Search results for: integrated audit quality model

Authors: Merav Ben Natan, May Revach, Or Sade, Yaniv Yonay, Yaron Berkovich

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Background: The inclusion of nurse practitioners (NPs) specializing in orthopedics holds promise for enhancing the quality of care for orthopedic patients. Understanding patients’ perspectives on this role is crucial for evaluating the feasibility and acceptance of integrating NPs into orthopedic settings. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic NPs and examines potential associations between patients’ willingness to engage with NPs, their familiarity with the NP role, perceptions of nursing, and satisfaction with orthopedic nursing care. Methods: This cross-sectional study involved patients admitted to an orthopedic department at a central Israeli hospital between January and February 2023. Data was collected using a validated questionnaire consisting of five sections, reviewed by content experts. Statistical analyses were conducted using SPSS and included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression. Results: Participants in the study showed a moderate willingness to receive treatment from orthopedic NPs, with more than two-thirds expressing strong openness. Patients were generally receptive to NPs performing various clinical tasks, though there was less enthusiasm for NPs’ involvement in medication management and preoperative evaluations. Positive attitudes towards nurses and familiarity with the NP role were significant predictors of patient receptiveness to NP treatment. Conclusion: Patient acceptance of orthopedic NPs varies across different aspects of care. While there is a general willingness to receive care from NPs, these nuanced preferences must be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions of the NP role play crucial roles in shaping patients’ willingness to engage with NPs.

Keywords: orthopedic nurse practitioners, patient receptiveness, perceptions of nursing, clinical tasks

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Authors: Ross Calvert, Colin Whittaker, Alison Raby, Alistair G. L. Borthwick, Ton S. van den Bremer

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Large concentrations of plastic have polluted the seas in the last half century, with harmful effects on marine wildlife and potentially to human health. Plastic pollution will have lasting effects because it is expected to take hundreds or thousands of years for plastic to decay in the ocean. The question arises how waves transport plastic in the ocean. The predominant motion induced by waves creates ellipsoid orbits. However, these orbits do not close, resulting in a drift. This is defined as Stokes drift. If a particle is infinitesimally small and the same density as water, it will behave exactly as the water does, i.e., as a purely Lagrangian tracer. However, as the particle grows in size or changes density, it will behave differently. The particle will then have its own inertia, the fluid will exert drag on the particle, because there is relative velocity, and it will rise or sink depending on the density and whether it is on the free surface. Previously, plastic pollution has all been considered to be purely Lagrangian. However, the steepness of waves in the ocean is small, normally about α = k₀a = 0.1 (where k₀ is the wavenumber and a is the wave amplitude), this means that the mean drift flows are of the order of ten times smaller than the oscillatory velocities (Stokes drift is proportional to steepness squared, whilst the oscillatory velocities are proportional to the steepness). Thus, the particle motion must have the forces of the full motion, oscillatory and mean flow, as well as a dynamic buoyancy term to account for the free surface, to determine whether inertia is important. To track the motion of a floating inertial particle under wave action requires the fluid velocities, which form the forcing, and the full equations of motion of a particle to be solved. Starting with the equation of motion of a sphere in unsteady flow with viscous drag. Terms can added then be added to the equation of motion to better model floating plastic: a dynamic buoyancy to model a particle floating on the free surface, quadratic drag for larger particles and a slope sliding term. Using perturbation methods to order the equation of motion into sequentially solvable parts allows a parametric equation for the transport of inertial finite-sized floating particles to be derived. This parametric equation can then be validated using numerical simulations of the equation of motion and flume experiments. This paper presents a parametric equation for the transport of inertial floating finite-size particles by ocean waves. The equation shows an increase in Stokes drift for larger, less dense particles. The equation has been validated using numerical solutions of the equation of motion and laboratory flume experiments. The difference in the particle transport equation and a purely Lagrangian tracer is illustrated using worlds maps of the induced transport. This parametric transport equation would allow ocean-scale numerical models to include inertial effects of floating plastic when predicting or tracing the transport of pollutants.

Keywords: perturbation methods, plastic pollution transport, Stokes drift, wave flume experiments, wave-induced mean flow

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Authors: Eshta Ranyal, Kamal Jain, Vikrant Ranyal

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Potholes are a severe threat to road safety and a major contributing factor towards road distress. In the Indian context, they are a major road hazard. Timely detection of potholes and subsequent repair can prevent the roads from deteriorating. To facilitate the roadway authorities in the timely detection and repair of potholes, we propose a pothole detection methodology using convolutional neural networks. The YOLOv3 model is used as it is fast and accurate in comparison to other state-of-the-art models. You only look once v3 (YOLOv3) is a state-of-the-art, real-time object detection system that features multi-scale detection. A mean average precision(mAP) of 73% was obtained on a training dataset of 200 images. The dataset was then increased to 500 images, resulting in an increase in mAP. We further calculated the depth of the potholes using stereoscopic vision by reconstruction of 3D potholes. This enables calculating pothole volume, its extent, which can then be used to evaluate the pothole severity as low, moderate, high.

Keywords: CNN, pothole detection, pothole severity, YOLO, stereovision

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Authors: Muhammad Karim Ahmadzai

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Floods are natural phenomena and are an integral part of the water cycle. The majority of them are the result of climatic conditions, but are also affected by the geology and geomorphology of the area, topography and hydrology, the water permeability of the soil and the vegetation cover, as well as by all kinds of human activities and structures. However, from the moment that human lives are at risk and significant economic impact is recorded, this natural phenomenon becomes a natural disaster. Flood management is now a key issue at regional and local levels around the world, affecting human lives and activities. The majority of floods are unlikely to be fully predicted, but it is feasible to reduce their risks through appropriate management plans and constructions. The aim of this Case Study is to identify, and map areas of flood risk in the Khinch District of Panjshir Province, Afghanistan specifically in the area of Peshghore, causing numerous damages. The main purpose of this study is to evaluate the contribution of remote sensing technology and Geographic Information Systems (GIS) in assessing the susceptibility of this region to flood events. Panjsher is facing Seasonal floods and human interventions on streams caused floods. The beds of which have been trampled to build houses and hotels or have been converted into roads, are causing flooding after every heavy rainfall. The streams crossing settlements and areas with high touristic development have been intensively modified by humans, as the pressure for real estate development land is growing. In particular, several areas in Khinch are facing a high risk of extensive flood occurrence. This study concentrates on the construction of a flood susceptibility map, of the study area, by combining vulnerability elements, using the Analytical Hierarchy Process/ AHP. The Analytic Hierarchy Process, normally called AHP, is a powerful yet simple method for making decisions. It is commonly used for project prioritization and selection. AHP lets you capture your strategic goals as a set of weighted criteria that you then use to score projects. This method is used to provide weights for each criterion which Contributes to the Flood Event. After processing of a digital elevation model (DEM), important secondary data were extracted, such as the slope map, the flow direction and the flow accumulation. Together with additional thematic information (Landuse and Landcover, topographic wetness index, precipitation, Normalized Difference Vegetation Index, Elevation, River Density, Distance from River, Distance to Road, Slope), these led to the final Flood Risk Map. Finally, according to this map, the Priority Protection Areas and Villages and the structural and nonstructural measures were demonstrated to Minimize the Impacts of Floods on residential and Agricultural areas.

Keywords: flood hazard, flood risk map, flood mitigation measures, AHP analysis

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Authors: Changshan Zhang, Zhijin Yu, Shixing Fan

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A comprehensive hazard evaluation for coal self-heating in composite long-wall gobs is heavily dependent on computational simulation. In this study, the spatial distributions of cracks which caused significant air leakage were simulated by universal distinct element code (UDEC) simulation. Based on the main routes of air leakage and characteristics of coal self-heating, a computational fluid dynamics (CFD) modeling was conducted to model the coal spontaneous combustion dangerous area in composite long-wall gobs. The results included the oxygen concentration distributions and temperature profiles showed that the numerical approach is validated by comparison with the test data. Furthermore, under the conditions of specific engineering, the major locations where some techniques for extinguishing and preventing long-wall gob fires need to be put into practice were also examined.

Keywords: computational simulation, UDEC simulation, coal self-heating, CFD modeling, long-wall gobs

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Authors: C. Mothobiso, D. Root

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Purpose: This study attempts to identify the clients’ main priorities when delivering green projects. The aim is to compare if the clients have the same interest that are similar in delivery of convectional buildings as compared to green buildings. The main purpose is to find why other clients are investing in green buildings while others are reluctant and adopting green building at a slow pace. Design/methodology/approach: A sample of construction professional accredited by the Green Building Council of South Africa (GBCSA) was sent a questionnaire to participate in the research. Since GBSCSA accredited professionals have knowledge and experience about the green buildings, they are chosen as the sample. The research is qualitative because it evaluates the perceptions and knowledge around the subject matter. Research limitations: The research focuses only on the South African construction clients. Findings: Findings reveal that private clients invest more on green buildings as compared to government and parastatal entities. Private clients prioritise on maximising returns on investments and they mainly invest on buildings that save energies and have low life cycle costs. Private clients are perceived to be more knowledgeable about the benefits of green building project as compared to government and Parastatals clients. Shortage of expertise and managerial skill leads to low adaptation of green buildings in the government and parastatal projects. Other factors, which seem to disintegrate the adoption of green buildings, are the readiness of supply chain within the industry and inappropriate procurements strategies adopted by clients. The evaluation of the clients’ priorities will enable the design team to come up with innovative ways to approach the design process so that clients’ priorities and needs are identified and met. Practical implications: The findings are indicating that clients’ needs and priorities have a huge impact on the delivery of the project in terms of time, quality and cost of the project.

Keywords: construction clients, design team, green construction and project deliver

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Authors: S. P. Koko, K. Kusakana, H. J. Vermaak

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Standalone micro-hydrokinetic river (MHR) system is one of the promising technologies to be used for remote rural electrification. It simply requires the flow of water instead of elevation or head, leading to expensive civil works. This paper demonstrates an economic benefit offered by a standalone MHR system when compared to the commonly used standalone systems such as solar, wind and diesel generator (DG) at the selected study site in Kwazulu Natal. Wind speed and solar radiation data of the selected rural site have been taken from national aeronautics and space administration (NASA) surface meteorology database. The hybrid optimization model for electric renewable (HOMER) software was used to determine the most feasible solution when using MHR, solar, wind or DG system to supply 5 rural houses. MHR system proved to be the best cost-effective option to consider at the study site due to its low cost of energy (COE) and low net present cost (NPC).

Keywords: economic analysis, micro-hydrokinetic, rural-electrification, cost of energy (COE), net present cost (NPC)

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Authors: Tristance Kee

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With the unprecedented increase in elderly population globally, it is critical to search for new sustainable housing and urban development alternatives to traditional housing options. This research examines concepts of elderly migration pattern in the context of a high density city in Hong Kong to Mainland China. The research objectives are to: 1) explore the relationships between soon-to-be-old elderly and their intentions to move to Mainland upon retirement and their demographic characteristics; and 2) What are the desired amenities, locational factors and activities that are expected in the soon-to-be-old generation’s retirement housing environment? Primary data was collected through questionnaire survey conducted using random sampling method with respondents aged between 45-64 years old. The face-to-face survey was completed by 500 respondents. The survey was divided into four sections. The first section focused on respondent’s demographic information such as gender, age, education attainment, monthly income, housing tenure type and their visits to Mainland China. The second section focused on their retirement plans in terms of intended retirement age, prospective retirement funding and retirement housing options. The third section focused on the respondent’s attitudes toward retiring in Mainland for housing. It asked about their intentions to migrate retire into Mainland and incentives to retire in Hong Kong. The fourth section focused on respondent’s ideal housing environment including preferred housing amenities, desired living environment and retirement activities. The dependent variable in this study was ‘respondent’s consideration to move to Mainland China upon retirement’. Eight primary independent variables were integrated into the study to identify the correlations between them and retirement migration plan. The independent variables include: gender, age, marital status, monthly income, present housing tenure type, property ownership in Hong Kong, relationship with Mainland and the frequency of visiting Mainland China. In addition to the above independent variables, respondents were asked to indicate their retirement plans (retirement age, funding sources and retirement housing options), incentives to migrate to retire (choices included: property ownership, family relations, cost of living, living environment, medical facilities, government welfare benefits, etc.), perceived ideal retirement life qualities including desired amenities (sports, medical and leisure facilities etc.), desired locational qualities (green open space, convenient transport options and accessibility to urban settings etc.) and desired retirement activities (home-based leisure, elderly friendly sports, cultural activities, child care, social activities, etc.). The finding shows correlations between the used independent variables and consideration to migrate for housing options. The two independent variables indicated a possible correlation were gender and the frequency of visiting Mainland at present. When considering the increasing property prices across the border and strong social relationships, potential retirement migration is a very subjective decision that could vary from person to person. This research adds knowledge to housing research and migration study. Although the research is based in Mainland, most of the characteristics identified including better medical services, government welfare and sound urban amenities are shared qualities for all sustainable urban development and housing strategies.

Keywords: elderly migration, housing alternative, soon-to-be-old, sustainable environment

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Authors: Jisun Jun, Eun Ko, Sooim Shin, Kitae Kim, Moonsung Choi

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Diabetes is a metabolic disease characterized by hyperglycemia, insulin resistant, mitochondrial dysfunction. Diabetes is associated with the development of diabetic retinopathy resulting in worsening vision and eventual blindness. In this study, eyes were enucleated from glucose-immersed zebrafish which is a good animal model to generate diabetes, and then mitochondria were isolated to evaluate activities of mitochondrial electron transfer complexes. Surprisingly, the amount of isolated mitochondria was increased in eyes from glucose-immersed zebrafish compared to those from non-glucose-immerged zebrafish. Spectrophotometric analysis for measuring activities of mitochondrial complex I, II, III, and IV revealed that mitochondria functions was even enhanced in eyes from glucose-immersed zebrafish. These results indicated that 3 days or 7 days glucose-immersion on zebrafish to induce diabetes might contribute metabolic compensatory mechanism to restore their mitochondrial homeostasis on the early stage of diabetes in eyes.

Keywords: diabetes, glucose immersion, mitochondrial complexes, zebrafish

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Authors: Ibrahim Beldjilali, Adel Ghenaiet

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The contra-rotating axial machine is a promising solution for several applications, where high pressure and efficiencies are needed. Also, they allow reducing the speed of rotation, the radial spacing and a better flexibility of use. However, this requires a better understanding of their operation, including the influence of second rotor on the overall aerodynamic performances. This work consisted of both experimental and numerical studies to characterize this counter-rotating fan, especially the analysis of the effects of the blades stagger angle and the inter-distance between the rotors. The experimental study served to validate the computational fluid dynamics model (CFD) used in the simulations. The numerical study permitted to cover a wider range of parameter and deeper investigation on flow structures details, including the effects of blade stagger angle and inter-distance, associated with the interaction between the rotors. As a result, there is a clear improvement in aerodynamic performance compared with a conventional machine.

Keywords: aerodynamic performance, axial fan, counter rotating rotors, CFD, experimental study

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Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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Authors: Ashkan Shafee, Masoud Ghodrati, Ahmad Fahimifar

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Pervious concrete combines considerable permeability with adequate strength, which makes it very beneficial in pavement construction and also in ground improvement projects. In this paper, a single pervious concrete pile subjected to vertical and lateral loading is analysed using a verified three dimensional finite element code. A parametric study was carried out in order to investigate load bearing capacity of a single unreinforced pervious concrete pile in saturated soft soil and also gain insight into the failure mechanism of this rather new soil improvement technique. The results show that concrete damaged plasticity constitutive model can perfectly simulate the highly brittle nature of the pervious concrete material and considering the computed vertical and horizontal load bearing capacities, some suggestions have been made for ground improvement projects.

Keywords: concrete damaged plasticity, ground improvement, load-bearing capacity, pervious concrete pile

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Authors: Hanan Begali, Shahi Dost, Annett Ziegler, Markus Cornberg, Maria-Esther Vidal, Anke R. M. Kraft

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Chronic hepatitis B virus (HBV) infection can be treated with nucleot(s)ide analog (NA), for example, which inhibits HBV replication. However, they have hardly any influence on the functional cure of HBV, which is defined by hepatitis B surface antigen (HBsAg) loss. NA needs to be taken life-long, which is not available for all patients worldwide. Additionally, NA-treated patients are still at risk of developing cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Although each patient has the same components of the immune system, immune responses vary between patients. Therefore, a deeper understanding of the immune response against HBV in different patients is necessary to understand the parameters leading to HBV cure and to use this knowledge to optimize HBV therapies. This requires seamless integration of an enormous amount of diverse and fine-grained data from viral markers, e.g., hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg). The data integration system relies on the assumption that profiling human immune systems requires the analysis of various variables (e.g., demographic data, treatments, pre-existing conditions, immune cell response, or HLA-typing) rather than only one. However, the values of these variables are collected independently. They are presented in a myriad of formats, e.g., excel files, textual descriptions, lab book notes, and images of flow cytometry dot plots. Additionally, patients can be identified differently in these analyses. This heterogeneity complicates the integration of variables, as data management techniques are needed to create a unified view in which individual formats and identifiers are transparent when profiling the human immune systems. The proposed study (HBsRE) aims at integrating heterogeneous data sets of 87 chronically HBV-infected patients, e.g., clinical data, immune cell response, and HLA-typing, with knowledge encoded in biomedical ontologies and open-source databases into a knowledge-driven framework. This new technique enables us to harmonize and standardize heterogeneous datasets in the defined modeling of the data integration system, which will be evaluated in the knowledge graph (KG). KGs are data structures that represent the knowledge and data as factual statements using a graph data model. Finally, the analytic data model will be applied on top of KG in order to develop a deeper understanding of the immune profiles among various patients and to evaluate factors playing a role in a holistic profile of patients with HBsAg level loss. Additionally, our objective is to utilize this unified approach to stratify patients for new effective treatments. This study is developed in the context of the project “Transforming big data into knowledge: for deep immune profiling in vaccination, infectious diseases, and transplantation (ImProVIT)”, which is a multidisciplinary team composed of computer scientists, infection biologists, and immunologists.

Keywords: chronic hepatitis B infection, immune response, knowledge graphs, ontology

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Xueqing Ivy Chen, Christo De Coning

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It is clear from practice that a gap exists between Result-Based Monitoring and Evaluation (RBME) as a discipline, and Knowledge Management (KM) on the other hand. Whereas various government departments have institutionalised these functions, KM and M&E has functioned in isolation from each other in a practical sense in the public sector. It’s therefore necessary to explore the relationship between KM and M&E and the necessity for integration, so that a convergence of these disciplines can be established. An integration of KM and M&E will lead to integration and improvement of evidence-based information and policy decision-making. M&E and KM process models are available but the complementarity between specific process steps of these process models are not exploited. A need exists to clarify the relationships between these functions in order to ensure evidence based information and policy decision-making. This paper will depart from the well-known policy process models, such as the generic model and consider recent on the interface between policy, M&E and KM.

Keywords: result-based monitoring and evaluation, RBME, knowledge management, KM, evident based decision making, public policy, information systems, institutional arrangement

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Authors: Chantel Snyman, Chrizanne van Eeden, Marita Heyns

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Autism spectrum disorder (ASD) is one of the most common disabilities in schools, with up to50% of children displaying behaviors that challenge, bringing about demanding teaching circumstances. The teachers and teaching assistants of such learners often experience a negative impact on their own quality of life. Research globally and in South Africa about the teachers of ASD learners and teaching interventions, especially positive psychology approaches aimed at supporting learners with ASD, is limited. The primary research aim of this study was to investigate the feasibility as well as the effect of a strength-based intervention for teachers on the behavior of their learners with ASD and on the wellbeing and self-efficacy of teachers and assistants over time. This quantitative study used a pre-experimental group design with a pre-test-post-test method for the proposed school-based intervention. Teachers and teaching assistants completed the Difficult Behavior Self-Efficacy Scale, the Mental Health Questionnaire, and the short Behaviors That Challenge Checklist for learners with ASD. The six-week intervention on character strengths was delivered by the researcher as part of Teacher Staff Development. Results were generally significant on a practical level (based on practical effect sizes), which indicate that the intervention had a visible effect on behaviors that challenge. Research scores over time suggested a positive effect of the intervention in the well-being of participants and an overall positive effect on behaviors that challenge of ASD learners. Results showed that the character strengths intervention shows promise as a simple but effective intervention for teachers and teaching assistants, with positive effects for learners and teaching staff in the ASD classroom. It is recommended that this intervention should be repeated over a longer period of time and with a larger sample to determine its validity.

Keywords: autism spectrum disorder (ASD), behavior that challenge, character strengths, disabilities, self-efficacy, teachers, teaching assistants, well-being

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Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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Authors: Massra M. Sabeima, Myriam lamolle, Mohamedade Farouk Nanne

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Adapting the learning resources of an e-learning system to the characteristics of the learners is an important aspect to consider when designing an adaptive e-learning system. However, this adaptation is not a simple process; it requires the extraction, analysis, and modeling of user information. This implies a good representation of the user's profile, which is the backbone of the adaptation process. Moreover, during the e-learning process, collaboration with similar users (same geographic province or knowledge context) is important. Productive collaboration motivates users to continue or not abandon the course and increases the assimilation of learning objects. The contribution of this work is the following: we propose an adaptive e-learning semantic platform to recommend learning resources to learners, using ontology to model the user profile and the course content, furthermore an implementation of a multi-agent system able to progressively generate the learning graph (taking into account the user's progress, and the changes that occur) for each user during the learning process, and to synchronize the users who collaborate on a learning object.

Keywords: adaptative learning, collaboration, multi-agent, ontology

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Authors: Nayan Kishore Giri, Ramakar Jha

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Water is a major element for the life of all the mankind in the earth. India’s surface water flows through fourteen major streams. Indian rivers are the main source of potable water in India. In the eastern part of India many toxic hazardous metals discharged into the river from mining industries, which leads many deadly diseases to human being. So the potable water quality is very significant and vital concern at present as it is related with the present and future health perspective of the human race. Consciousness of health risks linked with unsafe water is still very low among the many rural and urban areas in India. Only about 7% of total Indian people using water purifier. This unhealthy situation of water is not only present in India but also present in many underdeveloped countries. The major reason behind this is the high cost of water purifier. This current study geared towards development of economical and efficient technology for the removal of maximum possible toxic metals and pathogen bacteria. The work involves the design of portable purification system and purifying material. In this design Coconut shell granular activated carbon(GAC) and polypropylene filter cloths were used in this system. The activated carbon is impregnated with Iron(Fe). Iron is used because it enhances the adsorption capacity of activated carbon. The thorough analysis of iron impregnated activated carbon(Fe-AC) is done by Scanning Electron Microscope (SEM), X-ray diffraction (XRD) , BET surface area test were done. Then 10 ppm of each toxic metal were infiltrated through the designed purification system and they were analysed in Atomic absorption spectrum (AAS). The results are very promising and it is low cost. This work will help many people who are in need of potable water. They can be benefited for its affordability. It could be helpful in industries and other domestic usage.

Keywords: potable water, coconut shell GAC, polypropylene filter cloths, SEM, XRD, BET, AAS

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Authors: Anna Sikharulidze, Gia Sirbiladze

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For the evaluation of unreliability levels of movement on the closed routes in the vehicle routing problem, the fuzzy operators family is constructed. The interactions between routing factors in extreme conditions on the roads are considered. A multi-criteria decision-making model (MCDM) is constructed. Constructed aggregations are based on the Choquet integral and the associated probability class of a fuzzy measure. Propositions on the correctness of the extension are proved. Connections between the operators and the compositions of dual triangular norms are described. The conjugate connections between the constructed operators are shown. Operators reflect interactions among all the combinations of the factors in the fuzzy MCDM process. Several variants of constructed operators are used in the decision-making problem regarding the assessment of unreliability and possibility levels of movement on closed routes.

Keywords: vehicle routing problem, associated probabilities of a fuzzy measure, choquet integral, fuzzy aggregation operator

Procedia PDF Downloads 321

Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Glaoui Hachemi

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In this paper, a scheme based on multi-input multi output Fuzzy Sliding Mode control (MIMO-FSMC) for linear speed regulation of winding system is proposed. Once the uncoupled model of the winding system was obtained, a smooth control function with a threshold was selected to indicate how far away the case was from the sliding surface. nevertheless, this control function depends closely on the higher bound of the uncertainties, which generates overlap. So, this size has to be chosen with broad care to obtain high performances. Usually, the upper bound of uncertainties is difficult to know before motor operation, so, a Fuzzy Sliding Mode controller is investigated to resolve this problem, a simple Fuzzy inference mechanism is used to decrease the chattering phenomenon by simple adjustments. A simulation study is achieved and that the indicate fuzzy sliding mode controllers have great potential for use as an alternative to the conventional sliding mode control.

Keywords: Winding system, induction machine, Mechanical tension, Proportional-integral (PI), sliding mode control, Fuzzy logic

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Authors: Ayon Mukherjee

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Covariate-adjusted response-adaptive (CARA) designs use the available responses to skew the treatment allocation in a clinical trial in towards treatment found at an interim stage to be best for a given patient's covariate profile. Extensive research has been done on various aspects of CARA designs with the patient responses assumed to follow a parametric model. However, ranges of application for such designs are limited in real-life clinical trials where the responses infrequently fit a certain parametric form. On the other hand, robust estimates for the covariate-adjusted treatment effects are obtained from the parametric assumption. To balance these two requirements, designs are developed which are free from distributional assumptions about the survival responses, relying only on the assumption of proportional hazards for the two treatment arms. The proposed designs are developed by deriving two types of optimum allocation designs, and also by using a distribution function to link the past allocation, covariate and response histories to the present allocation. The optimal designs are based on biased coin procedures, with a bias towards the better treatment arm. These are the doubly-adaptive biased coin design (DBCD) and the efficient randomized adaptive design (ERADE). The treatment allocation proportions for these designs converge to the expected target values, which are functions of the Cox regression coefficients that are estimated sequentially. These expected target values are derived based on constrained optimization problems and are updated as information accrues with sequential arrival of patients. The design based on the link function is derived using the distribution function of a probit model whose parameters are adjusted based on the covariate profile of the incoming patient. To apply such designs, the treatment allocation probabilities are sequentially modified based on the treatment allocation history, response history, previous patients’ covariates and also the covariates of the incoming patient. Given these information, an expression is obtained for the conditional probability of a patient allocation to a treatment arm. Based on simulation studies, it is found that the ERADE is preferable to the DBCD when the main aim is to minimize the variance of the observed allocation proportion and to maximize the power of the Wald test for a treatment difference. However, the former procedure being discrete tends to be slower in converging towards the expected target allocation proportion. The link function based design achieves the highest skewness of patient allocation to the best treatment arm and thus ethically is the best design. Other comparative merits of the proposed designs have been highlighted and their preferred areas of application are discussed. It is concluded that the proposed CARA designs can be considered as suitable alternatives to the traditional balanced randomization designs in survival trials in terms of the power of the Wald test, provided that response data are available during the recruitment phase of the trial to enable adaptations to the designs. Moreover, the proposed designs enable more patients to get treated with the better treatment during the trial thus making the designs more ethically attractive to the patients. An existing clinical trial has been redesigned using these methods.

Keywords: censored response, Cox regression, efficiency, ethics, optimal allocation, power, variability

Procedia PDF Downloads 159

Authors: Thapelo Jacob Moloi

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This paper purports to present the findings in relation to the competencies of commercial grain farmers using a classic grounded theory method. A total of about eighteen semi-structured interviews with farmers, former farmers, farm workers, and agriculture experts were conducted. Findings explored competencies in the form of skills, knowledge and personal attributes that commercial grain farmers possess. Skills range from production skills, financial management skill, time management skill, human resource management skill, planning skill to mechanical skill. Knowledge ranges from soil preparation, locality, and technology to weather knowledge. The personal attributes that contribute to shaping a commercial grain farmer are so many, but for this study, seven stood out as a passion, work dedication, self-efficacy, humbleness, intelligence, emotional stability, and patience.

Keywords: grain farming, farming competencies, classic grounded theory, competency model

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Authors: P. Pistelok

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The article presents the concept of an electromagnetic circuit generator with permanent magnets mounted on the surface rotor core designed for single phase work. Computation field-circuit model was shown. The spectrum of time course of voltages in the idle work was presented. The cross section with graphically presentation of magnetic induction in particular parts of electromagnetic circuits was presented. Distribution of magnetic induction at the rated load point for each phase were shown. The time course of voltages and currents for each phases for rated power were displayed. An analysis of laboratory results and measurement of load characteristics of the generator was discussed. The work deals with three electromagnetic circuits of generators with permanent magnet where output voltage characteristics versus rated power were expressed.

Keywords: permanent magnet generator, permanent magnets, vibration, course of torque, single phase work, asymmetrical three phase work

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Authors: J. C. Colmenares, M. Paszkiewicz-Gawron, D. Lomot, S. R. Pradhan, A. Qayyum

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This work is a report of recent selected experiments of photocatalysis intensification using flow microphotoreactors (fabricated by an ultrasound-based technique) for photocatalytic selective oxidation of benzyl alcohol (BnOH) to benzaldehyde (PhCHO) (in the frame of the concept of lignin valorization), and the proof of concept of intensifying a flow selective photocatalytic oxidation process by acoustic cavitation. The synthesized photocatalysts were characterized by using different techniques such as UV-Vis diffuse reflectance spectroscopy, X-ray diffraction, nitrogen sorption, thermal gravimetric analysis, and transmission electron microscopy. More specifically, the work will be on: a Design and development of metal-containing TiO₂ coated microflow reactor for photocatalytic partial oxidation of benzyl alcohol: The current work introduces an efficient ultrasound-based metal (Fe, Cu, Co)-containing TiO₂ deposition on the inner walls of a perfluoroalkoxy alkanes (PFA) microtube under mild conditions. The experiments were carried out using commercial TiO₂ and sol-gel synthesized TiO₂. The rough surface formed during sonication is the site for the deposition of these nanoparticles in the inner walls of the microtube. The photocatalytic activities of these semiconductor coated fluoropolymer based microreactors were evaluated for the selective oxidation of BnOH to PhCHO in the liquid flow phase. The analysis of the results showed that various features/parameters are crucial, and by tuning them, it is feasible to improve the conversion of benzyl alcohol and benzaldehyde selectivity. Among all the metal-containing TiO₂ samples, the 0.5 at% Fe/TiO₂ (both, iron and titanium, as cheap, safe, and abundant metals) photocatalyst exhibited the highest BnOH conversion under visible light (515 nm) in a microflow system. This could be explained by the higher crystallite size, high porosity, and flake-like morphology. b. Designing/fabricating photocatalysts by a sonochemical approach and testing them in the appropriate flow sonophotoreactor towards sustainable selective oxidation of key organic model compounds of lignin: Ultrasonication (US)-assitedprecipitaion and US-assitedhydrosolvothermal methods were used for the synthesis of metal-oxide-based and metal-free-carbon-based photocatalysts, respectively. Additionally, we report selected experiments of intensification of a flow photocatalytic selective oxidation through the use of ultrasonic waves. The effort of our research is focused on the utilization of flow sonophotocatalysis for the selective transformation of lignin-based model molecules by nanostructured metal oxides (e.g., TiO₂), and metal-free carbocatalysts. A plethora of parameters that affects the acoustic cavitation phenomena, and as a result the potential of sonication were investigated (e.g. ultrasound frequency and power). Various important photocatalytic parameters such as the wavelength and intensity of the irradiated light, photocatalyst loading, type of solvent, mixture of solvents, and solution pH were also optimized.

Keywords: heterogeneous photo-catalysis, metal-free carbonaceous materials, selective redox flow sonophotocatalysis, titanium dioxide

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Authors: Julius Adebayo John

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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

Procedia PDF Downloads 148

Authors: Hamza A. A. Al-Sewadi, Adnan H. M. Al-Helali, Samaa A. K. Khamis

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Ownership proofs of multimedia such as text, image, audio or video files can be achieved by the burial of watermark is them. It is achieved by introducing modifications into these files that are imperceptible to the human senses but easily recoverable by a computer program. These modifications would be in the time domain or frequency domain or both. This paper presents a procedure for watermarking by mixing amplitude modulation with frequency transformation histogram; namely a specific value is used to modulate the intensity component Y of the YIQ components of the carrier image. This scheme is referred to as histogram embedding technique (HET). Results comparison with those of other techniques such as discrete wavelet transform (DWT), discrete cosine transform (DCT) and singular value decomposition (SVD) have shown an enhance efficiency in terms of ease and performance. It has manifested a good degree of robustness against various environment effects such as resizing, rotation and different kinds of noise. This method would prove very useful technique for copyright protection and ownership judgment.

Keywords: authentication, copyright protection, information hiding, ownership, watermarking

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Authors: Arash Heydarian Pashakhanlou

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The security dilemma is one of the key concepts in International Relations (IR), and the numerous engagements with it have created a great deal of confusion regarding its essence. That is why this article seeks to dissect the security dilemma and rebuild it from its foundational core. In doing so, the present study highlights that the security dilemma requires interaction among actors that seek to protect themselves from other's capacity for harm under the condition of uncertainty to operate. In this constellation, actors are confronted with the dilemma of motives, power, and action, which they seek to resolve by acquiring information regarding their opponents. The relationship between the parties is shaped by the harm-uncertainty index (HUI) consisting of geographical distance, MAD, and joint democracy that determines the intensity of the security dilemma. These elements define the unified theory of the security dilemma (UTSD) developed here. UTSD challenges the prevailing view that the security dilemma is a unidimensional paradoxical concept, regulated by the offense-defense balance and differentiation that only occurs in anarchic settings with tragic outcomes and is equivalent to the spiral model.

Keywords: security dilemma, revisionism, status quo, anarchy, uncertainty, tragedy, spiral, deterrence

Procedia PDF Downloads 231

Authors: Toka Aly

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Historically, marketplaces were the most important nodes and focal points of cities, where different activities took place. Commercial streets offer more than just spaces for shopping; they also offer choices for social activities and cultural exchange. They are considered the backbone of the city’s vibrancy and vitality. Despite that, the public life in Cairo’s commercial streets has deteriorated, where the shopping activities became reliant mainly on 'planned formal places', mainly in privatized or indoor spaces like shopping malls. The main aim of this paper is to explore the key elements and tools of assessing the successfulness of commercial streets in Cairo. The methodology followed in this paper is based on a case study methodology (multiple cases) that is based on assessing and analyzing the physical and social elements in historical and contemporary commercial streets in El Muiz Street and Baghdad Street in Cairo. The data collection is based on personal observations, photographs, maps and street sections. Findings indicate that the key factors of analyzing commercial streets are factors affecting the sensory experience, factors affecting the social behavior, and general aspects that attract people. Findings also indicate that urban features have clear influence on shopping pedestrian activities in both streets. Moreover, in order for a commercial street to be successful, shopping patterns must provide people with a quality public space that can provide easy navigation and accessibility, good visual continuity, and well-designed urban features and social gathering. Outcomes of this study will be a significant endeavor in providing a good background for urban designers on analyzing and assessing successfulness of commercial streets. The study will also help in understanding the different physical and social pattern of vending activities taking place in Cairo.

Keywords: activities, commercial street, marketplace, successful, vending

Procedia PDF Downloads 291