Search results for: design studies
1649 Tackling Inequalities in Regional Health Care: Accompanying an Inter-Sectoral Cooperation Project between University Medicine and Regional Care Structures
Authors: Susanne Ferschl, Peter Holzmüller, Elisabeth Wacker
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Ageing populations, advances in medical sciences and digitalization, diversity and social disparities, as well as the increasing need for skilled healthcare professionals, are challenging healthcare systems around the globe. To address these challenges, future healthcare systems need to center on human needs taking into account the living environments that shape individuals’ knowledge of and opportunities to access healthcare. Moreover, health should be considered as a common good and an integral part of securing livelihoods for all people. Therefore, the adoption of a systems approach, as well as inter-disciplinary and inter-sectoral cooperation among healthcare providers, are essential. Additionally, the active engagement of target groups in the planning and design of healthcare structures is indispensable to understand and respect individuals’ health and livelihood needs. We will present the research project b4 – identifying needs | building bridges | developing health care in the social space, which is situated within this reasoning and accompanies the cross-sectoral cooperation project Brückenschlag (building bridges) in a Bavarian district. Brückenschlag seeks to explore effective ways of health care linking university medicine (Maximalversorgung | maximum care) with regional inpatient, outpatient, rehabilitative, and preventive care structures (Regionalversorgung | regional care). To create advantages for both (potential) patients and the involved cooperation partners, project b4 qualitatively assesses needs and motivations among professionals, population groups, and political stakeholders at individual and collective levels. Besides providing an overview of the project structure as well as of regional population and healthcare characteristics, the first results of qualitative interviews conducted with different health experts will be presented. Interviewed experts include managers of participating hospitals, nurses, medical specialists working in the hospital and registered doctors operating in practices in rural areas. At the end of the project life and based on the identified factors relevant to the success -and also for failure- of participatory cooperation in health care, the project aims at informing other districts embarking on similar systems-oriented and human-centered healthcare projects. Individuals’ health care needs in dependence on the social space in which they live will guide the development of recommendations.Keywords: cross-sectoral collaboration in health care, human-centered health care, regional health care, individual and structural health conditions
Procedia PDF Downloads 1011648 The Effectiveness of a Six-Week Yoga Intervention on Body Awareness, Warnings of Relapse, and Emotion Regulation among Incarcerated Females
Authors: James Beauchemin
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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.Keywords: yoga, mental health, incarceration, wellness
Procedia PDF Downloads 1381647 Comparison Conventional with Microwave-Assisted Drying Method on the Physicochemical Characteristics of Rice Bran Noodle
Authors: Chien-Chun Huang, Yi-U Chiou, Chiun-C.R. Wang
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For longer shelf life of noodles, air-dried method is the traditional way for the noodle preparation. Microwave drying has the specific advantage of rapid and uniform heating due to the penetration of microwaves into the body of the product. Microwave-assisted facility offers a quick and energy saving method during food dehydration as compares to the conventional air-dried method. Recently, numerous studies in the rheological characteristics of pasta or spaghetti were carried out with microwave–assisted air driers and many agricultural products were dried successfully. There are few researches about the evaluation of physicochemical characteristics and cooking quality of microwave-assisted air dried salted noodles. The purposes of this study were to compare the difference between conventional and microwave-assisted drying method on the physicochemical properties and eating quality of rice bran noodles. Three different microwave power including 0.5 KW, 0.75 KW and 1.0 KW installing with 50℃ hot air were applied for dehydration of rice bran noodles in this study. Three proportion of rice bran ranging in 0-20% were incorporated into salted noodles processing. The appearance, optimum cooking time, cooking yield and losses, textural profiles analysis, sensory evaluation of rice bran noodles were measured in this study. The results indicated that high power (1.0 KW) microwave facility caused partially burnt and porous on the surface of rice bran noodles. However, no characteristic of noodle was appeared on the surface of noodles preparing by low power (0.5 KW) microwave facility. The optimum cooking time of noodles was decreased as higher power microwave or higher proportion of rice bran was incorporated into noodles preparation. The higher proportion of rice bran (20%) or higher power of microwave-assisted dried noodles obtained the higher color intensity and the higher cooking losses as compared with conventional air dried noodles. The firmness of cooked rice bran noodles slightly decreased in the cooked noodles which were dried by high power microwave-assisted method. The shearing force, tensile strength, elasticity and texture profiles of cooked rice noodles decreased with the progress of the proportion of rice bran. The results of sensory evaluation indicated conventional dried noodles obtained the higher springiness, cohesiveness and acceptability of cooked noodles than high power (1.0 KW) microwave-assisted dried noodles. However, low power (0.5 KW) microwave-assisted dried noodles showed the comparable sensory attributes and acceptability with conventional dried noodles. Moreover, the sensory attributes including firmness, springiness, cohesiveness decreased, but stickiness increased, with the increases of rice bran proportion. These results inferred that incorporation of lower proportion of rice bran and lower power microwave-assisted dried noodles processing could produce faster cooking time and acceptable quality of cooked noodles as compared to conventional dried noodles.Keywords: microwave-assisted drying method, physicochemical characteristics, rice bran noodles, sensory evaluation
Procedia PDF Downloads 4821646 A Case Study Demonstrating the Benefits of Low-Carb Eating in an Adult with Latent Autoimmune Diabetes Highlights the Necessity and Effectiveness of These Dietary Therapies
Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay
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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.Keywords: autoimmune, diabetes, LADA, low_carb, nutrition
Procedia PDF Downloads 391645 Prediction of Terrorist Activities in Nigeria using Bayesian Neural Network with Heterogeneous Transfer Functions
Authors: Tayo P. Ogundunmade, Adedayo A. Adepoju
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Terrorist attacks in liberal democracies bring about a few pessimistic results, for example, sabotaged public support in the governments they target, disturbing the peace of a protected environment underwritten by the state, and a limitation of individuals from adding to the advancement of the country, among others. Hence, seeking for techniques to understand the different factors involved in terrorism and how to deal with those factors in order to completely stop or reduce terrorist activities is the topmost priority of the government in every country. This research aim is to develop an efficient deep learning-based predictive model for the prediction of future terrorist activities in Nigeria, addressing low-quality prediction accuracy problems associated with the existing solution methods. The proposed predictive AI-based model as a counterterrorism tool will be useful by governments and law enforcement agencies to protect the lives of individuals in society and to improve the quality of life in general. A Heterogeneous Bayesian Neural Network (HETBNN) model was derived with Gaussian error normal distribution. Three primary transfer functions (HOTTFs), as well as two derived transfer functions (HETTFs) arising from the convolution of the HOTTFs, are namely; Symmetric Saturated Linear transfer function (SATLINS ), Hyperbolic Tangent transfer function (TANH), Hyperbolic Tangent sigmoid transfer function (TANSIG), Symmetric Saturated Linear and Hyperbolic Tangent transfer function (SATLINS-TANH) and Symmetric Saturated Linear and Hyperbolic Tangent Sigmoid transfer function (SATLINS-TANSIG). Data on the Terrorist activities in Nigeria gathered through questionnaires for the purpose of this study were used. Mean Square Error (MSE), Mean Absolute Error (MAE) and Test Error are the forecast prediction criteria. The results showed that the HETFs performed better in terms of prediction and factors associated with terrorist activities in Nigeria were determined. The proposed predictive deep learning-based model will be useful to governments and law enforcement agencies as an effective counterterrorism mechanism to understand the parameters of terrorism and to design strategies to deal with terrorism before an incident actually happens and potentially causes the loss of precious lives. The proposed predictive AI-based model will reduce the chances of terrorist activities and is particularly helpful for security agencies to predict future terrorist activities.Keywords: activation functions, Bayesian neural network, mean square error, test error, terrorism
Procedia PDF Downloads 1651644 Phantom and Clinical Evaluation of Block Sequential Regularized Expectation Maximization Reconstruction Algorithm in Ga-PSMA PET/CT Studies Using Various Relative Difference Penalties and Acquisition Durations
Authors: Fatemeh Sadeghi, Peyman Sheikhzadeh
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Introduction: Block Sequential Regularized Expectation Maximization (BSREM) reconstruction algorithm was recently developed to suppress excessive noise by applying a relative difference penalty. The aim of this study was to investigate the effect of various strengths of noise penalization factor in the BSREM algorithm under different acquisition duration and lesion sizes in order to determine an optimum penalty factor by considering both quantitative and qualitative image evaluation parameters in clinical uses. Materials and Methods: The NEMA IQ phantom and 15 clinical whole-body patients with prostate cancer were evaluated. Phantom and patients were injected withGallium-68 Prostate-Specific Membrane Antigen(68 Ga-PSMA)and scanned on a non-time-of-flight Discovery IQ Positron Emission Tomography/Computed Tomography(PET/CT) scanner with BGO crystals. The data were reconstructed using BSREM with a β-value of 100-500 at an interval of 100. These reconstructions were compared to OSEM as a widely used reconstruction algorithm. Following the standard NEMA measurement procedure, background variability (BV), recovery coefficient (RC), contrast recovery (CR) and residual lung error (LE) from phantom data and signal-to-noise ratio (SNR), signal-to-background ratio (SBR) and tumor SUV from clinical data were measured. Qualitative features of clinical images visually were ranked by one nuclear medicine expert. Results: The β-value acts as a noise suppression factor, so BSREM showed a decreasing image noise with an increasing β-value. BSREM, with a β-value of 400 at a decreased acquisition duration (2 min/ bp), made an approximately equal noise level with OSEM at an increased acquisition duration (5 min/ bp). For the β-value of 400 at 2 min/bp duration, SNR increased by 43.7%, and LE decreased by 62%, compared with OSEM at a 5 min/bp duration. In both phantom and clinical data, an increase in the β-value is translated into a decrease in SUV. The lowest level of SUV and noise were reached with the highest β-value (β=500), resulting in the highest SNR and lowest SBR due to the greater noise reduction than SUV reduction at the highest β-value. In compression of BSREM with different β-values, the relative difference in the quantitative parameters was generally larger for smaller lesions. As the β-value decreased from 500 to 100, the increase in CR was 160.2% for the smallest sphere (10mm) and 12.6% for the largest sphere (37mm), and the trend was similar for SNR (-58.4% and -20.5%, respectively). BSREM visually was ranked more than OSEM in all Qualitative features. Conclusions: The BSREM algorithm using more iteration numbers leads to more quantitative accuracy without excessive noise, which translates into higher overall image quality and lesion detectability. This improvement can be used to shorter acquisition time.Keywords: BSREM reconstruction, PET/CT imaging, noise penalization, quantification accuracy
Procedia PDF Downloads 971643 Saco Sweet Cherry: Phenolic Profile and Biological Activity of Coloured and Non-Coloured Fractions
Authors: Catarina Bento, Ana Carolina Gonçalves, Fábio Jesus, Luís Rodrigues Silva
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Increasing evidence suggests that a diet rich in fruits and vegetables plays important roles in the prevention of chronic diseases, such as heart disease, cancer, stroke, diabetes, Alzheimer’s disease, among others. Fruits and vegetables gained prominence due their richness in bioactive compounds, being the focus of many studies due to their biological properties acting as health promoters. Prunus avium Linnaeus (L.), commonly known as sweet cherry has been the centre of attention due to its health benefits, and has been highly studied. In Portugal, most of the cherry production comes from the Fundão region. The Saco is one of the most important cultivar produced in this region, attributed with geographical protection. In this work, we prepared 3 extracts through solid-phase extraction (SPE): a whole extract, fraction I (non-coloured phenolics) and fraction II (coloured phenolics). The three extracts were used to determine the phenolic profile of Saco cultivar by liquid chromatography with diode array detection (LC-DAD) technique. This was followed by the evaluation of their biological potential, testing the extracts’ capacity to scavenge free-radicals (DPPH•, nitric oxide (•NO) and superoxide radical (O2●-)) and to inhibit α-glucosidase enzyme of all extracts. Additionally, we evaluated, for the first time, the protective effects against peroxyl radical (ROO•)-induced hemoglobin oxidation and hemolysis in human erythrocytes. A total of 16 non-coloured phenolics were detected, 3-O-caffeoylquinic and ρ-coumaroylquinic acids were the main ones, and 6 anthocyanins were found, among which cyanidin-3-O-rutinoside represented the majority. In respect to antioxidant activity, Saco showed great antioxidant potential in a concentration-dependent manner, demonstrated through the DPPH•,•NO and O2●-radicals, and greater ability to inhibit the α-glucosidase enzyme in comparison to the regular drug acarbose used to treat diabetes. Additionally, Saco proved to be effective to protect erythrocytes against oxidative damage in a concentration-dependent manner against hemoglobin oxidation and hemolysis. Our work demonstrated that Saco cultivar is an excellent source of phenolic compounds which are natural antioxidants that easily capture reactive species, such as ROO• before they can attack the erythrocytes’ membrane. In a general way, the whole extract showed the best efficiency, most likely due to a synergetic interaction between the different compounds. Finally, comparing the two separate fractions, the coloured fraction showed the most activity in all the assays, proving to be the biggest contributor of Saco cherries’ biological activity.Keywords: biological potential, coloured phenolics, non-coloured phenolics, sweet cherry
Procedia PDF Downloads 2561642 Connecting the Dots: Bridging Academia and National Community Partnerships When Delivering Healthy Relationships Programming
Authors: Nicole Vlasman, Karamjeet Dhillon
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Over the past four years, the Healthy Relationships Program has been delivered in community organizations and schools across Canada. More than 240 groups have been facilitated in collaboration with 33 organizations. As a result, 2157 youth have been engaged in the programming. The purpose and scope of the Healthy Relationships Program are to offer sustainable, evidence-based skills through small group implementation to prevent violence and promote positive, healthy relationships in youth. The program development has included extensive networking at regional and national levels. The Healthy Relationships Program is currently being implemented, adapted, and researched within the Resilience and Inclusion through Strengthening and Enhancing Relationships (RISE-R) project. Alongside the project’s research objectives, the RISE-R team has worked to virtually share the ongoing findings of the project through a slow ontology approach. Slow ontology is a practice integrated into project systems and structures whereby slowing the pace and volume of outputs offers creative opportunities. Creative production reveals different layers of success and complements the project, the building blocks for sustainability. As a result of integrating a slow ontology approach, the RISE-R team has developed a Geographic Information System (GIS) that documents local landscapes through a Story Map feature, and more specifically, video installations. Video installations capture the cartography of space and place within the context of singular diverse community spaces (case studies). By documenting spaces via human connections, the project captures narratives, which further enhance the voices and faces of the community within the larger project scope. This GIS project aims to create a visual and interactive flow of information that complements the project's mixed-method research approach. Conclusively, creative project development in the form of a geographic information system can provide learning and engagement opportunities at many levels (i.e., within community organizations and educational spaces or with the general public). In each of these disconnected spaces, fragmented stories are connected through a visual display of project outputs. A slow ontology practice within the context of the RISE-R project documents activities on the fringes and within internal structures; primarily through documenting project successes as further contributions to the Centre for School Mental Health framework (philosophy, recruitment techniques, allocation of resources and time, and a shared commitment to evidence-based products).Keywords: community programming, geographic information system, project development, project management, qualitative, slow ontology
Procedia PDF Downloads 1551641 Assessment of Five Photoplethysmographic Methods for Estimating Heart Rate Variability
Authors: Akshay B. Pawar, Rohit Y. Parasnis
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Heart Rate Variability (HRV) is a widely used indicator of the regulation between the autonomic nervous system (ANS) and the cardiovascular system. Besides being non-invasive, it also has the potential to predict mortality in cases involving critical injuries. The gold standard method for determining HRV is based on the analysis of RR interval time series extracted from ECG signals. However, because it is much more convenient to obtain photoplethysmogramic (PPG) signals as compared to ECG signals (which require the attachment of several electrodes to the body), many researchers have used pulse cycle intervals instead of RR intervals to estimate HRV. They have also compared this method with the gold standard technique. Though most of their observations indicate a strong correlation between the two methods, recent studies show that in healthy subjects, except for a few parameters, the pulse-based method cannot be a surrogate for the standard RR interval- based method. Moreover, the former tends to overestimate short-term variability in heart rate. This calls for improvements in or alternatives to the pulse-cycle interval method. In this study, besides the systolic peak-peak interval method (PP method) that has been studied several times, four recent PPG-based techniques, namely the first derivative peak-peak interval method (P1D method), the second derivative peak-peak interval method (P2D method), the valley-valley interval method (VV method) and the tangent-intersection interval method (TI method) were compared with the gold standard technique. ECG and PPG signals were obtained from 10 young and healthy adults (consisting of both males and females) seated in the armchair position. In order to de-noise these signals and eliminate baseline drift, they were passed through certain digital filters. After filtering, the following HRV parameters were computed from PPG using each of the five methods and also from ECG using the gold standard method: time domain parameters (SDNN, pNN50 and RMSSD), frequency domain parameters (Very low-frequency power (VLF), Low-frequency power (LF), High-frequency power (HF) and Total power or “TP”). Besides, Poincaré plots were also plotted and their SD1/SD2 ratios determined. The resulting sets of parameters were compared with those yielded by the standard method using measures of statistical correlation (correlation coefficient) as well as statistical agreement (Bland-Altman plots). From the viewpoint of correlation, our results show that the best PPG-based methods for the determination of most parameters and Poincaré plots are the P2D method (shows more than 93% correlation with the standard method) and the PP method (mean correlation: 88%) whereas the TI, VV and P1D methods perform poorly (<70% correlation in most cases). However, our evaluation of statistical agreement using Bland-Altman plots shows that none of the five techniques agrees satisfactorily well with the gold standard method as far as time-domain parameters are concerned. In conclusion, excellent statistical correlation implies that certain PPG-based methods provide a good amount of information on the pattern of heart rate variation, whereas poor statistical agreement implies that PPG cannot completely replace ECG in the determination of HRV.Keywords: photoplethysmography, heart rate variability, correlation coefficient, Bland-Altman plot
Procedia PDF Downloads 3241640 Quality Assessment of the Given First Aid on the Spot Events in the Opinion of Members of the Teams of the Medical Rescue in Warsaw in Poland
Authors: Aneta Binkowska, Artur Kamecki
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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.Keywords: BLS, first aid, medical rescue, resuscitation
Procedia PDF Downloads 1521639 Stuttering Persistence in Children: Effectiveness of the Psicodizione Method in a Small Italian Cohort
Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri
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Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.Keywords: early treatment, fluency, preschool children, stuttering
Procedia PDF Downloads 2171638 Grouping Pattern, Habitat Assessment and Overlap Analysis of Five Ungulates Species in Different Altitudinal Gradients of Western Himalaya, Uttarakhand, India
Authors: Kaleem Ahmed, Jamal A. Khan
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Grouping patterns, habitat use, and overlap studies were conducted on five sympatric ungulate species sambar (Cervus unicolor), chital (Axis axis), muntjac (Muntiacus muntjac), goral (Nemorhaedus goral), and serow (Capricornis sumatraensis) in the Dabka watershed area within Indian West Himalayan range. Data on age, sex composition, group size, and various ecological and topographical factors governing the presence/absence of species within the study area were collected using a 250 km of a trail walk, 95 permanent circular plots of 10 m radius, and 3 vantage points with 58 scannings. The highest mean group size was recorded for chital (6.35 ± 0.50), followed by sambar (1.35 ± 0.10), goral (1.25 ±0.63), muntjac (1.12 ± 0.05), and serow (1.00 ± 0.00). Grouping pattern significantly varied among sympatric species (F = 85.10, df. = 6, P = 0.000). The highest mean pellet group density (/ha ± SE) was recorded for sambar (41.56 ± 3.51), followed by goral (23.31 ± 3.45), chital (19.21 ± 3.51), muntjac (7.43 ± 1.21), and serow (1.02 ± 0.10). Two-way variance analysis showed a significant difference in the density of the pellet group of all ungulate species across different study area habitats (F = 6.38, df = 4, P = 0.027). The availability-utilization (AU) analysis reveals that goral was mostly sighted in steep slopes, preferred > 2100 m altitudinal range with low shrub understory, avoided dense forest, and relatively more southern aspects were used. Chital had used a wide range of tree and shrub coverings with a preference towards moderate cover range (26-50%), preferred areas with low slope category ( < 25), avoided areas of high altitude > 900 m. Sambar avoided less tree cover (0-25), preferred slope category (26-500), altitudes between 1600-2100 m, and preferred dense forest with northern aspects. Muntjac used all elevation ranges in the study area with a preference towards the dense forest and northern aspects. Serow preferred high tree cover > 75%, avoided low shrub cover (0-25%), preferred high shrub cover 51-75%, utilized higher elevation > 2100 m, avoided low elevation range and northern aspects. All species occupied similar habitat types, forest or scrub, except for the goral, which preferred open spaces. Between muntjac and sambar, the highest overlap was found (65%), and there was no overlap between chital and serow, chital and goral. Aspect, slope, altitude, and vegetation characteristics were found to be important factors for the overlap of ungulate sympatric species. One major reason for their ecological separation at the fine-scale level is the differential use of altitude by ungulates in the present study. This is confirmed by the avoidance by chital of altitudes > 900 m and serow of < 2100 m.Keywords: altitude, grouping pattern, Himalayas, overlap, ungulates
Procedia PDF Downloads 1411637 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital
Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon
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Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania
Procedia PDF Downloads 3311636 Toxicity Evaluation of Reduced Graphene Oxide on First Larval Stages of Artemia sp.
Authors: Roberta Pecoraro
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The focus of this work was to investigate the potential toxic effect of titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites on nauplii of microcrustacean Artemia sp. In order to assess the nanocomposite’s toxicity, a short-term test was performed by exposing nauplii to solutions containing TiO₂-rGO. To prepare titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites, a green procedure based on solar photoreduction was proposed; it allows to obtain the photocatalysts by exploiting the photocatalytic properties of titania activated by the solar irradiation in order to avoid the high temperatures and pressures required for the standard hydrothermal synthesis. Powders of TiO₂-rGO supplied by the Department of Chemical Sciences (University of Catania) are indicated as TiO₂-rGO at 1% and TiO₂-rGO at 2%. Starting from a stock solution (1mg rGO-TiO₂/10 ml ASPM water) of each type, we tested four different concentrations (serial dilutions ranging from 10⁻¹ to 10⁻⁴ mg/ml). All the solutions have been sonicated for 12 min prior to use. Artificial seawater (called ASPM water) was prepared to guarantee the hatching of the cysts and to maintain nauplii; the durable cysts used in this study, marketed by JBL (JBL GmbH & Co. KG, Germany), were hydrated with ASPM water to obtain nauplii (instar II-III larvae). The hatching of the cysts was carried out in the laboratory by immersing them in ASPM water inside a 500 ml beaker and keeping them constantly oxygenated thanks to an aerator for the insufflation of microbubble air: after 24-48 hours, the cysts hatched, and the nauplii appeared. The nauplii in the second and third stages of development were collected one-to-one, using stereomicroscopes, and transferred into 96-well microplates where one nauplius per well was added. The wells quickly have been filled with 300 µl of each specific concentration of the solution used, and control samples were incubated only with ASPM water. Replication was performed for each concentration. Finally, the microplates were placed on an orbital shaker, and the tests were read after 24 and 48 hours from inoculating the solutions to assess the endpoint (immobility/death) for the larvae. Nauplii that appeared motionless were counted as dead, and the percentages of mortality were calculated for each treatment. The results showed a low percentage of immobilization both for TiO₂-rGO at 1% and TiO₂-rGO at 2% for all concentrations tested: for TiO₂-rGO at 1% was below 12% after 24h and below 15% after 48h; for TiO₂-rGO at 2% was below 8% after 24h and below 12% after 48h. According to other studies in the literature, the results have not shown mortality nor toxic effects on the development of larvae after exposure to rGO. Finally, it is important to highlight that the TiO₂-rGO catalysts were tested in the solar photodegradation of a toxic herbicide (2,4-Dichlorophenoxyacetic acid, 2,4-D), obtaining a high percentage of degradation; therefore, this alternative approach could be considered a good strategy to obtain performing photocatalysts.Keywords: Nauplii, photocatalytic properties, reduced GO, short-term toxicity test, titanium dioxide
Procedia PDF Downloads 1831635 The Use of Social Stories and Digital Technology as Interventions for Autistic Children; A State-Of-The-Art Review and Qualitative Data Analysis
Authors: S. Hussain, C. Grieco, M. Brosnan
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Background and Aims: Autism is a complex neurobehavioural disorder, characterised by impairments in the development of language and communication skills. The study involved a state-of-art systematic review, in addition to qualitative data analysis, to establish the evidence for social stories as an intervention strategy for autistic children. An up-to-date review of the use of digital technologies in the delivery of interventions to autistic children was also carried out; to propose the efficacy of digital technologies and the use of social stories to improve intervention outcomes for autistic children. Methods: Two student researchers reviewed a range of randomised control trials and observational studies. The aim of the review was to establish if there was adequate evidence to justify recommending social stories to autistic patients. Students devised their own search strategies to be used across a range of search engines, including Ovid-Medline, Google Scholar and PubMed. Students then critically appraised the generated literature. Additionally, qualitative data obtained from a comprehensive online questionnaire on social stories was also thematically analysed. The thematic analysis was carried out independently by each researcher, using a ‘bottom-up’ approach, meaning contributors read and analysed responses to questions and devised semantic themes from reading the responses to a given question. The researchers then placed each response into a semantic theme or sub-theme. The students then joined to discuss the merging of their theme headings. The Inter-rater reliability (IRR) was calculated before and after theme headings were merged, giving IRR for pre- and post-discussion. Lastly, the thematic analysis was assessed by a third researcher, who is a professor of psychology and the director for the ‘Centre for Applied Autism Research’ at the University of Bath. Results: A review of the literature, as well as thematic analysis of qualitative data found supporting evidence for social story use. The thematic analysis uncovered some interesting themes from the questionnaire responses, relating to the reasons why social stories were used and the factors influencing their effectiveness in each case. However, overall, the evidence for digital technologies interventions was limited, and the literature could not prove a causal link between better intervention outcomes for autistic children and the use of technologies. However, they did offer valid proposed theories for the suitability of digital technologies for autistic children. Conclusions: Overall, the review concluded that there was adequate evidence to justify advising the use of social stories with autistic children. The role of digital technologies is clearly a fast-emerging field and appears to be a promising method of intervention for autistic children; however, it should not yet be considered an evidence-based approach. The students, using this research, developed ideas on social story interventions which aim to help autistic children.Keywords: autistic children, digital technologies, intervention, social stories
Procedia PDF Downloads 1211634 Mature Field Rejuvenation Using Hydraulic Fracturing: A Case Study of Tight Mature Oilfield with Reveal Simulator
Authors: Amir Gharavi, Mohamed Hassan, Amjad Shah
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The main characteristics of unconventional reservoirs include low-to ultra low permeability and low-to-moderate porosity. As a result, hydrocarbon production from these reservoirs requires different extraction technologies than from conventional resources. An unconventional reservoir must be stimulated to produce hydrocarbons at an acceptable flow rate to recover commercial quantities of hydrocarbons. Permeability for unconventional reservoirs is mostly below 0.1 mD, and reservoirs with permeability above 0.1 mD are generally considered to be conventional. The hydrocarbon held in these formations naturally will not move towards producing wells at economic rates without aid from hydraulic fracturing which is the only technique to assess these tight reservoir productions. Horizontal well with multi-stage fracking is the key technique to maximize stimulated reservoir volume and achieve commercial production. The main objective of this research paper is to investigate development options for a tight mature oilfield. This includes multistage hydraulic fracturing and spacing by building of reservoir models in the Reveal simulator to model potential development options based on sidetracking the existing vertical well. To simulate potential options, reservoir models have been built in the Reveal. An existing Petrel geological model was used to build the static parts of these models. A FBHP limit of 40bars was assumed to take into account pump operating limits and to maintain the reservoir pressure above the bubble point. 300m, 600m and 900m lateral length wells were modelled, in conjunction with 4, 6 and 8 stages of fracs. Simulation results indicate that higher initial recoveries and peak oil rates are obtained with longer well lengths and also with more fracs and spacing. For a 25year forecast, the ultimate recovery ranging from 0.4% to 2.56% for 300m and 1000m laterals respectively. The 900m lateral with 8 fracs 100m spacing gave the highest peak rate of 120m3/day, with the 600m and 300m cases giving initial peak rates of 110m3/day. Similarly, recovery factor for the 900m lateral with 8 fracs and 100m spacing was the highest at 2.65% after 25 years. The corresponding values for the 300m and 600m laterals were 2.37% and 2.42%. Therefore, the study suggests that longer laterals with 8 fracs and 100m spacing provided the optimal recovery, and this design is recommended as the basis for further study.Keywords: unconventional, resource, hydraulic, fracturing
Procedia PDF Downloads 2981633 Villages and Their City: Bridging the Rural-Urban Dichotomy Through Spatial Development
Authors: Ishan Kumar Garg
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Urban Fringes have been witnessing unforeseeable, haphazard, and ineffective spatial planning systems for many decades. It invades peripheral villages in the zest of the land as an abundant resource. The process, popularly known as "Urban Sprawl", is commonly seen in many fast-growing cities, especially in developing countries like India. The research for this paper reveals significant neglect in rural development policies, which are not recognized as crucial in current town and country planning regulations. This promotes urban-centric development in the fringe areas that are subjected to real-estate speculation. Therefore, being surrounded by arbitrary urban functions, these villages compromise with necessary strategies to retain the rural cultural identities, traditional ways of living, and villages’ interconnections while remaining deprived of urban amenities such as adequate water supply, education, sanitation, etc. Such socio-spatial separation makes us wonder about their right to development. The possibilities of a sustainable and socially inclusive city expansion are also explored through direct consumer–manufacturer media to bring positive socio-financial transformation. The paper aims to identify a rational playground for both the rural and urban population, which creates possibilities for economic and knowledge transactions beyond their local boundaries. This is achieved by empowering the intact community of villages with economic sufficiency and developing skills to pass on to future generations. In the above context, revolving around unregulated urban sprawl, the northeast region of Bareilly city in the Indian state of Uttar Pradesh is also discussed, i.e., currently under the influence of such development pressures. As we see, exclusive developments like residential, hospitality, industries, etc., over the unplanned landscapes are emerging with the development aligned to only urban means, not the rural. The paper ultimately re-envisions urban-rural associations through appropriate design combinations with economic growth. It integrates broken linkages by revising methodologies and encourages local entrepreneurship that taps the possibility of a gradual social transformation. Concurrently, the addition of required urban amenities leads to rural life strengthening and fulfilling aspirations. Since the proposed thesis carries through an inclusive fringe development, the study caters to cities of similar scales and situations that bolster such coexistence.Keywords: smart growth framework, empowering rural economy, socio spatial separation, urban fringe development, urban sprawl consequences
Procedia PDF Downloads 1461632 Examining the Critical Factors for Success and Failure of Common Ticketing Systems
Authors: Tam Viet Hoang
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With a plethora of new mobility services and payment systems found in our cities and across modern public transportation systems, several cities globally have turned to common ticketing systems to help navigate this complexity. Helping to create time and space-differentiated fare structures and tariff schemes, common ticketing systems can optimize transport utilization rates, achieve cost efficiencies, and provide key incentives to specific target groups. However, not all cities and transportation systems have enjoyed a smooth journey towards the adoption, roll-out, and servicing of common ticketing systems, with both the experiences of success and failure being attributed to a wide variety of critical factors. Using case study research as a methodology and cities as the main unit of analysis, this research will seek to address the fundamental question of “what are the critical factors for the success and failure of common ticketing systems?” Using rail/train systems as the entry point for this study will start by providing a background to the evolution of transport ticketing and justify the improvements in operational efficiency that can be achieved through common ticketing systems. Examining the socio-economic benefits of common ticketing, the research will also help to articulate the value derived for different key identified stakeholder groups. By reviewing case studies of the implementation of common ticketing systems in different cities, the research will explore lessons learned from cities with the aim to elicit factors to ensure seamless connectivity integrated e-ticketing platforms. In an increasingly digital age and where cities are now coming online, this paper seeks to unpack these critical factors, undertaking case study research drawing from literature and lived experiences. Offering us a better understanding of the enabling environment and ideal mixture of ingredients to facilitate the successful roll-out of a common ticketing system, interviews will be conducted with transport operators from several selected cities to better appreciate the challenges and strategies employed to overcome those challenges in relation to common ticketing systems. Meanwhile, as we begin to see the introduction of new mobile applications and user interfaces to facilitate ticketing and payment as part of the transport journey, we take stock of numerous policy challenges ahead and implications on city-wide and system-wide urban planning. It is hoped that this study will help to identify the critical factors for the success and failure of common ticketing systems for cities set to embark on their implementation while serving to fine-tune processes in those cities where common ticketing systems are already in place. Outcomes from the study will help to facilitate an improved understanding of common pitfalls and essential milestones towards the roll-out of a common ticketing system for railway systems, especially for emerging countries where mass rapid transit transport systems are being considered or in the process of construction.Keywords: common ticketing, public transport, urban strategies, Bangkok, Fukuoka, Sydney
Procedia PDF Downloads 881631 Prediction of Sound Transmission Through Framed Façade Systems
Authors: Fangliang Chen, Yihe Huang, Tejav Deganyar, Anselm Boehm, Hamid Batoul
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With growing population density and further urbanization, the average noise level in cities is increasing. Excessive noise is not only annoying but also leads to a negative impact on human health. To deal with the increasing city noise, environmental regulations bring up higher standards on acoustic comfort in buildings by mitigating the noise transmission from building envelope exterior to interior. Framed window, door and façade systems are the leading choice for modern fenestration construction, which provides demonstrated quality of weathering reliability, environmental efficiency, and installation ease. The overall sound insulation of such systems depends both on glasses and frames, where glass usually covers the majority of the exposed surfaces, thus it is the main source of sound energy transmission. While frames in modern façade systems become slimmer for aesthetic appearance, which contribute to a minimal percentage of exposed surfaces. Nevertheless, frames might provide substantial transmission paths for sound travels through because of much less mass crossing the path, thus becoming more critical in limiting the acoustic performance of the whole system. There are various methodologies and numerical programs that can accurately predict the acoustic performance of either glasses or frames. However, due to the vast variance of size and dimension between frame and glass in the same system, there is no satisfactory theoretical approach or affordable simulation tool in current practice to access the over acoustic performance of a whole façade system. For this reason, laboratory test turns out to be the only reliable source. However, laboratory test is very time consuming and high costly, moreover different lab might provide slightly different test results because of varieties of test chambers, sample mounting, and test operations, which significantly constrains the early phase design of framed façade systems. To address this dilemma, this study provides an effective analytical methodology to predict the acoustic performance of framed façade systems, based on vast amount of acoustic test results on glass, frame and the whole façade system consist of both. Further test results validate the current model is able to accurately predict the overall sound transmission loss of a framed system as long as the acoustic behavior of the frame is available. Though the presented methodology is mainly developed from façade systems with aluminum frames, it can be easily extended to systems with frames of other materials such as steel, PVC or wood.Keywords: city noise, building facades, sound mitigation, sound transmission loss, framed façade system
Procedia PDF Downloads 611630 Using Chatbots to Create Situational Content for Coursework
Authors: B. Bricklin Zeff
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This research explores the development and application of a specialized chatbot tailored for a nursing English course, with a primary objective of augmenting student engagement through situational content and responsiveness to key expressions and vocabulary. Introducing the chatbot, elucidating its purpose, and outlining its functionality are crucial initial steps in the research study, as they provide a comprehensive foundation for understanding the design and objectives of the specialized chatbot developed for the nursing English course. These elements establish the context for subsequent evaluations and analyses, enabling a nuanced exploration of the chatbot's impact on student engagement and language learning within the nursing education domain. The subsequent exploration of the intricate language model development process underscores the fusion of scientific methodologies and artistic considerations in this application of artificial intelligence (AI). Tailored for educators and curriculum developers in nursing, practical principles extending beyond AI and education are considered. Some insights into leveraging technology for enhanced language learning in specialized fields are addressed, with potential applications of similar chatbots in other professional English courses. The overarching vision is to illuminate how AI can transform language learning, rendering it more interactive and contextually relevant. The presented chatbot is a tangible example, equipping educators with a practical tool to enhance their teaching practices. Methodologies employed in this research encompass surveys and discussions to gather feedback on the chatbot's usability, effectiveness, and potential improvements. The chatbot system was integrated into a nursing English course, facilitating the collection of valuable feedback from participants. Significant findings from the study underscore the chatbot's effectiveness in encouraging more verbal practice of target expressions and vocabulary necessary for performance in role-play assessment strategies. This outcome emphasizes the practical implications of integrating AI into language education in specialized fields. This research holds significance for educators and curriculum developers in the nursing field, offering insights into integrating technology for enhanced English language learning. The study's major findings contribute valuable perspectives on the practical impact of the chatbot on student interaction and verbal practice. Ultimately, the research sheds light on the transformative potential of AI in making language learning more interactive and contextually relevant, particularly within specialized domains like nursing.Keywords: chatbot, nursing, pragmatics, role-play, AI
Procedia PDF Downloads 651629 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy
Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes
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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation
Procedia PDF Downloads 3921628 Predictability of Kiremt Rainfall Variability over the Northern Highlands of Ethiopia on Dekadal and Monthly Time Scales Using Global Sea Surface Temperature
Authors: Kibrom Hadush
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Countries like Ethiopia, whose economy is mainly rain-fed dependent agriculture, are highly vulnerable to climate variability and weather extremes. Sub-seasonal (monthly) and dekadal forecasts are hence critical for crop production and water resource management. Therefore, this paper was conducted to study the predictability and variability of Kiremt rainfall over the northern half of Ethiopia on monthly and dekadal time scales in association with global Sea Surface Temperature (SST) at different lag time. Trends in rainfall have been analyzed on annual, seasonal (Kiremt), monthly, and dekadal (June–September) time scales based on rainfall records of 36 meteorological stations distributed across four homogenous zones of the northern half of Ethiopia for the period 1992–2017. The results from the progressive Mann–Kendall trend test and the Sen’s slope method shows that there is no significant trend in the annual, Kiremt, monthly and dekadal rainfall total at most of the station's studies. Moreover, the rainfall in the study area varies spatially and temporally, and the distribution of the rainfall pattern increases from the northeast rift valley to northwest highlands. Methods of analysis include graphical correlation and multiple linear regression model are employed to investigate the association between the global SSTs and Kiremt rainfall over the homogeneous rainfall zones and to predict monthly and dekadal (June-September) rainfall using SST predictors. The results of this study show that in general, SST in the equatorial Pacific Ocean is the main source of the predictive skill of the Kiremt rainfall variability over the northern half of Ethiopia. The regional SSTs in the Atlantic and the Indian Ocean as well contribute to the Kiremt rainfall variability over the study area. Moreover, the result of the correlation analysis showed that the decline of monthly and dekadal Kiremt rainfall over most of the homogeneous zones of the study area are caused by the corresponding persistent warming of the SST in the eastern and central equatorial Pacific Ocean during the period 1992 - 2017. It is also found that the monthly and dekadal Kiremt rainfall over the northern, northwestern highlands and northeastern lowlands of Ethiopia are positively correlated with the SST in the western equatorial Pacific, eastern and tropical northern the Atlantic Ocean. Furthermore, the SSTs in the western equatorial Pacific and Indian Oceans are positively correlated to the Kiremt season rainfall in the northeastern highlands. Overall, the results showed that the prediction models using combined SSTs at various ocean regions (equatorial and tropical) performed reasonably well in the prediction (With R2 ranging from 30% to 65%) of monthly and dekadal rainfall and recommends it can be used for efficient prediction of Kiremt rainfall over the study area to aid with systematic and informed decision making within the agricultural sector.Keywords: dekadal, Kiremt rainfall, monthly, Northern Ethiopia, sea surface temperature
Procedia PDF Downloads 1411627 Climate Change and Perceived Socialization: The Role of Parents’ Climate Change Coping Style and Household Communication
Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce
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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization
Procedia PDF Downloads 851626 Sweepline Algorithm for Voronoi Diagram of Polygonal Sites
Authors: Dmitry A. Koptelov, Leonid M. Mestetskiy
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Voronoi Diagram (VD) of finite set of disjoint simple polygons, called sites, is a partition of plane into loci (for each site at the locus) – regions, consisting of points that are closer to a given site than to all other. Set of polygons is a universal model for many applications in engineering, geoinformatics, design, computer vision, and graphics. VD of polygons construction usually done with a reduction to task of constructing VD of segments, for which there are effective O(n log n) algorithms for n segments. Preprocessing – constructing segments from polygons’ sides, and postprocessing – polygon’s loci construction by merging the loci of the sides of each polygon are also included in reduction. This approach doesn’t take into account two specific properties of the resulting segment sites. Firstly, all this segments are connected in pairs in the vertices of the polygons. Secondly, on the one side of each segment lies the interior of the polygon. The polygon is obviously included in its locus. Using this properties in the algorithm for VD construction is a resource to reduce computations. The article proposes an algorithm for the direct construction of VD of polygonal sites. Algorithm is based on sweepline paradigm, allowing to effectively take into account these properties. The solution is performed based on reduction. Preprocessing is the constructing of set of sites from vertices and edges of polygons. Each site has an orientation such that the interior of the polygon lies to the left of it. Proposed algorithm constructs VD for set of oriented sites with sweepline paradigm. Postprocessing is a selecting of edges of this VD formed by the centers of empty circles touching different polygons. Improving the efficiency of the proposed sweepline algorithm in comparison with the general Fortune algorithm is achieved due to the following fundamental solutions: 1. Algorithm constructs only such VD edges, which are on the outside of polygons. Concept of oriented sites allowed to avoid construction of VD edges located inside the polygons. 2. The list of events in sweepline algorithm has a special property: the majority of events are connected with “medium” polygon vertices, where one incident polygon side lies behind the sweepline and the other in front of it. The proposed algorithm processes such events in constant time and not in logarithmic time, as in the general Fortune algorithm. The proposed algorithm is fully implemented and tested on a large number of examples. The high reliability and efficiency of the algorithm is also confirmed by computational experiments with complex sets of several thousand polygons. It should be noted that, despite the considerable time that has passed since the publication of Fortune's algorithm in 1986, a full-scale implementation of this algorithm for an arbitrary set of segment sites has not been made. The proposed algorithm fills this gap for an important special case - a set of sites formed by polygons.Keywords: voronoi diagram, sweepline, polygon sites, fortunes' algorithm, segment sites
Procedia PDF Downloads 1771625 Prevalence of Emotional Problems among Adolescent Students of Corporation Schools in Chennai
Authors: Vithya Veeramani, Karunanidhi Subbaiah
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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.Keywords: adolescents, corporation schools, emotional problems, prevalence
Procedia PDF Downloads 2221624 Assessment of Microclimate in Abu Dhabi Neighborhoods: On the Utilization of Native Landscape in Enhancing Thermal Comfort
Authors: Maryam Al Mheiri, Khaled Al Awadi
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Urban population is continuously increasing worldwide and the speed at which cities urbanize creates major challenges, particularly in terms of creating sustainable urban environments. Rapid urbanization often leads to negative environmental impacts and changes in the urban microclimates. Moreover, when rapid urbanization is paired with limited landscape elements, the effects on human health due to the increased pollution, and thermal comfort due to Urban Heat Island effects are increased. Urban Heat Island (UHI) describes the increase of urban temperatures in urban areas in comparison to its rural surroundings, and, as we discuss in this paper, it impacts on pedestrian comfort, reducing the number of walking trips and public space use. It is thus very necessary to investigate the quality of outdoor built environments in order to improve the quality of life incites. The main objective of this paper is to address the morphology of Emirati neighborhoods, setting a quantitative baseline by which to assess and compare spatial characteristics and microclimate performance of existing typologies in Abu Dhabi. This morphological mapping and analysis will help to understand the built landscape of Emirati neighborhoods in this city, whose form has changed and evolved across different periods. This will eventually help to model the use of different design strategies, such as landscaping, to mitigate UHI effects and enhance outdoor urban comfort. Further, the impact of different native plants types and native species in reducing UHI effects and enhancing outdoor urban comfort, allowing for the assessment of the impact of increasing landscaped areas in these neighborhoods. This study uses ENVI-met, an analytical, three-dimensional, high-resolution microclimate modeling software. This micro-scale urban climate model will be used to evaluate existing conditions and generate scenarios in different residential areas, with different vegetation surfaces and landscaping, and examine their impact on surface temperatures during summer and autumn. In parallel to these simulations, field measurement will be included to calibrate the Envi-met model. This research therefore takes an experimental approach, using simulation software, and a case study strategy for the evaluation of a sample of residential neighborhoods. A comparison of the results of these scenarios constitute a first step towards making recommendations about what constitutes sustainable landscapes for Abu Dhabi neighborhoods.Keywords: landscape, microclimate, native plants, sustainable neighborhoods, thermal comfort, urban heat island
Procedia PDF Downloads 3101623 Health-Related Problems of International Migrant Groups in Eskisehir, Turkey
Authors: Temmuz Gönç Şavran
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Migration is a multidimensional and health-related concept that has important consequences for both migrants and the host society. Due to past conflicts and poor living conditions that lead to migration, the dangerous and difficult journey, and the problems they face upon arrival in the destination country, migrants are at higher risk for poor health. Health is a human right, and all societies and communities, including migrant groups, must receive adequate health care. In addition, the health of migrants must be improved to protect the health of the host society and ensure social integration. The main determinants of health are employment, income, education, good housing, and adequate nutrition. It can be said that migrants are among the most vulnerable groups in society in these respects, and migrant health is negatively affected by this situation. Rigid immigration policies or financial constraints in destination countries, the complexity and bureaucracy of health systems, the low health literacy of migrant groups, and the inadequate provision of translation services in health facilities are among the other main factors affecting migrant health. Migrants are also at risk of stigma, exclusion, detection, and deportation when seeking medical care. Based on data from a qualitative study with a descriptive case study design, this paper aims to highlight and sociologically assess the health-related problems of international migrants in Eskisehir, Turkey. The sample consists of 30 international migrants living in Eskisehir, two-thirds of whom are from Syria, Iraq, Afghanistan, and Pakistan. Those who are citizens of the Republic of Turkey are excluded from the study; otherwise, the legal status of the participants is not considered in the selection of the sample. This makes it possible to distinguish the different needs and problems of subgroups and to consider migrant health as a comprehensive concept. The research is supported by Anadolu University in Eskisehir, and data will be collected through semi-structured interviews between November 2022 and February 2023. With holistic sociology of health approach, this study considers migrant health as a comprehensive sociological concept. It aims to reveal the health-related resources and needs of the international migrant groups living in the center of Eskisehir, the problems they encounter in meeting these needs, and the strategies they use to solve these problems. The results are expected to show that the health of migrants is not only influenced by legislation but is shaped by many processes, from housing conditions to cultural habits. It is expected that the results will also raise awareness of discrimination, exclusion, marginalization, and hate speech in migrants’ access to health services.Keywords: migrant health, sociology of health, sociology of migration, Turkey, refugees
Procedia PDF Downloads 791622 BiVO₄‑Decorated Graphite Felt as Highly Efficient Negative Electrode for All-Vanadium Redox Flow Batteries
Authors: Daniel Manaye Kabtamu, Anteneh Wodaje Bayeh
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With the development and utilization of new energy technology, people’s demand for large-scale energy storage system has become increasingly urgent. Vanadium redox flow battery (VRFB) is one of the most promising technologies for grid-scale energy storage applications because of numerous attractive features, such as long cycle life, high safety, and flexible design. However, the relatively low energy efficiency and high production cost of the VRFB still limit its practical implementations. It is of great attention to enhance its energy efficiency and reduce its cost. One of the main components of VRFB that can impressively impact the efficiency and final cost is the electrode materials, which provide the reactions sites for redox couples (V₂₊/V³⁺ and VO²⁺/VO₂⁺). Graphite felt (GF) is a typical carbon-based material commonly employed as electrode for VRFB due to low-cost, good chemical and mechanical stability. However, pristine GF exhibits insufficient wettability, low specific surface area, and poor kinetics reversibility, leading to low energy efficiency of the battery. Therefore, it is crucial to further modify the GF electrode to improve its electrochemical performance towards VRFB by employing active electrocatalysts, such as less expensive metal oxides. This study successfully fabricates low-cost plate-like bismuth vanadate (BiVO₄) material through a simple one-step hydrothermal route, employed as an electrocatalyst to adorn the GF for use as the negative electrode in VRFB. The experimental results show that BiVO₄-3h exhibits the optimal electrocatalytic activity and reversibility for the vanadium redox couples among all samples. The energy efficiency of the VRFB cell assembled with BiVO₄-decorated GF as the negative electrode is found to be 75.42% at 100 mA cm−2, which is about 10.24% more efficient than that of the cell assembled with heat-treated graphite felt (HT-GF) electrode. The possible reasons for the activity enhancement can be ascribed to the existence of oxygen vacancies in the BiVO₄ lattice structure and the relatively high surface area of BiVO₄, which provide more active sites for facilitating the vanadium redox reactions. Furthermore, the BiVO₄-GF electrode obstructs the competitive irreversible hydrogen evolution reaction on the negative side of the cell, and it also has better wettability. Impressively, BiVO₄-GF as the negative electrode shows good stability over 100 cycles. Thus, BiVO₄-GF is a promising negative electrode candidate for practical VRFB applications.Keywords: BiVO₄ electrocatalyst, electrochemical energy storage, graphite felt, vanadium redox flow battery
Procedia PDF Downloads 15731621 Branched Chain Amino Acid Kinesio PVP Gel Tape from Extract of Pea (Pisum sativum L.) Based on Ultrasound-Assisted Extraction Technology
Authors: Doni Dermawan
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Modern sports competition as a consequence of the increase in the value of the business and entertainment in the field of sport has been demanding athletes to always have excellent physical endurance performance. Physical exercise is done in a long time, and intensive may pose a risk of muscle tissue damage caused by the increase of the enzyme creatine kinase. Branched Chain Amino Acids (BCAA) is an essential amino acid that is composed of leucine, isoleucine, and valine which serves to maintain muscle tissue, keeping the immune system, and prevent further loss of coordination and muscle pain. Pea (Pisum sativum L.) is a kind of leguminous plants that are rich in Branched Chain Amino Acids (BCAA) where every one gram of protein pea contains 82.7 mg of leucine; 56.3 mg isoleucine; and 56.0 mg of valine. This research aims to develop Branched Chain Amino Acids (BCAA) from pea extract is applied in dosage forms Gel PVP Kinesio Tape technology using Ultrasound-assisted Extraction. The method used in the writing of this paper is the Cochrane Collaboration Review that includes literature studies, testing the quality of the study, the characteristics of the data collection, analysis, interpretation of results, and clinical trials as well as recommendations for further research. Extraction of BCAA in pea done using ultrasound-assisted extraction technology with optimization variables includes the type of solvent extraction (NaOH 0.1%), temperature (20-250C), time (15-30 minutes) power (80 watt) and ultrasonic frequency (35 KHz). The advantages of this extraction method are the level of penetration of the solvent into the membrane of the cell is high and can increase the transfer period so that the BCAA substance separation process more efficient. BCAA extraction results are then applied to the polymer PVP (Polyvinylpyrrolidone) Gel powder composed of PVP K30 and K100 HPMC dissolved in 10 mL of water-methanol (1: 1) v / v. Preparations Kinesio Tape Gel PVP is the BCAA in the gel are absorbed into the muscle tissue, and joints through tensile force then provides stimulation to the muscle circulation with variable pressure so that the muscle can increase the biomechanical movement and prevent damage to the muscle enzyme creatine kinase. Analysis and evaluation of test preparation include interaction, thickness, weight uniformity, humidity, water vapor permeability, the levels of the active substance, content uniformity, percentage elongation, stability testing, release profile, permeation in vitro and in vivo skin irritation testing.Keywords: branched chain amino acid, BCAA, Kinesio tape, pea, PVP gel, ultrasound-assisted extraction
Procedia PDF Downloads 2891620 Item-Trait Pattern Recognition of Replenished Items in Multidimensional Computerized Adaptive Testing
Authors: Jianan Sun, Ziwen Ye
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Multidimensional computerized adaptive testing (MCAT) is a popular research topic in psychometrics. It is important for practitioners to clearly know the item-trait patterns of administered items when a test like MCAT is operated. Item-trait pattern recognition refers to detecting which latent traits in a psychological test are measured by each of the specified items. If the item-trait patterns of the replenished items in MCAT item pool are well detected, the interpretability of the items can be improved, which can further promote the abilities of the examinees who attending the MCAT to be accurately estimated. This research explores to solve the item-trait pattern recognition problem of the replenished items in MCAT item pool from the perspective of statistical variable selection. The popular multidimensional item response theory model, multidimensional two-parameter logistic model, is assumed to fit the response data of MCAT. The proposed method uses the least absolute shrinkage and selection operator (LASSO) to detect item-trait patterns of replenished items based on the essential information of item responses and ability estimates of examinees collected from a designed MCAT procedure. Several advantages of the proposed method are outlined. First, the proposed method does not strictly depend on the relative order between the replenished items and the selected operational items, so it allows the replenished items to be mixed into the operational items in reasonable order such as considering content constraints or other test requirements. Second, the LASSO used in this research improves the interpretability of the multidimensional replenished items in MCAT. Third, the proposed method can exert the advantage of shrinkage method idea for variable selection, so it can help to check item quality and key dimension features of replenished items and saves more costs of time and labors in response data collection than traditional factor analysis method. Moreover, the proposed method makes sure the dimensions of replenished items are recognized to be consistent with the dimensions of operational items in MCAT item pool. Simulation studies are conducted to investigate the performance of the proposed method under different conditions for varying dimensionality of item pool, latent trait correlation, item discrimination, test lengths and item selection criteria in MCAT. Results show that the proposed method can accurately detect the item-trait patterns of the replenished items in the two-dimensional and the three-dimensional item pool. Selecting enough operational items from the item pool consisting of high discriminating items by Bayesian A-optimality in MCAT can improve the recognition accuracy of item-trait patterns of replenished items for the proposed method. The pattern recognition accuracy for the conditions with correlated traits is better than those with independent traits especially for the item pool consisting of comparatively low discriminating items. To sum up, the proposed data-driven method based on the LASSO can accurately and efficiently detect the item-trait patterns of replenished items in MCAT.Keywords: item-trait pattern recognition, least absolute shrinkage and selection operator, multidimensional computerized adaptive testing, variable selection
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