Search results for: Plan Do Check Act (PDCA)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2566

Search results for: Plan Do Check Act (PDCA)

466 Development of an Intervention Program for Moral Education of Undergraduate Students of Sport Sciences and Physical Education

Authors: Najia Zulfiqar

Abstract:

Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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465 Features of Urban Planning Design of the Largest Cities Located in Areas with High Seismic (on the example of Almaty city, Republic of Kazakhstan)

Authors: Arkinzhan Mametov, Alexey Abilov

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Strong earthquakes are dangerous natural phenomena that lead to the destruction of entire cities and the death of a large number of people. The recent strong earthquakes in Turkey and in a number of other states have shown that as a result of them, there are significant human casualties and huge destruction. The city of Almaty is located in the foothill basin of the Trans-Ili Alatau of the Tien Shan Mountain system, in a zone with 9–10-point seismicity. Almaty (formerly Verniy) was founded in 1856 and, since that period, has experienced two catastrophic earthquakes - in 1887 and 1911, which led almost to the complete destruction of the city. Since that time, according to seismologists, the city has been annually exposed to small seismic impacts of 2-3 points. This forced the subsequent search for ways to protect buildings and the public through the use of earthquake-resistant structures and materials, limiting the number of stores of buildings and increasing gaps between them, which was carried out quite consistently and since 1957. However, at present, it is necessary to state a number of violations, primarily of the urban development plan – the placement of high-density multi-stores commercial housing in the urban environment, bypassing the existing regulations and standards in the city. Their appearance contributes to a greater concentration of residents transport in a limited area, which can lead to harmful consequences during powerful earthquakes. The experience of eliminating the consequences of catastrophic earthquakes shows that an important factor in reducing human losses is timely technical and medical assistance to victims of earthquakes, the elimination of blockages, provision of temporary housing and evacuation of the population, especially in winter. In cities located in areas with high seismicity, it is necessary to ensure strict compliance with the requirements of urban development regulations, taking into account the entire complex of planning and organizational measures to minimize the destruction of buildings and human casualties.

Keywords: high seismic zones, urban planning regulations, special standards for planing, minimizing the human casualties

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464 The Impact of Passive Design Factors on House Energy Efficiency for New Cities in Egypt

Authors: Mahmoud Mourad, Ahmad Hamza H. Ali, S.Ookawara, Ali Kamel Abdel-Rahman, Nady M. Abdelkariem

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The energy consumption of a house can be affected simultaneously by many building design factors related to its main architectural features, building elements and materials. This study focuses on the impact of passive design factors on the annual energy consumption of a suggested prototype house for single-family detached houses of 240 m2 in two floors, each floor of 120 m2 in new Egyptian cities located in (Alexandria - Cairo - Siwa - Assuit – Aswan) which resemble five different climatic zones (Northern coast – Northern upper Egypt - dessert region- Southern upper Egypt – South Egypt) respectively. This study present the effect of the passive design factors affecting the building energy consumption as building orientation, building material (walls, roof and slabs), building type (residential, educational, commercial), building occupancy (type of occupant, no. of occupant, age), building landscape and site selection, building envelope and fenestration (glazing material, shading), and building plan form. This information can be used to estimate the approximate saving in energy consumption, which would result on a change in the design datum for the future houses development, and to identify the major design problems for energy efficiency. To achieve the above objective, this paper presents a study for the factors affecting on the building energy consumption in the hot arid area in new Egyptian cities in five different climatic zones , followed by defining the energy needs for different utilization in this suggested prototype house. Consequently, a detailed analysis of the available Renewable Energy utilizations technologies used in the suggested home, and a calculation of the energy as a function of yearly distribution that required for this home will presented. The results obtained from building annual energy analyses show that architecture passive design factors saves about 35% of the annual energy consumption. It shows also passive cooling techniques saves about 45%, and renewable energy systems saves about 40% of the annual energy needs for this proposed home depending on the cities location on the climatic zones.

Keywords: architecture passive design factors, energy efficient homes, Egypt new cites, renewable energy technologies

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463 The Role of Online Platforms in Economic Growth and the Introduction of Local Culture in Tourist Areas

Authors: Maryam Nzari

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Today, with the advancement of Internet technology, one of the tools used by humans is a tool that allows them to do what they need easily. Online platforms in different forms and by providing different services make it possible for users to communicate with each other and users with platforms. Audience communication with mass media is not the same as in the past. Today the conditions are different; With online platforms that provide the latest news minute by minute, he has access to all the content and can choose more quickly and easily. According to professionals Galloway, Apple, Amazon, Facebook and Google companies create a wide range. They are among the products and services that are connected with the daily life of billions of people all over the planet. Over time, platforms gain high economic value and in this way gain power that will influence the social, cultural, economic and political aspects of people’s lives. As a result of the effects of the process of platformization on all areas of individual and collective life, we now live in a platform society, which communicates It is close to “platform politics”. Nowadays, with social media platforms, users can interact with many people and people can share their data on various topics with others in this space. In this research, what will be investigated is the role of these online platforms in economic growth and the introduction of local culture areas in tourist areas. Tourism in a region is linked with various factors; One of the important factors that attract tourists to a region is its culture, and on the other hand, this culture can also affect economic growth. Without a proper understanding of the culture of these tourist areas, it is not possible to plan properly for the growth of the tourism industry and the subsequent increase in economic growth. The interaction of local people and tourists will have social and cultural effects on each other and will give them the opportunity to get to know each other. Therefore, the purpose of this research is to examine issues such as the role that online platforms play in cultural interaction in tourist areas and to understand that online platforms are only seeking to show the good aspects of a region and then generate enough extra income or that platforms can They play a role beyond what we imagine and introduce the culture of a region in a proper way so that we don’t see disagreements in the tourism planning of that region. in this article It has been tried by using library and field methods Answer the questions.

Keywords: online platforms, economic growth, culture Indigenous, tourism

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462 Cryotopic Macroporous Polymeric Matrices for Regenerative Medicine and Tissue Engineering Applications

Authors: Archana Sharma, Vijayashree Nayak, Ashok Kumar

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Three-dimensional matrices were fabricated from blend of natural-natural polymers like carrageenan-gelatin and synthetic -natural polymers such as PEG- gelatin (PEG of different molecular weights (2,000 and 6,000) using two different crosslinkers; glutaraldehyde and EDC-NHS by cryogelation technique. Blends represented a feasible approach to design 3-D scaffolds with controllable mechanical, physical and biochemical properties without compromising biocompatibility and biodegradability. These matrices possessed interconnected porous structure, good mechanical strength, biodegradable nature, constant swelling kinetics, ability to withstand high temperature and visco-elastic behavior. Hemocompatibility of cryogel matrices was determined by coagulation assays and hemolytic activity assay which demonstrated that these cryogels have negligible effects on coagulation time and have excellent blood compatibility. In vitro biocompatibility (cell-matrix interaction) inferred good cell adhesion, proliferation, and secretion of ECM on matrices. These matrices provide a microenvironment for the growth, proliferation, differentiation and secretion of ECM of different cell types such as IMR-32, C2C12, Cos-7, rat bone marrow derived MSCs and human bone marrow MSCs. Hoechst 33342 and PI staining also confirmed that the cells were uniformly distributed, adhered and proliferated properly on the cryogel matrix. An ideal scaffold used for tissue engineering application should allow the cells to adhere, proliferate and maintain their functionality. Neurotransmitter analysis has been done which indicated that IMR-32 cells adhered, proliferated and secreted neurotransmitters when they interacted with these matrices which showed restoration of their functionality. The cell-matrix interaction up to molecular level was also evaluated so to check genotoxicity and protein expression profile which indicated that these cryogel matrices are non-genotoxic and maintained biofunctionality of cells growing on these matrices. All these cryogels, when implanted subcutaneously in balb/c mice, showed no adverse systemic or local toxicity effects at implantation site. There was no significant increase in inflammatory cell count has otherwise been observed after scaffold implantation. These cryogels are supermacroporous and this porous structure allows cell infiltration and proliferation of host cells. This showed the integration and presence of infiltrated cells into the cryogel implants. Histological analysis confirmed that the implanted cryogels do not have any adverse effect in spite of host immune system recognition at the site of implantation, on its surrounding tissues and other vital host organs. In vivo biocompatibility study after in vitro biocompatibility analysis has also concluded that these synthesized cryogels act as important biological substitutes, more adaptable and appropriate for transplantation. Thus, these cryogels showed their potential for soft tissue engineering applications.

Keywords: cryogelation, hemocompatibility, in vitro biocompatibility, in vivo biocompatibility, soft tissue engineering applications

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461 Metamorphic Approach in Architecture Studio to Re-Imagine Drawings in Acknowledgement of Architectural/Artistic Identity

Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

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The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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460 Stochastic Fleet Sizing and Routing in Drone Delivery

Authors: Amin Karimi, Lele Zhang, Mark Fackrell

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Rural-to-urban population migrations are a global phenomenon, with projections indicating that by 2050, 68% of the world's population will inhabit densely populated urban centers. Concurrently, the popularity of e-commerce shopping has surged, evidenced by a 51% increase in total e-commerce sales from 2017 to 2021. Consequently, distribution and logistics systems, integral to effective supply chain management, confront escalating hurdles in efficiently delivering and distributing products within bustling urban environments. Additionally, events like environmental challenges and the COVID-19 pandemic have indicated that decision-makers are facing numerous sources of uncertainty. Therefore, to design an efficient and reliable logistics system, uncertainty must be considered. In this study, it examine fleet sizing and routing while considering uncertainty in demand rate. Fleet sizing is typically a strategic-level decision, while routing is an operational-level one. In this study, a carrier must make two types of decisions: strategic-level decisions regarding the number and types of drones to be purchased, and operational-level decisions regarding planning routes based on available fleet and realized demand. If the available fleets are insufficient to serve some customers, the carrier must outsource that delivery at a relatively high cost, calculated per order. With this hierarchy of decisions, it can model the problem using two-stage stochastic programming. The first-stage decisions involve planning the number and type of drones to be purchased, while the second-stage decisions involve planning routes. To solve this model, it employ logic-based benders decomposition, which decomposes the problem into a master problem and a set of sub-problems. The master problem becomes a mixed integer programming model to find the best fleet sizing decisions, and the sub-problems become capacitated vehicle routing problems considering battery status. Additionally, it assume a heterogeneous fleet based on load and battery capacity, and it consider that battery health deteriorates over time as it plan for multiple periods.

Keywords: drone-delivery, stochastic demand, VRP, fleet sizing

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459 Kuwait Environmental Remediation Program: Waste Management Data Analytics for Planning and Optimization of Waste Collection

Authors: Aisha Al-Baroud

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The United Nations Compensation Commission (UNCC), Kuwait National Focal Point (KNFP) and Kuwait Oil Company (KOC) cooperated in a joint project to undertake comprehensive and collaborative efforts to remediate 26 million m3 of crude oil contaminated soil that had resulted from the Gulf War in 1990/1991. These efforts are referred to as the Kuwait Environmental Remediation Program (KERP). KOC has developed a Total Remediation Solution (TRS) for KERP, which will guide the Remediation projects, comprises of alternative remedial solutions with treatment techniques inclusive of limited landfills for non-treatable soil materials disposal, and relies on treating certain ranges of Total Petroleum Hydrocarbon (TPH) contamination with the most appropriate remediation techniques. The KERP Remediation projects will be implemented within the KOC’s oilfields in North and South East Kuwait. The objectives of this remediation project is to clear land for field development and treat all the oil contaminated features (dry oil lakes, wet oil lakes, and oil contaminated piles) through TRS plan to optimize the treatment processes and minimize the volume of contaminated materials to be placed into landfills. The treatment strategy will comprise of Excavation and Transportation (E&T) of oil contaminated soils from contaminated land to remote treatment areas and to use appropriate remediation technologies or a combination of treatment technologies to achieve remediation target criteria (RTC). KOC has awarded five mega projects to achieve the same and is currently in the execution phase. As a part of the company’s commitment to environment and for the fulfillment of the mandatory HSSEMS procedures, all the Remediation contractors needs to report waste generation data from the various project activities on a monthly basis. Data on waste generation is collected in order to implement cost-efficient and sustainable waste management operations. Data analytics approaches can be built on the top of the data to produce more detailed, and in-time waste generation information for the basis of waste management and collection. The results obtained highlight the potential of advanced data analytic approaches in producing more detailed waste generation information for planning and optimization of waste collection and recycling.

Keywords: waste, tencnolgies, KERP, data, soil

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458 Dosimetric Comparison of Conventional Plans versus Three Dimensional Conformal Simultaneously Integrated Boost Plans

Authors: Shoukat Ali, Amjad Hussain, Latif-ur-Rehman, Sehrish Inam

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Radiotherapy plays an important role in the management of cancer patients. Approximately 50% of the cancer patients receive radiotherapy at one point or another during the course of treatment. The entire radiotherapy treatment of curative intent is divided into different phases, depending on the histology of the tumor. The established protocols are useful in deciding the total dose, fraction size, and numbers of phases. The objective of this study was to evaluate the dosimetric differences between the conventional treatment protocols and the three-dimensional conformal simultaneously integrated boost (SIB) plans for three different tumors sites (i.e. bladder, breast, and brain). A total of 30 patients with brain, breast and bladder cancers were selected in this retrospective study. All the patients were CT simulated initially. The primary physician contoured PTV1 and PTV2 in the axial slices. The conventional doses prescribed for brain and breast is 60Gy/30 fractions, and 64.8Gy/36 fractions for bladder treatment. For the SIB plans biological effective doses (BED) were calculated for 25 fractions. The two conventional (Phase I and Phase II) and a single SIB plan for each patient were generated on Eclipse™ treatment planning system. Treatment plans were compared and analyzed for coverage index, conformity index, homogeneity index, dose gradient and organs at risk doses.In both plans 95% of PTV volume received a minimum of 95% of the prescribe dose. Dose deviation in the optic chiasm was found to be less than 0.5%. There is no significant difference in lung V20 and heart V30 in the breast plans. In the rectum plans V75%, V50% and V25% were found to be less than 1.2% different. Deviation in the tumor coverage, conformity and homogeneity indices were found to be less than 1%. SIB plans with three dimensional conformal radiotherapy technique reduce the overall treatment time without compromising the target coverage and without increasing dose to the organs at risk. The higher dose per fraction may increase the late effects to some extent. Further studies are required to evaluate the late effects with the intention of standardizing the SIB technique for practical implementation.

Keywords: coverage index, conformity index, dose gradient, homogeneity index, simultaneously integrated boost

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457 The Role of Evaluation for Effective and Efficient Change in Higher Education Institutions

Authors: Pattaka Sa-Ngimnet

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That the University as we have known it is no longer serving the needs of the vast majority of students and potential students has been a topic of much discussion. Institutions of higher education, in this age of global culture, are in a process of metamorphosis. Technology is being used to allow more students, older students, working students and disabled students, who cannot attend conventional classes, to have greater access to higher education through the internet. But change must come about only after much evaluation and experimentation or education will simply become a commodity as, in some cases, it already has. This paper will be concerned with the meaning and methods of change and evaluation as they are applied to institutions of higher education. Organization’s generally have different goals and different approaches in order to be successful. However, the means of reaching those goals requires rational and effective planning. Any plans for successful change in any institution must take into account both effectiveness and efficiency and the differences between them. “Effectiveness” refers to an adequate means of achieving an objective. “Efficiency” refers to the ability to achieve an objective without waste of time or resources (The Free Dictionary). So an effective means may not be efficient and an efficient means may not be effective. The goal is to reach a synthesis of effectiveness and efficiency that will maximize both to the extent each is limited by the other. This focus of this paper then is to determine how an educational institution can become either successful or oppressive depending on the kinds of planning, evaluating and changes that operate by and on the administration. If the plan is concerned only with efficiency, the institution can easily become oppressive and lose sight of its purpose of educating students. If it is overly concentrated on effectiveness, the students may receive a superior education in the short run but the institution will face operating difficulties. In becoming only goal oriented, institutions also face problems. Simply stated, if the institution reaches its goals, the stake holders may become satisfied and fail to change and keep up with the needs of the times. So goals should be seen only as benchmarks in a process of becoming even better in providing quality education. Constant and consistent evaluation is the key to making all these factors come together in a successful process of planning, testing and changing the plans as needed. The focus of the evaluation has to be considered. Evaluations must take into account progress and needs of students, methods and skills of instructors, resources available from the institution and the styles and objectives of administrators. Thus the role of evaluation is pivotal in providing for the maximum of both effective and efficient change in higher education institutions.

Keywords: change, effectiveness, efficiency, education

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456 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic

Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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455 Analysing the Applicability of a Participatory Approach to Life Cycle Sustainability Assessment: Case Study of a Housing Estate Regeneration in London

Authors: Sahar Navabakhsh, Rokia Raslan, Yair Schwartz

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Decision-making on regeneration of housing estates, whether to refurbish or re-build, has been mostly triggered by economic factors. To enable sustainable growth, it is vital that environmental and social impacts of different scenarios are also taken into account. The methodology used to include all the three sustainable development pillars is called Life Cycle Sustainability Assessment (LCSA), which comprises of Life Cycle Assessment (LCA) for the assessment of environmental impacts of buildings. Current practice of LCA is regularly conducted post design stage and by sustainability experts. Not only is undertaking an LCA at this stage less effective, but issues such as the limited scope for the definition and assessment of environmental impacts, the implication of changes in the system boundary and the alteration of each of the variable metrics, employment of different Life Cycle Impact Assessment Methods and use of various inventory data for Life Cycle Inventory Analysis can result in considerably contrasting results. Given the niche nature and scarce specialist domain of LCA of buildings, the majority of the stakeholders do not contribute to the generation or interpretation of the impact assessment, and the results can be generated and interpreted subjectively due to the mentioned uncertainties. For an effective and democratic assessment of environmental impacts, different stakeholders, and in particular the community and design team should collaborate in the process of data collection, assessment and analysis. This paper examines and evaluates a participatory approach to LCSA through the analysis of a case study of a housing estate in South West London. The study has been conducted throughout tier-based collaborative methods to collect and share data through surveys and co-design workshops with the community members and the design team as the main stakeholders. The assessment of lifecycle impacts is conducted throughout the process and has influenced the decision-making on the design of the Community Plan. The evaluation concludes better assessment transparency and outcome, alongside other socio-economic benefits of identifying and engaging the most contributive stakeholders in the process of conducting LCSA.

Keywords: life cycle assessment, participatory LCA, life cycle sustainability assessment, participatory processes, decision-making, housing estate regeneration

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454 Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV

Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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453 Energy Efficiency of Secondary Refrigeration with Phase Change Materials and Impact on Greenhouse Gases Emissions

Authors: Michel Pons, Anthony Delahaye, Laurence Fournaison

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Secondary refrigeration consists of splitting large-size direct-cooling units into volume-limited primary cooling units complemented by secondary loops for transporting and distributing cold. Such a design reduces the refrigerant leaks, which represents a source of greenhouse gases emitted into the atmosphere. However, inserting the secondary circuit between the primary unit and the ‘users’ heat exchangers (UHX) increases the energy consumption of the whole process, which induces an indirect emission of greenhouse gases. It is thus important to check whether that efficiency loss is sufficiently limited for the change to be globally beneficial to the environment. Among the likely secondary fluids, phase change slurries offer several advantages: they transport latent heat, they stabilize the heat exchange temperature, and the formerly evaporators still can be used as UHX. The temperature level can also be adapted to the desired cooling application. Herein, the slurry {ice in mono-propylene-glycol solution} (melting temperature Tₘ of 6°C) is considered for food preservation, and the slurry {mixed hydrate of CO₂ + tetra-n-butyl-phosphonium-bromide in aqueous solution of this salt + CO₂} (melting temperature Tₘ of 13°C) is considered for air conditioning. For the sake of thermodynamic consistency, the analysis encompasses the whole process, primary cooling unit plus secondary slurry loop, and the various properties of the slurries, including their non-Newtonian viscosity. The design of the whole process is optimized according to the properties of the chosen slurry and under explicit constraints. As a first constraint, all the units must deliver the same cooling power to the user. The other constraints concern the heat exchanges areas, which are prescribed, and the flow conditions, which prevent deposition of the solid particles transported in the slurry, and their agglomeration. Minimization of the total energy consumption leads to the optimal design. In addition, the results are analyzed in terms of exergy losses, which allows highlighting the couplings between the primary unit and the secondary loop. One important difference between the ice-slurry and the mixed-hydrate one is the presence of gaseous carbon dioxide in the latter case. When the mixed-hydrate crystals melt in the UHX, CO₂ vapor is generated at a rate that depends on the phase change kinetics. The flow in the UHX, and its heat and mass transfer properties are significantly modified. This effect has never been investigated before. Lastly, inserting the secondary loop between the primary unit and the users increases the temperature difference between the refrigerated space and the evaporator. This results in a loss of global energy efficiency, and therefore in an increased energy consumption. The analysis shows that this loss of efficiency is not critical in the first case (Tₘ = 6°C), while the second case leads to more ambiguous results, partially because of the higher melting temperature.The consequences in terms of greenhouse gases emissions are also analyzed.

Keywords: exergy, hydrates, optimization, phase change material, thermodynamics

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452 Polymer Composites Containing Gold Nanoparticles for Biomedical Use

Authors: Bozena Tyliszczak, Anna Drabczyk, Sonia Kudlacik-Kramarczyk, Agnieszka Sobczak-Kupiec

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Introduction: Nanomaterials become one of the leading materials in the synthesis of various compounds. This is a reason for the fact that nano-size materials exhibit other properties compared to their macroscopic equivalents. Such a change in size is reflected in a change in optical, electric or mechanical properties. Among nanomaterials, particular attention is currently directed into gold nanoparticles. They find application in a wide range of areas including cosmetology or pharmacy. Additionally, nanogold may be a component of modern wound dressings, which antibacterial activity is beneficial in the viewpoint of the wound healing process. Specific properties of this type of nanomaterials result in the fact that they may also be applied in cancer treatment. Studies on the development of new techniques of the delivery of drugs are currently an important research subject of many scientists. This is due to the fact that along with the development of such fields of science as medicine or pharmacy, the need for better and more effective methods of administering drugs is constantly growing. The solution may be the use of drug carriers. These are materials that combine with the active substance and lead it directly to the desired place. A role of such a carrier may be played by gold nanoparticles that are able to covalently bond with many organic substances. This allows the combination of nanoparticles with active substances. Therefore gold nanoparticles are widely used in the preparation of nanocomposites that may be used for medical purposes with special emphasis on drug delivery. Methodology: As part of the presented research, synthesis of composites was carried out. The mentioned composites consisted of the polymer matrix and gold nanoparticles that were introduced into the polymer network. The synthesis was conducted with the use of a crosslinking agent, and photoinitiator and the materials were obtained by means of the photopolymerization process. Next, incubation studies were conducted using selected liquids that simulated fluids are occurring in the human body. The study allows determining the biocompatibility of the tested composites in relation to selected environments. Next, the chemical structure of the composites was characterized as well as their sorption properties. Conclusions: Conducted research allowed for the preliminary characterization of prepared polymer composites containing gold nanoparticles in the viewpoint of their application for biomedical use. Tested materials were characterized by biocompatibility in tested environments. What is more, synthesized composites exhibited relatively high swelling capacity that is essential in the viewpoint of their potential application as drug carriers. During such an application, composite swells and at the same time releases from its interior introduced active substance; therefore, it is important to check the swelling ability of such material. Acknowledgements: The authors would like to thank The National Science Centre (Grant no: UMO - 2016/21/D/ST8/01697) for providing financial support to this project. This paper is based upon work from COST Action (CA18113), supported by COST (European Cooperation in Science and Technology).

Keywords: nanocomposites, gold nanoparticles, drug carriers, swelling properties

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451 Expert Supporting System for Diagnosing Lymphoid Neoplasms Using Probabilistic Decision Tree Algorithm and Immunohistochemistry Profile Database

Authors: Yosep Chong, Yejin Kim, Jingyun Choi, Hwanjo Yu, Eun Jung Lee, Chang Suk Kang

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For the past decades, immunohistochemistry (IHC) has been playing an important role in the diagnosis of human neoplasms, by helping pathologists to make a clearer decision on differential diagnosis, subtyping, personalized treatment plan, and finally prognosis prediction. However, the IHC performed in various tumors of daily practice often shows conflicting and very challenging results to interpret. Even comprehensive diagnosis synthesizing clinical, histologic and immunohistochemical findings can be helpless in some twisted cases. Another important issue is that the IHC data is increasing exponentially and more and more information have to be taken into account. For this reason, we reached an idea to develop an expert supporting system to help pathologists to make a better decision in diagnosing human neoplasms with IHC results. We gave probabilistic decision tree algorithm and tested the algorithm with real case data of lymphoid neoplasms, in which the IHC profile is more important to make a proper diagnosis than other human neoplasms. We designed probabilistic decision tree based on Bayesian theorem, program computational process using MATLAB (The MathWorks, Inc., USA) and prepared IHC profile database (about 104 disease category and 88 IHC antibodies) based on WHO classification by reviewing the literature. The initial probability of each neoplasm was set with the epidemiologic data of lymphoid neoplasm in Korea. With the IHC results of 131 patients sequentially selected, top three presumptive diagnoses for each case were made and compared with the original diagnoses. After the review of the data, 124 out of 131 were used for final analysis. As a result, the presumptive diagnoses were concordant with the original diagnoses in 118 cases (93.7%). The major reason of discordant cases was that the similarity of the IHC profile between two or three different neoplasms. The expert supporting system algorithm presented in this study is in its elementary stage and need more optimization using more advanced technology such as deep-learning with data of real cases, especially in differentiating T-cell lymphomas. Although it needs more refinement, it may be used to aid pathological decision making in future. A further application to determine IHC antibodies for a certain subset of differential diagnoses might be possible in near future.

Keywords: database, expert supporting system, immunohistochemistry, probabilistic decision tree

Procedia PDF Downloads 209
450 The Efficacy of Government Strategies to Control COVID 19: Evidence from 22 High Covid Fatality Rated Countries

Authors: Imalka Wasana Rathnayaka, Rasheda Khanam, Mohammad Mafizur Rahman

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TheCOVID-19 pandemic has created unprecedented challenges to both the health and economic states in countries around the world. This study aims to evaluate the effectiveness of governments' decisions to mitigate the risks of COVID-19 through proposing policy directions to reduce its magnitude. The study is motivated by the ongoing coronavirus outbreaks and comprehensive policy responses taken by countries to mitigate the spread of COVID-19 and reduce death rates. This study contributes to filling the knowledge by exploiting the long-term efficacy of extensive plans of governments. This study employs a Panel autoregressive distributed lag (ARDL) framework. The panels incorporate both a significant number of variables and fortnightly observations from22 countries. The dependent variables adopted in this study are the fortnightly death rates and the rates of the spread of COVID-19. Mortality rate and the rate of infection data were computed based on the number of deaths and the number of new cases per 10000 people.The explanatory variables are fortnightly values of indexes taken to investigate the efficacy of government interventions to control COVID-19. Overall government response index, Stringency index, Containment and health index, and Economic support index were selected as explanatory variables. The study relies on the Oxford COVID-19 Government Measure Tracker (OxCGRT). According to the procedures of ARDL, the study employs (i) the unit root test to check stationarity, (ii) panel cointegration, and (iii) PMG and ARDL estimation techniques. The study shows that the COVID-19 pandemic forced immediate responses from policymakers across the world to mitigate the risks of COVID-19. Of the four types of government policy interventions: (i) Stringency and (ii) Economic Support have been most effective and reveal that facilitating Stringency and financial measures has resulted in a reduction in infection and fatality rates, while (iii) Government responses are positively associated with deaths but negatively with infected cases. Even though this positive relationship is unexpected to some extent in the long run, social distancing norms of the governments have been broken by the public in some countries, and population age demographics would be a possible reason for that result. (iv) Containment and healthcare improvements reduce death rates but increase the infection rates, although the effect has been lower (in absolute value). The model implies that implementation of containment health practices without association with tracing and individual-level quarantine does not work well. The policy implication based on containment health measures must be applied together with targeted, aggressive, and rapid containment to extensively reduce the number of people infected with COVID 19. Furthermore, the results demonstrate that economic support for income and debt relief has been the key to suppressing the rate of COVID-19 infections and fatality rates.

Keywords: COVID-19, infection rate, deaths rate, government response, panel data

Procedia PDF Downloads 54
449 Climate Change Adaptation Strategy Recommended for the Conservation of Biodiversity in Western Ghats, India

Authors: Mukesh Lal Das, Muthukumar Muthuchamy

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Climate change Adaptation strategy (AS) is a scientific approach to dealing with the impacts of climate change (CC). Efforts are being made to contain the global emission of greenhouse gas within threshold limits, thereby limiting the rise of global temperature to an optimal level. Global Climate change is a spontaneous process; therefore, reversing the damage would take decades. The climate change adaptation strategy recommended by various stakeholders could be a key to resilience for biodiversity. The Indian Government has constituted the panel to synthesize the climate change action report at the federal and state levels. This review scavenged the published literature on the Western Ghats hotspots. And highlight the adaptation strategy recommended by diverse scientific actors to conserve biodiversity. It also reviews the grey literature adopted by state and federal governments and its effectiveness in mitigating the impacts on biodiversity. We have narrowed the scope of interest to the state action report by 6 Indian states such as Gujarat, Maharashtra, Goa, Karnataka, Kerala and Tamil Nadu, which host Western Ghats global biodiversity hotspot. Western Ghats(WGs) act as the water tower to the peninsular part of India, and its extensive watershed caters to the water demand of the Industry sector, Agriculture and urban community. Conservation of WGs is the key to the prosperity of Peninsular India. The global scientific community suggested more than 600+ Climate change adaptation strategies for the policymakers, stakeholders, and other state actors to take proactive actions. The preliminary analysis of the federal and the state action plan on climate change in the wake of CC indicate inadequacy in motion as per recommended scientific adaptation strategies. Tamil Nadu and Kerala state constitute nine effective adaptation strategies out of the 40+ recommended for Western Ghats conservation. And other four states' adaptation strategies are deficient, confusing and vague. Western Ghats' resilience capacity will soon or might have reached its threshold, and the frequency of severe drought and flash floods might upsurge manifold in the decades to come. The lack of a clear roadmap to climate change adaptation strategies in the federal and state action stirred us to identify the gap and address it by offering a holistic approach to WGs biodiversity conservation.

Keywords: adaptation strategy, biodiversity conservation, climate change, resilience, Western Ghats

Procedia PDF Downloads 87
448 Towards Sustainable African Urban Design Concepts

Authors: Gerald Steyn

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Sub-Saharan Africa is the world's fastest urbanizing region, but approximately 60 to 70 percent of urban African households are poor and living in slums. Although influential global institutions such as the World Bank propagate a new approach to housing and land policies, sustainable African urban concepts have yet to be applied significantly or even convincingly conceptualized. Most African city planners, urban designers, architects, policymakers, and developers have been trained in Western curriculums and continue to practice and plan according to such formal paradigms. Only a few activists promote Post-Colonial Afrocentric urbanism, recognizing the imperative of foregrounding the needs of low-income people. There is a vast body of authoritative literature on analyzing poverty and slums in sub-Saharan Africa and on promoting the need for land and city planning reform. However, of the latter, only a few venture beyond advising and sometimes outlining policy changes. The current study moves beyond a purely theoretical discourse into the realm of practice by designing replicable diagrammatic concepts at different urban scales. The guiding philosophy was that land-use concepts and urban requirements favoring low-income households must be fully integrated into the larger conurbation. Information was derived from intensive research over two decades, involving literature surveys and observations during regular travels into East and Southern Africa. Appropriate existing urban patterns, particularly vernacular and informal, were subsequently analyzed and reimagined as precedents to inform and underpin the represented design concepts. Five interrelated concepts are proposed, ranging in scale from (1) regional to (2) cities and (3) urban villages to (4) neighborhoods and (5) streets. Each concept is described, first in terms of its context and associated issues of concern, followed by a discussion of the patterns available to inform a possible solution, and finally, an explanation and graphic illustration of the proposal. Since each of the five concepts is unfolded from existing informal and vernacular practices studied in situ, the approach is entirely bottom-up. Contrary to an idealized vision of the African city, this study proposes actual concepts for critical assessment by peers in the tradition of architectural research in design.

Keywords: african urban concepts, post-colonial afrocentric urbanism, sub-saharan africa, sustainable african urban design

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447 Laboratory Indices in Late Childhood Obesity: The Importance of DONMA Indices

Authors: Orkide Donma, Mustafa M. Donma, Muhammet Demirkol, Murat Aydin, Tuba Gokkus, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

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Obesity in childhood establishes a ground for adulthood obesity. Especially morbid obesity is an important problem for the children because of the associated diseases such as diabetes mellitus, cancer and cardiovascular diseases. In this study, body mass index (BMI), body fat ratios, anthropometric measurements and ratios were evaluated together with different laboratory indices upon evaluation of obesity in morbidly obese (MO) children. Children with nutritional problems participated in the study. Written informed consent was obtained from the parents. Study protocol was approved by the Ethics Committee. Sixty-two MO girls aged 129.5±35.8 months and 75 MO boys aged 120.1±26.6 months were included into the scope of the study. WHO-BMI percentiles for age-and-sex were used to assess the children with those higher than 99th as morbid obesity. Anthropometric measurements of the children were recorded after their physical examination. Bio-electrical impedance analysis was performed to measure fat distribution. Anthropometric ratios, body fat ratios, Index-I and Index-II as well as insulin sensitivity indices (ISIs) were calculated. Girls as well as boys were binary grouped according to homeostasis model assessment-insulin resistance (HOMA-IR) index of <2.5 and >2.5, fasting glucose to insulin ratio (FGIR) of <6 and >6 and quantitative insulin sensitivity check index (QUICKI) of <0.33 and >0.33 as the frequently used cut-off points. They were evaluated based upon their BMIs, arms, legs, trunk, whole body fat percentages, body fat ratios such as fat mass index (FMI), trunk-to-appendicular fat ratio (TAFR), whole body fat ratio (WBFR), anthropometric measures and ratios [waist-to-hip, head-to-neck, thigh-to-arm, thigh-to-ankle, height/2-to-waist, height/2-to-hip circumference (C)]. SPSS/PASW 18 program was used for statistical analyses. p≤0.05 was accepted as statistically significance level. All of the fat percentages showed differences between below and above the specified cut-off points in girls when evaluated with HOMA-IR and QUICKI. Differences were observed only in arms fat percent for HOMA-IR and legs fat percent for QUICKI in boys (p≤ 0.05). FGIR was unable to detect any differences for the fat percentages of boys. Head-to-neck C was the only anthropometric ratio recommended to be used for all ISIs (p≤0.001 for both girls and boys in HOMA-IR, p≤0.001 for girls and p≤0.05 for boys in FGIR and QUICKI). Indices which are recommended for use in both genders were Index-I, Index-II, HOMA/BMI and log HOMA (p≤0.001). FMI was also a valuable index when evaluated with HOMA-IR and QUICKI (p≤0.001). The important point was the detection of the severe significance for HOMA/BMI and log HOMA while they were evaluated also with the other indices, FGIR and QUICKI (p≤0.001). These parameters along with Index-I were unique at this level of significance for all children. In conclusion, well-accepted ratios or indices may not be valid for the evaluation of both genders. This study has emphasized the limiting properties for boys. This is particularly important for the selection process of some ratios and/or indices during the clinical studies. Gender difference should be taken into consideration for the evaluation of the ratios or indices, which will be recommended to be used particularly within the scope of obesity studies.

Keywords: anthropometry, childhood obesity, gender, insulin sensitivity index

Procedia PDF Downloads 341
446 Improving the Constructability of Highway Design Plans

Authors: R. Edward Minchin Jr.

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The U.S. Federal Highway Administration (FHWA) Every Day Counts Program (EDC) has resulted in state DOTs putting evermore emphasis on speeding up the delivery of highway and bridge construction projects for use by the driving public. This has resulted in an increase in the use of alternative construction delivery systems such as design-build (D-B), construction manager at-risk (CMR) or construction manager/general contractor (CM/GC), and adding alternative technical concepts (ATCs) to traditional design-bid-build (DBB) contracts. ATCs have exhibited great potential for delivering substantial benefits like cost savings, increased constructability, and quicker project delivery. Previous research has found that knowledge of project constructability was lacking in state Department of Transportation (DOT) planning, programming, and environmental staffs. Many agencies have therefore relied on a set of ‘acceptable’ design solutions over the years of working with their local resource agencies. The result is that the permitting process for several government agencies has become increasingly restrictive with the result that the DOTs and their industry partners lose the ability to innovate after a permit is approved. The intent of this paper is to report on the research team’s progress in this ongoing effort furnish the United States government with a uniform set of guidelines for the application of constructability reviews during all phases of project development and delivery. The research uses surveys and interviews to determine which states have implemented formal programs to ensure that the constructor is furnished with a set of contract documents that affords said constructor with the best possible opportunity to successfully construct the project with the highest quality standards, within the contract duration and without exceeding the construction budget. Once these states are identified, workshops are held all over the nation, resulting in the team learning the best current practices and giving the team the ability to recommend new practices that will improve the process. The plan is for the FHWA to encourage or require state DOTs to use these practices on all federally funded highway and bridge construction projects. The project deliverable is a Guidebook for FHWA to use in disseminating the recommended practices to the states.

Keywords: alternative construction delivery, alternative technical concepts, constructability, construction design plans

Procedia PDF Downloads 190
445 Culvert Blockage Evaluation Using Australian Rainfall And Runoff 2019

Authors: Rob Leslie, Taher Karimian

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The blockage of cross drainage structures is a risk that needs to be understood and managed or lessened through the design. A blockage is a random event, influenced by site-specific factors, which needs to be quantified for design. Under and overestimation of blockage can have major impacts on flood risk and cost associated with drainage structures. The importance of this matter is heightened for those projects located within sensitive lands. It is a particularly complex problem for large linear infrastructure projects (e.g., rail corridors) located within floodplains where blockage factors can influence flooding upstream and downstream of the infrastructure. The selection of the appropriate blockage factors for hydraulic modeling has been subject to extensive research by hydraulic engineers. This paper has been prepared to review the current Australian Rainfall and Runoff 2019 (ARR 2019) methodology for blockage assessment by applying this method to a transport corridor brownfield upgrade case study in New South Wales. The results of applying the method are also validated against asset data and maintenance records. ARR 2019 – Book 6, Chapter 6 includes advice and an approach for estimating the blockage of bridges and culverts. This paper concentrates specifically on the blockage of cross drainage structures. The method has been developed to estimate the blockage level for culverts affected by sediment or debris due to flooding. The objective of the approach is to evaluate a numerical blockage factor that can be utilized in a hydraulic assessment of cross drainage structures. The project included an assessment of over 200 cross drainage structures. In order to estimate a blockage factor for use in the hydraulic model, a process has been advanced that considers the qualitative factors (e.g., Debris type, debris availability) and site-specific hydraulic factors that influence blockage. A site rating associated with the debris potential (i.e., availability, transportability, mobility) at each crossing was completed using the method outlined in ARR 2019 guidelines. The hydraulic results inputs (i.e., flow velocity, flow depth) and qualitative factors at each crossing were developed into an advanced spreadsheet where the design blockage level for cross drainage structures were determined based on the condition relating Inlet Clear Width and L10 (average length of the longest 10% of the debris reaching the site) and the Adjusted Debris Potential. Asset data, including site photos and maintenance records, were then reviewed and compared with the blockage assessment to check the validity of the results. The results of this assessment demonstrate that the estimated blockage factors at each crossing location using ARR 2019 guidelines are well-validated with the asset data. The primary finding of the study is that the ARR 2019 methodology is a suitable approach for culvert blockage assessment that has been validated against a case study spanning a large geographical area and multiple sub-catchments. The study also found that the methodology can be effectively coded within a spreadsheet or similar analytical tool to automate its application.

Keywords: ARR 2019, blockage, culverts, methodology

Procedia PDF Downloads 313
444 The Role of the Coach in Elite Equestrian Sport

Authors: Victoria Lewis, L. Dumbell

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The British Equestrian Federation (BEF) aims to develop a holistic coach education and certification program, moving away from traditional autocratic instruction in line with the UK Coaching Framework. This framework is based on generic coaching science research where the coach is cited as a pivotal aspect in developing sporting success. Theoretic knowledge suggests that the role of the sports coach is to develop the physical, tactical, technical and psychological attributes of the athlete and is responsible for the planning, organization and delivery of the training plan and competition schedule. However, to the best of the author’s knowledge, there is no empirical evidence to suggest that is the role required in equestrian sport as the rider takes responsibility for many of these tasks. This research aimed to address the void in current knowledge by gaining an understanding of coaching in equestrian sport in order to improve coaching education system through awareness of the role of the coach. Objectives were to examine the relationship between coach and rider at elite level in equestrian sport providing empirical evidence to suggest that the rider is, in part, ‘self –coached’. To identify the elite equestrian coaches’ role in coaching these ‘self-coached riders. A qualitative method using semi-structured interviews was used. A sample of elite coaches (N=3) and elite riders (N=3) were interviewed. Analysis of the transcripts revealed a total of 534 meaning units that were further grouped into sub-themes and general themes from the coaches’ perspective and the riders’ perspective. This led to the development of a final thematic structure revealing major dimensions that characterized coaching in elite equestrian sport. It was found that the riders at the elite level coach themselves the majority of the time, therefore, can be considered as ‘self-coached’ athletes. However, they do use elite coaches in a mentoring and consultancy role, where they seek guidance from the coach on specific problems, to sound ideas off or to seek reassurance that what they are doing is correct. Findings from this research suggest that the rider-coach relationship at the elite level is a professional one, based on trust and respect, but not a close relationship as seen in other sports. The results show the imperative need for the BEF to educate coaches in coaching the self-coached rider at the elite level, particularly in terms of mentoring skills. As well as incorporating rider education aimed at developing the independent, self-coached riders.

Keywords: coaching, elite sport, equestrian, self coached

Procedia PDF Downloads 155
443 Quick Response Codes in Physio: A Simple Click to Long-Term Oxygen Therapy Education

Authors: K. W. Lee, C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, L. Y. Chan, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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QR (Quick Response) Code is a matrix barcode. It enables users to open websites, photos and other information with mobile devices by just snapping the code. In usual Long Term Oxygen Therapy arrangement, piles of LTOT related information like leaflets from different oxygen service providers are given to patients to choose an appropriate plan according to their needs. If these printed materials are transformed into electronic format (QR Code), it would be more environmentally-friendly. More importantly, electronic materials including LTOT equipment operation and dyspnoea relieving techniques also empower patients in long-term disease management. The objective to this study is to investigate the effect of QR code in patient education on new LTOT users. This study was carried out in medical wards of North District Hospital. Adult patients and relatives who followed commands, were able to use smartphones with internet services and required LTOT arrangement on hospital discharge were recruited. In LTOT arrangement, apart from the usual LTOT education booklets which included patients’ personal information (e.g. oxygen titration and six-minute walk test results etc.), extra leaflets consisted of 1. QR codes of LTOT plans from different oxygen service providers, 2. Education materials of dyspnoea management and 3. Instructions on LTOT equipment operation were given. Upon completion of LTOT arrangement, a questionnaire about the use of QR code on patient education was filled in by patients or relatives. A total of 10 new LTOT users were recruited from November 2017 to January 2018. Initially, 70% of them did not know anything about the QR code, but all of them understood its operation after a simple demonstration. 70% of them agreed that it was convenient to use (20% strongly agree, 40% agree, 10% somewhat agree). 80% of them agreed that QR code could facilitate the retrieval of more LTOT related information (10% strongly agree, 70% agree) while 90% agreed that we should continue delivering QR code leaflets to new LTOT users in the future (30% strongly agree, 40% agree, 20% somewhat agree). It is proven that QR code is a convenient and environmentally-friendly tool to deliver information. It is also relatively easy to be introduced to new users. It has received welcoming feedbacks from current users.

Keywords: long-term oxygen therapy, physiotherapy, patient education, QR code

Procedia PDF Downloads 125
442 Achieving Design-Stage Elemental Cost Planning Accuracy: Case Study of New Zealand

Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

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An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

Procedia PDF Downloads 247
441 Strontium and Selenium Doped Bioceramic Incorporated Hydrogel for Faster Apatite Growth and Bone Regeneration Applications

Authors: Nonita Sarin, K.J.Singh, Anuj Kumar, Davinder Singh

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Polymeric 3D hydrogels have pivotal role in bone tissue regeneration applications. Hydrogels behave similar to the living tissues because they have large water imbibing capacity in swollen state and adjust their shape according to the tissues during tissue formation after implantation. On the other hand, hydrogels are very soft, fragile and lack mechanical strength. Incorporation of bioceramics can improve mechanical strength. Furthermore, bioceramics synthesized by sol gel technique may enhance the apatite formation and degradation rates which can lead to the increase in faster rates for new bone and tissue regeneration. Simulated body fluid (SBF) induces the poly-condensation of silanol groups which leads to formation of silica matrix and provide active sites for the precipitation of Ca2+ and PO43- ions to form apatite layer which is similar to mineral form of bone. Therefore, authors have synthesized bioceramic incorporated Polyacrylamide-carboxymethylcellulose hydrogels by free radical polymerization and bioceramic compositions of xSrO-(36-x)CaO-45SiO2-ySeO3-(12-y)P2O5-7MgO (where x=0,4 and y=0,2 mol%) were synthesized by sol gel technique. Bioceramics incorporated in polymer matrix induces quicker apatite formation during immersion in SBF by raising the pH with the release of alkaline ions during ion exchange process and the apatite formation takes place in alkaline medium. The behavior of samples PABC-0 (without bioceramics) and PABC-20 (with 20 wt% bioceramics) were evaluated by X-Ray Diffraction and FTIR. In term of bioactivity, it was observed that PABC-20 has shown hydroxyapatite (HA) formation on 1st day of immersion whereas, PABC-0 was shown apatite formation on 7th day of immersion in SBF. The rapid rate of HA growth on 1st day of immersion in SBF signifies easy regeneration of damaged bone tissues. Degradation studies have been undertaken in Phosphate Buffer Saline and PABC-20 exhibited slower degradation rate up to 9%as compared to PABC-0 up to 18%. Slower degradation rate is suitable for new tissue regeneration and cell attachment. Also, Zeta potential studies have been employed to check the surface charge and it has been observed that samples carry negative charge when immersed in SBF. In addition, the swelling test of the samples have been performed and relative swelling ratio % observed for PABC-0 is 607% and PABC-20 is 305%. This indicates that the incorporation of bioceramics leads to the filling up of the voids in between the polymer matrix which in result reduces porosity and increase the mechanical strength by filling the voids. The porosity of PABC-0 is 84% and PABC-20 is 72%. PABC-20 sample demonstrates that bioceramics incorporation reduce the porosity and improves mechanical strength. Also, maximum in vitro cell viability up to 98% with MG63 cell line has been observed which indicate that the bioceramic incorporated hydrogel(PABC-20) provide the alkaline medium which is suitable environment for cell growth.

Keywords: hydrogels, hydroxyapatite, MG63 cell line, zeta potential

Procedia PDF Downloads 121
440 Fulfillment of Models of Prenatal Care in Adolescents from Mexico and Chile

Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

Procedia PDF Downloads 186
439 Exploring Exposed Political Economy in Disaster Risk Reduction Efforts in Bangladesh

Authors: Shafiqul Islam, Cordia Chu

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Bangladesh is one of the most vulnerable countries to climate related disasters such as flood and cyclone. Exploring from the semi-structured in-depth interviews of 38 stakeholders and literature review, this study examined the public spending distribution process in DRR. This paper demonstrates how the processes of political economy-enclosure, exclusion, encroachment, and entrenchment hinder the Disaster Risk Reduction (DRR) efforts of Department of Disaster Management (DDM) such as distribution of flood centres, cyclone centres and 40 days employment generation programs. Enclosure refers to when DRR projects allocated to less vulnerable areas or expand the roles of influencing actors into the public sphere. Exclusion refers to when DRR projects limit affected people’s access to resources or marginalize particular stakeholders in decision-making activities. Encroachment refers to when allocation of DRR projects and selection of location and issues degrade the environmental affect or contribute to other forms of disaster risk. Entrenchment refers to when DRR projects aggravate the disempowerment of common people worsen the concentrations of wealth and income inequality within a community. In line with United Nations (UN) Sustainable Development Goals (SDGs), Hyogo and Sendai Frameworks, in the case of Bangladesh, DRR policies implemented under the country’s national five-year plan, disaster-related acts and rules. These policies and practices have somehow enabled influential-elites to mobilize and distribute resources through bureaucracies. Exclusionary forms of fund distribution of DRR exist at both the national and local scales. DRR related allocations have encroached through the low land areas development project without consulting local needs. Most severely, DRR related unequal allocations have entrenched social class trapping the backward communities vulnerable to climate related disasters. Planners and practitioners of DRR need to take necessary steps to eliminate the potential risks from the processes of enclosure, exclusion, encroachment, and entrenchment happens in project fund allocations.

Keywords: Bangladesh, disaster risk reduction, fund distribution, political economy

Procedia PDF Downloads 114
438 Clinical Validation of an Automated Natural Language Processing Algorithm for Finding COVID-19 Symptoms and Complications in Patient Notes

Authors: Karolina Wieczorek, Sophie Wiliams

Abstract:

Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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437 The Boy Who Cried Wolf-North Korea Nuclear Test and Its Implication to the Regional Stability

Authors: Mark Wenyi Lai

Abstract:

The very lethal weapon of nuclear warhead had threatened the survival of the world for half of the 20th century. When most of the countries have already denounced and stopped the development, one country is eager to produce and use them. Since 2006, Pyongyang has launched six times of nuclear tests. The most recent one in September 2017 signaled North Korea’s military capability to project the mass destruction through ICBM (Intercontinental Ballistic Missile) over Seoul, Tokyo, Guam, Hawaii, Alaska or probably the West Coast of the United States with the explosive energy ten times of the atom bombing of Hiroshima in 1945. This research paper adopted time-series content analysis focusing on the related countries responses to North Korea’s tests in 2006, 2009, 2013, and 2016. The preliminary hypotheses are first, North Korea determined to protect the regime by having triad nuclear capability. Negotiations are mere means to this end. Second, South Korea is paralyzed by its ineffective domestic politics and unable to develop its independent strategy toward the North. Third, Japan was using the external threat to campaign for its rearmament plan and brought instability in foreign relations. Fourth, China found herself in the strange position of defending the loyal buffer state meanwhile witnessing the fourth and dangerous neighboring country gaining the card into nuclear club. Fifth, the United States had admitted that North Korea’s going nuclear is unstoppable. Therefore, to keep the regional stability in the East Asia, the US relied on the new balance of power formed by everyone versus Pyongyang. But, countries in East Asia actually have problems getting along with each other. Sixth, Russia distanced herself from the North Kore row but benefitted by advancing its strategic importance in the Far East. Tracing back the history of nuclear states, this research paper concluded that North Korea will head on becoming a more confident country. The regional stability will restore once related countries deal with the new fact and treat Pyongyang regime with a new strategy. The gradual opening and economic reform are on the way for the North Korea in the near future.

Keywords: nuclear test, North Korea, six party talk, US foreign policy

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