Search results for: Total Productive Maintenance (TPM)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10464

Search results for: Total Productive Maintenance (TPM)

8544 Bond-Slip Response of Reinforcing Bars Embedded in High Performance Fiber Reinforced Cement Composites

Authors: Lee Siong Wee, Tan Kang Hai, Yang En-Hua

Abstract:

This paper presents the results of an experimental study undertaken to evaluate the local bond stress-slip response of short embedment of reinforcing bars in normal concrete (NC) and high performance fiber reinforced cement composites (HPFRCC) blocks. Long embedment was investigated as well to gain insights on the distribution of strain, slip, bar stress and bond stress along the bar especially in post-yield range. A total of 12 specimens were tested, by means of pull-out of the reinforcing bars from concrete blocks. It was found that the enhancement of local bond strength can be reached up to 50% and ductility of the bond behavior was improved significantly if HPFRCC is used. Also, under a constant strain at loaded end, HPFRCC has delayed yielding of bars at other location from the loaded end. Hence, the reduction of bond stress was slower for HPFRCC in comparison with NC. Due to the same reason, the total slips at loaded end for HPFRCC was smaller than NC as expected. Test results indicated that HPFRCC has better bond slip behavior which makes it a suitable material to be employed in anchorage zone such as beam-column joints.

Keywords: bond stress, high performance fiber reinforced cement composites, slip, strain

Procedia PDF Downloads 481
8543 A Framework for the Design of Green Giga Passive Optical Fiber Access Network in Kuwait

Authors: Ali A. Hammadi

Abstract:

In this work, a practical study on a commissioned Giga Passive Optical Network (GPON) fiber to the home access network in Kuwait is presented. The work covers the framework of the conceptual design of the deployed Passive Optical Networks (PONs), access network, optical fiber cable network distribution, technologies, and standards. The work also describes methodologies applied by system engineers for design of Optical Network Terminals (ONTs) and Optical Line Terminals (OLTs) transceivers with respect to the distance, operating wavelengths, splitting ratios. The results have demonstrated and justified the limitation of transmission distance of a PON link in Fiber to The Premises (FTTP) to not exceed 20 km. Optical Time Domain Reflector (OTDR) test has been carried for this project to confirm compliance with International Telecommunication Union (ITU) specifications regarding the total length of the deployed optical cable, total loss in dB, and loss per km in dB/km with respect to the operating wavelengths. OTDR test results with traces for segments of implemented fiber network will be provided and discussed.

Keywords: passive optical networks (PONs), fiber to the premises (FTTx), access network, OTDR

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8542 Preparation and Characterization of Maltodextrin Microcapsules Containing Walnut Green Husk Extract

Authors: Fatemeh Cheraghali, Saeedeh Shojaee-Aliabadi, Seyede Marzieh Hosseini, Leila Mirmoghtadaie

Abstract:

In recent years, the field of natural antimicrobial and antioxidant compounds is one of the main research topics in the food industry. Application of agricultural residues is mainly cheap, and available resources are receiving increased attention. Walnut green husk is one of the agricultural residues that is considered as natural compounds with biological properties because of phenolic compounds. In this study, maltodextrin 10% was used for microencapsulation of walnut green husk extract. At first, the extract was examined to consider extraction yield, total phenolic compounds, and antioxidant activation. The results showed the extraction yield of 81.43%, total phenolic compounds of 3997 [mg GAE/100 g], antioxidant activity [DPPH] of 84.85% for walnut green husk extract. Antioxidant activity is about 75%-81% and by DPPH. At the next stage, microencapsulation was done by spry-drying method. The microencapsulation efficiency was 72%-79%. The results of SEM tests confirmed this microencapsulation process. In addition, microencapsulated and free extract was more effective on gram-positive bacteria’s rather than the gram-negative ones. According to the study, walnut green husk can be used as a cheap antioxidant and antimicrobial compounds due to sufficient value of phenolic compounds.

Keywords: biopolymer, microencapsulation, spray-drying, walnut green husk

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8541 Analysis of Oral and Maxillofacial Histopathology Service in Tertiary Center in Oman in the Past 13 Years

Authors: Sabreen Al Shamli, Abdul Rahman Al azure

Abstract:

Microscopic examination by histopathology is the gold standard for diagnosing many oral and maxillofacial pathologies. Current clinical guidelines and medicolegal regulations recommend the utilization of histopathology services for confirming pathologies being treated. The goal of this study was to determine the prevalence and distribution of oral and maxillofacial biopsies that had been histopathologically diagnosed at Anahdha Hospital (ANH). A total of 512 biopsies randomly selected from a ground total of 3310 biopsies, which were submitted for oral and maxillofacial histopathological specimens, were analyzed at Nahdha Hospital in Oman between January 2010 and December 2022. Data collected retrospectively selected from all case notes of patients who had oral histopathology examinations performed as part of their treatment. Data collected from the Shifa system was transferred to Microsoft Excel and analyzed using SPSS. Research ethics approval was obtained from the research committee of the hospital. This study provides background information on oral histopathology prevalence that could be helpful in future research in Oman. The findings of the present study are in agreement with the reported data from other investigations, even when it is taken into account how difficult it is to compare prevalence rates from different studies.

Keywords: oral biopsy, maxillofacial histopathology, oral disease, maxillofacial specimens

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8540 Study on Preparation and Storage of Jam Incorporating Carrots (Dacus Carrota), Banana (Musa Acuminata) and Lime (Citrus Aurantifola)

Authors: K. Premakumar, D. S. Rushani, H. N. Hettiarachchi

Abstract:

The production and consumption of preserved foods have gained much importance due to globalization, and they provide a health benefit apart from the basic nutritional functions. Therefore, a study was conducted to develop a jam incorporating carrot, banana, and lime. Considering the findings of several preliminary studies, five formulations of the jam were prepared by blending different percentages of carrot and banana including control (where the only carrot was added). The freshly prepared formulations were subjected to physicochemical and sensory analysis.Physico-Chemical parameters such as pH, TSS, titrable acidity, ascorbic acid content, total sugar and non-reducing sugar and organoleptic qualities such as colour, aroma, taste, spread ability and overall acceptability and microbial analysis (total plate count) were analyzed after formulations. Physico-Chemical Analysis of the freshly prepared Carrot –Banana Blend jam showed increasing trend in titrable acidity (from 0.8 to 0.96, as % of citric acid), TSS (from 70.05 to 67.5 0Brix), ascorbic acid content (from 0.83 to 11.465 mg/100ml), reducing sugar (from 15.64 to 20.553%) with increase in carrot pulp from 50 to 100%. pH, total sugar, and non-reducing sugar were also reduced when carrot concentration is increased. Five points hedonic scale was used to evaluate the organoleptic characters. According to Duncan's Multiple Range Test, the mean scores for all the assessed sensory characters varied significantly (p<0.05) in the freshly made carrot-banana blend jam formulations. Based on the physicochemical and sensory analysis, the most preferred carrot: banana combinations of 50:50, 100:0 and 80:20 (T1, T2, and T5) were selected for storage studies.The formulations were stored at 300 °C room temperature and 70-75% of RH for 12 weeks. The physicochemical characteristics were measured at two weeks interval during storage. The decreasing trends in pH and ascorbic acid and an increasing trend in TSS, titrable acidity, total sugar, reducing sugar and non-reducing sugar were noted with advancement of storage periods of 12 weeks. The results of the chemical analysis showed that there were significance differences (p<0.05) between the tested formulations. Sensory evaluation was done for carrot –banana blends jam after a period of 12 weeks through a panel of 16 semi-trained panelists. The sensory analysis showed that there were significant differences (p<0.05) for organoleptic characters between carrot-banana blend jam formulations. The highest overall acceptability was observed in formulation with 80% carrot and 20% banana pulp. Microbiological Analysis was carried out on the day of preparation, 1 month, 2 months and 3 months after preparation. No bacterial growth was observed in the freshly made carrot -banana blend jam. There were no counts of yeast and moulds and coliforms in all treatments after the heat treatments and during the storage period. Only the bacterial counts (Total Plate Counts) were observed after three months of storage below the critical level, and all formulations were microbiologically safe for consumption. Based on the results of physio-chemical characteristics, sensory attributes, and microbial test, the carrot –banana blend jam with 80% carrot and 20% banana (T2) was selected as best formulation and could be stored up to 12 weeks without any significant changes in the quality characteristics.

Keywords: formulations, physicochemical parameters, microbiological analysis, sensory evaluation

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8539 Evaluation on Heat and Drought Tolerance Capacity of Chickpea

Authors: Derya Yucel, Nigar Angın, Dürdane Mart, Meltem Turkeri, Volkan Catalkaya, Celal Yucel

Abstract:

Chickpea (Cicer arietinum L.) is one of the important legumes widely grown for dietery proteins in semi-arid Mediteranean climatic conditions. To evaluate the genetic diversity with improved heat and drought tolerance capacity in chickpea, thirty-four selected chickpea genotypes were tested under different field-growing conditions (rainfed winter sowing, irrigated-late sowing and rainfed-late sowing) in 2015 growing season. A factorial experiment in randomized complete block design with 3 reps was conducted at the Eastern Mediterranean Research Institute Adana, Turkey. Based on grain yields under different growing conditions, several indices were calculated to identify economically higher-yielding chickpea genotypes with greater heat and drought tolerance capacity. Average across chickpea genotypes, the values of tolerance index, mean productivity, yield index, yield stability index, stress tolerance index, stress susceptibility index, and geometric mean productivity were ranged between 1.1 to 218, 38 to 202, 0.3 to 1.7, 0.2 to 1, 0.1 to 1.2, 0.02 to 1.4, and 36 to 170 for drought stress and 3 to 54, 23 to 118, 0.3 to 1.7, 0.4 to 0.9, 0.2 to 2, 0.2to 2.3, and 23 to 118 for heat stress, respectively. There were highly significant differences observed among the tested chickpea genotypes response to drought and heat stresses. Among the chickpea genotypes, the Aksu, Arda, Çakır, F4 09 (X 05 TH 21-16189), FLIP 03-108 were identified with a higher drought and heat tolerance capacity. Based on our field studies, it is suggested that the drought and heat tolerance indicators of plants can be used by breeders to select stress-resistant economically productive chickpea genotypes suitable to grow under Mediteranean climatic conditions.

Keywords: irrigation, rainfed, stress susceptibility, tolerance indice

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8538 Assessing and Identifying Factors Affecting Customers Satisfaction of Commercial Bank of Ethiopia: The Case of West Shoa Zone (Bako, Gedo, Ambo, Ginchi and Holeta), Ethiopia

Authors: Habte Tadesse Likassa, Bacha Edosa

Abstract:

Customer’s satisfaction was very important thing that is required for the existence of banks to be more productive and success in any organization and business area. The main goal of the study is assessing and identifying factors that influence customer’s satisfaction in West Shoa Zone of Commercial Bank of Ethiopia (Holeta, Ginchi, Ambo, Gedo and Bako). Stratified random sampling procedure was used in the study and by using simple random sampling (lottery method) 520 customers were drawn from the target population. By using Probability Proportional Size Techniques sample size for each branch of banks were allocated. Both descriptive and inferential statistics methods were used in the study. A binary logistic regression model was fitted to see the significance of factors affecting customer’s satisfaction in this study. SPSS statistical package was used for data analysis. The result of the study reveals that the overall level of customer’s satisfaction in the study area is low (38.85%) as compared those who were not satisfied (61.15%). The result of study showed that all most all factors included in the study were significantly associated with customer’s satisfaction. Therefore, it can be concluded that based on the comparison of branches on their customers satisfaction by using odd ratio customers who were using Ambo and Bako are less satisfied as compared to customers who were in Holeta branch. Additionally, customers who were in Ginchi and Gedo were more satisfied than that of customers who were in Holeta. Since the level of customers satisfaction was low in the study area, it is more advisable and recommended for concerned body works cooperatively more in maximizing satisfaction of their customers.

Keywords: customers, satisfaction, binary logistic, complain handling process, waiting time

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8537 Impact of Organic Farming on Soil Fertility and Microbial Activity

Authors: Menuka Maharjan

Abstract:

In the name of food security, agriculture intensification through conventional farming is being implemented in Nepal. Government focus on increasing agriculture production completely ignores soil as well human health. This leads to create serious soil degradation, i.e., reduction of soil fertility and microbial activity and health hazard in the country. On this note, organic farming is sustainable agriculture approach which can address challenge of sustaining food security while protecting the environment. This creates a win-win situation both for people and the environment. However, people have limited knowledge on significance of organic farming for environment conservation and food security especially developing countries like Nepal. Thus, the objective of the study was to assess the impacts of organic farming on soil fertility and microbial activity compared to conventional farming and forest in Chitwan, Nepal. Total soil organic carbon (C) was highest in organic farming (24 mg C g⁻¹ soil) followed by conventional farming (15 mg C g⁻¹ soil) and forest (9 mg C g⁻¹ soil) in the topsoil layer (0-10 cm depth). A similar trend was found for total nitrogen (N) content in all three land uses with organic farming soil possessing the highest total N content in both 0-10 cm and 10-20 cm depth. Microbial biomass C and N were also highest under organic farming, especially in the topsoil layer (350 and 46 mg g⁻¹ soil, respectively). Similarly, microbial biomass phosphorus (P) was higher (3.6 and 1.0 mg P kg⁻¹ at 0-10 and 10-20 cm depth, respectively) in organic farming compared to conventional farming and forest at both depths. However, conventional farming and forest soils had similar microbial biomass (C, N, and P) content. After conversion of forest, the P stock significantly increased by 373% and 170% in soil under organic farming at 0-10 and 10-20 cm depth, respectively. In conventional farming, the P stock increased by 64% and 36% at 0-10 cm and 10-20 cm depth, respectively, compared to forest. Overall, organic farming practices, i.e., crop rotation, residue input and farmyard manure application, significantly alters soil fertility and microbial activity. Organic farming system is emerging as a sustainable land use system which can address the issues of food security and environment conservation by increasing sustainable agriculture production and carbon sequestration, respectively, supporting to achieve goals of sustainable development.

Keywords: organic farming, soil fertility, micobial biomas, food security

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8536 Morpho-Dynamic Modelling of the Western 14 Km of the Togolese Coast

Authors: Sawsan Eissa, Omnia Kabbany

Abstract:

The coastline of Togo has been historically suffering from erosion for decades, which requires a solution to help control and reduce the erosion to allow for the development of the coastal area. A morpho-dynamic model using X-beach software was developed for the Western 14 Km of the Togolese coast. The model was coupled with the hydrodynamic module of DELFT 3D, flow, and the Wave module, SWAN. The data used as input included a recent bathymetric survey, a recent shoreline topographic survey, aerial photographs, ERA 5 water level and wave data, and recent test results of seabed samples. A number of scenarios were modeled: do nothing scenario, groynes, detached breakwaters system with different crest levels and alignments. The findings showed that groynes is not expected to be effective for protection against erosion, and that the best option is a system of detached breakwater, partially emerged-partially submerged couples with periodical maintenance.

Keywords: hydrodynamics, morphology, Togo, Delft3D, SWAN, XBeach, coastal erosion, detached breakwaters

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8535 An Integrated Cloud Service of Application Delivery in Virtualized Environments

Authors: Shuen-Tai Wang, Yu-Ching Lin, Hsi-Ya Chang

Abstract:

Virtualization technologies are experiencing a renewed interest as a way to improve system reliability, and availability, reduce costs, and provide flexibility. This paper presents the development on leverage existing cloud infrastructure and virtualization tools. We adopted some virtualization technologies which improve portability, manageability and compatibility of applications by encapsulating them from the underlying operating system on which they are executed. Given the development of application virtualization, it allows shifting the user’s applications from the traditional PC environment to the virtualized environment, which is stored on a remote virtual machine rather than locally. This proposed effort has the potential to positively provide an efficient, resilience and elastic environment for online cloud service. Users no longer need to burden the platform maintenance and drastically reduces the overall cost of hardware and software licenses. Moreover, this flexible and web-based application virtualization service represent the next significant step to the mobile workplace, and it lets user executes their applications from virtually anywhere.

Keywords: cloud service, application virtualization, virtual machine, elastic environment

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8534 Chemical Characteristics of Soils Based on Toposequence Under Wet Tropical Area Bukit Sarasah Padang

Authors: Y. Yulnafatmawita, H. Hermansah

Abstract:

Topography is a factor affecting soil characteristics. Chemical characteristics of a soil is a factor determining the productivity of the land. A research was conducted in Bukit Sarasah Padang, an area receiving > 5000 mm rainfall annually. The purpose of this research was to determine the chemical characteristics of soils at sequence topography in hill-slope of Bukit Sarasah. Soils were sampled at 3 different altitudes in the research area from 315 m – 515 m asl with 100 m interval. At each location, soil samples were taken from two depths (0-20 cm and 30-50 cm) for soil chemical characteristics (pH, CEC, organic-C, N-total, C/N, Ca-, Mg-, K-, Na-, Al-, and H-exchangeable). Based on the data resulted, it was found that there was a tendency of decreasing soil organic matter (SOC) content by increasing location from 315 to 515 m asl as well as from the top 0-20 cm to 30-50 cm soil depth. The same tendency was also found for the CEC, pH, N-total, and C/N ratio of the soil. On the other hand, exchangeable-Al and -H tended to increase by increasing elevation in Bukit Sarasah. There was no significant difference found for the concentration of exchangeable cations among the elevations and between the depths. The soil chemical characteristics on the top 20 cm were generally better than those on 30-50 cm soil depth, however, different elevation did not gave significant difference of the concentration.

Keywords: soil chemical characteristics, soil depths, topo-sequence, wet tropical area

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8533 Climate Change and the Invasive Alien Species of Western Himalayan State of India

Authors: Yashasvi Thakur, Vikas K. Sharma

Abstract:

The fragile Himalayan ecosystems are sensitive to environmental stresses, including direct and indirect impacts of climate stresses. A total of 297 naturalized alien plant species belonging to 65 families in the IHR have already been reported. Of the total 297 naturalized alien plant species in IHR, the maximum species occur in Himachal Pradesh (232; 78.1%), followed by Jammu & Kashmir (192; 64.6%) and Uttarakhand (181; 60.90%). The present study reports the spread of some invasive and existing weed species like Ageratum conyzoides, Bidens pilosa, Chromolaena odorata, Lantana camara, Brossnetia papyrifera, Oxalis corniculata, Galinsoga parviflora, Panicum maximum at an extent that they are not only invading the agricultural fields but are also replacing the native plant species and degrading the existing grassland quality. Moreover, the degradation of grassland has led to the dry fodder shortage for livestock in the lower Shivalik ranges of the state of Himachal Pradesh and has also encouraged the use of herbicides at an extensive scale. This article provides a mapping of the current spread of some of these species at the block level to allow the development of appropriate management strategies and policy planning for addressing issues pertaining to plant invasion, agricultural fields, and grasslands across the IHR states.

Keywords: climate change, invasive alien species, agriculture, grassland, IHR

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8532 In vitro Characterization of Mice Bone Microstructural Changes by Low-Field and High-Field Nuclear Magnetic Resonance

Authors: Q. Ni, J. A. Serna, D. Holland, X. Wang

Abstract:

The objective of this study is to develop Nuclear Magnetic Resonance (NMR) techniques to enhance bone related research applied on normal and disuse (Biglycan knockout) mice bone in vitro by using both low-field and high-field NMR simultaneously. It is known that the total amplitude of T₂ relaxation envelopes, measured by the Carr-Purcell-Meiboom-Gill NMR spin echo train (CPMG), is a representation of the liquid phase inside the pores. Therefore, the NMR CPMG magnetization amplitude can be transferred to the volume of water after calibration with the NMR signal amplitude of the known volume of the selected water. In this study, the distribution of mobile water, porosity that can be determined by using low-field (20 MHz) CPMG relaxation technique, and the pore size distributions can be determined by a computational inversion relaxation method. It is also known that the total proton intensity of magnetization from the NMR free induction decay (FID) signal is due to the water present inside the pores (mobile water), the water that has undergone hydration with the bone (bound water), and the protons in the collagen and mineral matter (solid-like protons). Therefore, the components of total mobile and bound water within bone that can be determined by low-field NMR free induction decay technique. Furthermore, the bound water in solid phase (mineral and organic constituents), especially, the dominated component of calcium hydroxyapatite (Ca₁₀(OH)₂(PO₄)₆) can be determined by using high-field (400 MHz) magic angle spinning (MAS) NMR. With MAS technique reducing NMR spectral linewidth inhomogeneous broadening and susceptibility broadening of liquid-solid mix, in particular, we can conduct further research into the ¹H and ³¹P elements and environments of bone materials to identify the locations of bound water such as OH- group within minerals and bone architecture. We hypothesize that with low-field and high-field magic angle spinning NMR can provide a more complete interpretation of water distribution, particularly, in bound water, and these data are important to access bone quality and predict the mechanical behavior of bone.

Keywords: bone, mice bone, NMR, water in bone

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8531 Histopathological Features of Basal Cell Carcinoma: A Ten Year Retrospective Statistical Study in Egypt

Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

Abstract:

The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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8530 Rheological Properties and Consumer Acceptability of Supplemented with Flaxseed

Authors: A. Albaridi Najla

Abstract:

Flaxseed (Linum usitatissimum) is well known to have beneficial effect on health. The seeds are rich in protein, α-linolenic fatty acid and dietary fiber. Bakery products are important part of our daily meals. Functional food recently received considerable attention among consumers. The increase in bread daily consumption leads to the production of breads with functional ingredients such as flaxseed The aim of this Study was to improve the nutritional value of bread by adding flaxseed flour and assessing the effect of adding 0, 5, 10 and 15% flaxseed on whole wheat bread rheological and sensorial properties. The total consumer's acceptability of the flaxseed bread was assessed. Dough characteristics were determined using Farinograph (C.W. Brabender® Instruments, Inc). The result shows no change was observed in water absorption between the stander dough (without flaxseed) and the bread with flaxseed (67%). An Increase in the peak time and dough stickiness was observed with the increase in flaxseed level. Further, breads were evaluated for sensory parameters, colour and texture. High flaxseed level increased the bread crumb softness. Bread with 5% flaxseed was optimized for total sensory evaluation. Overall, flaxseed bread produced in this study was highly acceptable for daily consumption as a functional foods with a potentially health benefits.

Keywords: bread, flaxseed, rheological properties, whole-wheat bread

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8529 Training Hearing Parents in SmiLE Therapy Supports the Maintenance and Generalisation of Deaf Children's Social Communication Skills

Authors: Martina Curtin, Rosalind Herman

Abstract:

Background: Deaf children can experience difficulties with understanding how social interaction works, particularly when communicating with unfamiliar hearing people. Deaf children often struggle with integrating into a mainstream, hearing environments. These negative experiences can lead to social isolation, depression and other mental health difficulties later in life. smiLE Therapy (Schamroth, 2015) is a video-based social communication intervention that aims to teach deaf children skills to confidently communicate with unfamiliar hearing people. Although two previous studies have reported improvements in communication skills immediately post intervention, evidence for maintenance of gains or generalisation of skills (i.e., the transfer of newly learnt skills to untrained situations) has not to date been demonstrated. Parental involvement has been shown to support deaf children’s therapy outcomes. Therefore, this study added parent training to the therapy children received to investigate the benefits to generalisation of children’s skills. Parents were also invited to present their perspective on the training they received. Aims: (1) To assess pupils’ progress from pre- to post-intervention in trained and untrained tasks, (2) to investigate if training parents improved their (a) understanding of their child’s needs and (b) their skills in supporting their child appropriately in smiLE Therapy tasks, (3) to assess if parent training had an impact on the pupil’s ability to (a) maintain their skills in trained tasks post-therapy, and (b) generalise their skills in untrained, community tasks. Methods: This was a mixed-methods, repeated measures study. 31 deaf pupils (aged between 7 and 14) received an hour of smiLE Therapy per week, for 6 weeks. Communication skills were assessed pre-, post- and 3-months post-intervention using the Communication Skills Checklist. Parents were then invited to attend two training sessions and asked to bring a video of their child communicating in a shop or café. These videos were used to assess whether, after parent training, the child was able to generalise their skills to a new situation. Finally, parents attended a focus group to discuss the effectiveness of the therapy, particularly the wider impact, i.e., more child participation within the hearing community. Results: All children significantly improved their scores following smiLE therapy and maintained these skills to high level. Children generalised a high percentage of their newly learnt skills to an untrained situation. Parents reported improved understanding of their child’s needs, their child’s potential and in how to support them in real-life situations. Parents observed that their children were more confident and independent when carrying out communication tasks with unfamiliar hearing people. Parents realised they needed to ‘let go’ and embrace their child’s independence and provide more opportunities for them to participate in their community. Conclusions: This study adds to the evidence base on smiLE Therapy; it is an effective intervention that develops deaf children’s ability to interact competently with unfamiliar, hearing, communication partners. It also provides preliminary evidence of the benefits of parent training in helping children to generalise their skills to other situations. These findings will be of value to therapists wishing to develop deaf children’s communication skills beyond the therapy setting.

Keywords: deaf children, generalisation, parent involvement, social communication

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8528 Mixed Integer Programing for Multi-Tier Rebate with Discontinuous Cost Function

Authors: Y. Long, L. Liu, K. V. Branin

Abstract:

One challenge faced by procurement decision-maker during the acquisition process is how to compare similar products from different suppliers and allocate orders among different products or services. This work focuses on allocating orders among multiple suppliers considering rebate. The objective function is to minimize the total acquisition cost including purchasing cost and rebate benefit. Rebate benefit is complex and difficult to estimate at the ordering step. Rebate rules vary for different suppliers and usually change over time. In this work, we developed a system to collect the rebate policies, standardized the rebate policies and developed two-stage optimization models for ordering allocation. Rebate policy with multi-tiers is considered in modeling. The discontinuous cost function of rebate benefit is formulated for different scenarios. A piecewise linear function is used to approximate the discontinuous cost function of rebate benefit. And a Mixed Integer Programing (MIP) model is built for order allocation problem with multi-tier rebate. A case study is presented and it shows that our optimization model can reduce the total acquisition cost by considering rebate rules.

Keywords: discontinuous cost function, mixed integer programming, optimization, procurement, rebate

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8527 Architectural Knowledge Systems Related to Use of Terracotta in Bengal

Authors: Nandini Mukhopadhyay

Abstract:

The prominence of terracotta as a building material in Bengal is well justified by its geographical location. The architectural knowledge system associated with terracotta can be comprehended in the typology of the built structures as they act as texts to interpret the knowledge. The history of Bengal has witnessed the influence of several rulers in developing the architectural vocabulary of the region. This metamorphosis of the architectural knowledge systems in the region includes the Bhakti movement, the Islamic influence, and the British rule, which led to the evolution of the use of terracotta from decorative elements to structural elements in the present-day context. This paper intends to develop an understanding of terracotta as a building material, its use in a built structure, the common problems associated with terracotta construction, and the techniques of maintenance, repair, and conservation. This paper also explores the size, shape, and geometry of the material and its varied use in temples, mosques in the region. It also takes into note that the use of terracotta was concentrated majorly to religious structures and not in the settlements of the common people. And the architectural style of temples and mosques of Bengal is hugely influenced by the houses of the common.

Keywords: terracotta, material, knowledge system, conservation

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8526 Sardine Oil as a Source of Lipid in the Diet of Giant Freshwater Prawn (Macrobrachium rosenbergii)

Authors: A. T. Ramachandra Naik, H. Shivananda Murthy, H. n. Anjanayappa

Abstract:

The freshwater prawn, Macrobrachium rosenbergii is a more popular crustacean cultured widely in monoculture system in India. It has got high nutritional value in the human diet. Hence, understanding its enzymatic and body composition is important in order to judge its flesh quality. Fish oil specially derived from Indian oil sardine is a good source of highly unsaturated fatty acid and lipid source in fish/prawn diet. A 35% crude protein diet with graded levels of Sardine oil as a source of fat was incorporated at four levels viz, 2.07, 4.07, 6.07 and 8.07% maintaining a total lipid level of feed at 8.11, 10.24, 12.28 and 14.33% respectively. Diet without sardine oil (6.05% total lipid) was served as basal treatment. The giant freshwater prawn, Macrobrachium rosenbergii was used as test animal and the experiment was lost for 112 days. Significantly, higher gain in weight of prawn was recorded in the treatment with 6.07% sardine oil incorporation followed by higher specific growth rate, food conversion rate and protein efficiency ratio. The 8.07% sardine oil diet produced the highest RNA: DNA ratio in the prawn muscle. Digestive enzyme analyses in the digestive tract and mid-gut gland showed the greatest activity in prawns fed the 8.07% diet.

Keywords: digestive enzyme, fish diet, Macrobrachium rosenbergii, sardine oil

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8525 Quantitative Analysis of the High-Value Bioactive Components of Pre-Germinated and Germinated Pigmented Rice (Oryza sativa L. Cv. Superjami and Superhongmi)

Authors: Lara Marie Pangan Lo, Soo Im Chung, Yao Cheng Zhang, Xingyue Jin, Mi Young Kang

Abstract:

Being the world’s most consumed grain crop, rice (Oryza sativa L.) demands’ have increase and this prompted the development of new rice cultivars with high bio-functional properties than the commonly used white rice. Ordinary rice variety is already known to be a potential source for a number of nutritional as well as bioactive compounds. To further enhance the rice’s nutritive values, germination is done in addition to making it more tasty and palatable when cooked. Pigmented rice, on the other hand, has become increasingly popular in the recent years for their greater antioxidant potential and other nutraceutical properties which can help alleviate the occurrence of the increasing incidence of metabolic diseases. Combining these two (2) parameters, this research study is sought to quantitatively determine the pre-germinated and germinated quantities of the major bioactive compounds of South Korea’s newly developed purplish pigmented rice grain cultivar Superjami (SJ) and red pigmented rice grain Superhongmi (SH) and compare them against the non-pigmented Normal Brown (NB) rice variety. Powdered rice grain cultivars were subjected to 72-hour germination period and the quantities of GABA, γ-oryzanol, ferulic acid, tocopherol and tocotrienol homologues were compared against their pre-germinated condition using γ- amino butyric acid (GABA) analysis and High Performance Liquid Chromatography (HPLC). Results revealed the effectiveness of germination in enhancing the bioactive components in all rice samples. GABA contents in germinated rice cultivars increased by more than 10-fold following the order: SJ >SH >NB. In addition, purple rice variety (SJ) has higher total γ-oryzanol and ferulic acid contents which increased by > 2-fold after germination followed by the red cultivar SH then the control, NB. Germinated varieties also possess higher total tocotrienol content than their pre-germinated state. As for the total tocopherol content, SJ has higher quantity, but the red-pigmented SH (0.16 mg/kg) is shown to have lower total tocopherol content than the control rice NB (0.86 mg/kg). However, all tocopherol and tocotrienol homologues were present only in small amounts ( < 3.0 mg/kg) in all pre-germinated and germinated samples. In general, all of the analyzed pigmented rice cultivars were found to possess higher bioactive compounds than the control NB rice variety. Also, regardless of their strain, germinated rice samples have higher bioactive compounds than their pre-germinated counterparts. This only shows the effectiveness of germinating rice in enhancing bioactive constituents. Overall, these results suggest the potential of the pigmented rice varieties as natural source of nutraceuticals in bio-functional food development.

Keywords: bioactive compounds, germinated rice, superhongmi, superjami

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8524 International Trade and Regional Inequality in South America: A Study Applied to Brazil and Argentina

Authors: Mónica Arroyo

Abstract:

South America shows increasing decline in regional export values in the last years, after a strong growth of trade flows especially with China up to 2013. This change is due to the end of the commodity price boom, the slowing of the Chinese economy and the effects of the 2008 economic crisis. This paper examines the integration of regional economies in this context, particularly the situation in Brazil and Argentina. Based on transformations over the last two decades, the analysis is focused on the spatial circuits of production linked to foreign markets, contributing to the understanding of the different uses of territory and the within-country inequality. The South American regional exports, consisting basically of raw materials, are concentrated in a few companies. Large areas are intended for the production of agriculture and mining commodities, under the command of major economic groups, both domestic and foreign, relegating the local population to less productive places or, in most cases, forcing them to change their activity and to migrate to other regions in search of some source of income. On the other hand, the dynamics of these commodities’ spatial circuits of production print requirements in territories in terms of infrastructure and regulation. Capturing this movement requires understanding businesses and government’s role in territorial regulation, and consequently how regional systems are changing – for instance, economic specialisation, growing role of services, investment in roads, railways, ports, and airports. This paper aims to highlight topics for discussion on regional economic dynamics and their different degrees of internationalisation. The intention is to contribute to the debate about the relations between trade, globalization, and development.

Keywords: regional inequality, international trade, developing world, South America

Procedia PDF Downloads 251
8523 Distribution Urban Public Spaces Among Riyadh Residential Neighborhoods

Authors: Abdulwahab Alalyani, Mahbub Rashid

Abstract:

Urban Open Space (UOS) a central role to promotes community health, including daily activities, but these resources may not available, accessible enough, and or equitably be distributed. This paper measures and compares spatial equity of the availability and accessibility UOS among low, middle, and high-income neighborhoods in Riyadh city. The measurement mothdulgy for the UOSavailability was by calculating the total of UOS with respect to the population total (m2/inhabitant) and the accessibility indicted by using walking distance of a 0.25 mi (0.4 km) buffering streets network.All UOS were mapped and measured using geographical information systems. To evaluate the significant differences in UOS availability and accessibility across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences.The findings are as follows; finding, UOSavailability was lower than global standers. Riyadh has only 1.13 m2 per capita of UOS, and the coverage accessible area by walking distance to UOS was lower than 50%. The final finding, spatial equity of the availability and accessibility, were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of UOS should be focused on increasing Urban park availability and should be given priority to those low-income and unhealthy communities.

Keywords: distribution urban open space, urban open space accessibility, spatial equity, riyadh city

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8522 Ranking the Elements of Relationship Market Orientation Banks (Case Study: Saderat Bank of Iran)

Authors: Sahar Jami, Iman Valizadeh

Abstract:

Today banks not only should seek for new customers but also should consider previous maintenance and retention and establish a stable relationship with them. In this term, relationship-manner marketing seeks to make, maintain, and promote the relationship between customers and other stakeholders in benefits to fulfill all involved parties. This fact is possible just by interactive transaction and promises fulfillment. According to the importance of relationship-manner marketing in banks, making context to make relationship-manner marketing has high importance. Therefore, the present study aims at exploring intention condition to relationship-manner marketing in Iran Province Iran Limited bank, and also prioritizing its variables using hierarchical analysis (AHP). There is questionnaire designed in this research to paired comparison of relationship-manner marketing elements. After distributing this questionnaire among statistical society members who are 20 of Iran Limited bank experts, data analysis has been done by Expert Choice software.

Keywords: relationship marketing, relationship market orientation, Saderat Bank of Iran, hierarchical analysis

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8521 Preparation vADL.net: A Software Architecture Tool with Support to All of Architectural Concepts Title

Authors: Adel Smeda, Badr Najep

Abstract:

Software architecture is a method of describing the architecture of a software system at a high level of abstraction. It represents a common abstraction of a system that stakeholders can use as a basis for mutual understanding, negotiation, consensus, and communication. It also manifests the earliest design decisions about a system, and these early bindings carry weight far out of proportion to their individual gravity with respect to the system's remaining development, its deployment, and its maintenance life, therefore it is the earliest point at which design decisions governing the system to be built can be analyzed. In this paper, we present a tool to model the architecture of software systems. It represents the first method by which system defects can be detected, and provide a clear representation of a system’s components and interactions at a high level of abstraction. It can be distinguished from other tools by its support to all software architecture elements. The tool is built using VB.net 2010. We used this tool to describe two well know systems, i.e. Capitalize and Client/Server, and the descriptions we obtained support all architectural elements of the two systems.

Keywords: software architecture, architecture description languages, modeling

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8520 The Role of Disturbed Dry Afromontane Forest of Ethiopia for Biodiversity Conservation and Carbon Storage

Authors: Mindaye Teshome, Nesibu Yahya, Carlos Moreira Miquelino Eleto Torres, Pedro Manuel Villaa, Mehari Alebachew

Abstract:

Arbagugu forest is one of the remnant dry Afromontane forests under severe anthropogenic disturbances in central Ethiopia. Despite this fact, up-to-date information is lacking about the status of the forest and its role in climate change mitigation. In this study, we evaluated the woody species composition, structure, biomass, and carbon stock in this forest. We employed a systematic random sampling design and established fifty-three sample plots (20 × 100 m) to collect the vegetation data. A total of 37 woody species belonging to 25 families were recorded. The density of seedlings, saplings, and matured trees were 1174, 101, and 84 stems ha-1, respectively. The total basal area of trees with DBH (diameter at breast height) ≥ 2 cm was 21.3 m2 ha-1. The characteristic trees of dry Afromontane Forest such as Podocarpus falcatus, Juniperus procera, and Olea europaea subsp. cuspidata exhibited a fair regeneration status. On the contrary, the least abundant species Lepidotrichilia volkensii, Canthium oligocarpum, Dovyalis verrucosa, Calpurnia aurea, and Maesa lanceolata exhibited good regeneration status. Some tree species such as Polyscias fulva, Schefflera abyssinica, Erythrina brucei, and Apodytes dimidiata lack regeneration. The total carbon stored in the forest ranged between 6.3 Mg C ha-1 and 835.6 Mg C ha-1. This value is equivalent to 639.6 Mg C ha-1. The forest had a very low number of woody species composition and diversity. The regeneration study also revealed that a significant number of tree species had unsatisfactory regeneration status. Besides, the forest had a lower carbon stock density compared with other dry Afromontane forests. This implies the urgent need for forest conservation and restoration activities by the local government, conservation practitioners, and other concerned bodies to maintain the forest and sustain the various ecosystem goods and services provided by the Arbagugu forest.

Keywords: aboveground biomass, forest regeneration, climate change, biodiversity conservation, restoration

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8519 Transient Enhanced LDO Voltage Regulator with Improved Feed Forward Path Compensation

Authors: A. Suresh, Sreehari Rao Patri, K. S. R. Krishnaprasad

Abstract:

An ultra low power capacitor less low-dropout voltage regulator with improved transient response using gain enhanced feed forward path compensation is presented in this paper. It is based on a cascade of a voltage amplifier and a transconductor stage in the feed forward path with regular error amplifier to form a composite gain-enhanced feed forward stage. It broadens the gain bandwidth and thus improves the transient response without substantial increase in power consumption. The proposed LDO, designed for a maximum output current of 100 mA in UMC 180 nm, requires a quiescent current of 69 µA. An undershoot of 153.79mV for a load current changes from 0mA to 100mA and an overshoot of 196.24mV for current change of 100mA to 0mA. The settling time is approximately 1.1 µs for the output voltage undershoot case. The load regulation is of 2.77 µV/mA at load current of 100mA. Reference voltage is generated by using an accurate band gap reference circuit of 0.8V.The costly features of SOC such as total chip area and power consumption is drastically reduced by the use of only a total compensation capacitance of 6pF while consuming power consumption of 0.096 mW.

Keywords: capacitor-less LDO, frequency compensation, transient response, latch, self-biased differential amplifier

Procedia PDF Downloads 437
8518 Significance of Occupational Safety for Healthcare Professionals

Authors: Nilgün Katrancı, Pınar Göv

Abstract:

The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

Procedia PDF Downloads 370
8517 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

Abstract:

The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

Procedia PDF Downloads 158
8516 Monitoring and Improving Performance of Soil Aquifer Treatment System and Infiltration Basins of North Gaza Emergency Sewage Treatment Plant as Case Study

Authors: Sadi Ali, Yaser Kishawi

Abstract:

As part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is to find non-conventional water resource from treated wastewater to irrigate 1500 hectares and serves over 100,000 inhabitants. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & 9 infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, phase A is functioning since Apr 2009. Since Apr 2009, a monitoring plan is conducted to monitor the infiltration rate (I.R.) of the 9 basins. Nearly 23 million m3 of partially treated wastewater were infiltrated up to Jun 2014. It is important to maintain an acceptable rate to allow the basins to handle the coming quantities (currently 10,000 m3 are pumped an infiltrated daily). The methodology applied was to review and analysis the collected data including the I.R.s, the WW quality and the drying-wetting schedule of the basins. One of the main findings is the relation between the Total Suspended Solids (TSS) at BLWWTP and the I.R. at the basins. Since April 2009, the basins scored an average I.R. of about 2.5 m/day. Since then the records showed a decreasing pattern of the average rate until it reached the lower value of 0.42 m/day in Jun 2013. This was accompanied with an increase of TSS (mg/L) concentration at the source reaching above 200 mg/L. The reducing of TSS concentration directly improved the I.R. (by cleaning the WW source ponds at Biet Lahia WWTP site). This was reflected in an improvement in I.R. in last 6 months from 0.42 m/day to 0.66 m/day then to nearly 1.0 m/day as the average of the last 3 months of 2013. The wetting-drying scheme of the basins was observed (3 days wetting and 7 days drying) besides the rainfall rates. Despite the difficulty to apply this scheme accurately a control of flow to each basin was applied to improve the I.R. The drying-wetting system affected the I.R. of individual basins, thus affected the overall system rate which was recorded and assessed. Also the ploughing activities at the infiltration basins as well were recommended at certain times to retain a certain infiltration level. This breaks the confined clogging layer which prevents the infiltration. It is recommended to maintain proper quality of WW infiltrated to ensure an acceptable performance of IBs. The continual maintenance of settling ponds at BLWWTP, continual ploughing of basins and applying soil treatment techniques at the IBs will improve the I.R.s. When the new WWTP functions a high standard effluent quality (TSS 20mg, BOD 20 mg/l, and TN 15 mg/l) will be infiltrated, thus will enhance I.R.s of IBs due to lower organic load.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, North Gaza

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8515 Factors Affecting the Mental and Physical Health of Nurses during the Outbreak of COVID-19: A Case Study of a Hospital in Mashhad

Authors: Ghorbanali Mohammadi

Abstract:

Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

Procedia PDF Downloads 105