parent application is so important that firms are going through the administrative burden of filing for divisional applications to ensure the protection of the invention and the preemption of competition. However, it could also be the case that the preempting is a result of divisional applications being used strategically as a backup plan and prolonging strategy, thus negatively impacting the innovation in the portfolio. Upon testing the level of novelty and innovation in the related patent portfolios by means of the originality and radicalness index, we find evidence for a significant negative association with related patent portfolios. The minimum innovation that has been brought on by the patents in the related patent portfolio is lower compared to the minimum innovation that can be found in nonrelated portfolios, providing evidence for the second argument.Keywords: patent portfolio management, patent quality, related patent portfolios, strategic patenting
Procedia PDF Downloads 949933 Evaluation of Triage Performance: Nurse Practice and Problem Classifications
Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli
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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.Keywords: assessment, education, nurse, triage
Procedia PDF Downloads 2329932 A Study on the Computation of Gourava Indices for Poly-L Lysine Dendrimer and Its Biomedical Applications
Authors: M. Helen
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Chemical graph serves as a convenient model for any real or abstract chemical system. Dendrimers are novel three dimensional hyper branched globular nanopolymeric architectures. Drug delivery scientists are especially enthusiastic about possible utility of dendrimers as drug delivery tool. Dendrimers like poly L lysine (PLL), poly-propylene imine (PPI) and poly-amidoamine (PAMAM), etc., are used as gene carrier in drug delivery system because of their chemical characteristics. These characteristics of chemical compounds are analysed using topological indices (invariants under graph isomorphism) such as Wiener index, Zagreb index, etc., Prof. V. R. Kulli motivated by the application of Zagreb indices in finding the total π energy and derived Gourava indices which is an improved version over Zagreb indices. In this paper, we study the structure of PLL-Dendrimer that has the following applications: reduction in toxicity, colon delivery, and topical delivery. Also, we determine first and second Gourava indices, first and second hyper Gourava indices, product and sum connectivity Gourava indices for PLL-Dendrimer. Gourava Indices have found applications in Quantitative Structure-Property Relationship (QSPR)/ Quantitative Structure-Activity Relationship (QSAR) studies.Keywords: connectivity Gourava indices, dendrimer, Gourava indices, hyper GouravaG indices
Procedia PDF Downloads 1389931 Thermomechanical Coupled Analysis of Fiber Reinforced Polymer Composite Square Tube: A Finite Element Study
Authors: M. Ali, K. Alam, E. Ohioma
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This paper presents a numerical investigation on the behavior of fiber reinforced polymer composite tubes (FRP) under thermomechanical coupled loading using finite element software ABAQUS and a special add-on subroutine, CZone. Three cases were explored; pure mechanical loading, pure thermal loading, and coupled thermomechanical loading. The failure index (Tsai-Wu) under all three loading cases was assessed for all plies in the tube walls. The simulation results under pure mechanical loading showed that composite tube failed at a tensile load of 3.1 kN. However, with the superposition of thermal load on mechanical load on the composite tube, the failure index of the previously failed plies in tube walls reduced significantly causing the tube to fail at 6 kN. This showed 93% improvement in the load carrying capacity of the composite tube in present study. The increase in load carrying capacity was attributed to the stress effects of the coefficients of thermal expansion (CTE) on the laminate as well as the inter-lamina stresses induced due to the composite stack layup.Keywords: thermal, mechanical, composites, square tubes
Procedia PDF Downloads 3869930 Validation of the Linear Trend Estimation Technique for Prediction of Average Water and Sewerage Charge Rate Prices in the Czech Republic
Authors: Aneta Oblouková, Eva Vítková
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The article deals with the issue of water and sewerage charge rate prices in the Czech Republic. The research is specifically focused on the analysis of the development of the average prices of water and sewerage charge rate in the Czech Republic in the years 1994-2021 and on the validation of the chosen methodology relevant for the prediction of the development of the average prices of water and sewerage charge rate in the Czech Republic. The research is based on data collection. The data for this research was obtained from the Czech Statistical Office. The aim of the paper is to validate the relevance of the mathematical linear trend estimate technique for the calculation of the predicted average prices of water and sewerage charge rates. The real values of the average prices of water and sewerage charge rates in the Czech Republic in the years 1994-2018 were obtained from the Czech Statistical Office and were converted into a mathematical equation. The same type of real data was obtained from the Czech Statistical Office for the years 2019-2021. Prediction of the average prices of water and sewerage charge rates in the Czech Republic in the years 2019-2021 were also calculated using a chosen method -a linear trend estimation technique. The values obtained from the Czech Statistical Office and the values calculated using the chosen methodology were subsequently compared. The research result is a validation of the chosen mathematical technique to be a suitable technique for this research.Keywords: Czech Republic, linear trend estimation, price prediction, water and sewerage charge rate
Procedia PDF Downloads 1209929 Photopolymerization of Dimethacrylamide with (Meth)acrylates
Authors: Yuling Xu, Haibo Wang, Dong Xie
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A photopolymerizable dimethacrylamide was synthesized and copolymerized with the selected (meth)acrylates. The polymerization rate, degree of conversion, gel time, and compressive strength of the formed neat resins were investigated. The results show that in situ photo-polymerization of the synthesized dimethacrylamide with comonomers having an electron-withdrawing and/or acrylate group dramatically increased the polymerization rate, degree of conversion, and compressive strength. On the other hand, an electron-donating group on either carbon-carbon double bond or the ester linkage slowed down the polymerization. In contrast, the triethylene glycol dimethacrylate-based system did not show a clear pattern. Both strong hydrogen-bonding between (meth)acrylamide and organic acid groups may be responsible for higher compressive strengths. Within the limitation of this study, the photo-polymerization of dimethacrylamide can be greatly accelerated by copolymerization with monomers having electron-withdrawing and/or acrylate groups. The monomers with methacrylate group can significantly reduce the polymerization rate and degree of conversion.Keywords: photopolymerization, dimethacrylamide, the degree of conversion, compressive strength
Procedia PDF Downloads 1569928 Principal Component Analysis of Body Weight and Morphometric Traits of New Zealand Rabbits Raised under Semi-Arid Condition in Nigeria
Authors: Emmanuel Abayomi Rotimi
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Context: Rabbits production plays important role in increasing animal protein supply in Nigeria. Rabbit production provides a cheap, affordable, and healthy source of meat. The growth of animals involves an increase in body weight, which can change the conformation of various parts of the body. Live weight and linear measurements are indicators of growth rate in rabbits and other farm animals. Aims: This study aimed to define the body dimensions of New Zealand rabbits and also to investigate the morphometric traits variables that contribute to body conformation by the use of principal component analysis (PCA). Methods: Data were obtained from 80 New Zealand rabbits (40 bucks and 40 does) raised in Livestock Teaching and Research Farm, Federal University Dutsinma. Data were taken on body weight (BWT), body length (BL), ear length (EL), tail length (TL), heart girth (HG) and abdominal circumference (AC). Data collected were subjected to multivariate analysis using SPSS 20.0 statistical package. Key results: The descriptive statistics showed that the mean BWT, BL, EL, TL, HG, and AC were 0.91kg, 27.34cm, 10.24cm, 8.35cm, 19.55cm and 21.30cm respectively. Sex showed significant (P<0.05) effect on all the variables examined, with higher values recorded for does. The phenotypic correlation coefficient values (r) between the morphometric traits were all positive and ranged from r = 0.406 (between EL and BL) to r = 0.909 (between AC and HG). HG is the most correlated with BWT (r = 0.786). The principal component analysis with variance maximizing orthogonal rotation was used to extract the components. Two principal components (PCs) from the factor analysis of morphometric traits explained about 80.42% of the total variance. PC1 accounted for 64.46% while PC2 accounted for 15.97% of the total variances. Three variables, representing body conformation, loaded highest in PC1. PC1 had the highest contribution (64.46%) to the total variance, and it is regarded as body conformation traits. Conclusions: This component could be used as selection criteria for improving body weight of rabbits.Keywords: conformation, multicollinearity, multivariate, rabbits and principal component analysis
Procedia PDF Downloads 1309927 Experimental and CFD Simulation of the Jet Pump for Air Bubbles Formation
Authors: L. Grinis, N. Lubashevsky, Y. Ostrovski
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A jet pump is a type of pump that accelerates the flow of a secondary fluid (driven fluid) by introducing a motive fluid with high velocity into a converging-diverging nozzle. Jet pumps are also known as adductors or ejectors depending on the motivator phase. The ejector's motivator is of a gaseous nature, usually steam or air, while the educator's motivator is a liquid, usually water. Jet pumps are devices that use air bubbles and are widely used in wastewater treatment processes. In this work, we will discuss about the characteristics of the jet pump and the computational simulation of this device. To find the optimal angle and depth for the air pipe, so as to achieve the maximal air volumetric flow rate, an experimental apparatus was constructed to ascertain the best geometrical configuration for this new type of jet pump. By using 3D printing technology, a series of jet pumps was printed and tested whilst aspiring to maximize air flow rate dependent on angle and depth of the air pipe insertion. The experimental results show a major difference of up to 300% in performance between the different pumps (ratio of air flow rate to supplied power) where the optimal geometric model has an insertion angle of 600 and air pipe insertion depth ending at the center of the mixing chamber. The differences between the pumps were further explained by using CFD for better understanding the reasons that affect the airflow rate. The validity of the computational simulation and the corresponding assumptions have been proved experimentally. The present research showed high degree of congruence with the results of the laboratory tests. This study demonstrates the potential of using of the jet pump in many practical applications.Keywords: air bubbles, CFD simulation, jet pump, applications
Procedia PDF Downloads 2439926 Analyzing the Street Pattern Characteristics on Young People’s Choice to Walk or Not: A Study Based on Accelerometer and Global Positioning Systems Data
Authors: Ebru Cubukcu, Gozde Eksioglu Cetintahra, Burcin Hepguzel Hatip, Mert Cubukcu
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Obesity and overweight cause serious health problems. Public and private organizations aim to encourage walking in various ways in order to cope with the problem of obesity and overweight. This study aims to understand how the spatial characteristics of urban street pattern, connectivity and complexity influence young people’s choice to walk or not. 185 public university students in Izmir, the third largest city in Turkey, participated in the study. Each participant had worn an accelerometer and a global positioning (GPS) device for a week. The accelerometer device records data on the intensity of the participant’s activity at a specified time interval, and the GPS device on the activities’ locations. Combining the two datasets, activity maps are derived. These maps are then used to differentiate the participants’ walk trips and motor vehicle trips. Given that, the frequency of walk and motor vehicle trips are calculated at the street segment level, and the street segments are then categorized into two as ‘preferred by pedestrians’ and ‘preferred by motor vehicles’. Graph Theory-based accessibility indices are calculated to quantify the spatial characteristics of the streets in the sample. Six different indices are used: (I) edge density, (II) edge sinuosity, (III) eta index, (IV) node density, (V) order of a node, and (VI) beta index. T-tests show that the index values for the ‘preferred by pedestrians’ and ‘preferred by motor vehicles’ are significantly different. The findings indicate that the spatial characteristics of the street network have a measurable effect on young people’s choice to walk or not. Policy implications are discussed. This study is funded by the Scientific and Technological Research Council of Turkey, Project No: 116K358.Keywords: graph theory, walkability, accessibility, street network
Procedia PDF Downloads 2259925 Effect of Enterprise Digital Transformation on Enterprise Growth: Theoretical Logic and Chinese Experience
Authors: Bin Li
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In the era of the digital economy, digital transformation has gradually become a strategic choice for enterprise development, but there is a relative lack of systematic research from the perspective of enterprise growth. Based on the sample of Chinese A-share listed companies from 2011 to 2021, this paper constructs A digital transformation index system and an enterprise growth composite index to empirically test the impact of enterprise digital transformation on enterprise growth and its mechanism. The results show that digital transformation can significantly promote corporate growth. The mechanism analysis finds that reducing operating costs, optimizing human capital structure, promoting R&D output and improving digital innovation capability play an important intermediary role in the process of digital transformation promoting corporate growth. At the same time, the level of external digital infrastructure and the strength of organizational resilience play a positive moderating role in the process of corporate digital transformation promoting corporate growth. In addition, while further analyzing the heterogeneity of enterprises, this paper further deepens the analysis of the driving factors and digital technology support of digital transformation, as well as the three dimensions of enterprise growth, thus deepening the research depth of enterprise digital transformation.Keywords: digital transformation, enterprise growth, digital technology, digital infrastructure, organization resilience, digital innovation
Procedia PDF Downloads 619924 Alterations of Gut Microbiota and Its Metabolomics in Child with 6PPDQ, PBDE, PCB, and Metal (Loid) Exposure
Authors: Xia Huo
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The composition and metabolites of the gut microbiota can be altered by environmental pollutants. However, the effect of co-exposure to multiple pollutants on the human gut microbiota has not been sufficiently studied. In this study, gut microorganisms and their metabolites were compared between 33 children from Guiyu and 34 children from Haojiang. The exposure level was assessed by estimating the daily intake (EDI) of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), 6PPD-quinone (6PPDQ), and metal(loid)s in dust. Significant correlations were found between the EDIs of 6PPDQ, BDE28, PCB52, Ni, Cu, and both the alpha diversity index and specific metabolites in single-element models. The study found that the Bayesian kernel machine regression (BKMR) model showed a negative correlation between the EDIs of five pollutants (6PPDQ, BDE28, PCB52, Ni, and Cu) and the Chao 1 index, particularly beyond the 55th percentile. Furthermore, the EDIs of these five pollutants were positively correlated with the levels of the metabolite 2,4-diaminobutyric acid while negatively correlated with the levels of d-erythro-sphingosine and d-threitol. Our research suggests that exposure to 6PPDQ, BDE28, PCB52, Ni, and Cu in kindergarten dust is associated with alterations in the gut microbiota and its metabolites. These alterations may be associated with neurodevelopmental abnormalities in children.Keywords: gut microbiota, 6PPDQ, PBDEs, PCBs, metal(loid)s, BKMR
Procedia PDF Downloads 569923 Effect of Plant Density and Planting Pattern on Yield and Quality of Single Cross 704 Silage Corn (Zea mays L.) in Isfahan
Authors: Seyed Mohammad Ali Zahedi
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This field experiment was conducted in Isfahan in 2011 in order to study the effect of plant density and planting pattern on growth, yield and quality of silage corn (SC 704) using a randomized complete block design with split plot layout and four replications. The main plot consisted of three planting patterns (60 and 75 cm single planting row and 75 cm double planting row referred to as 60S, 75S and 75T, respectively). The subplots consisted of four levels of plant densities (65000, 80000, 95000 and 110000 plants per hectare). Each subplot consisted of 7 rows, each with 10m length. Vegetative and reproductive characteristics of plants at silking and hard dough stages (when the plants were harvested for silage) were evaluated. Results of variance analysis showed that the effects of planting pattern and plant density were significant on leaf area per plant, leaf area index (at silking), plant height, stem diameter, dry weights of leaf, stem and ear in silking and harvest stages and on fresh and dry yield, dry matter percentage and crude protein percentage at harvest. There was no planting pattern × plant density interaction for these parameters. As row space increased from 60 cm with single planting to 75 cm with single planting, leaf area index and plant height increased, but leaf area per plant, stem diameter, dry weight of leaf, stem and ear, dry matter percentage, dry matter yield and crude protein percentage decreased. Dry matter yield reduced from 24.9 to 18.5 t/ha and crude protein percentage decreased from 6.11 to 5.60 percent. When the plant density increased from 65000 to 110000 plant per hectare, leaf area index, plant height, dry weight of leaf, stem and ear and dry matter yield increased from 19.2 to 23.3 t/ha, whereas leaf area per plant, stem diameter, dry matter percentage and crude protein percentage decreased from 6.30 to 5.25. The best results were obtained with 60 cm row distance with single planting and 110000 plants per hectare.Keywords: silage corn, plant density, planting pattern, yield
Procedia PDF Downloads 3389922 The Effect of Corporate Governance to Islamic Banking Performance Using Maqasid Index Approach in Indonesia
Authors: Audia Syafa'atur Rahman, Rozali Haron
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The practices of Islamic banking are more attuned to the goals of profit maximization rather than obtaining ethical profit. Ethical profit is obtained from interest-free earnings and to give an impact which benefits to the growth of society and economy. Good corporate governance practices are needed to assure the sustainability of Islamic banks in order to achieve Maqasid Shariah with the main purpose of boosting the well-being of people. The Maqasid Shariah performance measurement is used to measure the duties and responsibilities expected to be performed by Islamic banks. It covers not only unification dimension like financial measurement, but also many dimensions covered to reflect the main purpose of Islamic banks. The implementation of good corporate governance is essential because it covers the interests of the stakeholders and facilitates effective monitoring to encourage Islamic banks to utilize resources more efficiently in order to achieve the Maqasid Shariah. This study aims to provide the empirical evidence on the Maqasid performance of Islamic banks in relation to the Maqasid performance evaluation model, to examine the influence of SSB characteristics and board structures to Islamic Banks performance as measured by Maqasid performance evaluation model. By employing the simple additive weighting method, Maqasid index for all the Islamic Banks in Indonesia within 2012 to 2016 ranged from above 11% to 28%. The Maqasid Syariah performance index where results reached above 20% are obtained by Islamic Banks such as Bank Muamalat Indonesia, Bank Panin Syariah, and Bank BRI Syariah. The consistent achievement above 23% is achieved by BMI. Other Islamic Banks such as Bank Victoria Syariah, Bank Jabar Banten Syariah, Bank BNI Syariah, Bank Mega Syariah, BCA Syariah, and Maybank Syariah Indonesia shows a fluctuating value of the Maqasid performance index every year. The impact of SSB characteristics and board structures are tested using random-effects generalized least square. The findings indicate that SSB characteristics (Shariah Supervisory Board size, Shariah Supervisory Board cross membership, Shariah Supervisory Board Education, and Shariah Supervisory Board reputation) and board structures (Board size and Board independence) have an essential role in improving the performance of Islamic Banks. The findings denote Shariah Supervisory Board with smaller size, higher portion of Shariah Supervisory Board cross membership; lesser Shariah Supervisory Board holds doctorate degree, lesser reputable scholar, more members on board of directors, and less independence non-executive directors will enhance the performance of Islamic Banks.Keywords: Maqasid Shariah, corporate governance, Islamic banks, Shariah supervisory board
Procedia PDF Downloads 2409921 Experimental Investigation of Heat Pipe with Annular Fins under Natural Convection at Different Inclinations
Authors: Gangacharyulu Dasaroju, Sumeet Sharma, Sanjay Singh
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Heat pipe is characterised as superconductor of heat because of its excellent heat removal ability. The operation of several engineering system results in generation of heat. This may cause several overheating problems and lead to failure of the systems. To overcome this problem and to achieve desired rate of heat dissipation, there is need to study the performance of heat pipe with annular fins under free convection at different inclinations. This study demonstrates the effect of different mass flow rate of hot fluid into evaporator section on the condenser side heat transfer coefficient with annular fins under natural convection at different inclinations. In this study annular fins are used for the experimental work having dimensions of length of fin, thickness of fin and spacing of fin as 10 mm, 1 mm and 6 mm, respectively. The main aim of present study is to discover at what inclination angles the maximum heat transfer coefficient shall be achieved. The heat transfer coefficient on the external surface of heat pipe condenser section is determined by experimental method and then predicted by empirical correlations. The results obtained from experimental and Churchill and Chu relation for laminar are in fair agreement with not more than 22% deviation. It is elucidated the maximum heat transfer coefficient of 31.2 W/(m2-K) at 25˚ tilt angle and minimal condenser heat transfer coefficient of 26.4 W/(m2-K) is seen at 45˚ tilt angle and 200 ml/min mass flow rate. Inclination angle also affects the thermal performance of heat pipe. Beyond 25o inclination, heat transport rate starts to decrease.Keywords: heat pipe, annular fins, natural convection, condenser heat transfer coefficient, tilt angle
Procedia PDF Downloads 154