Search results for: special testimony
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2386

Search results for: special testimony

316 Development and Validation of a Green Analytical Method for the Analysis of Daptomycin Injectable by Fourier-Transform Infrared Spectroscopy (FTIR)

Authors: Eliane G. Tótoli, Hérida Regina N. Salgado

Abstract:

Daptomycin is an important antimicrobial agent used in clinical practice nowadays, since it is very active against some Gram-positive bacteria that are particularly challenges for the medicine, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). The importance of environmental preservation has receiving special attention since last years. Considering the evident need to protect the natural environment and the introduction of strict quality requirements regarding analytical procedures used in pharmaceutical analysis, the industries must seek environmentally friendly alternatives in relation to the analytical methods and other processes that they follow in their routine. In view of these factors, green analytical chemistry is prevalent and encouraged nowadays. In this context, infrared spectroscopy stands out. This is a method that does not use organic solvents and, although it is formally accepted for the identification of individual compounds, also allows the quantitation of substances. Considering that there are few green analytical methods described in literature for the analysis of daptomycin, the aim of this work was the development and validation of a green analytical method for the quantification of this drug in lyophilized powder for injectable solution, by Fourier-transform infrared spectroscopy (FT-IR). Method: Translucent potassium bromide pellets containing predetermined amounts of the drug were prepared and subjected to spectrophotometric analysis in the mid-infrared region. After obtaining the infrared spectrum and with the assistance of the IR Solution software, quantitative analysis was carried out in the spectral region between 1575 and 1700 cm-1, related to a carbonyl band of the daptomycin molecule, and this band had its height analyzed in terms of absorbance. The method was validated according to ICH guidelines regarding linearity, precision (repeatability and intermediate precision), accuracy and robustness. Results and discussion: The method showed to be linear (r = 0.9999), precise (RSD% < 2.0), accurate and robust, over a concentration range from 0.2 to 0.6 mg/pellet. In addition, this technique does not use organic solvents, which is one great advantage over the most common analytical methods. This fact contributes to minimize the generation of organic solvent waste by the industry and thereby reduces the impact of its activities on the environment. Conclusion: The validated method proved to be adequate to quantify daptomycin in lyophilized powder for injectable solution and can be used for its routine analysis in quality control. In addition, the proposed method is environmentally friendly, which is in line with the global trend.

Keywords: daptomycin, Fourier-transform infrared spectroscopy, green analytical chemistry, quality control, spectrometry in IR region

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315 Improving Screening and Treatment of Binge Eating Disorders in Pediatric Weight Management Clinic through a Quality Improvement Framework

Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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314 The 2017 Summer Campaign for Night Sky Brightness Measurements on the Tuscan Coast

Authors: Andrea Giacomelli, Luciano Massetti, Elena Maggi, Antonio Raschi

Abstract:

The presentation will report the activities managed during the Summer of 2017 by a team composed by staff from a University Department, a National Research Council Institute, and an outreach NGO, collecting measurements of night sky brightness and other information on artificial lighting, in order to characterize light pollution issues on portions of the Tuscan coast, in Central Italy. These activities combine measurements collected by the principal scientists, citizen science observations led by students, and outreach events targeting a broad audience. This campaign aggregates the efforts of three actors: the BuioMetria Partecipativa project, which started collecting light pollution data on a national scale in 2008 with an environmental engineering and free/open source GIS core team; the Institute of Biometeorology from the National Research Council, with ongoing studies on light and urban vegetation and a consolidated track record in environmental education and citizen science; the Department of Biology from the University of Pisa, which started experiments to assess the impact of light pollution in coastal environments in 2015. While the core of the activities concerns in situ data, the campaign will account also for remote sensing data, thus considering heterogeneous data sources. The aim of the campaign is twofold: (1) To test actions of citizen and student engagement in monitoring sky brightness (2) To collect night sky brightness data and test a protocol for applications to studies on the ecological impact of light pollution, with a special focus on marine coastal ecosystems. The collaboration of an interdisciplinary team in the study of artificial lighting issues is not a common case in Italy, and the possibility of undertaking the campaign in Tuscany has the added value of operating in one of the territories where it is possible to observe both sites with extremely high lighting levels, and areas with extremely low light pollution, especially in the Southern part of the region. Combining environmental monitoring and communication actions in the context of the campaign, this effort will contribute to the promotion of night skies with a good quality as an important asset for the sustainability of coastal ecosystems, as well as to increase citizen awareness through star gazing, night photography and actively participating in field campaign measurements.

Keywords: citizen science, light pollution, marine coastal biodiversity, environmental education

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313 Investigating the Aerosol Load of Eastern Mediterranean Basin with Sentinel-5p Satellite

Authors: Deniz Yurtoğlu

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Aerosols directly affect the radiative balance of the earth by absorbing and/or scattering the sun rays reaching the atmosphere and indirectly affect the balance by acting as a nucleus in cloud formation. The composition, physical, and chemical properties of aerosols vary depending on their sources and the time spent in the atmosphere. The Eastern Mediterranean Basin has a high aerosol load that is formed from different sources; such as anthropogenic activities, desert dust outbreaks, and the spray of sea salt; and the area is subjected to atmospheric transport from other locations on the earth. This region, which includes the deserts of Africa, the Middle East, and the Mediterranean sea, is one of the most affected areas by climate change due to its location and the chemistry of the atmosphere. This study aims to investigate the spatiotemporal deviation of aerosol load in the Eastern Mediterranean Basin between the years 2018-2022 with the help of a new pioneer satellite of ESA (European Space Agency), Sentinel-5P. The TROPOMI (The TROPOspheric Monitoring Instrument) traveling on this low-Earth orbiting satellite is a UV (Ultraviolet)-sensing spectrometer with a resolution of 5.5 km x 3.5 km, which can make measurements even in a cloud-covered atmosphere. By using Absorbing Aerosol Index data produced by this spectrometer and special scripts written in Python language that transforms this data into images, it was seen that the majority of the aerosol load in the Eastern Mediterranean Basin is sourced from desert dust and anthropogenic activities. After retrieving the daily data, which was separated from the NaN values, seasonal analyses match with the normal aerosol variations expected, which are high in warm seasons and lower in cold seasons. Monthly analyses showed that in four years, there was an increase in the amount of Absorbing Aerosol Index in spring and winter by 92.27% (2019-2021) and 39.81% (2019-2022), respectively. On the other hand, in the summer and autumn seasons, a decrease has been observed by 20.99% (2018-2021) and 0.94% (2018-2021), respectively. The overall variation of the mean absorbing aerosol index from TROPOMI between April 2018 to April 2022 reflects a decrease of 115.87% by annual mean from 0.228 to -0.036. However, when the data is analyzed by the annual mean values of the years which have the data from January to December, meaning from 2019 to 2021, there was an increase of 57.82% increase (0.108-0.171). This result can be interpreted as the effect of climate change on the aerosol load and also, more specifically, the effect of forest fires that happened in the summer months of 2021.

Keywords: aerosols, eastern mediterranean basin, sentinel-5p, tropomi, aerosol index, remote sensing

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312 Phytoremediation; Pb, Cr and Cd Accumulation in Fruits and Leaves of Vitis Vinifera L. From Air Pollutions and Intraction between Their Uptake Based on the Distance from the Main Road

Authors: Fatemeh Mohsennezhad

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Air pollution is one of major problems for environment. Providing healthy food and protecting water sources from pollution has been one of the concerns of human societies and decision-making centers so that protecting food from pollution, detecting sources of pollution and measuring them become important. Nutritive and political significance of grape in this area, extensive use of leaf and fruit of this plant and development of urban areas around grape gardens and construction of Tabriz – Miandoab road, which is the most important link between East and West Azarbaijan, led us to examine the impact of this road construction and urban environment pollutants such as lead chromium and cadmium on the quality of this valuable crop. First, the samples were taken from different adjacent places and medium distances from the road, each place being located exactly by Google earth and GPS. Digestion was done through burning dry material and hydrochloric acid and their ashes were analyzed by atomic absorption to determine (Pb, Cr, Cd) accumulations. In this experiments effects of 2 following factors were examined as a variable: Garden distance from the main road with levels 1: For 50 meters, 2: For 120-200 meters, 3: For above 800 meters, and plant organ with levels 1: For fruit, 2: For leaves. At the end, the results were processed by SPSS software. 3.54 ppm, the most lead quantity, was at sample No. 54 in fruits with 800 meters distance from the road and 1.00 ppm was the least lead quantity at sample No. 50 in fruits with 1000 meters from the road. In leaves, the most lead quantity was 19.16 ppm at sample No. 15 with 50 meters distance from the road and the least quantity was 1.41 ppm at sample No. 31 with 50 meters from the road. Pb uptake is significantly different at 50 meters and 200 meters distance. It means that Pb uptake near the main road is the highest. But this result is not true for others elements. Distance has not a meaningful effect on Cr uptake. The result of analysis of variation in distance and plant organ for Cd showed that between fruit and leaf, Cd uptake is significantly different. But distance and interaction between distance and plant organ is not meaningful. There is neither meaningful interaction between these elements uptakes in fruits nor in leaves. If leaves and fruits, assumed all together, showed a very meaningful integration between heavy metal accumulations. It means that each of these elements causes uptake others without considering special organs. In the tested area, it became clear that, from the accumulation of heavy metals perspective, there is no meaningful difference in existing distance between road and garden. There is a meaningful difference among heavy metals accumulation. In other words, increase ratio of one metal to another was different from the resulted differences shown in corresponding graphs. Interaction among elements and distance between garden and road was not meaningful.

Keywords: Vitis vinifera L., phytoremediation, heavy metals accumulation, lead, chromium, cadmium

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311 Freshwater Cyanobacterial Bioactive Insights: Planktothricoides raciorskii Compounds vs. Green Synthesized Silver Nanoparticles: Characterization, in vitro Cytotoxicity, and Antibacterial Exploration

Authors: Sujatha Edla

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Introduction: New compounds and possible uses for the bioactive substances produced by freshwater cyanobacteria are constantly being discovered through research. Certain molecules are hazardous to the environment and human health, but others have potential applications in industry, biotechnology, and pharmaceuticals. These discoveries advance our knowledge of the varied functions these microbes perform in different ecosystems. Cyanobacterial silver nanoparticles (AgNPs) have special qualities and possible therapeutic advantages, which make them very promising for a range of medicinal uses. Aim: In our study; the attention was focused on the analysis and characterization of bioactive compounds extracted from freshwater cyanobacteria Planktothricoides raciorskii and its comparative study on Cyanobacteria-mediated silver nanoparticles synthesized by cell-free extract of Planktothricoides raciorskii. Material and Methods: A variety of bioactive secondary metabolites have been extracted, purified, and identified from cyanobacterial species using column chromatography, FTIR, and GC-MS/MS chromatography techniques and evaluated for antibacterial and cytotoxic studies, where the Cyanobacterial silver nanoparticles (CSNPs) were characterized by UV-Vis spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) analysis and were further tested for antibacterial and cytotoxic efficiency. Results: The synthesis of CSNPs was confirmed through visible color change and shift of peaks at 430–445 nm by UV-Vis spectroscopy. The size of CSNPs was between 22 and 34 nm and oval-shaped which were confirmed by SEM and TEM analyses. The FTIR spectra showed a new peak at the range of 3,400–3,460 cm−1 compared to the control, confirming the reduction of silver nitrate. The antibacterial activity of both crude bioactive compound extract and CSNPs showed remarkable activity with Zone of inhibition against E. coli with 9.5mm and 10.2mm, 13mm and 14.5mm against S. paratyphi, 9.2mm and 9.8mm zone of inhibition against K. pneumonia by both crude extract and CSNPs, respectively. The cytotoxicity as evaluated by extracts of Planktothricoides raciorskii against MCF7-Human Breast Adenocarcinoma cell line and HepG2- Human Hepatocellular Carcinoma cell line employing MTT assay gave IC50 value of 47.18ug/ml, 110.81ug/ml against MCF7cell line and HepG2 cell line, respectively. The cytotoxic evaluation of Planktothricoides raciorskii CSNPs against the MCF7cell line was 43.37 ug/ml and 20.88 ug/ml against the HepG2 cell line. Our ongoing research in this field aims to uncover the full therapeutic potential of cyanobacterial silver nanoparticles and address any associated challenges.

Keywords: cyanobacteria, silvernanoparticles, pharmaceuticals, bioactive compounds, cytotoxic

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310 Social Justice and Castes Discrimination: Experiences of Scheduled Castes Students in India

Authors: Dhaneswar Bhoi

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In Indian History, the Dalits (Scheduled Castes) were exploited with caste, since the Vedic Age (1500 BCE). They were deprived of many rights in the society and their education was also restricted by the upper castes since the introduction of the Law of Manu (1500 BCE). The Dalits were treated as lower castes (Sudras and Ati-Sudra) in the society. Occupation of these caste groups were attached to some low profile and menial occupation. Whereas, the upper caste (Brahamins) declared themselves as the top most caste groups who chose the occupation of priests and had the supreme right to education. During those days occupation was not decided by the caliber of a person rather, it was decided by the upper caste Brahamins and kept on transferring from one generation to another generation. At this juncture of the society, the upper caste people oppressed and suppressed the lower caste people endlessly. To get rid of these social problems the emancipator and the charismatic leader (Prophet for the lower caste communities), Dr. Babasaheb Ambedkar appeard in the scene of Indian unjust society. Restlessly he fought against the caste oppression, social dogmas and tyranny on the basis of caste. Finally, he succeeded to affirm statutory safeguards for the oppressed and depressed or lower caste communities. Today these communities are scheduled as Scheduled Castes to access social justice for their upliftment and development. Through the liberty, equality and fraternity, he established social justice for the first time in the Indian history with the implementation of Indian Constitution on 26th January 1950. Since then the social justice has been accessed through the Constitution and Indian Republics. However, even after sixty five years of the Indian Republic and Constitutional safeguards the Scheduled Castes (SCs) are suffering many problems in the phases of their life. Even if there are special provisions made by the state aimed to meet the challenges of the weaker sections, they are still deprived of access to it, which is true especially for the Dalits or SCs. Many of the people of these communities are still not accessing education and particularly, higher education. Those who are managing to access the education have been facing many challenges in their educational premises as well as in their social life. This paper tries to find out the problem of discrimination in educational and societal level. Secondly, this paper aims to know the relation between the discrimination and access to social justice for the SCs in the educational institution and society. It also enquires the experiences of SCs who faced discrimination in their educational and social life. This study is based on the both quantitative and qualitative methods. Both of which were interpreted through the data triangulation method in mixed methodology approach. In this paper, it is found that the SCs are struggling with injustice in their social and educational spheres. Starting from their primary level to higher education, they were discriminated in curricular, co-curricular and extra-curricular activities.

Keywords: social justice, discrimination, caste, scheduled castes, education

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309 My Perfect Partner: Creative Methods in Relationship Education

Authors: Janette Porter, Kay Standing

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The paper presents our experiences of working in both mainstream and Special Education Needs and Disabilities (SEND) schools in England from 2012-2019, using creative methodologies to deliver and evaluate healthy relationship education. It aims to explore to explore how young people's perceptions of relationships and their "perfect partner" are mediated by factors such as gender, body image, and social media. It will be an interactive session, inviting participants to reflect on their own experiences of relationship education, and to take part in an example of a classroom activity of 'a perfect partner'. Young people aged 16-25 are most at risk of relationship abuse and intimate partner violence. This can be enacted both on the body, through physical and sexual violence, but also emotional and psychological abuse. In England and Wales relationship education became compulsory in schools in September 2020. There is increasing recognition for the need for whole school approaches to prevent gender-based violence, in particular domestic abuse, from happening in the first place and for equipping schools to feel more confident supporting young people affected by gender-based violence. The project used creative methods, including arts, drama, music, poetry, song, and creative writing, to engage participants in sensitive topics related to relationship education. Interactive workshops with pupils aged 11-19 enabled young people to express themselves freely, pupils then used drama to share their knowledge with their peer group. We co-produced material with young people, including an accessible resource pack for use in SEND schools, particularly for children with visual and sensory impairments. The project was evaluated by questionnaires and interviews with pupils. The paper also reflects on the ethical issues involved in the research. After the project, young people had a better understanding of healthy and unhealthy relationships, improved knowledge of the early warning signs of abuse and knew where to go to for help and advice. It found that creative methods are an effective way to engage young people in relationship education and sensitive topics. We argue that age and ability appropriate relationship education should be compulsory across the curriculum and that implementing creative and art-based approaches to address sensitive topics can enhance the effectiveness of relationship education programs in promoting healthy relationships and preventing abuse. The paper provides academic and practitioner perspectives, providing a reflection on our research, looking at practical, methodological, and ethical issues involved in research on Gender Based Violence with young people in a school setting.

Keywords: relationship education, healthy relationships, creative methods, young people

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308 Microbiological Profile of UTI along with Their Antibiotic Sensitivity Pattern with Special Reference to Nitrofurantoin

Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

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Introduction: Urinary tract infections (UTI) are considered to be one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to widespread usage of uncontrolled antibiotics. Materials and Methods: A total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G.M.C Patiala. Urine samples were inoculated on MacConkey’s and blood agar plates by using calibrated loop delivering 0.001 ml of sample and incubated at 37 °C for 24 hrs. The organisms were identified by colony characters, gram’s staining and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby-Bauer disk diffusion method on Muller Hinton agar plates. Results: Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Out of 9149 urine sample, the culture was positive in 25% (2290) samples. Esch. coli was the most common isolate 60.3% (n = 1378) followed by Klebsiella pneumoniae 13.5% (n = 310), Proteus spp. 9% (n = 209), Staphylococcus aureus 7.6 % (n = 173), Pseudomonas aeruginosa 3.7% (n = 84), Citrobacter spp. 3.1 % (70), Staphylococcus saprophyticus 1.8 % (n = 142), Enterococcus faecalis 0.8%(n=19) and Acinetobacter spp. 0.2%(n=5). Gram negative isolates showed higher sensitivity towards, Piperacillin +Tazobactum (67%), Amikacin (80%), Nitrofurantoin (82%), Aztreonam (100%), Imipenem (100%) and Meropenam (100%) while gram positive showed good response towards Netilmicin (69%), Nitrofurantoin (79%), Linezolid (98%), Vancomycin (100%) and Teicoplanin (100%). 465 (23%) isolates were resistant to Penicillins, 1st generation and 2nd generation Cehalosporins which were further tested by double disk approximation test and combined disk method for ESBL production. Out of 465 isolates, 375 were ESBLs consisting of n 264 (70.6%) Esch.coli and 111 (29.4%) Klebsiella pneumoniae. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Conclusion: Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatients UTIs challenging. Ampicillin, Cotrimoxazole, and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help inappropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL

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307 Revival and Protection of Traditional Jewellery Motifs of Assam (India), over Eri Silk by Innovative Techniques

Authors: Ratna Sharma, Kaveri Dutta

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Assam (India), the gate way to the Northeast India is mainly known for its exquisite silks, the art and craft. The state has a rich collection of traditional jewellery which is unique and exclusive to the state. These jewelleries hold a special place in the heart of the Assamese women. Similarly handloom industry of Assam is basically silk oriented. Among the wild silk, Eri silk fabric has remained as “the poor man’s silk” but it is closely attached to the assamese society, dress for it's warm quality. In view of the changing market trends, fashion and consumer demands, Silk is emerging as a fashion fabric both in India and abroad. In case of Eri silk fabric it has limited use in clothing and accessories. Hence the restructured and redesigned traditional jewellery motifs of Assam (India) over Eri silk products will have greater potential in reviving the decline of art, generate revenue, self employment towards craftsmen and also recognition of the art. The information incorporated in the paper is primary and the data have been collected by purposive sampling method. This work of art was expressed on Eri silk fabric in the form of traditional hand embroidery as it is closely connected with the era of the individual in history of mankind and reflects the personal expression of an entity. For this study selected traditional motifs of Assamese ornaments was used. Some of the popular traditional Assamese jewellery include earrings with exquisite Lokaparo, Keru, Thuriya, Jangphai, etc. An array of necklaces including Golpata, Satsori, Jon biri, Bena, Gejera, Dhol biri, Doog doogi, Biri Moni, Mukuta Moni, Poalmoni, Silikha Moni and Magardana and diversified rings including Senpata, Horinsakua, Jethinejia, bakharpata and others. Selected two motifs each from necklace, earring and finger ring designs. Selected motifs were further developed into 3 categories- the border, the main motif and all over butta followed by placement of developed patterns on products. Products developed were stoles, scarf’s, purses, brooch pins, skirts for women and ties, handkerchief, jackets for men. The developed products were surveyed by selected respondents. From the present study it can be observed that the embellished traditional jewellery motifs resulted in fresh and colourful pattern on developed Eri silk products. Moreover the motifs which were gradually fading among the community itself showed a very good recognition towards art. The embroidered Eri silk fabric also created a huge change in a positive way among craftsman.

Keywords: Art and craft of Assam, eri silk, hand embroidery, traditional Assamese jewellery motifs

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306 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time

Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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305 Digital Value Co-Creation: The Case of Worthy a Virtual Collaborative Museum across Europe

Authors: Camilla Marini, Deborah Agostino

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Cultural institutions provide more than service-based offers; indeed, they are experience-based contexts. A cultural experience is a special event that encompasses a wide range of values which, for visitors, are primarily cultural rather than economic and financial. Cultural institutions have always been characterized by inclusivity and participatory practices, but the upcoming of digital technologies has put forward their interest in collaborative practices and the relationship with their audience. Indeed, digital technologies highly affected the cultural experience as it was conceived. Especially, museums, as traditional and authoritative cultural institutions, have been highly challenged by digital technologies. They shifted by a collection-oriented toward a visitor-centered approach, and digital technologies generated a highly interactive ecosystem in which visitors have an active role, shaping their own cultural experience. Most of the studies that investigate value co-creation in museums adopt a single perspective which is separately one of the museums or one of the users, but the analysis of the convergence/divergence of these perspectives is still emphasized. Additionally, many contributions focus on digital value co-creation as an outcome rather than as a process. The study aims to provide a joint perspective on digital value co-creation which include both museum and visitors. Also, it deepens the contribution of digital technologies in the value co-creation process, addressing the following research questions: (i) what are the convergence/divergence drivers on digital value co-creation and (ii) how digital technologies can be means of value co-creation? The study adopts an action research methodology that is based on the case of WORTHY, an educational project which involves cultural institutions and schools all around Europe, creating a virtual collaborative museum. It represents a valuable case for the aim of the study since it has digital technologies at its core, and the interaction through digital technologies is fundamental, all along with the experience. Action research has been identified as the most appropriate methodology for researchers to have direct contact with the field. Data have been collected through primary and secondary sources. Cultural mediators such as museums, teachers and students’ families have been interviewed, while a focus group has been designed to interact with students, investigating all the aspects of the cultural experience. Secondary sources encompassed project reports and website contents in order to deepen the perspective of cultural institutions. Preliminary findings highlight the dimensions of digital value co-creation in cultural institutions from a museum-visitor integrated perspective and the contribution of digital technologies in the value co-creation process. The study outlines a two-folded contribution that encompasses both an academic and a practitioner level. Indeed, it contributes to fulfilling the gap in cultural management literature about the convergence/divergence of service provider-user perspectives but it also provides cultural professionals with guidelines on how to evaluate the digital value co-creation process.

Keywords: co-creation, digital technologies, museum, value

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304 A Longitudinal Study of Social Engagement in Classroom in Children with Autism Spectrum Disorder

Authors: Cecile Garry, Katia Rovira, Julie Brisson

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Autism Spectrum Disorder (ASD) is defined by a qualitative and quantitative impairment of social interaction. Indeed early intervention programs, such as the Early Start Denver Model (ESDM), aimed at encouraging the development of social skills. In classroom, the children need to be socially engaged to learn. Early intervention programs can thus be implemented in kindergarten schools. In these schools, ASD children have more opportunities to interact with their peers or adults than in elementary schools. However, the preschool children with ASD are less socially engaged than their typically developing peers in the classroom. They initiate, respond and maintain less the social interactions. In addition, they produce more responses than initiations. When they interact, the non verbal communication is more used than verbal or symbolic communication forms and they are more engaged with adults than with peers. Nevertheless, communicative patterns may vary according to the clinical profiles of ASD children. Indeed, the ASD children with better cognitive skills interact more with their peers and use more symbolic communication than the ASD children with a low cognitive level. ASD children with the less severe symptoms use more the verbal communication than ASD children with the more severe symptoms. Small groups and structured activities encourage coordinated joint engagement episodes in ASD children. Our goal is to evaluate ASD children’s social engagement development in class, with their peers or adults, during dyadic or group activities. Participants were 19 preschool children with ASD aged from 3 to 6 years old that benefited of an early intervention in special kindergarten schools. Severity of ASD symptoms was measured with the CARS at the beginning of the follow-up. Classroom situations of interaction were recorded during 10 minutes (5 minutes of dyadic interaction and 5 minutes of a group activity), every 2 months, during 10 months. Social engagement behaviors of children, including initiations, responses and imitation, directed to a peer or an adult, were then coded. The Observer software (Noldus) that allows to annotate behaviors was the coding system used. A double coding was conducted and revealed a good inter judges fidelity. Results show that ASD children were more often and longer socially engaged in dyadic than in groups situations. They were also more engaged with adults than with peers. Children with the less severe symptoms of ASD were more socially engaged in groups situations than children with the more severe symptoms of ASD. Then, ASD children with the less severe symptoms of ASD were more engaged with their peers than ASD children with the more severe symptoms of ASD. However, the engagement frequency increased during the 10 month of follow-up but only for ASD children with the more severe symptoms at the beginning. To conclude, these results highlighted the necessity of individualizing early intervention programs according to the clinical profile of the child.

Keywords: autism spectrum disorder, preschool children, developmental psychology, early interventions, social interactions

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303 An Acyclic Zincgermylene: Rapid H₂ Activation

Authors: Martin Juckel

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Probably no other field of inorganic chemistry has undergone such a rapid development in the past two decades than the low oxidation state chemistry of main group elements. This rapid development has only been possible by the development of new bulky ligands. In case of our research group, super-bulky monodentate amido ligands and β-diketiminate ligands have been used to a great success. We first synthesized the unprecedented magnesium(I) dimer [ᴹᵉˢNacnacMg]₂ (ᴹᵉˢNacnac = [(ᴹᵉˢNCMe)₂CH]-; Mes = mesityl, which has since been used both as reducing agent and also for the synthesis of new metal-magnesium bonds. In case of the zinc bromide precursor [L*ZnBr] (L*=(N(Ar*)(SiPri₃); (Ar* = C₆H₂{C(H)Ph₂}₂Me-2,6,4, the reduction with [ᴹᵉˢNacnacMg]₂ led to such a metal-magnesium bond. This [L*ZnMg(ᴹᵉˢNacnac)] compound can be seen as an ‘inorganic Grignard reagent’, which can be used to transfer the metal fragment onto other functional groups or other metal centers; just like the conventional Grignard reagent. By simple addition of (TBoN)GeCl (TBoN = N(SiMe₃){B(DipNCH)₂) to the aforesaid compound, we were able to transfer the amido-zinc fragment to the Ge center of the germylene starting material and to synthesize the first example of a germanium(II)-zinc bond: [:Ge(TBoN)(ZnL*)]. While these reactions typically led to complex product mixture, [:Ge(TBoN)(ZnL*)] could be isolated as dark blue crystals in a good yield. This new compound shows interesting reactivity towards small molecules, especially dihydrogen gas. This is of special interest as dihydrogen is one of the more difficult small molecules to activate, due to its strong (BDE = 108 kcal/mol) and non-polar bond. In this context, the interaction between H₂ σ-bond with the tetrelylene p-Orbital (LUMO), with concomitant donation of the tetrelylene lone pair (HOMO) into the H₂ σ* orbital are responsible for the activation of dihydrogen gas. Accordingly, the narrower the HOMO-LUMO gap of tertelylene, the more reactivity towards H₂ it typically is. The aim of a narrow HOMO-LUMO gap was reached by transferring electropositive substituents respectively metal substituents with relatively low Pauling electronegativity (zinc: 1.65) onto the Ge center (here: the zinc-amido fragment). In consideration of the unprecedented reactivity of [:Ge(TBoN)(ZnL*)], a computational examination of its frontier orbital energies was undertaken. The energy separation between the HOMO, which has significant Ge lone pair character, and the LUMO, which has predominantly Ge p-orbital character, is narrow (40.8 kcal/mol; cf.∆S-T= 24.8 kcal/mol), and comparable to the HOMO-LUMO gaps calculated for other literature known complexes). The calculated very narrow HOMO-LUMO gap for the [:Ge(TBoN)(ZnL*)] complex is consistent with its high reactivity, and is remarkable considering that it incorporates a π-basic amide ligand, which are known to raise the LUMO of germylenes considerably.

Keywords: activation of dihydrogen gas, narrow HOMO-LUMO gap, first germanium(II)-zinc bond, inorganic Grignard reagent

Procedia PDF Downloads 182
302 Environmental Aspects of Alternative Fuel Use for Transport with Special Focus on Compressed Natural Gas (CNG)

Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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The history of gaseous fuel use in the motive power of vehicles dates back to the second half of the nineteenth century, and thus the beginnings of the automotive industry. The engines were powered by coal gas and became the prototype for internal combustion engines built so far. It can thus be considered that this construction gave rise to the automotive industry. As the socio-economic development advances, so does the number of motor vehicles. Although, due to technological progress in recent decades, the emissions generated by internal combustion engines of cars have been reduced, a sharp increase in the number of cars and the rapidly growing traffic are an important source of air pollution and a major cause of acoustic threat, in particular in large urban agglomerations. One of the solutions, in terms of reducing exhaust emissions and improving air quality, is a more extensive use of alternative fuels: CNG, LNG, electricity and hydrogen. In the case of electricity use for transport, it should be noted that the environmental outcome depends on the structure of electricity generation. The paper shows selected regulations affecting the use of alternative fuels for transport (including Directive 2014/94/EU) and its dynamics between 2000 and 2015 in Poland and selected EU countries. The paper also gives a focus on the impact of alternative fuels on the environment by comparing the volume of individual emissions (compared to the emissions from conventional fuels: petrol and diesel oil). Bearing in mind that the extent of various alternative fuel use is determined in first place by economic conditions, the article describes the price relationships between alternative and conventional fuels in Poland and selected EU countries. It is pointed out that although Poland has a wealth of experience in using methane alternative fuels for transport, one of the main barriers to their development in Poland is the extensive use of LPG. In addition, a poorly developed network of CNG stations in Poland, which does not allow easy transport, especially in the northern part of the country, is a serious problem to a further development of CNG use as fuel for transport. An interesting solution to this problem seems to be the use of home CNG filling stations: Home Refuelling Appliance (HRA, refuelling time 8-10 hours) and Home Refuelling Station (HRS, refuelling time 8-10 minutes). The team is working on HRA and HRS technologies. The article also highlights the impact of alternative fuel use on energy security by reducing reliance on imports of crude oil and petroleum products.

Keywords: alternative fuels, CNG (Compressed Natural Gas), CNG stations, LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles), pollutant emissions

Procedia PDF Downloads 227
301 Development of a Bus Information Web System

Authors: Chiyoung Kim, Jaegeol Yim

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Bus service is often either main or the only public transportation available in cities. In metropolitan areas, both subways and buses are available whereas in the medium sized cities buses are usually the only type of public transportation available. Bus Information Systems (BIS) provide current locations of running buses, efficient routes to travel from one place to another, points of interests around a given bus stop, a series of bus stops consisting of a given bus route, and so on to users. Thanks to BIS, people do not have to waste time at a bus stop waiting for a bus because BIS provides exact information on bus arrival times at a given bus stop. Therefore, BIS does a lot to promote the use of buses contributing to pollution reduction and saving natural resources. BIS implementation costs a huge amount of budget as it requires a lot of special equipment such as road side equipment, automatic vehicle identification and location systems, trunked radio systems, and so on. Consequently, medium and small sized cities with a low budget cannot afford to install BIS even though people in these cities need BIS service more desperately than people in metropolitan areas. It is possible to provide BIS service at virtually no cost under the assumption that everybody carries a smartphone and there is at least one person with a smartphone in a running bus who is willing to reveal his/her location details while he/she is sitting in a bus. This assumption is usually true in the real world. The smartphone penetration rate is greater than 100% in the developed countries and there is no reason for a bus driver to refuse to reveal his/her location details while driving. We have developed a mobile app that periodically reads values of sensors including GPS and sends GPS data to the server when the bus stops or when the elapsed time from the last send attempt is greater than a threshold. This app detects the bus stop state by investigating the sensor values. The server that receives GPS data from this app has also been developed. Under the assumption that the current locations of all running buses collected by the mobile app are recorded in a database, we have also developed a web site that provides all kinds of information that most BISs provide to users through the Internet. The development environment is: OS: Windows 7 64bit, IDE: Eclipse Luna 4.4.1, Spring IDE 3.7.0, Database: MySQL 5.1.7, Web Server: Apache Tomcat 7.0, Programming Language: Java 1.7.0_79. Given a start and a destination bus stop, it finds a shortest path from the start to the destination using the Dijkstra algorithm. Then, it finds a convenient route considering number of transits. For the user interface, we use the Google map. Template classes that are used by the Controller, DAO, Service and Utils classes include BUS, BusStop, BusListInfo, BusStopOrder, RouteResult, WalkingDist, Location, and so on. We are now integrating the mobile app system and the web app system.

Keywords: bus information system, GPS, mobile app, web site

Procedia PDF Downloads 216
300 Carbon Sequestration in Spatio-Temporal Vegetation Dynamics

Authors: Nothando Gwazani, K. R. Marembo

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An increase in the atmospheric concentration of carbon dioxide (CO₂) from fossil fuel and land use change necessitates identification of strategies for mitigating threats associated with global warming. Oceans are insufficient to offset the accelerating rate of carbon emission. However, the challenges of oceans as a source of reducing carbon footprint can be effectively overcome by the storage of carbon in terrestrial carbon sinks. The gases with special optical properties that are responsible for climate warming include carbon dioxide (CO₂), water vapors, methane (CH₄), nitrous oxide (N₂O), nitrogen oxides (NOₓ), stratospheric ozone (O₃), carbon monoxide (CO) and chlorofluorocarbons (CFC’s). Amongst these, CO₂ plays a crucial role as it contributes to 50% of the total greenhouse effect and has been linked to climate change. Because plants act as carbon sinks, interest in terrestrial carbon sequestration has increased in an effort to explore opportunities for climate change mitigation. Removal of carbon from the atmosphere is a topical issue that addresses one important aspect of an overall strategy for carbon management namely to help mitigate the increasing emissions of CO₂. Thus, terrestrial ecosystems have gained importance for their potential to sequester carbon and reduce carbon sink in oceans, which have a substantial impact on the ocean species. Field data and electromagnetic spectrum bands were analyzed using ArcGIS 10.2, QGIS 2.8 and ERDAS IMAGINE 2015 to examine the vegetation distribution. Satellite remote sensing data coupled with Normalized Difference Vegetation Index (NDVI) was employed to assess future potential changes in vegetation distributions in Eastern Cape Province of South Africa. The observed 5-year interval analysis examines the amount of carbon absorbed using vegetation distribution. In 2015, the numerical results showed low vegetation distribution, therefore increased the acidity of the oceans and gravely affected fish species and corals. The outcomes suggest that the study area could be effectively utilized for carbon sequestration so as to mitigate ocean acidification. The vegetation changes measured through this investigation suggest an environmental shift and reduced vegetation carbon sink, and that threatens biodiversity and ecosystem. In order to sustain the amount of carbon in the terrestrial ecosystems, the identified ecological factors should be enhanced through the application of good land and forest management practices. This will increase the carbon stock of terrestrial ecosystems thereby reducing direct loss to the atmosphere.

Keywords: remote sensing, vegetation dynamics, carbon sequestration, terrestrial carbon sink

Procedia PDF Downloads 151
299 Life Cycle Assessment-Based Environmental Assessment of the Production and Maintenance of Wooden Windows

Authors: Pamela Del Rosario, Elisabetta Palumbo, Marzia Traverso

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The building sector plays an important role in addressing pressing environmental issues such as climate change and resource scarcity. The energy performance of buildings is considerably affected by the external envelope. In fact, a considerable proportion of the building energy demand is due to energy losses through the windows. Nevertheless, according to literature, to pay attention only to the contribution of windows to the building energy performance, i.e., their influence on energy use during building operation, could result in a partial evaluation. Hence, it is important to consider not only the building energy performance but also the environmental performance of windows, and this not only during the operational stage but along its complete life cycle. Life Cycle Assessment (LCA) according to ISO 14040:2006 and ISO 14044:2006+A1:2018 is one of the most adopted and robust methods to evaluate the environmental performance of products throughout their complete life cycle. This life-cycle based approach avoids the shift of environmental impacts of a life cycle stage to another, allowing to allocate them to the stage in which they originated and to adopt measures that optimize the environmental performance of the product. Moreover, the LCA method is widely implemented in the construction sector to assess whole buildings as well as construction products and materials. LCA is regulated by the European Standards EN 15978:2011, at the building level, and EN 15804:2012+A2:2019, at the level of construction products and materials. In this work, the environmental performance of wooden windows was assessed by implementing the LCA method and adopting primary data. More specifically, the emphasis is given to embedded and operational impacts. Furthermore, correlations are made between these environmental impacts and aspects such as type of wood and window transmittance. In the particular case of the operational impacts, special attention is set on the definition of suitable maintenance scenarios that consider the potential climate influence on the environmental impacts. For this purpose, a literature review was conducted, and expert consultation was carried out. The study underlined the variability of the embedded environmental impacts of wooden windows by considering different wood types and transmittance values. The results also highlighted the need to define appropriate maintenance scenarios for precise assessment results. It was found that both the service life and the window maintenance requirements in terms of treatment and its frequency are highly dependent not only on the wood type and its treatment during the manufacturing process but also on the weather conditions of the place where the window is installed. In particular, it became evident that maintenance-related environmental impacts were the highest for climate regions with the lowest temperatures and the greatest amount of precipitation.

Keywords: embedded impacts, environmental performance, life cycle assessment, LCA, maintenance stage, operational impacts, wooden windows

Procedia PDF Downloads 232
298 Spatial Analysis in the Impact of Aquifer Capacity Reduction on Land Subsidence Rate in Semarang City between 2014-2017

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

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The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

Procedia PDF Downloads 182
297 Modeling Search-And-Rescue Operations by Autonomous Mobile Robots at Sea

Authors: B. Kriheli, E. Levner, T. C. E. Cheng, C. T. Ng

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During the last decades, research interest in planning, scheduling, and control of emergency response operations, especially people rescue and evacuation from the dangerous zone of marine accidents, has increased dramatically. Until the survivors (called ‘targets’) are found and saved, it may cause loss or damage whose extent depends on the location of the targets and the search duration. The problem is to efficiently search for and detect/rescue the targets as soon as possible with the help of intelligent mobile robots so as to maximize the number of saved people and/or minimize the search cost under restrictions on the amount of saved people within the allowable response time. We consider a special situation when the autonomous mobile robots (AMR), e.g., unmanned aerial vehicles and remote-controlled robo-ships have no operator on board as they are guided and completely controlled by on-board sensors and computer programs. We construct a mathematical model for the search process in an uncertain environment and provide a new fast algorithm for scheduling the activities of the autonomous robots during the search-and rescue missions after an accident at sea. We presume that in the unknown environments, the AMR’s search-and-rescue activity is subject to two types of error: (i) a 'false-negative' detection error where a target object is not discovered (‘overlooked') by the AMR’s sensors in spite that the AMR is in a close neighborhood of the latter and (ii) a 'false-positive' detection error, also known as ‘a false alarm’, in which a clean place or area is wrongly classified by the AMR’s sensors as a correct target. As the general resource-constrained discrete search problem is NP-hard, we restrict our study to finding local-optimal strategies. A specificity of the considered operational research problem in comparison with the traditional Kadane-De Groot-Stone search models is that in our model the probability of the successful search outcome depends not only on cost/time/probability parameters assigned to each individual location but, as well, on parameters characterizing the entire history of (unsuccessful) search before selecting any next location. We provide a fast approximation algorithm for finding the AMR route adopting a greedy search strategy in which, in each step, the on-board computer computes a current search effectiveness value for each location in the zone and sequentially searches for a location with the highest search effectiveness value. Extensive experiments with random and real-life data provide strong evidence in favor of the suggested operations research model and corresponding algorithm.

Keywords: disaster management, intelligent robots, scheduling algorithm, search-and-rescue at sea

Procedia PDF Downloads 172
296 HRCT of the Chest and the Role of Artificial Intelligence in the Evaluation of Patients with COVID-19

Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

Procedia PDF Downloads 63
295 Epidemiology, Clinical, Immune, and Molecular Profiles of Microsporidiosis and Cryptosporidiosis among HIV/AIDS patients

Authors: Roger WUMBA

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The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

Procedia PDF Downloads 125
294 Cross-Comparison between Land Surface Temperature from Polar and Geostationary Satellite over Heterogenous Landscape: A Case Study in Hong Kong

Authors: Ibrahim A. Adeniran, Rui F. Zhu, Man S. Wong

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Owing to the insufficiency in the spatial representativeness and continuity of in situ temperature measurements from weather stations (WS), the use of temperature measurement from WS for large-range diurnal analysis in heterogenous landscapes has been limited. This has made the accurate estimation of land surface temperature (LST) from remotely sensed data more crucial. Moreover, the study of dynamic interaction between the atmosphere and the physical surface of the Earth could be enhanced at both annual and diurnal scales by using optimal LST data derived from satellite sensors. The tradeoff between the spatial and temporal resolution of LSTs from satellite’s thermal infrared sensors (TIRS) has, however, been a major challenge, especially when high spatiotemporal LST data are recommended. It is well-known from existing literature that polar satellites have the advantage of high spatial resolution, while geostationary satellites have a high temporal resolution. Hence, this study is aimed at designing a framework for the cross-comparison of LST data from polar and geostationary satellites in a heterogeneous landscape. This could help to understand the relationship between the LST estimates from the two satellites and, consequently, their integration in diurnal LST analysis. Landsat-8 satellite data will be used as the representative of the polar satellite due to the availability of its long-term series, while the Himawari-8 satellite will be used as the data source for the geostationary satellite because of its improved TIRS. For the study area, Hong Kong Special Administrative Region (HK SAR) will be selected; this is due to the heterogeneity in the landscape of the region. LST data will be retrieved from both satellites using the Split window algorithm (SWA), and the resulting data will be validated by comparing satellite-derived LST data with temperature data from automatic WS in HK SAR. The LST data from the satellite data will then be separated based on the land use classification in HK SAR using the Global Land Cover by National Mapping Organization version3 (GLCNMO 2013) data. The relationship between LST data from Landsat-8 and Himawari-8 will then be investigated based on the land-use class and over different seasons of the year in order to account for seasonal variation in their relationship. The resulting relationship will be spatially and statistically analyzed and graphically visualized for detailed interpretation. Findings from this study will reveal the relationship between the two satellite data based on the land use classification within the study area and the seasons of the year. While the information provided by this study will help in the optimal combination of LST data from Polar (Landsat-8) and geostationary (Himawari-8) satellites, it will also serve as a roadmap in the annual and diurnal urban heat (UHI) analysis in Hong Kong SAR.

Keywords: automatic weather station, Himawari-8, Landsat-8, land surface temperature, land use classification, split window algorithm, urban heat island

Procedia PDF Downloads 73
293 Effect of Fuel Type on Design Parameters and Atomization Process for Pressure Swirl Atomizer and Dual Orifice Atomizer for High Bypass Turbofan Engine

Authors: Mohamed K. Khalil, Mohamed S. Ragab

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Atomizers are used in many engineering applications including diesel engines, petrol engines and spray combustion in furnaces as well as gas turbine engines. These atomizers are used to increase the specific surface area of the fuel, which achieve a high rate of fuel mixing and evaporation. In all combustion systems reduction in mean drop size is a challenge which has many advantages since it leads to rapid and easier ignition, higher volumetric heat release rate, wider burning range and lower exhaust concentrations of the pollutant emissions. Pressure atomizers have a different configuration for design such as swirl atomizer (simplex), dual orifice, spill return, plain orifice, duplex and fan spray. Simplex pressure atomizers are the most common type of all. Among all types of atomizers, pressure swirl types resemble a special category since they differ in quality of atomization, the reliability of operation, simplicity of construction and low expenditure of energy. But, the disadvantages of these atomizers are that they require very high injection pressure and have low discharge coefficient owing to the fact that the air core covers the majority of the atomizer orifice. To overcome these problems, dual orifice atomizer was designed. This paper proposes a detailed mathematical model design procedure for both pressure swirl atomizer (Simplex) and dual orifice atomizer, examines the effects of varying fuel type and makes a clear comparison between the two types. Using five types of fuel (JP-5, JA1, JP-4, Diesel and Bio-Diesel) as a case study, reveal the effect of changing fuel type and its properties on atomizers design and spray characteristics. Which effect on combustion process parameters; Sauter Mean Diameter (SMD), spray cone angle and sheet thickness with varying the discharge coefficient from 0.27 to 0.35 during takeoff for high bypass turbofan engines. The spray atomizer performance of the pressure swirl fuel injector was compared to the dual orifice fuel injector at the same differential pressure and discharge coefficient using Excel. The results are analyzed and handled to form the final reliability results for fuel injectors in high bypass turbofan engines. The results show that the Sauter Mean Diameter (SMD) in dual orifice atomizer is larger than Sauter Mean Diameter (SMD) in pressure swirl atomizer, the film thickness (h) in dual orifice atomizer is less than the film thickness (h) in pressure swirl atomizer. The Spray Cone Angle (α) in pressure swirl atomizer is larger than Spray Cone Angle (α) in dual orifice atomizer.

Keywords: gas turbine engines, atomization process, Sauter mean diameter, JP-5

Procedia PDF Downloads 165
292 Towards a More Inclusive Society: A Study on the Assimilation and Integration of the Migrant Children in Kerala

Authors: Arun Perumbilavil Anand

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For the past few years, the state of Kerala has been witnessing a large inflow of migrant workers from other states of the country, which emerged as a result of demographic transition and Gulf emigration. The in-migration patterns in Kerala have changed over the time with the migrants having a higher residence history bringing their families to the state, thereby making the process more complicated and divergent in its approach. These developments have led to an increase in the young migrant population at least in some parts of the state, which has opened up doubts and questions related to their future in the host society. At this juncture, the study ponders into the factors that are associated with the assimilation and wellbeing of migrant children in the society of Kerala. As one of the objectives, the study also analyzed the influence and role played by the educational institutions (both public and private) in meeting the needs and aspirations of both the children and their parents. The study gains significance as it tries to identify various impediments that hinder the cognitive skill formation and behaviour patterns of the migrant children in the host society. Data and Methodology: The study is based on the primary data collected through a series of interviews and interactions held with parents, children, and teachers of different educational institutions, including both public and private. The primary survey also made use of research techniques like observation, in-depth interviews, and case study method. The study was conducted in schools in the Kanjikode area of the Palakkad district in Kerala. The findings of the study are on the basis of a survey conducted in four schools and 40 migrant children. Findings: The study found that majority of the children have wholly integrated and assimilated into the host society. The influence of the peer group was quite visible in giving stimulus to the assimilation process. Most of the children do not have any emotional or cultural sentiments attached to their state of origin, and they consider Kerala as their ‘home state’ and the local language (Malayalam) as their ‘mother tongue'. The study could also find that the existing education system in the host society fails to meet the needs and aspirations of migrants as well as that of their children. On a comparative scale, to some extent, private schools have succeeded in fulfiling the special requirements of the migrant children. An interesting point that the study could pinpoint at is that the children of the migrants show better health conditions and wellbeing than compared to the natives, which is usually addressed as an epidemiologic paradox. As a concluding remark, the study recommends the inclusion concept of inclusive education into the education system of the state with giving due emphasis on those who are at higher risk of being excluded or marginalized, along with fostering increased interaction between diverse groups.

Keywords: assimilation, Kerala, migrant children, well-being

Procedia PDF Downloads 170
291 Mobile Technology Use by People with Learning Disabilities: A Qualitative Study

Authors: Peter Williams

Abstract:

Mobile digital technology, in the form of smart phones, tablets, laptops and their accompanying functionality/apps etc., is becoming ever more used by people with Learning Disabilities (LD) - for entertainment, to communicate and socialize, and enjoy self-expression. Despite this, there has been very little research into the experiences of such technology by this cohort, it’s role in articulating personal identity and self-advocacy and the barriers encountered in negotiating technology in everyday life. The proposed talk describes research funded by the British Academy addressing these issues. It aims to explore: i) the experiences of people with LD in using mobile technology in their everyday lives – the benefits, in terms of entertainment, self-expression and socialising, and possible greater autonomy; and the barriers, such as accessibility or usability issues, privacy or vulnerability concerns etc. ii) how the technology, and in particular the software/apps and interfaces, can be improved to enable the greater access to entertainment, information, communication and other benefits it can offer. It is also hoped that results will inform parents, carers and other supporters regarding how they can use the technology with their charges. Rather than the project simply following the standard research procedure of gathering and analysing ‘data’ to which individual ‘research subjects’ have no access, people with Learning Disabilities (and their supporters) will help co-produce an accessible, annotated and hyperlinked living e-archive of their experiences. Involving people with LD as informants, contributors and, in effect, co-researchers will facilitate digital inclusion and empowerment. The project is working with approximately 80 adults of all ages who have ‘mild’ learning disabilities (people who are able to read basic texts and write simple sentences). A variety of methods is being used. Small groups of participants have engaged in simple discussions or storytelling about some aspect of technology (such as ‘when my phone saved me’ or ‘my digital photos’ etc.). Some individuals have been ‘interviewed’ at a PC, laptop or with a mobile device etc., and asked to demonstrate their usage and interests. Social media users have shown their Facebook pages, Pinterest uploads or other material – giving them an additional focus they have used to discuss their ‘digital’ lives. During these sessions, participants have recorded (or employed the researcher to record) their observations on to the e-archive. Parents, carers and other supporters are also being interviewed to explore their experiences of using mobile technology with the cohort, including any difficulties they have observed their charges having. The archive is supplemented with these observations. The presentation will outline the methods described above, highlighting some of the special considerations required when working inclusively with people with LD. It will describe some of the preliminary findings and demonstrate the e-archive with a commentary on the pages shown.

Keywords: inclusive research, learning disabilities, methods, technology

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290 Impact of Terrorism as an Asymmetrical Threat on the State's Conventional Security Forces

Authors: Igor Pejic

Abstract:

The main focus of this research will be on analyzing correlative links between terrorism as an asymmetrical threat and the consequences it leaves on conventional security forces. The methodology behind the research will include qualitative research methods focusing on comparative analysis of books, scientific papers, documents and other sources, in order to deduce, explore and formulate the results of the research. With the coming of the 21st century and the rising multi-polar, new world threats quickly emerged. The realistic approach in international relations deems that relations among nations are in a constant state of anarchy since there are no definitive rules and the distribution of power varies widely. International relations are further characterized by egoistic and self-orientated human nature, anarchy or absence of a higher government, security and lack of morality. The asymmetry of power is also reflected on countries' security capabilities and its abilities to project power. With the coming of the new millennia and the rising multi-polar world order, the asymmetry of power can be also added as an important trait of the global society which consequently brought new threats. Among various others, terrorism is probably the most well-known, well-based and well-spread asymmetric threat. In today's global political arena, terrorism is used by state and non-state actors to fulfill their political agendas. Terrorism is used as an all-inclusive tool for regime change, subversion or a revolution. Although the nature of terrorist groups is somewhat inconsistent, terrorism as a security and social phenomenon has a one constant which is reflected in its political dimension. The state's security apparatus, which was embodied in the form of conventional armed forces, is now becoming fragile, unable to tackle new threats and to a certain extent outdated. Conventional security forces were designed to defend or engage an exterior threat which is more or less symmetric and visible. On the other hand, terrorism as an asymmetrical threat is a part of hybrid, special or asymmetric warfare in which specialized units, institutions or facilities represent the primary pillars of security. In today's global society, terrorism is probably the most acute problem which can paralyze entire countries and their political systems. This problem, however, cannot be engaged on an open field of battle, but rather it requires a different approach in which conventional armed forces cannot be used traditionally and their role must be adjusted. The research will try to shed light on the phenomena of modern day terrorism and to prove its correlation with the state conventional armed forces. States are obliged to adjust their security apparatus to the new realism of global society and terrorism as an asymmetrical threat which is a side-product of the unbalanced world.

Keywords: asymmetrical warfare, conventional forces, security, terrorism

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289 Exposure to Radon on Air in Tourist Caves in Bulgaria

Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska

Abstract:

The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.

Keywords: tourist caves, radon concentration, exposure, Bulgaria

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288 Rehabilitation Team after Brain Damages as Complex System Integrating Consciousness

Authors: Olga Maksakova

Abstract:

A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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287 ISIS Women Recruitment in Spain and De-Radicalization Programs in Prisons

Authors: Inmaculada Yuste Martinez

Abstract:

Since July 5, 2014, Abubaker al Bagdadi, leader of the Islamic State since 2010 climbed the pulpit of the Great Mosque of Al Nuri of Mosul and proclaimed the Caliphate, the number of fighters who have travelled to Syria to join the Caliphate has increased as never before. Although it is true that the phenomenon of foreign fighters is not a new phenomenon, as it occurred after the Spanish Civil War, Republicans from Ireland and the conflict of the Balkans among others, it is highly relevant the fact that in this case, it has reached figures unknown in Europe until now. The approval of the resolution 2178 (2014) of the Security Council, foreign terrorist fighters placed the subject a priority position on the International agenda. The available data allow us to affirm that women have increasingly assumed operative functions in jihadist terrorism and in the activities linked to it in the development of attacks in the European Union, including minors and young adults. In the case of Spain, one in four of the detainees in 2016 were women, a significant increase compared to 2015. This contrasts with the fact that until 2014 no woman had been prosecuted in Spain for terrorist activities of a jihadist nature. It is fundamental when we talk about the prevention of radicalization and counterterrorism that we do not underestimate the potential threat to the security of countries like Spain that women from the West can assume to the global jihadist movement. This work aims to deepen the radicalization processes of these women and their profiles influencing the female inmate population. It also wants to focus on the importance of creating de-radicalization programs for these inmates since women are a crucial element in radicalization processes. A special focus it is made on young radicalized female inmate population as this target group is the most recoverable and on which it would result more fruitful to intervene. De-radicalization programs must also be designed to fit their profiles and circumstances; a sensitive environment will be prisons and juvenile centers, areas that until now had been unrelated to this problem and which are already hosting the first convicted in judicial offices in Spanish territory. A qualitative research and an empirical and analytical method has been implemented in this work, focused on the cases that took place in Spain of young women and the imaginary that the Islamic State uses for the processes of radicalization for this target group and how it does not fit with their real role in the Jihad, as opposed to other movements in which women do have a real and active role in the armed conflict as YPJ do it as a part of the armed wing of the Democratic Union Party of Syria.

Keywords: caliphate, de-radicalization, foreign fighter, gender perspective, ISIS, jihadism, recruitment

Procedia PDF Downloads 171