Search results for: test methods
Commenced in January 2007
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Edition: International
Paper Count: 22046

Search results for: test methods

896 Optimization of Rehabilitation in Scapolohumeral Periarthrosis Using Botulinum Toxin

Authors: M. A. Akulov, V. O. Zaharov, A. A. Tomskij

Abstract:

Introduction: Scapulohumeral periarthrosis, resulting as a reaction to mechanical injury of shoulder tendons and muscles, is associated with high incidence of temporal and permanent disability. There is a strong need for investigation of treatment of that patient group. Severe pain leads to limitation of movements range, which result in secondary alterations of joint capsule and ligamentous apparatus. Muscle tension and edema, swelling of fascial and fibrous structures result in nerve and vascular compression in intramuscular and osseo-muscular-fibrous spaces. Botulinum toxin injection leads to decrease of muscle tone, increase of movements range and associated pain alleviation. Study aim: Optimization of rehabilitation process in scapolohumeral periarthrosis using Xeomin. Patients and methods: 40 patients aged 37-56 years with scapulohumeral periarthrosis were evaluated. Patients were divided into two groups according to treatment regimen. The first (main) group included 21 patients, receiving intramuscular Xeomin 150-200 U in the area of brachio-scapular joint and trigger points (inducing motion range limitation and pain). Treatment procedures were combined with physical therapy and osteopathic procedures. The second (control) group included 19 patients, receiving conventional physical therapy and osteopathic procedures. The evaluation and efficacy comparison was carried out using McGill pain questionnaire, Clinical Global Impression scale (CGI), and patient-reported increase of brachio-scapular joint movement range and pain decrease at 1, 3 and 6 months of treatment. Results. The study demonstrated a significant improvement in the main group after one month of treatment, which persisted during months of treatment. At baseline, rank pain index on McGill pain questionnaire was 18,4±4,9 and 17,8±5,1 in the main and control group, respectively (p > 0,05). At 1 month of treatment we observed a significant decrease of pain syndrome (no pain or modest pain) and increase of movement range in angular degrees in the main group (р < 0,05). In the control group significant improvements were observed only on the 3 month of treatment (р < 0,05), but at 6 months of treatment the improvement in pain syndrome and motion range in brachio-scapular joint was significantly smaller, than in the main group. Rank pain index on McGill pain scale was 5,2±1,8 in the main group compared to 12,0±2,6 in the control group (р < 0,05). At 6 months of treatment patients in the first group reported a significant/highly significant improvement of general health on CGI, whereas in the second group most patients reported a minimal improvement. We observed a sustained and persistent improvement of motion range in brachio-scapular joint in the main group. Conclusion: Xeomin injections as a part of rehabilitation process in scapulohumeral periarthrosis lead to reduced time and increased quality of rehabilitation.

Keywords: botulinum toxin, rehabilitation, scapulohumeral periarthrosis

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895 Association of Ovine Lymphocyte Antigen (OLA) with the Parasitic Infestation in Kashmiri Sheep Breeds

Authors: S. A. Bhat, Ahmad Arif, Muneeb U. Rehman, Manzoor R Mir, S. Bilal, Ishraq Hussain, H. M Khan, S. Shanaz, M. I Mir, Sabhiya Majid

Abstract:

Background: Geologically Climatic conditions of the state range from sub-tropical (Jammu), temperate (Kashmir) to cold artic (Ladakh) zones, which exerts significant influence on its agro-climatic conditions. Gastrointestinal parasitism is a major problem in sheep production worldwide. Materials and Methods: The present study was to evaluate the resistance status of sheep breeds reared in Kashmir Valley for natural resistance against Haemonchus contortus by natural pasture challenge infection. Ten microsatellite markers were used in the study for evaluation of association of Ovar-MHC with parasitic resistance in association with biochemical and parasitological parameters. Following deworming, 500 animals were subjected to selected contaminated pastures in a vicinity of the livestock farms of SKUAST-K and Sheep Husbandry Kashmir. For each animal about 10-15 ml blood was collected aseptically for molecular and biochemical analysis. Weekly fecal samples (3g) were taken, directly from the rectum of all experimental animals and examined for Fecal egg count (FEC) with modified McMaster technique. Packed cell volume (PCV) was determined within 2-5 h of blood collection, all the biochemical parameters were determined in serum by semi automated analyzer. DNA was extracted from all the blood samples with phenol-chloroform method. Microsatellite analysis was done by denaturing sequencing gel electrophoresis Results: Overall sheep from Bakerwal breed followed by Corriediale breed performed relatively better in the trial; however difference between breeds remained low. Both significant (P<0.05) and non-significant differences with respect to resistance against haemonchosis were noted at different intervals in all the parameters.. All the animals were typed for the microsatellites INRA132, OarCP73, DRB1 (U0022), OLA-DQA2, BM1818, TFAP2A, HH56, BM1815, IL-3 and BM-1258. An association study including the effect of FEC, PCV, TSP, SA, LW, and the number of alleles within each marker was done. All microsatellite markers showed degree of heterozygosity of 0.72, 0.72, 0.75, 0.62, 0.84, 0.69, 0.66, 0.65, 0.73 and 0.68 respectively. Significant association between alleles and the parameters measured were only found for the OarCP73, OLA-DQA2 and BM1815 microsatellite marker. Standard alleles of the above markers showed significant effect on the TP, SA and body weight. The three sheep breeds included in the study responded differently to the nematode infection, which may be attributed to their differences in their natural resistance against nematodes. Conclusion: Our data confirms that some markers (OarCP73, OLA-DQA2 and BM1815) within Ovar-MHC are associated with phenotypic parameters of resistance and suggest superiority of Bakerwal sheep breed in natural resistance against Haemonchus contortus.

Keywords: Ovar-Mhc, ovine leukocyte antigen (OLA), sheep, parasitic resistance, Haemonchus contortus, phenotypic & genotypic markers

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894 Effects of a School-based Mindfulness Intervention on Stress Levels and Emotion Regulation of Adolescent Students Enrolled in an Independent School

Authors: Tracie Catlett

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Students enrolled in high-achieving schools are under tremendous pressure to perform at high levels inside and outside the classroom. Achievement pressure is a prevalent source of stress for students enrolled in high-achieving schools, and female students, in particular, experience a higher frequency and higher levels of stress compared to their male peers. The practice of mindfulness in a school setting is one tool that has been linked to improved self-regulation of emotions, increased positive emotions, and stress reduction. A mixed methods randomized pretest-posttest no-treatment control trial evaluated the effects of a six-session mindfulness intervention taught during a regularly scheduled life skills period in an independent day school, one type of high-achieving school. Twenty-nine students in Grades 10 and 11 were randomized by class, where Grade 11 students were in the intervention group (n = 14) and Grade 10 students were in the control group (n = 15). Findings from the study produced mixed results. There was no evidence that the mindfulness program reduced participants’ stress levels and negative emotions. In fact, contrary to what was expected, students enrolled in the intervention group experienced higher levels of stress and increased negative emotions at posttreatment when compared to pretreatment. Neither the within-group nor the between-groups changes in stress level were statistically significant, p > .05, and the between-groups effect size was small, d = .2. The study found evidence that the mindfulness program may have had a positive impact on students’ ability to regulate their emotions. The within-group comparison and the between-groups comparison at posttreatment found that students in the mindfulness course experienced statistically significant improvement in the in their ability to regulate their emotions at posttreatment, p = .009 < .05 and p =. 034 < .05, respectively. The between-groups effect size was medium, d =.7, suggesting that the positive differences in emotion regulation difficulties were substantial and have practical implications. The analysis of gender differences, as they relate to stress and emotions, revealed that female students perceive higher levels of stress and report experiencing stress more often than males. There were no gender differences when analyzing sources of stress experienced by the student participants. Both females and males experience regular achievement pressures related to their school performance and worry about their future, college acceptance, grades, and parental expectations. Females reported an increased awareness of their stress and actively engaged in practicing mindfulness to manage their stress. Students in the treatment group expressed that the practice of mindfulness resulted in feelings of relaxation and calmness.

Keywords: achievement pressure, adolescents, emotion regulation, emotions, high-achieving schools, independent schools, mindfulness, negative affect, positive affect, stress

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893 Experience of Two Major Research Centers in the Diagnosis of Cardiac Amyloidosis from Transthyretin

Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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892 The Therapeutic Potential, Functions, and Use of Ibogaine

Authors: João Pedro Zanella, Michel J. O. Fagundes

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Introduction: Drug use has been practised by humans universally for millennia, not excluding any population from these habits, however, the rampant drug use is a global concern due to the harm that affects the health of the world population. In this sense, it is observed the reduction of lasting and effective public policies for the resolution, increasing the demand for treatment services. With this comes ibogaine, an alkaloid derived from the root of an African bush (Tabernanthe Iboga), found mostly in Gabon and used widely by the native Bwiti population in rituals, and also other social groups, which demonstrates efficacy against chemical dependence, psychic and emotional disorders, opioid withdrawal was first confirmed by a study in rats done by Michailo Dzoljic and associates in 1988 and again in 1994. Methods: A brief description of the plant, its neurohumoral potential and the effects caused by ingested doses, in a simplified and objective way, will be discussed in the course of this abstract. Results: Ibogaine is not registered or passed by Anvisa, regarding safety and efficacy, and cannot be sold in Brazil. Its illegal trade reaches R$ 5 thousand for a session with the proceeds of the root, and its effect can last up to 72 hours, attributing Iboga's psychoactive effects to the alkaloid called ibogaine. The shrub where Ibogaine is located has pink and yellow flowers, and its fruit produced does not have psychoactive substances, but its root bark contains 6 to 7% indolic alkaloids. Besides extraction from the iboga plant, ibogaine hydrochloride can be semisynthesized from voacangine, another plant alkaloid that acts as a precursor. Its potential has the ability to perform multiple interactions with the neurotransmitter system, which are closely associated with addiction, including nicotinic, opioid and serotoninergic systems. Studies carried out by Edwards found that the doses administered of Iboga should be determined by a health professional when its purpose is to treat individuals for dependence on other drugs. Its use in small doses may cause an increase in sensibility, impaired vision and motor alterations; in moderate quantities, hallucinations, motor and neurological alterations and impaired vision; in high quantities it may cause hallucinations with personal events at a deeper level lasting up to 24 hours or more, followed by motor and visual alterations. Conclusion: The product extracted from the Iboga plant is of great importance in controlling addiction, reducing the need for the use of narcotics by patients, thus gaining a space of extreme importance in the treatment of users of psychoactive substances. It is remarkable the progress of the latest’s research about the usefulness of Ibogaine, and its benefits for certain treatments, even with the restriction of its sale in Brazil. Besides this, Ibogaine has an additional benefit of helping the patient to gain self-control over their destructive behaviours.

Keywords: alkaloids, dependence, Gabon, ibogaine

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891 Fractional, Component and Morphological Composition of Ambient Air Dust in the Areas of Mining Industry

Authors: S.V. Kleyn, S.Yu. Zagorodnov, А.А. Kokoulina

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Technogenic emissions of the mining and processing complex are characterized by a high content of chemical components and solid dust particles. However, each industrial enterprise and the surrounding area have features that require refinement and parameterization. Numerous studies have shown the negative impact of fine dust PM10 and PM2.5 on the health, as well as the possibility of toxic components absorption, including heavy metals by dust particles. The target of the study was the quantitative assessment of the fractional and particle size composition of ambient air dust in the area of impact by primary magnesium production complex. Also, we tried to describe the morphology features of dust particles. Study methods. To identify the dust emission sources, the analysis of the production process has been carried out. The particulate composition of the emissions was measured using laser particle analyzer Microtrac S3500 (covered range of particle size is 20 nm to 2000 km). Particle morphology and the component composition were established by electron microscopy by scanning microscope of high resolution (magnification rate - 5 to 300 000 times) with X-ray fluorescence device S3400N ‘HITACHI’. The chemical composition was identified by X-ray analysis of the samples using an X-ray diffractometer XRD-700 ‘Shimadzu’. Determination of the dust pollution level was carried out using model calculations of emissions in the atmosphere dispersion. The calculations were verified by instrumental studies. Results of the study. The results demonstrated that the dust emissions of different technical processes are heterogeneous and fractional structure is complicated. The percentage of particle sizes up to 2.5 micrometres inclusive was ranged from 0.00 to 56.70%; particle sizes less than 10 microns inclusive – 0.00 - 85.60%; particle sizes greater than 10 microns - 14.40% -100.00%. During microscopy, the presence of nanoscale size particles has been detected. Studied dust particles are round, irregular, cubic and integral shapes. The composition of the dust includes magnesium, sodium, potassium, calcium, iron, chlorine. On the base of obtained results, it was performed the model calculations of dust emissions dispersion and establishment of the areas of fine dust РМ 10 and РМ 2.5 distribution. It was found that the dust emissions of fine powder fractions PM10 and PM2.5 are dispersed over large distances and beyond the border of the industrial site of the enterprise. The population living near the enterprise is exposed to the risk of diseases associated with dust exposure. Data are transferred to the economic entity to make decisions on the measures to minimize the risks. Exposure and risks indicators on the health are used to provide named patient health and preventive care to the citizens living in the area of negative impact of the facility.

Keywords: dust emissions, еxposure assessment, PM 10, PM 2.5

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890 The Role of Professional Teacher Development in Introducing Trilingual Education into the Secondary School Curriculum: Lessons from Kazakhstan, Central Asia

Authors: Kairat Kurakbayev, Dina Gungor, Adil Ashirbekov, Assel Kambatyrova

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Kazakhstan, a post-Soviet economy located in the Central Asia, is making great efforts to internationalize its national system of education. The country is very ambitious in making the national economy internationally competitive and education has become one of the main pillars of the nation’s strategic development plan for 2030. This paper discusses the role of professional teacher development in upgrading the secondary education curriculum with the introduction of English as a medium of instruction (EMI) in grades 10-11 grades. Having Kazakh as the state language and Russian as the official language, English bears a status of foreign language in the country. The development of trilingual education is very high on the agenda of the Ministry of Education and Science. It is planned that by 2019 STEM-related subjects – Biology, Chemistry, Computing and Physics – will be taught in EMI. Introducing English-medium education appears to be a very drastic reform and the teaching cadre is the key driver here. At the same time, after the collapse of the Soviet Union, the teaching profession is still struggling to become attractive in the eyes of the local youth. Moreover, the quality of Kazakhstan’s secondary education is put in question by OECD national review reports. The paper presents a case study of the nation-wide professional development programme arranged for 5 010 school teachers so that they could be able to teach their content subjects in English starting from 2019 onwards. The study is based on the mixed methods research involving the data derived from the surveys and semi-structured interviews held with the programme participants, i.e. school teachers. The findings of the study imply the significance of the school teachers’ attitudes towards the top-down reform of trilingual education. The qualitative research data reveal the teachers’ beliefs about advantages and disadvantages of having their content subjects (e.g. Biology or Chemistry) taught in EMI. The study highlights teachers’ concerns about their professional readiness to implement the top-down reform of English-medium education and discusses possible risks of academic underperforming on the part of students whose English language proficiency is not advanced. This paper argues that for the effective implementation of the English-medium education in secondary schools, the state should adopt a comprehensive approach to upgrading the national academic system where teachers’ attitudes and beliefs play the key role in making the trilingual education policy effective. The study presents lessons for other national academic systems considering to transfer its secondary education to English as a medium of instruction.

Keywords: teacher education, teachers' beliefs, trilingual education, case study

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889 Teaching Academic Writing for Publication: A Liminal Threshold Experience Towards Development of Scholarly Identity

Authors: Belinda du Plooy, Ruth Albertyn, Christel Troskie-De Bruin, Ella Belcher

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In the academy, scholarliness or intellectual craftsmanship is considered the highest level of achievement, culminating in being consistently successfully published in impactful, peer-reviewed journals and books. Scholarliness implies rigorous methods, systematic exposition, in-depth analysis and evaluation, and the highest level of critical engagement and reflexivity. However, being a scholar does not happen automatically when one becomes an academic or completes graduate studies. A graduate qualification is an indication of one’s level of research competence but does not necessarily prepare one for the type of scholarly writing for publication required after a postgraduate qualification has been conferred. Scholarly writing for publication requires a high-level skillset and a specific mindset, which must be intentionally developed. The rite of passage to become a scholar is an iterative process with liminal spaces, thresholds, transitions, and transformations. The journey from researcher to published author is often fraught with rejection, insecurity, and disappointment and requires resilience and tenacity from those who eventually triumph. It cannot be achieved without support, guidance, and mentorship. In this article, the authors use collective auto-ethnography (CAE) to describe the phases and types of liminality encountered during the liminal journey toward scholarship. The authors speak as long-time facilitators of Writing for Academic Publication (WfAP) capacity development events (training workshops and writing retreats) presented at South African universities. Their WfAP facilitation practice is structured around experiential learning principles that allow them to act as critical reading partners and reflective witnesses for the writer-participants of their WfAP events. They identify three essential facilitation features for the effective holding of a generative, liminal, and transformational writing space for novice academic writers in order to enable their safe passage through the various liminal spaces they encounter during their scholarly development journey. These features are that facilitators should be agents of disruption and liminality while also guiding writers through these liminal spaces; that there should be a sense of mutual trust and respect, shared responsibility and accountability in order for writers to produce publication-worthy scholarly work; and that this can only be accomplished with the continued application of high levels of sensitivity and discernment by WfAP facilitators. These are key features for successful WfAP scholarship training events, where focused, individual input triggers personal and professional transformational experiences, which in turn translate into high-quality scholarly outputs.

Keywords: academic writing, liminality, scholarship, scholarliness, threshold experience, writing for publication

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888 Stability in Slopes Related to Expansive Soils

Authors: Ivelise M. Strozberg, Lucas O. Vale, Maria V. V. Morais

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Expansive soils are characterized by their significant volumetric variations, tending to suffer an increase of this volume when added water in their voids and a decrease of volume when this water is removed. The parameters of resistance (especially the angle of friction, cohesion and specific weight) of expansive or non-expansive soils of the same field present differences, as found in laboratory tests. What is expected is that, through this research, demonstrate that this variation directly affects the results of the calculation of factors of safety for slope stability. The expansibility due to specific clay minerals such as montmorillonites and vermiculites is the most common form of expansion of soils or rocks, causing expansion pressures. These pressures can become an aggravating problem in regions across the globe that, when not previously studied, may present high risks to the enterprise, such as cracks, fissures, movements in structures, breaking of retaining walls, drilling of wells, among others. The study provides results based on analyzes carried out in the Slide 2018 software belonging to the Rocsience group, where the software is a two-dimensional equilibrium slope stability program that calculates the factor of safety or probability of failure of certain surfaces composed of soils or rocks (or both, depending on the situation), - through the methods of: Bishop simplified, Fellenius and Janbu corrected. This research compares the factors of safety of a homogeneous earthfill dam geometry, analysed for operation and end-of-construction situations, having a height of approximately 35 meters, with a slope of 1.5: 1 in the slope downstream and 2: 1 on the upstream slope. As the water level is 32.73m high and the water table is drawn automatically by the Slide program using the finite element method for the operating situation, considering two hypotheses for the use of materials - the first with soils with characteristics of expansion and the second with soils without expansibility. For this purpose, soil samples were collected from the region of São Bento do Una - Pernambuco, Brazil and taken to the soil mechanics laboratory to characterize and determine the percentage of expansibility. There were found 2 types of soils in that area: 1 site of expansive soils (8%) and another with non- expansive ones. Based on the results found, the analysis of the values of factors of safety indicated, both upstream and downstream slopes, the highest values were obtained in the case where there is no presence of materials with expansibility resulting, for one of the situations, values of 1.353 (Fellenius), 1,295 (Janbu corrected) and 1,409 (Bishop simplified). There is a considerable drop in safety factors in cases where soils are potentially expansive, resulting in values for the same situation of 0.859 (Fellenius), 0.809 (Janbu corrected) and 0.842 (Bishop simplified), in the case of higher expansibility (8 %). This shows that the expansibility is a determinant factor in the fall of resistance of soil, determined by the factors of cohesion and angle of friction.

Keywords: dam. slope. software. swelling soil

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887 Frailty and Quality of Life among Older Adults: A Study of Six LMICs Using SAGE Data

Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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886 Treatment of Onshore Petroleum Drill Cuttings via Soil Washing Process: Characterization and Optimal Conditions

Authors: T. Poyai, P. Painmanakul, N. Chawaloesphonsiya, P. Dhanasin, C. Getwech, P. Wattana

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Drilling is a key activity in oil and gas exploration and production. Drilling always requires the use of drilling mud for lubricating the drill bit and controlling the subsurface pressure. As drilling proceeds, a considerable amount of cuttings or rock fragments is generated. In general, water or Water Based Mud (WBM) serves as drilling fluid for the top hole section. The cuttings generated from this section is non-hazardous and normally applied as fill materials. On the other hand, drilling the bottom hole to reservoir section uses Synthetic Based Mud (SBM) of which synthetic oils are composed. The bottom-hole cuttings, SBM cuttings, is regarded as a hazardous waste, in accordance with the government regulations, due to the presence of hydrocarbons. Currently, the SBM cuttings are disposed of as an alternative fuel and raw material in cement kiln. Instead of burning, this work aims to propose an alternative for drill cuttings management under two ultimate goals: (1) reduction of hazardous waste volume; and (2) making use of the cleaned cuttings. Soil washing was selected as the major treatment process. The physiochemical properties of drill cuttings were analyzed, such as size fraction, pH, moisture content, and hydrocarbons. The particle size of cuttings was analyzed via light scattering method. Oil present in cuttings was quantified in terms of total petroleum hydrocarbon (TPH) through gas chromatography equipped with flame ionization detector (GC-FID). Other components were measured by the standard methods for soil analysis. Effects of different washing agents, liquid-to-solid (L/S) ratio, washing time, mixing speed, rinse-to-solid (R/S) ratio, and rinsing time were also evaluated. It was found that drill cuttings held the electrical conductivity of 3.84 dS/m, pH of 9.1, and moisture content of 7.5%. The TPH in cuttings existed in the diesel range with the concentration ranging from 20,000 to 30,000 mg/kg dry cuttings. A majority of cuttings particles held a mean diameter of 50 µm, which represented silt fraction. The results also suggested that a green solvent was considered most promising for cuttings treatment regarding occupational health, safety, and environmental benefits. The optimal washing conditions were obtained at L/S of 5, washing time of 15 min, mixing speed of 60 rpm, R/S of 10, and rinsing time of 1 min. After washing process, three fractions including clean cuttings, spent solvent, and wastewater were considered and provided with recommendations. The residual TPH less than 5,000 mg/kg was detected in clean cuttings. The treated cuttings can be then used for various purposes. The spent solvent held the calorific value of higher than 3,000 cal/g, which can be used as an alternative fuel. Otherwise, the recovery of the used solvent can be conducted using distillation or chromatography techniques. Finally, the generated wastewater can be combined with the produced water and simultaneously managed by re-injection into the reservoir.

Keywords: drill cuttings, green solvent, soil washing, total petroleum hydrocarbon (TPH)

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885 Study of Silent Myocardial Ischemia in Type 2 Diabeic Males: Egyptian Experience

Authors: Ali Kassem, Yhea Kishik, Ali Hassan, Mohamed Abdelwahab

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Introduction: Accelerated coronary and peripheral vascular atherosclerosis is one of the most common and chronic complications of diabetes mellitus. A recent aspect of coronary artery disease in this condition is its silent nature. The aim of the work: Detection of the prevalence of silent myocardial ischemia (SMI) in Upper Egypt type 2 diabetic males and to select male diabetic population who should be screened for SMI. Patients and methods: 100 type 2 diabetic male patients with a negative history of angina or anginal equivalent symptoms and 30 healthy control were included. Full medical history and thorough clinical examination were done for all participants. Fasting and post prandial blood glucose level, lipid profile, (HbA1c), microalbuminuria, and C-reactive protein were done for all participants Resting ECG, trans-thoracic echocardiography, treadmill exercise ECG, myocardial perfusion imaging were done for all participants and patients positive for one or more NITs were subjected for coronary angiography. Results Twenty nine patients (29%) were positive for one or more NITs in the patients group compared to only one case (3.3%) in the controls. After coronary angiography, 20 patients were positive for significant coronary artery stenosis in the patients group, while it was refused to be done by the patient in the controls. There were statistical significant difference between the two groups regarding, hypertension, dyslipidemia and obesity, family history of DM and IHD with higher levels of microalbuminuria, C-reactive protein, total lipids in patient group versus controls According to coronary angiography, patients were subdivided into two subgroups, 20 positive for SMI (positive for coronary angiography) and 80 negative for SMI (negative for coronary angiography). No statistical difference regarding family history of DM and type of diabetic therapy was found between the two subgroups. Yet, smoking, hypertension, obesity, dyslipidemia and family history of IHD were significantly higher in diabetics positive versus those negative for SMI. 90% of patients in subgroup positive for SMI had two or more cardiac risk factors while only two patients had one cardiac risk factor (10%). Uncontrolled DM was detected more in patients positive for SMI. Diabetic complications were more prevalent in patients positive for SMI versus those negative for SMI. Most of the patients positive for SMI have DM more than 5 years duration. Resting ECG and resting Echo detected only 6 and 11 cases, respectively, of the 20 positive cases in group positive for SMI compared to treadmill exercise ECG and myocardial perfusion imaging that detected 16 and 18 cases respectively, Conclusion: Type 2 diabetic male patients should be screened for detection of SMI when aged above 50 years old, diabetes duration is more than 5 years, presence of two or more cardiac risk factors and/or patients suffering from one or more of the chronic diabetic complications. CRP, is an important parameter for selection of type 2 diabetic male patients who should be screened for SMI. Non invasive cardiac tests are reliable for screening of SMI in these patients in our locality.

Keywords: C-reactive protein, Silent myocardial ischemia, Stress tests, type 2 DM

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884 The Properties of Risk-based Approaches to Asset Allocation Using Combined Metrics of Portfolio Volatility and Kurtosis: Theoretical and Empirical Analysis

Authors: Maria Debora Braga, Luigi Riso, Maria Grazia Zoia

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Risk-based approaches to asset allocation are portfolio construction methods that do not rely on the input of expected returns for the asset classes in the investment universe and only use risk information. They include the Minimum Variance Strategy (MV strategy), the traditional (volatility-based) Risk Parity Strategy (SRP strategy), the Most Diversified Portfolio Strategy (MDP strategy) and, for many, the Equally Weighted Strategy (EW strategy). All the mentioned approaches were based on portfolio volatility as a reference risk measure but in 2023, the Kurtosis-based Risk Parity strategy (KRP strategy) and the Minimum Kurtosis strategy (MK strategy) were introduced. Understandably, they used the fourth root of the portfolio-fourth moment as a proxy for portfolio kurtosis to work with a homogeneous function of degree one. This paper contributes mainly theoretically and methodologically to the framework of risk-based asset allocation approaches with two steps forward. First, a new and more flexible objective function considering a linear combination (with positive coefficients that sum to one) of portfolio volatility and portfolio kurtosis is used to alternatively serve a risk minimization goal or a homogeneous risk distribution goal. Hence, the new basic idea consists in extending the achievement of typical risk-based approaches’ goals to a combined risk measure. To give the rationale behind operating with such a risk measure, it is worth remembering that volatility and kurtosis are expressions of uncertainty, to be read as dispersion of returns around the mean and that both preserve adherence to a symmetric framework and consideration for the entire returns distribution as well, but also that they differ from each other in that the former captures the “normal” / “ordinary” dispersion of returns, while the latter is able to catch the huge dispersion. Therefore, the combined risk metric that uses two individual metrics focused on the same phenomena but differently sensitive to its intensity allows the asset manager to express, in the context of an objective function by varying the “relevance coefficient” associated with the individual metrics, alternatively, a wide set of plausible investment goals for the portfolio construction process while serving investors differently concerned with tail risk and traditional risk. Since this is the first study that also implements risk-based approaches using a combined risk measure, it becomes of fundamental importance to investigate the portfolio effects triggered by this innovation. The paper also offers a second contribution. Until the recent advent of the MK strategy and the KRP strategy, efforts to highlight interesting properties of risk-based approaches were inevitably directed towards the traditional MV strategy and SRP strategy. Previous literature established an increasing order in terms of portfolio volatility, starting from the MV strategy, through the SRP strategy, arriving at the EQ strategy and provided the mathematical proof for the “equalization effect” concerning marginal risks when the MV strategy is considered, and concerning risk contributions when the SRP strategy is considered. Regarding the validity of similar conclusions when referring to the MK strategy and KRP strategy, the development of a theoretical demonstration is still pending. This paper fills this gap.

Keywords: risk parity, portfolio kurtosis, risk diversification, asset allocation

Procedia PDF Downloads 51
883 Significant Growth in Expected Muslim Inbound Tourists in Japan Towards 2020 Tokyo Olympic and Still Incipient Stage of Current Halal Implementations in Hiroshima

Authors: Kyoko Monden

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Tourism has moved to the forefront of national attention in Japan since September of 2013 when Tokyo won its bid to host the 2020 Summer Olympics. The number of foreign tourists has continued to break records, reaching 13.4 million in 2014, and is now expected to hit 20 million sooner than initially targeted 2020 due to government stimulus promotions; an increase in low cost carriers; the weakening of the Japanese yen, and strong economic growth in Asia. The tourism industry can be an effective trigger in Japan’s economic recovery as foreign tourists spent two trillion yen ($16.6 million) in Japan in 2014. In addition, 81% of them were all from Asian countries, and it is essential to know that 68.9% of the world’s Muslims, about a billion people, live in South and Southeast Asia. An important question is ‘Do Muslim tourists feel comfortable traveling in Japan?’ This research was initiated by an encounter with Muslim visitors in Hiroshima, a popular international tourist destination, who said they had found very few suitable restaurants in Hiroshima. The purpose of this research is to examine halal implementation in Hiroshima and suggest the next steps to be taken to improve current efforts. The goal will be to provide anyone, Muslims included, with first class hospitality in the near future in preparation for the massive influx of foreign tourists in 2020. The methods of this research were questionnaires, face-to-face interviews, phone interviews, and internet research. First, this research aims to address the significance of growing inbound tourism in Japan, especially the expected growth in Muslim tourists. Additionally, it should address the strong popularity of eating Japanese foods in Asian Muslim countries and as ranked no. 1 thing foreign tourists want to do in Japan. Secondly, the current incipient stage of Hiroshima’s halal implementation at hotels, restaurants, and major public places were exposed, and the existing action plans by Hiroshima Prefecture Government were presented. Furthermore, two surveys were conducted to clarify basic halal awareness of local residents in Hiroshima, and to gauge the inconveniences Muslims living in Hiroshima faced. Thirdly, the reasons for this lapse were observed and compared to the benchmarking data of other major tourist sites, Hiroshima’s halal implementation plans were proposed. The conclusion is, despite increasing demands and interests in halal-friendly businesses, overall halal actions have barely been applied in Hiroshima. 76% of Hiroshima residents had no idea what halal or halaal meant. It is essential to increase halal awareness and its importance to the economy and to launch further actions to make Muslim tourists feel welcome in Hiroshima and the entire country.

Keywords: halaal, halal implementation, Hiroshima, inbound tourists in Japan

Procedia PDF Downloads 210
882 The Possible Interaction between Bisphenol A, Caffeine and Epigallocatechin-3-Gallate on Neurotoxicity Induced by Manganese in Rats

Authors: Azza A. Ali, Hebatalla I. Ahmed, Asmaa Abdelaty

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Background: Manganese (Mn) is a naturally occurring element. Exposure to high levels of Mn causes neurotoxic effects and represents an environmental risk factor. Mn neurotoxicity is poorly understood but changing of AChE activity, monoamines and oxidative stress has been established. Bisphenol A (BPA) is a synthetic compound widely used in the production of polycarbonate plastics. There is considerable debate about whether its exposure represents an environmental risk. Caffeine is one of the major contributors to the dietary antioxidants which prevent oxidative damage and may reduce the risk of chronic neurodegenerative diseases. Epigallocatechin-3-gallate is another major component of green tea and has known interactions with caffeine. It also has health-promoting effects in CNS. Objective: To evaluate the potential protective effects of Caffeine and/or EGCG against Mn-induced neurotoxicity either alone or in the presence of BPA in rats. Methods: Seven groups of rats were used and received daily for 5 weeks MnCl2.4H2O (10 mg/kg, IP) except the control group which received saline, corn oil and distilled H2O. Mn was injected either alone or in combination with each of the following: BPA (50 mg/kg, PO), caffeine (10 mg/kg, PO), EGCG (5 mg/kg, IP), caffeine + EGCG and BPA +caffeine +EGCG. All rats were examined in five behavioral tests (grid, bar, swimming, open field and Y- maze tests). Biochemical changes in monoamines, caspase-3, PGE2, GSK-3B, glutamate, acetyl cholinesterase and oxidative parameters, as well as histopathological changes in the brain, were also evaluated for all groups. Results: Mn significantly increased MDA and nitrite content as well as caspase-3, GSK-3B, PGE2 and glutamate levels while significantly decreased TAC and SOD as well as cholinesterase in the striatum. It also decreased DA, NE and 5-HT levels in the striatum and frontal cortex. BPA together with Mn enhanced oxidative stress generation induced by Mn while increased monoamine content that was decreased by Mn in rat striatum. BPA abolished neuronal degeneration induced by Mn in the hippocampus but not in the substantia nigra, striatum and cerebral cortex. Behavioral examinations showed that caffeine and EGCG co-administration had more pronounced protective effect against Mn-induced neurotoxicity than each one alone. EGCG alone or in combination with caffeine prevented neuronal degeneration in the substantia nigra, striatum, hippocampus and cerebral cortex induced by Mn while caffeine alone prevented neuronal degeneration in the substantia nigra and striatum but still showed some nuclear pyknosis in cerebral cortex and hippocampus. The marked protection of caffeine and EGCG co-administration also confirmed by the significant increase in TAC, SOD, ACHE, DA, NE and 5-HT as well as the decrease in MDA, nitrite, caspase-3, PGE2, GSK-3B, the glutamic acid in the striatum. Conclusion: Neuronal degeneration induced by Mn showed some inhibition with BPA exposure despite the enhancement in oxidative stress generation. Co-administration of EGCG and caffeine can protect against neuronal degeneration induced by Mn and improve behavioral deficits associated with its neurotoxicity. The protective effect of EGCG was more pronounced than that of caffeine even with BPA co-exposure.

Keywords: manganese, bisphenol a, caffeine, epigallocatechin-3-gallate, neurotoxicity, behavioral tests, rats

Procedia PDF Downloads 221
881 2,7-Diazaindole as a Photophysical Probe for Excited State Hydrogen/Proton Transfer

Authors: Simran Baweja, Bhavika Kalal, Surajit Maity

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Photoinduced tautomerization reactions have been the centre of attention among the scientific community over the past several decades because of their significance in various biological systems. 7-azaindole (7AI) is considered a model system for DNA base pairing and to understand the role of such tautomerization reactions in mutations. To the best of our knowledge, extensive studies have been carried out on 7-azaindole and its solvent clusters exhibiting proton/ hydrogen transfer in both solution as well as gas phases. Derivatives of the above molecule, like 2,7- and 2,6-diazaindoles are proposed to have even better photophysical properties due to the presence of -aza group on the 2nd position. However, there are studies in the solution phase that suggest the relevance of these molecules, but there are no experimental studies reported in the gas phase yet. In our current investigation, we present the first gas phase spectroscopic data of 2,7-diazaindole (2,7-DAI) and its solvent cluster (2,7-DAI-H2O). In this, we have employed state-of-the-art laser spectroscopic methods such as fluorescence excitation (LIF), dispersed fluorescence (DF), resonant two-photon ionization-time of flight mass spectrometry (2C-R2PI), photoionization efficiency spectroscopy (PIE), IR-UV double resonance spectroscopy, i.e., fluorescence-dip infrared spectroscopy (FDIR) and resonant ion-dip infrared spectroscopy (IDIR) to understand the electronic structure of the molecule. The origin band corresponding to the S1 ← S0 transition of the bare 2,7-DAI is found to be positioned at 33910 cm-1, whereas the origin band corresponding to S1 ← S0 transition of the 2,7-DAI-H2O is positioned at 33074 cm-1. The red-shifted transition in the case of solvent cluster suggests the enhanced feasibility of excited state hydrogen/ proton transfer. The ionization potential for the 2,7-DAI molecule is found to be 8.92 eV which is significantly higher than the previously reported 7AI (8.11 eV) molecule, making it a comparatively complex molecule to study. The ionization potential is reduced by 0.14 eV in the case of 2,7-DAI-H2O (8.78 eV) cluster compared to that of 2,7-DAI. Moreover, on comparison with the available literature values of 7AI, we found the origin band of 2,7-DAI and 2,7-DAI-H2O to be red-shifted by -729 and -280 cm-1 respectively. The ground and excited state N-H stretching frequencies of the 27DAI molecule were determined using fluorescence-dip infrared spectra (FDIR) and resonant ion dip infrared spectroscopy (IDIR), obtained at 3523 and 3467 cm-1, respectively. The lower value of vNH in the electronically excited state of 27DAI implies the higher acidity of the group compared to the ground state. Moreover, we have done extensive computational analysis, which suggests that the energy barrier in the excited state reduces significantly as we increase the number of catalytic solvent molecules (S= H2O, NH3) as well as the polarity of solvent molecules. We found that the ammonia molecule is a better candidate for hydrogen transfer compared to water because of its higher gas-phase basicity. Further studies are underway to understand the excited state dynamics and photochemistry of such N-rich chromophores.

Keywords: excited state hydrogen transfer, supersonic expansion, gas phase spectroscopy, IR-UV double resonance spectroscopy, laser induced fluorescence, photoionization efficiency spectroscopy

Procedia PDF Downloads 62
880 Improving Literacy Level Through Digital Books for Deaf and Hard of Hearing Students

Authors: Majed A. Alsalem

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In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.

Keywords: deaf and hard of hearing, digital books, literacy, technology

Procedia PDF Downloads 478
879 Advancing the Analysis of Physical Activity Behaviour in Diverse, Rapidly Evolving Populations: Using Unsupervised Machine Learning to Segment and Cluster Accelerometer Data

Authors: Christopher Thornton, Niina Kolehmainen, Kianoush Nazarpour

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Background: Accelerometers are widely used to measure physical activity behavior, including in children. The traditional method for processing acceleration data uses cut points, relying on calibration studies that relate the quantity of acceleration to energy expenditure. As these relationships do not generalise across diverse populations, they must be parametrised for each subpopulation, including different age groups, which is costly and makes studies across diverse populations difficult. A data-driven approach that allows physical activity intensity states to emerge from the data under study without relying on parameters derived from external populations offers a new perspective on this problem and potentially improved results. We evaluated the data-driven approach in a diverse population with a range of rapidly evolving physical and mental capabilities, namely very young children (9-38 months old), where this new approach may be particularly appropriate. Methods: We applied an unsupervised machine learning approach (a hidden semi-Markov model - HSMM) to segment and cluster the accelerometer data recorded from 275 children with a diverse range of physical and cognitive abilities. The HSMM was configured to identify a maximum of six physical activity intensity states and the output of the model was the time spent by each child in each of the states. For comparison, we also processed the accelerometer data using published cut points with available thresholds for the population. This provided us with time estimates for each child’s sedentary (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Data on the children’s physical and cognitive abilities were collected using the Paediatric Evaluation of Disability Inventory (PEDI-CAT). Results: The HSMM identified two inactive states (INS, comparable to SED), two lightly active long duration states (LAS, comparable to LPA), and two short-duration high-intensity states (HIS, comparable to MVPA). Overall, the children spent on average 237/392 minutes per day in INS/SED, 211/129 minutes per day in LAS/LPA, and 178/168 minutes in HIS/MVPA. We found that INS overlapped with 53% of SED, LAS overlapped with 37% of LPA and HIS overlapped with 60% of MVPA. We also looked at the correlation between the time spent by a child in either HIS or MVPA and their physical and cognitive abilities. We found that HIS was more strongly correlated with physical mobility (R²HIS =0.5, R²MVPA= 0.28), cognitive ability (R²HIS =0.31, R²MVPA= 0.15), and age (R²HIS =0.15, R²MVPA= 0.09), indicating increased sensitivity to key attributes associated with a child’s mobility. Conclusion: An unsupervised machine learning technique can segment and cluster accelerometer data according to the intensity of movement at a given time. It provides a potentially more sensitive, appropriate, and cost-effective approach to analysing physical activity behavior in diverse populations, compared to the current cut points approach. This, in turn, supports research that is more inclusive across diverse populations.

Keywords: physical activity, machine learning, under 5s, disability, accelerometer

Procedia PDF Downloads 195
878 Socio-Cultural Factors Influencing Adherence to Anti-Retroviral Therapy among HIV Patients in a University Teaching Hospital in South-Western Nigeria

Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

Procedia PDF Downloads 266
877 Screening Tools and Its Accuracy for Common Soccer Injuries: A Systematic Review

Authors: R. Christopher, C. Brandt, N. Damons

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Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

Procedia PDF Downloads 165
876 Evidence for Replication of an Unusual G8P[14] Human Rotavirus Strain in the Feces of an Alpine Goat: Zoonotic Transmission from Caprine Species

Authors: Amine Alaoui Sanae, Tagjdid Reda, Loutfi Chafiqa, Melloul Merouane, Laloui Aziz, Touil Nadia, El Fahim, E. Mostafa

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Background: Rotavirus group A (RVA) strains with G8P[14] specificities are usually detected in calves and goats. However, these strains have been reported globally in humans and have often been characterized as originating from zoonotic transmissions, particularly in area where ruminants and humans live side-by-side. Whether human P[14] genotypes are two-way and can be transmitted to animal species remains to be established. Here we describe VP4 deduced amino-acid relationships of three Moroccan P[14] genotypes originating from different species and the receptiveness of an alpine goat to a human G8P[14] through an experimental infection. Material/methods: the human MA31 RVA strain was originally identified in a four years old girl presenting an acute gastroenteritis hospitalized at the pediatric care unit in Rabat Hospital in 2011. The virus was isolated and propagated in MA104 cells in the presence of trypsin. Ch_10S and 8045_S animal RVA strains were identified in fecal samples of a 2-week-old native goat and 3-week-old calf with diarrhea in 2011 in Bouaarfa and My Bousselham respectively. Genomic RNAs of all strains were subjected to a two-step RT-PCR and sequenced using the consensus primers VP4. The phylogenetic tree for MA31, Ch_10S and 8045_S VP4 and a set of published P[14] genotypes was constructed using MEGA6 software. The receptivity of MA31 strain by an eight month-old alpine goat was assayed. The animal was orally and intraperitonally inoculated with a dose of 8.5 TCID50 of virus stock at passage level 3. The shedding of the virus was tested by a real time RT-PCR assay. Results: The phylogenetic tree showed that the three Moroccan strains MA31, Ch_10S and 8045_S VP4 were highly related to each other (100% similar at the nucleotide level). They were clustered together with the B10925, Sp813, PA77 and P169 strains isolated in Belgium, Spain and Italy respectively. The Belgian strain B10925 was the most closely related to the Moroccan strains. In contrast, the 8045_S and Ch_10S strains were clustered distantly from the Tunisian calf strain B137 and the goat strain cap455 isolated in South Africa respectively. The human MA31 RVA strain was able to induce bloody diarrhea at 2 days post infection (dpi) in the alpine goat kid. RVA virus shedding started by 2 dpi (Ct value of 28) and continued until 5 dpi (Ct value of 25) with a concomitant elevation in the body temperature. Conclusions: Our study while limited to one animal, is the first study proving experimentally that a human P[14] genotype causes diarrhea and virus shedding in the goat. This result reinforce the potential role of inter- species transmission in generating novel and rare rotavirus strains such G8P[14] which infect humans.

Keywords: interspecies transmission, rotavirus, goat, human

Procedia PDF Downloads 273
875 The Lonely Entrepreneur: Antecedents and Effects of Social Isolation on Entrepreneurial Intention and Output

Authors: Susie Pryor, Palak Sadhwani

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The purpose of this research is to provide the foundations for a broad research agenda examining the role loneliness plays in entrepreneurship. While qualitative research in entrepreneurship incidentally captures the existence of loneliness as a part of the lived reality of entrepreneurs, to the authors’ knowledge, no academic work has to date explored this construct in this context. Moreover, many individuals reporting high levels of loneliness (women, ethnic minorities, immigrants, low income, low education) reflect those who are currently driving small business growth in the United States. Loneliness is a persistent state of emotional distress which results from feelings of estrangement and rejection or develops in the absence of social relationships and interactions. Empirical work finds links between loneliness and depression, suicide and suicide ideation, anxiety, hostility and passiveness, lack of communication and adaptability, shyness, poor social skills and unrealistic social perceptions, self-doubts, fear of rejection, and negative self-evaluation. Lonely individuals have been found to exhibit lower levels of self-esteem, higher levels of introversion, lower affiliative tendencies, less assertiveness, higher sensitivity to rejection, a heightened external locus of control, intensified feelings of regret and guilt over past events and rigid and overly idealistic goals concerning the future. These characteristics are likely to impact entrepreneurs and their work. Research identifies some key dangers of loneliness. Loneliness damages human love and intimacy, can disturb and distract individuals from channeling creative and effective energies in a meaningful way, may result in the formation of premature, poorly thought out and at times even irresponsible decisions, and produce hard and desensitized individuals, with compromised health and quality of life concerns. The current study utilizes meta-analysis and text analytics to distinguish loneliness from other related constructs (e.g., social isolation) and categorize antecedents and effects of loneliness across subpopulations. This work has the potential to materially contribute to the field of entrepreneurship by cleanly defining constructs and providing foundational background for future research. It offers a richer understanding of the evolution of loneliness and related constructs over the life cycle of entrepreneurial start-up and development. Further, it suggests preliminary avenues for exploration and methods of discovery that will result in knowledge useful to the field of entrepreneurship. It is useful to both entrepreneurs and those work with them as well as academics interested in the topics of loneliness and entrepreneurship. It adopts a grounded theory approach.

Keywords: entrepreneurship, grounded theory, loneliness, meta-analysis

Procedia PDF Downloads 105
874 Evaluation of Ocular Changes in Hypertensive Disorders of Pregnancy

Authors: Rajender Singh, Nidhi Sharma, Aastha Chauhan, Meenakshi Barsaul, Jyoti Deswal, Chetan Chhikara

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Introduction: Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy with multisystem involvement and are common causes of morbidity and mortality in obstetrics. It is believed that changes in retinal arterioles may indicate similar changes in the placenta. Therefore, this study was undertaken to evaluate the ocular manifestations in cases of pre-eclampsia and eclampsia and to deduce any association between the retinal changes and blood pressure, the severity of disease, gravidity, proteinuria, and other lab parameters so that a better approach could be devised to ensure maternal and fetal well-being. Materials and Methods: This was a hospital-based cross-sectional study conducted over a period of one year, from April 2021 to May 2022. 350 admitted patients with diagnosed pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension were included in the study. A pre-structured proforma was used. After taking consent and ocular history, a bedside examination to record visual acuity, pupillary size, corneal curvature, field of vision, and intraocular pressure was done. Dilated fundus examination was done with a direct and indirect ophthalmoscope. Age, parity, BP, proteinuria, platelet count, liver and kidney function tests were noted down. The patients with positive findings only were followed up after 72 hours and 6 weeks of termination of pregnancy. Results: The mean age of patients was 26.18±4.33 years (range 18-39 years).157 (44.9%) were primigravida while 193(55.1%) were multigravida.53 (15.1%) patients had eclampsia, 128(36.5%) had mild pre-eclampsia,128(36.5%) had severe pre-eclampsia and 41(11.7%) had chronic hypertension with superimposed pre-eclampsia. Retinal changes were found in 208 patients (59.42%), and grade I changes were the most common. 82(23.14%) patients had grade I changes, 75 (21.4%) had grade II changes, 41(11.71%) had grade III changes, and 11(3.14%) had serous retinal detachment/grade IV changes. 36 patients had unaided visual acuity <6/9, of these 17 had refractive error and 19(5.4%) had varying degrees of retinal changes. 3(0.85%) out of 350 patients had an abnormal field of vision in both eyes. All 3 of them had eclampsia and bilateral exudative retinal detachment. At day 4, retinopathy in 10 patients resolved, and 3 patients had improvement in visual acuity. At 6 weeks, retinopathy in all the patients resolved spontaneously except persistence of grade II changes in 23 patients with chronic hypertension with superimposed pre-eclampsia, while visual acuity and field of vision returned to normal in all patients. Pupillary size, intraocular pressure, and corneal curvature were found to be within normal limits at all times of examination. There was a statistically significant positive association between retinal changes and mean arterial pressure. The study showed a positive correlation between fundus findings and severity of disease (p value<0.05) and mean arterial pressure (p value<0.005). Primigravida had more retinal changes than multigravida patients. A significant association was found between fundus changes and thrombocytopenia and deranged liver and kidney function tests (p value<0.005). Conclusion: As the severity of pre-eclampsia and eclampsia increases, the incidence of retinopathy also increases, and it affects visual acuity and visual fields of the patients. Thus, timely ocular examination should be done in all such cases to prevent complications.

Keywords: eclampsia, hypertensive, ocular, pre-eclampsia

Procedia PDF Downloads 66
873 Improving the Biomechanical Resistance of a Treated Tooth via Composite Restorations Using Optimised Cavity Geometries

Authors: Behzad Babaei, B. Gangadhara Prusty

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The objective of this study is to assess the hypotheses that a restored tooth with a class II occlusal-distal (OD) cavity can be strengthened by designing an optimized cavity geometry, as well as selecting the composite restoration with optimized elastic moduli when there is a sharp de-bonded edge at the interface of the tooth and restoration. Methods: A scanned human maxillary molar tooth was segmented into dentine and enamel parts. The dentine and enamel profiles were extracted and imported into a finite element (FE) software. The enamel rod orientations were estimated virtually. Fifteen models for the restored tooth with different cavity occlusal depths (1.5, 2, and 2.5 mm) and internal cavity angles were generated. By using a semi-circular stone part, a 400 N load was applied to two contact points of the restored tooth model. The junctions between the enamel, dentine, and restoration were considered perfectly bonded. All parts in the model were considered homogeneous, isotropic, and elastic. The quadrilateral and triangular elements were employed in the models. A mesh convergence analysis was conducted to verify that the element numbers did not influence the simulation results. According to the criteria of a 5% error in the stress, we found that a total element number of over 14,000 elements resulted in the convergence of the stress. A Python script was employed to automatically assign 2-22 GPa moduli (with increments of 4 GPa) for the composite restorations, 18.6 GPa to the dentine, and two different elastic moduli to the enamel (72 GPa in the enamel rods’ direction and 63 GPa in perpendicular one). The linear, homogeneous, and elastic material models were considered for the dentine, enamel, and composite restorations. 108 FEA simulations were successively conducted. Results: The internal cavity angles (α) significantly altered the peak maximum principal stress at the interface of the enamel and restoration. The strongest structures against the contact loads were observed in the models with α = 100° and 105. Even when the enamel rods’ directional mechanical properties were disregarded, interestingly, the models with α = 100° and 105° exhibited the highest resistance against the mechanical loads. Regarding the effect of occlusal cavity depth, the models with 1.5 mm depth showed higher resistance to contact loads than the model with thicker cavities (2.0 and 2.5 mm). Moreover, the composite moduli in the range of 10-18 GPa alleviated the stress levels in the enamel. Significance: For the class II OD cavity models in this study, the optimal geometries, composite properties, and occlusal cavity depths were determined. Designing the cavities with α ≥100 ̊ was significantly effective in minimizing peak stress levels. The composite restoration with optimized properties reduced the stress concentrations on critical points of the models. Additionally, when more enamel was preserved, the sturdier enamel-restoration interface against the mechanical loads was observed.

Keywords: dental composite restoration, cavity geometry, finite element approach, maximum principal stress

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872 The Practise of Hand Drawing as a Premier Form of Representation in Architectural Design Teaching: The Case of FAUP

Authors: Rafael Santos, Clara Pimenta Do Vale, Barbara Bogoni, Poul Henning Kirkegaard

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In the last decades, the relevance of hand drawing has decreased in the scope of architectural education. However, some schools continue to recognize its decisive role, not only in the architectural design teaching, but in the whole of architectural training. With this paper it is intended to present the results of a research developed on the following problem: the practise of hand drawing as a premier form of representation in architectural design teaching. The research had as its object the educational model of the Faculty of Architecture of the University of Porto (FAUP) and was led by three main objectives: to identify the circumstance that promoted hand drawing as a form of representation in FAUP's model; to characterize the types of hand drawing and their role in that model; to determine the particularities of hand drawing as a premier form of representation in architectural design teaching. Methodologically, the research was conducted according to a qualitative embedded single-case study design. The object – i.e., the educational model – was approached in FAUP case considering its Context and three embedded unities of analysis: the educational Purposes, Principles and Practices. In order to guide the procedures of data collection and analysis, a Matrix for the Characterization (MCC) was developed. As a methodological tool, the MCC allowed to relate the three embedded unities of analysis with the three main sources of evidence where the object manifests itself: the professors, expressing how the model is Assumed; the architectural design classes, expressing how the model is Achieved; and the students, expressing how the model is Acquired. The main research methods used were the naturalistic and participatory observation, in-person-interview and documentary and bibliographic review. The results reveal that the educational model of FAUP – following the model of the former Porto School – was largely due to the methodological foundations created with the hand drawing teaching-learning processes. In the absence of a culture of explicit theoretical elaboration or systematic research, hand drawing was the support for the continuity of the school, an expression of a unified thought about what should be the reflection and practice of architecture. As a form of representation, hand drawing plays a transversal role in the entire educational model, since its purposes are not limited to the conception of architectural design – it is also a means for perception, analysis and synthesis. Regarding the architectural design teaching, there seems to be an understanding of three complementary dimensions of didactics: the instrumental, methodological and propositional dimension. At FAUP, hand drawing is recognized as the common denominator among these dimensions, according to the idea of "globality of drawing". It is expected that the knowledge base developed in this research may have three main contributions: to contribute to the maintenance and valorisation of FAUP’s model; through the precise description of the methodological procedures, to contribute by transferability to similar studies; through the critical and objective framework of the problem underlying the hand drawing in architectural design teaching, to contribute to the broader discussion concerning the contemporary challenges on architectural education.

Keywords: architectural design teaching, architectural education, forms of representation, hand drawing

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871 Design Flood Estimation in Satluj Basin-Challenges for Sunni Dam Hydro Electric Project, Himachal Pradesh-India

Authors: Navneet Kalia, Lalit Mohan Verma, Vinay Guleria

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Introduction: Design Flood studies are essential for effective planning and functioning of water resource projects. Design flood estimation for Sunni Dam Hydro Electric Project located in State of Himachal Pradesh, India, on the river Satluj, was a big challenge in view of the river flowing in the Himalayan region from Tibet to India, having a large catchment area of varying topography, climate, and vegetation. No Discharge data was available for the part of the river in Tibet, whereas, for India, it was available only at Khab, Rampur, and Luhri. The estimation of Design Flood using standard methods was not possible. This challenge was met using two different approaches for upper (snow-fed) and lower (rainfed) catchment using Flood Frequency Approach and Hydro-metrological approach. i) For catchment up to Khab Gauging site (Sub-Catchment, C1), Flood Frequency approach was used. Around 90% of the catchment area (46300 sqkm) up to Khab is snow-fed which lies above 4200m. In view of the predominant area being snow-fed area, 1 in 10000 years return period flood estimated using Flood Frequency analysis at Khab was considered as Probable Maximum Flood (PMF). The flood peaks were taken from daily observed discharges at Khab, which were increased by 10% to make them instantaneous. Design Flood of 4184 cumec thus obtained was considered as PMF at Khab. ii) For catchment between Khab and Sunni Dam (Sub-Catchment, C2), Hydro-metrological approach was used. This method is based upon the catchment response to the rainfall pattern observed (Probable Maximum Precipitation - PMP) in a particular catchment area. The design flood computation mainly involves the estimation of a design storm hyetograph and derivation of the catchment response function. A unit hydrograph is assumed to represent the response of the entire catchment area to a unit rainfall. The main advantage of the hydro-metrological approach is that it gives a complete flood hydrograph which allows us to make a realistic determination of its moderation effect while passing through a reservoir or a river reach. These studies were carried out to derive PMF for the catchment area between Khab and Sunni Dam site using a 1-day and 2-day PMP values of 232 and 416 cm respectively. The PMF so obtained was 12920.60 cumec. Final Result: As the Catchment area up to Sunni Dam has been divided into 2 sub-catchments, the Flood Hydrograph for the Catchment C1 has been routed through the connecting channel reach (River Satluj) using Muskingum method and accordingly, the Design Flood was computed after adding the routed flood ordinates with flood ordinates of catchment C2. The total Design Flood (i.e. 2-Day PMF) with a peak of 15473 cumec was obtained. Conclusion: Even though, several factors are relevant while deciding the method to be used for design flood estimation, data availability and the purpose of study are the most important factors. Since, generally, we cannot wait for the hydrological data of adequate quality and quantity to be available, flood estimation has to be done using whatever data is available. Depending upon the type of data available for a particular catchment, the method to be used is to be selected.

Keywords: design flood, design storm, flood frequency, PMF, PMP, unit hydrograph

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870 The Social Ecology of Serratia entomophila: Pathogen of Costelytra giveni

Authors: C. Watson, T. Glare, M. O'Callaghan, M. Hurst

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The endemic New Zealand grass grub (Costelytra giveni, Coleoptera: Scarabaeidae) is an economically significant grassland pest in New Zealand. Due to their impacts on production within the agricultural sector, one of New Zealand's primary industries, several methods are being used to either control or prevent the establishment of new grass grub populations in the pasture. One such method involves the use of a biopesticide based on the bacterium Serratia entomophila. This species is one of the causative agents of amber disease, a chronic disease of the larvae which results in death via septicaemia after approximately 2 to 3 months. The ability of S. entomophila to cause amber disease is dependant upon the presence of the amber disease associated plasmid (pADAP), which encodes for the key virulence determinants required for the establishment and maintenance of the disease. Following the collapse of grass grub populations within the soil, resulting from either natural population build-up or application of the bacteria, non-pathogenic plasmid-free Serratia strains begin to predominate within the soil. Whilst the interactions between S. entomophila and grass grub larvae are well studied, less information is known on the interactions between plasmid-bearing and plasmid-free strains, particularly the potential impact of these interactions upon the efficacy of an applied biopesticide. Using a range of constructed strains with antibiotic tags, in vitro (broth culture) and in vivo (soil and larvae) experiments were conducted using inoculants comprised of differing ratios of isogenic pathogenic and non-pathogenic Serratia strains, enabling the relative growth of pADAP+ and pADAP- strains under competition conditions to be assessed. In nutrient-rich, the non-pathogenic pADAP- strain outgrew the pathogenic pADAP+ strain by day 3 when inoculated in equal quantities, and by day 5 when applied as the minority inoculant, however, there was an overall gradual decline in the number of viable bacteria for both strains over a 7-day period. Similar results were obtained in additional experiments using the same strains and continuous broth cultures re-inoculated at 24-hour intervals, although in these cultures, the viable cell count did not diminish over the 7-day period. When the same ratios were assessed in soil microcosms with limited available nutrients, the strains remained relatively stable over a 2-month period. Additionally, in vivo grass grub co-infections assays using the same ratios of tagged Serratia strains revealed similar results to those observed in the soil, but there was also evidence of horizontal transfer of pADAP from the pathogenic to the non-pathogenic strain within the larval gut after a period of 4 days. Whilst the influence of competition is more apparent in broth cultures than within the soil or larvae, further testing is required to determine whether this competition between pathogenic and non-pathogenic Serratia strains has any influence on efficacy and disease progression, and how this may impact on the ability of S. entomophila to cause amber disease within grass grub larvae when applied as a biopesticide.

Keywords: biological control, entomopathogen, microbial ecology, New Zealand

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869 Fuzzy Availability Analysis of a Battery Production System

Authors: Merve Uzuner Sahin, Kumru D. Atalay, Berna Dengiz

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In today’s competitive market, there are many alternative products that can be used in similar manner and purpose. Therefore, the utility of the product is an important issue for the preferability of the brand. This utility could be measured in terms of its functionality, durability, reliability. These all are affected by the system capabilities. Reliability is an important system design criteria for the manufacturers to be able to have high availability. Availability is the probability that a system (or a component) is operating properly to its function at a specific point in time or a specific period of times. System availability provides valuable input to estimate the production rate for the company to realize the production plan. When considering only the corrective maintenance downtime of the system, mean time between failure (MTBF) and mean time to repair (MTTR) are used to obtain system availability. Also, the MTBF and MTTR values are important measures to improve system performance by adopting suitable maintenance strategies for reliability engineers and practitioners working in a system. Failure and repair time probability distributions of each component in the system should be known for the conventional availability analysis. However, generally, companies do not have statistics or quality control departments to store such a large amount of data. Real events or situations are defined deterministically instead of using stochastic data for the complete description of real systems. A fuzzy set is an alternative theory which is used to analyze the uncertainty and vagueness in real systems. The aim of this study is to present a novel approach to compute system availability using representation of MTBF and MTTR in fuzzy numbers. Based on the experience in the system, it is decided to choose 3 different spread of MTBF and MTTR such as 15%, 20% and 25% to obtain lower and upper limits of the fuzzy numbers. To the best of our knowledge, the proposed method is the first application that is used fuzzy MTBF and fuzzy MTTR for fuzzy system availability estimation. This method is easy to apply in any repairable production system by practitioners working in industry. It is provided that the reliability engineers/managers/practitioners could analyze the system performance in a more consistent and logical manner based on fuzzy availability. This paper presents a real case study of a repairable multi-stage production line in lead-acid battery production factory in Turkey. The following is focusing on the considered wet-charging battery process which has a higher production level than the other types of battery. In this system, system components could exist only in two states, working or failed, and it is assumed that when a component in the system fails, it becomes as good as new after repair. Instead of classical methods, using fuzzy set theory and obtaining intervals for these measures would be very useful for system managers, practitioners to analyze system qualifications to find better results for their working conditions. Thus, much more detailed information about system characteristics is obtained.

Keywords: availability analysis, battery production system, fuzzy sets, triangular fuzzy numbers (TFNs)

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868 Reducing System Delay to Definitive Care For STEMI Patients, a Simulation of Two Different Strategies in the Brugge Area, Belgium

Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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867 Effect of Compaction Method on the Mechanical and Anisotropic Properties of Asphalt Mixtures

Authors: Mai Sirhan, Arieh Sidess

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Asphaltic mixture is a heterogeneous material composed of three main components: aggregates; bitumen and air voids. The professional experience and scientific literature categorize asphaltic mixture as a viscoelastic material, whose behavior is determined by temperature and loading rate. Properties characterization of the asphaltic mixture used under the service conditions is done by compacting and testing cylindric asphalt samples in the laboratory. These samples must resemble in a high degree internal structure of the mixture achieved in service, and the mechanical characteristics of the compacted asphalt layer in the pavement. The laboratory samples are usually compacted in temperatures between 140 and 160 degrees Celsius. In this temperature range, the asphalt has a low degree of strength. The laboratory samples are compacted using the dynamic or vibrational compaction methods. In the compaction process, the aggregates tend to align themselves in certain directions that lead to anisotropic behavior of the asphaltic mixture. This issue has been studied in the Strategic Highway Research Program (SHRP) research, that recommended using the gyratory compactor based on the assumption that this method is the best in mimicking the compaction in the service. In Israel, the Netivei Israel company is considering adopting the Gyratory Method as a replacement for the Marshall method used today. Therefore, the compatibility of the Gyratory Method for the use with Israeli asphaltic mixtures should be investigated. In this research, we aimed to examine the impact of the compaction method used on the mechanical characteristics of the asphaltic mixtures and to evaluate the degree of anisotropy in relation to the compaction method. In order to carry out this research, samples have been compacted in the vibratory and gyratory compactors. These samples were cylindrically cored both vertically (compaction wise) and horizontally (perpendicular to compaction direction). These models were tested under dynamic modulus and permanent deformation tests. The comparable results of the tests proved that: (1) specimens compacted by the vibratory compactor had higher dynamic modulus values than the specimens compacted by the gyratory compactor (2) both vibratory and gyratory compacted specimens had anisotropic behavior, especially in high temperatures. Also, the degree of anisotropy is higher in specimens compacted by the gyratory method. (3) Specimens compacted by the vibratory method that were cored vertically had the highest resistance to rutting. On the other hand, specimens compacted by the vibratory method that were cored horizontally had the lowest resistance to rutting. Additionally (4) these differences between the different types of specimens rise mainly due to the different internal arrangement of aggregates resulting from the compaction method. (5) Based on the initial prediction of the performance of the flexible pavement containing an asphalt layer having characteristics based on the results achieved in this research. It can be concluded that there is a significant impact of the compaction method and the degree of anisotropy on the strains that develop in the pavement, and the resistance of the pavement to fatigue and rutting defects.

Keywords: anisotropy, asphalt compaction, dynamic modulus, gyratory compactor, mechanical properties, permanent deformation, vibratory compactor

Procedia PDF Downloads 112