Search results for: pain intensity

Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: Zahra R. Almansoor

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Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: Arushi Singh, Anjana Jain, Prakash Vyavahare

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Recently, Li-Fi(light-fiedelity) has been launched based on VLC(visible light communication) technique, 100 times faster than WiFi. Now 5G mobile communication system is proposed to use VLC-OFDM as the transmission technique. The VLC system focused on visible rays, is considered for efficient spectrum use and easy intensity modulation through LEDs. The reason of high speed in VLC is LED, as they flicker incredibly fast(order of MHz). Another advantage of employing LED is-it acts as low pass filter results no out-of-band emission. The VLC system falls under the category of ‘green technology’ for utilizing LEDs. In present scenario, OFDM is used for high data-rates, interference immunity and high spectral efficiency. Inspite of the advantages OFDM suffers from large PAPR, ICI among carriers and frequency offset errors. Since, the data transmission technique used in VLC system is OFDM, the system suffers the drawbacks of OFDM as well as VLC, the non-linearity dues to non-linear characteristics of LED and PAPR of OFDM due to which the high power amplifier enters in non-linear region. The proposed paper focuses on reduction of PAPR in VLC-OFDM systems. Many techniques are applied to reduce PAPR such as-clipping-introduces distortion in the carrier; selective mapping technique-suffers wastage of bandwidth; partial transmit sequence-very complex due to exponentially increased number of sub-blocks. The paper discusses three companding techniques namely- µ-law, A-law and advance A-law companding technique. The analysis shows that the advance A-law companding techniques reduces the PAPR of the signal by adjusting the companding parameter within the range. VLC-OFDM systems are the future of the wireless communication but non-linearity in VLC-OFDM is a severe issue. The proposed paper discusses the techniques to reduce PAPR, one of the non-linearities of the system. The companding techniques mentioned in this paper provides better results without increasing the complexity of the system.

Keywords: non-linear companding techniques, peak to average power ratio (PAPR), visible light communication (VLC), VLC-OFDM

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Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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Authors: Neel K. Shah

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Passive flow control on aerofoils has largely been achieved through the use of protrusions such as vane-type vortex generators. Consequently, innovative flow-control concepts should be explored in an effort to improve current component performance. Therefore, experimental research has been performed at The University of Manchester to evaluate the flow-control effectiveness of a vortex generator made in the form of a surface indentation. The surface indentation has a trapezoidal planform. A spanwise array of indentations has been applied in a convergent orientation around the maximum-thickness location of the upper surface of a NACA-0015 aerofoil. The aerofoil has been tested in a two-dimensional set-up in a low-speed wind tunnel at an angle of attack (AoA) of 3° and a chord-based Reynolds number (Re) of ~2.7 x 105. The baseline model has been found to suffer from a laminar separation bubble at low AoA. The application of the indentations at 3° AoA has considerably shortened the separation bubble. The indentations achieve this by shedding up-flow pairs of streamwise vortices. Despite the considerable reduction in bubble length, the increase in leading-edge suction due to the shorter bubble is limited by the removal of surface curvature and blockage (increase in surface pressure) caused locally by the convergent indentations. Furthermore, the up-flow region of the vortices, which locally weakens the pressure recovery around the trailing edge of the aerofoil by thickening the boundary layer, also contributes to this limitation. Due to the conflicting effects of the indentations, the changes in the pressure-lift and pressure-drag coefficients, i.e., cl,p and cd,p, are small. Nevertheless, the indentations have improved cl,p and cd,p beyond the uncertainty range, i.e., by ~1.30% and ~0.30%, respectively, at 3° AoA. The wake measurements show that turbulence intensity and Reynolds stresses have considerably increased in the indented case, thus implying that the indentations increase the viscous drag on the model. In summary, the convergent indentations are able to reduce the size of the laminar separation bubble, but conversely, they are not highly effective in reducing cd,p at the tested Reynolds number.

Keywords: aerofoil flow control, laminar separation bubbles, low Reynolds-number flows, surface indentations

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Authors: Beatrice Wamuyu Muchiri, Monika M. L. Dos Santos

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An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested.

Keywords: risk factors, protective factors, substance use, adolescents

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Authors: Nhan N. T. Ton, Anh T. N. Dao, Kouichirou Katou, Toshiaki Taniike

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Facile electron-hole recombination and the broad band gap are two major drawbacks of titanium dioxide (TiO₂) when applied in visible-light photocatalysis. Hybridization of TiO₂ with graphene is a promising strategy to lessen these pitfalls. Recently, there have been many reports on the synthesis of TiO₂/graphene nanocomposites, in most of which graphene oxide (GO) was used as a starting material. However, the reduction of GO introduced a large number of defects on the graphene framework. In addition, the sensitivity of titanium alkoxide to water (GO usually contains) significantly obstructs the uniform and controlled growth of TiO₂ on graphene. Here, we demonstrate a novel technique to synthesize TiO₂/graphene nanocomposites without the use of GO. Graphene dispersion was obtained through the chemical exfoliation of graphite in titanium tetra-n-butoxide with the aid of ultrasonication. The dispersion was directly used for the sol-gel reaction in the presence of different catalysts. A TiO₂/reduced graphene oxide (TiO₂/rGO) nanocomposite, which was prepared by a solvothermal method from GO, and the commercial TiO₂-P25 were used as references. It was found that titanium alkoxide afforded the graphene dispersion of a high quality in terms of a trace amount of defects and a few layers of dispersed graphene. Moreover, the sol-gel reaction from this dispersion led to TiO₂/graphene nanocomposites featured with promising characteristics for visible-light photocatalysts including: (I) the formation of a TiO₂ nano layer (thickness ranging from 1 nm to 5 nm) that uniformly and thinly covered graphene sheets, (II) a trace amount of defects on the graphene framework (low ID/IG ratio: 0.21), (III) a significant extension of the absorption edge into the visible light region (a remarkable extension of the absorption edge to 578 nm beside the usual edge at 360 nm), and (IV) a dramatic suppression of electron-hole recombination (the lowest photoluminescence intensity compared to reference samples). These advantages were successfully demonstrated in the photocatalytic decomposition of methylene blue under visible light irradiation. The TiO₂/graphene nanocomposites exhibited 15 and 5 times higher activity than TiO₂-P25 and the TiO₂/rGO nanocomposite, respectively.

Keywords: chemical exfoliation, photocatalyst, TiO₂/graphene, sol-gel reaction

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Authors: Elisa K. Schoenell, Cristiano De Oliveira, Luiz R. H. Dos Santos, Alexandre Giacobbo, Andréa M. Bernardes, Marco A. S. Rodrigues

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Water is an indispensable natural resource, which must be preserved to human activities as well the ecosystems. However, the sewage discharge has been contaminating water resources. Conventional treatment, such as physicochemical treatment followed by biological processes, has not been efficient to the complete degradation of persistent organic compounds, such as medicines and hormones. Therefore, the use of advanced technologies to sewage treatment has become urgent and necessary. The aim of this study was to apply Reverse Osmosis (RO) on sewage tertiary treatment from a Waste Water Treatment Plant (WWTP) in south Brazil. It was collected 200 L of sewage pre-treated by wetland with aquatic macrophytes. The sewage was treated in a RO pilot plant, using a polyamide membrane BW30-4040 model (DOW FILMTEC), with 7.2 m² membrane area. In order to avoid damage to the equipment, this system contains a pleated polyester filter with 5 µm pore size. It was applied 8 bar until achieve 5 times of concentration, obtaining 80% of recovery of permeate, with 10 L.min-1 of concentrate flow rate. Samples of sewage pre-treated on WWTP, permeate and concentrate generated on RO was analyzed for physicochemical parameters and by gas chromatography (GC) to qualitative analysis of organic compounds. The results proved that the sewage treated on WWTP does not comply with the limit of phosphorus and nitrogen of Brazilian legislation. Besides this, it was found many organic compounds in this sewage, such as benzene, which is carcinogenic. Analyzing permeate results, it was verified that the RO as sewage tertiary treatment was efficient to remove of physicochemical parameters, achieving 100% of iron, copper, zinc and phosphorus removal, 98% of color removal, 91% of BOD and 62% of ammoniacal nitrogen. RO was capable of removing organic compounds, however, it was verified the presence of some organic compounds on de RO permeate, showing that RO did not have the capacity of removal all organic compounds of sewage. It has to be considered that permeate showed lower intensity of peaks in chromatogram in comparison to the sewage of WWTP. It is important to note that the concentrate generate on RO needs a treatment before its disposal in environment.

Keywords: organic compounds, reverse osmosis, sewage treatment, tertiary treatment

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Authors: Desmond F. Bellamy

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Discourses about animal rights usually assume an ontological abyss between human and animal. This supposition of non-animality allows us to utilise and exploit non-humans, particularly those with commercial value, with little regard for their rights or interests. We can and do confine them, inflict painful treatments such as castration and branding, and slaughter them at an age determined only by financial considerations. This paper explores the way images and texts depicting human cannibalism reflect this deprivation of rights back onto our species and examines how this offers new perspectives on our granting or withholding of rights to farmed animals. The animals we eat – sheep, pigs, cows, chickens and a small handful of other species – are during processing de-animalised, turned into commodities, and made unrecognisable as formerly living beings. To do the same to a human requires the cannibal to enact another step – humans must first be considered as animals before they can be commodified or de-animalised. Different iterations of cannibalism in a selection of fiction and non-fiction texts will be considered: survivalism (necessitated by catastrophe or dystopian social collapse), the primitive savage of colonial discourses, and the inhuman psychopath. Each type of cannibalism shows alternative ways humans can be animalised and thereby dispossessed of both their human and animal rights. Human rights, summarised in the UN Universal Declaration of Human Rights as ‘life, liberty, and security of person’ are stubbornly denied to many humans, and are refused to virtually all farmed non-humans. How might this paradigm be transformed by seeing the animal victim replaced by an animalised human? People are fascinated as well as repulsed by cannibalism, as demonstrated by the upsurge of films on the subject in the last few decades. Cannibalism is, at its most basic, about envisaging and treating humans as objects: meat. It is on the dinner plate that the abyss between human and ‘animal’ is most challenged. We grasp at a conscious level that we are a species of animal and may become, if in the wrong place (e.g., shark-infested water), ‘just food’. Culturally, however, strong traditions insist that humans are much more than ‘just meat’ and deserve a better fate than torment and death. The billions of animals on death row awaiting human consumption would ask the same if they could. Depictions of cannibalism demonstrate in graphic ways that humans are animals, made of meat and that we can also be butchered and eaten. These depictions of us as having the same fleshiness as non-human animals reminds us that they have the same capacities for pain and pleasure as we do. Depictions of cannibalism, therefore, unconsciously aid in deconstructing the human/animal binary and give a unique glimpse into the often unnoticed repudiation of animal rights.

Keywords: animal rights, cannibalism, human/animal binary, objectification

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Authors: Nino KItoshvili

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The family is an integral part of society, which plays a major role in the socialization and the formation of a person as a full member of society. The marital conflict even harms family members and finds a different effect on each member of the family, especially on children. There is a significant difference in the behavior of adolescents in conflict and non-conflict families. In times of marital conflict, adolescent psycho-social well-being is significantly dependent on socio-cultural mediating variables such as; Family income; Parenting style; The functioning of the family, and the existence of psycho-social support. In a family with low economic performance, low psychosocial harassment, family dysfunction, and bad parenting style, marital conflict significantly increases the risk of deteriorating adolescent psycho-social well-being. At this time, to support the well-being of the child, a special role is played by improving the marital relationship, which must be supported by state and community services. There are very few family studies in this field in Georgia, the therapeutic direction of the family is at an early stage, and there are no family-supporting psycho-social programs. This increases the chances of adolescent psycho-social well-being deteriorating amd socialization problems. The study will examine the mediating variables of marital conflict and adolescent psycho-social well-being and will attempt to determine their mediating and moderating role. Research suggests that an increase in the rate of marital conflict is associated with a decrease in child well-being. The well-being of children in conflict families is lower than that of children in non-conflict families and depends on the variables of mediating variables. Quantitative research will be conducted to study this phenomenon through a questionnaire developed and standardized in the research process. The study will be attended by families living in Georgia - spouses (married) and their adolescent children. By analyzing the data obtained from the research, we will be able to determine in which cases the intensity of the relationship between the marital conflict and the well-being of the adolescent increases or decreases; To conclude the mediating and moderating role of mediating variables and also to make relevant recommendations to reduce the negative impact on the psycho-social well-being of a child of marital conflict.

Keywords: adolescent, mediation, moderation, conflict, couple, well-being

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Authors: B. Hammouti, H. Oudda, A. Benabdellah, A. Benayada, A. Aouniti

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Corrosion behaviour of carbon steel was studied in various concentrated HClO4 solutions. To explain the acid attack in relation of H+ activity, new sensor was realised: two carbon paste electrodes (CPE) were constructed by incorporating ferrocene (Fc) and orthoquinone into the carbon paste matrix and crossed by weak current to stabilize potential difference. The potentiometric method at imposed weak current between these two electrodes permits the in situ determination of both concentration and acidity level of various concentrated HClO4 solutions. The different factors affecting the potential at imposed current as current intensity, temperature and H+ ion concentration are studied. The potentials measured between ferrocene and chloranil electrodes are directly linked to the acid concentration. The acidity Ri(H) function defined represents the determination of the H+ activity and constitutes the extend of pH is concentrated acid solutions. Ri(H) has been determined and compared to Strehlow Ro(H), Janata HGF and Hammett Ho functions. The collected data permit to give a scale of strength of mineral concentrated acids at a given concentration. Ri(H) is numerically equal to the thermodynamic Ro(H), but deviated from Hammett functions based on indicator determination. The CPE electrode with inserted ferrocene in presence of ferricinium (Fc+) ion in concentrated HClO4 at various concentrations is realized without junction potential and may plays the role of a practical reference electrode (FRE) in concentrated acids. Fc+ was easily prepared in biphasic medium HClO4-acid by the quantitative oxidation of ferrocene by the ortho-chloranil (oQ). Potential of FRE is stable with time. The variation of equilibrium potential of the interface Fc/ Fc+ at various concentrations of Fc+ (10-4 - 2 10-2 M) obeyed to the Nernst equation with a slope 0.059 Volt per decade. Corrosion rates obtained by weight loss and electrochemical techniques were then easily linked to acidity level.

Keywords: ferrocene, strehlow, concentrated acid, corrosion, Generalised pH, sensor carbon paste electrode

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Authors: Kevin A. Droguett, Edwin G. Pérez, Denis Fuentealba, Margarita E. Aliaga, Angélica M. Fierro

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Supramolecular chemistry is a field of growing interest. Moreover, studying the formation of host-guest complexes between macrocycles and dyes is highly attractive due to their potential applications. Examples of the above are drug delivery, catalytic process, and sensing, among others. There are different dyes of interest in the literature; one example is the quinolinone derivatives. Those molecules have good optical properties and chemical and thermal stability, making them suitable for developing fluorescent probes. Secondly, several macrocycles can be seen in the literature. One example is the cucurbiturils. This water-soluble macromolecule family has a hydrophobic cavity and two identical carbonyl portals. Additionally, the thermodynamic analysis of those supramolecular systems could help understand the affinity between the host and guest, their interaction, and the main stabilization energy of the complex. In this work, two 7-(diethylamino) quinoline-2 (1H)-one derivative (QD1-2) and their interaction with cucurbit[7]uril (CB[7]) were studied from an experimental and in-silico point of view. For the experimental section, the complexes showed a 1:1 stoichiometry by HRMS-ESI and isothermal titration calorimetry (ITC). The inclusion of the derivatives on the macrocycle lends to an upward shift in the fluorescence intensity, and the pKa value of QD1-2 exhibits almost no variation after the formation of the complex. The thermodynamics of the inclusion complexes was investigated using ITC; the results demonstrate a non-classical hydrophobic effect with a minimum contribution from the entropy term and a constant binding on the order of 106 for both ligands. Additionally, dynamic molecular studies were carried out during 300 ns in an explicit solvent at NTP conditions. Our finding shows that the complex remains stable during the simulation (RMSD ~1 Å), and hydrogen bonds contribute to the stabilization of the systems. Finally, thermodynamic parameters from MMPBSA calculations were obtained to generate new computational insights to compare with experimental results.

Keywords: host-guest complexes, molecular dynamics, quinolin-2(1H)-one derivatives dyes, thermodynamics

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Authors: Ibrahim Siddig Hamid, Ikram Mohamed Eltayeb

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Trachyspermum ammi belongs to the family Apiaceae, is used traditionally for the treatment of gastrointestinal ailments, lack of appetite and bronchial problems as well used as antiseptic, antimicrobial, antipyretic, febrifugal and in the treatment of typhoid fever. Peganum harmala belongs to the family Zygophyllaceae it has been reported to have an antibacterial activity and used to treat depression and recurring fevers. It also used to kill algae, bacteria, intestinal parasites and molds. In Sudan, the combination of two plants are traditionally used for the treatment of bacillary dysentery. Bacillary dysentery is caused by one or more types of Shigella species bacteria mainly Shigella dysenteri and shigella flexneri. Bacillary dysentery is mainly found in hot countries like Sudan with poor hygiene and sanitation. Bacillary dysentery causes sudden onset of high fever and chills, abdominal pain, cramps and bloating, urgency to pass stool, weight loss, and dehydration and if left untreated it can lead to serious complications including delirium, convulsions and coma. A serious infection like this can be fatal within 24 hours. The objective of this study is to investigate the in vitro susceptibility of Sh. flexneri and Sh. dysenteriae to the T. ammi and P. harmala. T. ammi and P. harmala were extracted by 96% ethanol using Soxhlet apparatus. The antimicrobial activity of the extracts was investigated according to the disc diffusion method. The discs were prepared by soaking sterilized filter paper discs in 20 microliter of serially diluted solutions of each plant extract with the concentrations (100, 50, 25, 12.5, 6.25mg/dl) then placing them on Muller Hinton Agar plates that were inoculated with bacterial suspension separately, the plates were incubated for 24 hours at 37c and the minimum inhibitory concentration of the extract which was the least concentration of the extract to inhibit fungal growth was determined. The results showed the high antimicrobial activity of T. ammi extract with an average diameter zone ranging from 18-20 mm and its minimum inhibitory concentration was found to be 25 mg/ml against the two shigella species. P. harmala extract was found to have slight antibacterial effect against the two bacteria. This result justified the Sudanese traditional use of Trachyspermum ammi plant for the treatment of bacillary dysentery.

Keywords: harmala, peganum, shigella, trachyspermum

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Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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Authors: Armin Bodaghkhani, Bruce Colbourne, Yuri S. Muzychka

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The process of spray-cloud formation and flow kinematics produced from breaking wave impact on vertical and slant lab-scale bow-shaped models were experimentally investigated. Bubble Image Velocimetry (BIV) and Image Processing (IP) techniques were applied to study the various types of wave-model impacts. Different wave characteristics were generated in a tow tank to investigate the effects of wave characteristics, such as wave phase velocity, wave steepness on droplet velocities, and behavior of the process of spray cloud formation. The phase ensemble-averaged vertical velocity and turbulent intensity were computed. A high-speed camera and diffused LED backlights were utilized to capture images for further post processing. Various pressure sensors and capacitive wave probes were used to measure the wave impact pressure and the free surface profile at different locations of the model and wave-tank, respectively. Droplet sizes and velocities were measured using BIV and IP techniques to trace bubbles and droplets in order to measure their velocities and sizes by correlating the texture in these images. The impact pressure and droplet size distributions were compared to several previously experimental models, and satisfactory agreements were achieved. The distribution of droplets in front of both models are demonstrated. Due to the highly transient process of spray formation, the drag coefficient for several stages of this transient displacement for various droplet size ranges and different Reynolds number were calculated based on the ensemble average method. From the experimental results, the slant model produces less spray in comparison with the vertical model, and the droplet velocities generated from the wave impact with the slant model have a lower velocity as compared with the vertical model.

Keywords: spray charachteristics, droplet size and velocity, wave-body interactions, bubble image velocimetry, image processing

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Authors: F. Berahmandpour, K. Bagheri

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Introduction: Spirulina is nutritious blue - green algae which are used as supplement or a preservative in many foods. The studies about the algae argue that the Spirulina can improve immune system, increase fat utilization, reduce oxidative stress and promote endurance at high-intensity exercise. The purpose of study is to assess the effects of Spirulina supplement on healthy weight control. Method: the study is a cross-sectional study which had 30 participants. The participants were men and women who referred to the nutrition and diet therapy clinic (in west of Tehran / Iran) for control weight. The sampling was a purposeful sampling. The participants were divided into three groups, and they were surveyed for 4 weeks. In the first group, 10 participants were used Spirulia supplement (dose: 500mg of Spiruvit Supplement as tablet / 3 times per day) without any special diet. The second group was 10 participants who received Spirulia supplement (dose 500mg of Spiruvit Supplement as tablet / 3 times per day) with a weight loss exercise program and without any special diet. The third group was 10 participants who used Spirulia supplement (dose 500mg of Spiruvit Supplement as tablet / 3 times per day) with an optimum weight loss diet. Results and Discussion: The results show that there were not any significant loss weights in first group. In while, the participants of second group argued that the Spirulina supplement had positive effects on their mud and physical body; however the clinical results showed that the loss weight had fixed tilt in this group. The significant results of study were related to the third group, because the participations could continuous loss weight during 4 weeks. However, the optimum weight loss diets were effective effects on weight loss in this group, but the researchers found that Spirulina supplement could improve loss weight with set of hormonal system (especially in women with menopause). Conclusion: The study is concluded that the Spirulina as a supplement (Spiruvit Supplement) can be an effective effect on healthy weight control, if it is used with a nutritious healthy weight loss diet. In fact, the effect of Spirulina can be related to powerful antioxidant effects and improvable hormonal system in the body.

Keywords: diet, healthy weight control, spirulina, spiruvit supplement

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Authors: Lucky Malise, Hilary Rutto, Tumisang Seodigeng

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Heavy metal contamination in waste water is a very serious issue affecting a lot of industrialized countries due to the health and environmental impact of these heavy metals on human life and the ecosystem. Adsorption using activated carbon is the most promising method for the removal of heavy metals from waste water but commercial activated carbon is expensive which gives rise to the need for alternatively activated carbon derived from cheap precursors, agricultural wastes, or byproducts from other processes. In this study activated bio-carbon derived from the carbonaceous material obtained from the pyrolysis of Marula nut shells was chemically activated and used as an adsorbent for the removal of lead (II) and copper (II) ions from aqueous solution. The surface morphology and chemistry of the adsorbent before and after chemical activation with zinc chloride impregnation were studied using SEM and FTIR analysis respectively and the results obtained indicate that chemical activation with zinc chloride improves the surface morphology of the adsorbent and enhances the intensity of the surface oxygen complexes on the surface of the adsorbent. The effect of process parameters such as adsorbent dosage, pH value of the solution, initial metal concentration, contact time, and temperature on the adsorption of lead (II) and copper (II) ions onto Marula nut activated carbon were investigated, and their optimum operating conditions were also determined. The experimental data was fitted to both the Langmuir and Freundlich isotherm models, and the data fitted best on the Freundlich isotherm model for both metal ions. The adsorption kinetics were also evaluated, and the experimental data fitted the pseudo-first order kinetic model better than the pseudo second-order kinetic model. The adsorption thermodynamics were also studied and the results indicate that the adsorption of lead and copper ions is spontaneous and exothermic in nature, feasible, and also involves a dissociative mechanism in the temperature range of 25-45 °C.

Keywords: adsorption, isotherms, kinetics, marula nut shells activated carbon, thermodynamics

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Authors: G. Vishnu, T. V. Bharat

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Rainfall plays a major role in the stability of natural slopes in tropical and subtropical regions. These slopes usually have high slope angles and are stable during the dry season. The critical rainfall intensity that might trigger a landslide may not be the highest rainfall. In addition to geological discontinuities and anthropogenic factors, water content, suction, and hydraulic conductivity also play a role. A thorough geotechnical investigation with the principles of unsaturated soil mechanics is required to predict the failures in these cases. The study discusses three landslide events that had occurred in residual hills of Guwahati, India. Rainfall data analysis, history image analysis, land use, and slope maps of the region were analyzed and discussed. The landslide occurred on June (24, 26, and 28) 2020, on the respective sites, but the highest rainfall was on June (6 and 17) 2020. The factors that lead to the landslide occurrence is the combination of critical events initiated with rainfall, causing a reduction in suction. The sites consist of a mixture of rocks and soil. The slope failure occurs due to the saturation of the soil layer leading to loss of soil strength resulting in the flow of the entire soil rock mass. The land-use change, construction activities, other human and natural activities that lead to faster disintegration of rock mass may accelerate the landslide events. Landslides in these slopes are inevitable, and the development of an early warning system (EWS) to save human lives and resources is a feasible way. The actual time of failure of a slope can be better predicted by considering all these factors rather than depending solely on the rainfall intensities. An effective EWS is required with less false alarms in these regions by proper instrumentation of slope and appropriate climatic downscaling.

Keywords: early warning system, historic image analysis, slope instrumentation, unsaturated soil mechanics

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Authors: Ibrahim Khan, Waqas Khalid

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The Healthcare sector is known to consume a higher proportion of total energy consumption in the HVAC market owing to an excessive cooling and heating requirement in maintaining human thermal comfort in indoor conditions, catering to patients undergoing treatment in hospital wards, rooms, and intensive care units. The indoor thermal comfort conditions in selected hospitals of Islamabad, Pakistan, were measured on a real-time basis with the collection of first-hand experimental data using calibrated sensors measuring Ambient Temperature, Wet Bulb Globe Temperature, Relative Humidity, Air Velocity, Light Intensity and CO2 levels. The Experimental data recorded was analyzed in conjunction with the Thermal Comfort Questionnaire Surveys, where the participants, including patients, doctors, nurses, and hospital staff, were assessed based on their thermal sensation, acceptability, preference, and comfort responses. The Recorded Dataset, including experimental and survey-based responses, was further analyzed in the development of a correlation between operative temperature, operative relative humidity, and other measured operative parameters with the predicted mean vote and adaptive predicted mean vote, with the adaptive temperature and adaptive relative humidity estimated using the seasonal data set gathered for both summer – hot and dry, and hot and humid as well as winter – cold and dry, and cold and humid climate conditions. The Machine Learning Logistic Regression Algorithm was incorporated to train the operative experimental data parameters and develop a correlation between patient sensations and the thermal environmental parameters for which a new ML-based adaptive thermal comfort model was proposed and developed in our study. Finally, the accuracy of our model was determined using the K-fold cross-validation.

Keywords: predicted mean vote, thermal comfort, energy management, logistic regression, machine learning

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Authors: Anupoju Rajeev, Joanne Mathew, Amit Shelke

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In the current study, a new type of Composite Structural Insulated Panels (CSIPs) is developed and investigated its performance against shock loading which can replace the conventional wooden structural materials. The CSIPs is made of Fibre Cement Board (FCB)/aluminum as the facesheet and the expanded polystyrene foam as the core material. As tornadoes are very often in the western countries, it is suggestable to monitor the health of the CSIPs during its lifetime. So, the composite structure is installed with three smart sensors located randomly at definite locations. Each smart sensor is fabricated with an embedded half stainless phononic crystal sensor attached to both ends of the nylon shaft that can resist the shock and impact on facesheet as well as polystyrene foam core and safeguards the system. In addition to the granular crystal sensors, the accelerometers are used in the horizontal spanning and vertical spanning with a definite offset distance. To estimate the health and damage of the CSIP panel using granular crystal sensor, shock wave loading experiments are conducted. During the experiments, the time of flight response from the granular sensors is measured. The main objective of conducting shock wave loading experiments on the CSIP panels is to study the effect and the sustaining capacity of the CSIP panels in the extreme hazardous situations like tornados and hurricanes which are very common in western countries. The effects have been replicated using a shock tube, an instrument that can be used to create the same wind and pressure intensity of tornado for the experimental study. Numerous experiments have been conducted to investigate the flexural strength of the CSIP. Furthermore, the study includes the damage detection using three smart sensors embedded in the CSIPs during the shock wave loading.

Keywords: composite structural insulated panels, damage detection, flexural strength, sandwich structures, shock wave loading

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Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

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Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

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Authors: Abrha Ybeyn Gebremedhn, Yitea Seneshaw Getahun, Alebachew Shumye Moges, Fikrey Tesfay

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Rainfed agriculture in Ethiopia has failed to produce enough food, to achieve the increasing demand for food. Pinpointing the appropriate site for rainwater harvesting (RWH) have a substantial contribution to increasing the available water and enhancing agricultural productivity. The current study related to the identification of the potential RWH sites was conducted at the Chacha watershed central highlands of Ethiopia which is endowed with rugged topography. The Geographic Information System with Analytical Hierarchy Process was used to generate the different maps for identifying appropriate sites for RWH. In this study, 11 factors that determine the RWH locations including slope, soil texture, runoff depth, land cover type, annual average rainfall, drainage density, lineament intensity, hydrologic soil group, antecedent moisture content, and distance to the roads were considered. The overall analyzed result shows that 10.50%, 71.10%, 17.90%, and 0.50% of the areas were found under highly, moderately, marginally suitable, and unsuitable areas for RWH, respectively. The RWH site selection was found highly dependent on a slope, soil texture, and runoff depth; moderately dependent on drainage density, annual average rainfall, and land use land cover; but less dependent on the other factors. The highly suitable areas for rainwater harvesting expansion are lands having a flat topography with a soil textural class of high-water holding capacity that can produce high runoff depth. The application of this study could be a baseline for planners and decision-makers and support any strategy adoption for appropriate RWH site selection.

Keywords: runoff depth, antecedent moisture condition, AHP, weighted overlay, water resource

Procedia PDF Downloads 47

Authors: Simone Tedeschi, Francesco Crespi, Paolo Liberati, Massimo Paradiso, Antonio Sciala

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This paper aims at contributing to the understanding of smokers’ responses to cigarette prices increases with a focus on heterogeneity, both across individuals and price levels. To do this, a stated preference quasi-experimental design grounded in a random utility framework is proposed to evaluate the effect on smokers’ utility of the price level and variation, along with social conditioning and health impact perception. The analysis is based on individual-level data drawn from a unique survey gathering very detailed information on Italian smokers’ habits. In particular, qualitative information on the individual reactions triggered by changes in prices of different magnitude and composition are exploited. The main findings stemming from the analysis are the following; the average price elasticity of cigarette consumption is comparable with previous estimates for advanced economies (-.32). However, the decomposition of this result across five latent-classes of smokers, reveals extreme heterogeneity in terms of price responsiveness, implying a potential price elasticity that ranges between 0.05 to almost 1. Such heterogeneity is in part explained by observable characteristics such as age, income, gender, education as well as (current and lagged) smoking intensity. Moreover, price responsiveness is far from being independent from the size of the prospected price increase. Finally, by comparing even and uneven price variations, it is shown that uniform across-brand price increases are able to limit the scope of product substitutions and downgrade. Estimated price-response heterogeneity has significant implications for tax policy. Among them, first, it provides evidence and a rationale for why the aggregate price elasticity is likely to follow a strictly increasing pattern as a function of the experienced price variation. This information is crucial for forecasting the effect of a given tax-driven price change on tax revenue. Second, it provides some guidance on how to design excise tax reforms to balance public health and revenue goals.

Keywords: smoking behaviour, preference heterogeneity, price responsiveness, cigarette taxation, random utility models

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Authors: Ebru Cubukcu, Gozde Eksioglu Cetintahra, Burcin Hepguzel Hatip, Mert Cubukcu

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Obesity and overweight cause serious health problems. Public and private organizations aim to encourage walking in various ways in order to cope with the problem of obesity and overweight. This study aims to understand how the spatial characteristics of urban street pattern, connectivity and complexity influence young people’s choice to walk or not. 185 public university students in Izmir, the third largest city in Turkey, participated in the study. Each participant had worn an accelerometer and a global positioning (GPS) device for a week. The accelerometer device records data on the intensity of the participant’s activity at a specified time interval, and the GPS device on the activities’ locations. Combining the two datasets, activity maps are derived. These maps are then used to differentiate the participants’ walk trips and motor vehicle trips. Given that, the frequency of walk and motor vehicle trips are calculated at the street segment level, and the street segments are then categorized into two as ‘preferred by pedestrians’ and ‘preferred by motor vehicles’. Graph Theory-based accessibility indices are calculated to quantify the spatial characteristics of the streets in the sample. Six different indices are used: (I) edge density, (II) edge sinuosity, (III) eta index, (IV) node density, (V) order of a node, and (VI) beta index. T-tests show that the index values for the ‘preferred by pedestrians’ and ‘preferred by motor vehicles’ are significantly different. The findings indicate that the spatial characteristics of the street network have a measurable effect on young people’s choice to walk or not. Policy implications are discussed. This study is funded by the Scientific and Technological Research Council of Turkey, Project No: 116K358.

Keywords: graph theory, walkability, accessibility, street network

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Authors: Pavana Basavakumar, Devadas Bhat

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Diabetes is a disease which often goes undiagnosed until its secondary effects are noticed. Early detection of the disease is necessary to avoid serious consequences which could lead to the death of the patient. Conventional invasive tests for screening of diabetes are mostly painful, time consuming and expensive. There’s also a risk of infection involved, therefore it is very essential to develop non-invasive methods to screen and estimate the level of blood glucose. Extensive research is going on with this perspective, involving various techniques that explore optical, electrical, chemical and thermal properties of the human body that directly or indirectly depend on the blood glucose concentration. Thus, non-invasive blood glucose monitoring has grown into a vast field of research. In this project, an attempt was made to device a prototype for screening of diabetes by measuring electrical impedance of the skin and building a model to predict a patient’s condition based on the measured impedance. The prototype developed, passes a negligible amount of constant current (0.5mA) across a subject’s index finger through tetra polar silver electrodes and measures output voltage across a wide range of frequencies (10 KHz – 4 MHz). The measured voltage is proportional to the impedance of the skin. The impedance was acquired in real-time for further analysis. Study was conducted on over 75 subjects with permission from the institutional ethics committee, along with impedance, subject’s blood glucose values were also noted, using conventional method. Nonlinear regression analysis was performed on the features extracted from the impedance data to obtain a model that predicts blood glucose values for a given set of features. When the predicted data was depicted on Clarke’s Error Grid, only 58% of the values predicted were clinically acceptable. Since the objective of the project was to screen diabetes and not actual estimation of blood glucose, the data was classified into three classes ‘NORMAL FASTING’,’NORMAL POSTPRANDIAL’ and ‘HIGH’ using linear Support Vector Machine (SVM). Classification accuracy obtained was 91.4%. The developed prototype was economical, fast and pain free. Thus, it can be used for mass screening of diabetes.

Keywords: Clarke’s error grid, electrical impedance of skin, linear SVM, nonlinear regression, non-invasive blood glucose monitoring, screening device for diabetes

Procedia PDF Downloads 321

Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei

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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.

Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences

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Authors: Liyun Chang, Cheng-Hsiang Tsai

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To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

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Authors: Shyamli Singh, Ishupinder Kaur, Vinod K. Sharma

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Climate Change refers to the change in climate for extended period of time. Climate is changing from the past history of earth but anthropogenic activities accelerate this rate of change and which is now being a global issue. Increase in greenhouse gas emissions is causing global warming and climate change related issues at an alarming rate. Increasing temperature results in climate variability across the globe. Changes in rainfall patterns, intensity and extreme events are some of the impacts of climate change. Rainfall variability refers to the degree to which rainfall patterns varies over a region (spatial) or through time period (temporal). Temporal rainfall variability can be directly or indirectly linked to climate change. Such variability in rainfall increases the vulnerability of communities towards climate change. Increasing urbanization and unplanned developmental activities, the air quality is deteriorating. This paper mainly focuses on the rainfall variability due to increasing level of greenhouse gases. Rainfall data of 65 years (1951-2015) of Safdarjung station of Delhi was collected from Indian Meteorological Department and analyzed using Mann-Kendall test for time-series data analysis. Mann-Kendall test is a statistical tool helps in analysis of trend in the given data sets. The slope of the trend can be measured through Sen’s slope estimator. Data was analyzed monthly, seasonally and yearly across the period of 65 years. The monthly rainfall data for the said period do not follow any increasing or decreasing trend. Monsoon season shows no increasing trend but here was an increasing trend in the pre-monsoon season. Hence, the actual rainfall differs from the normal trend of the rainfall. Through this analysis, it can be projected that there will be an increase in pre-monsoon rainfall than the actual monsoon season. Pre-monsoon rainfall causes cooling effect and results in drier monsoon season. This will increase the vulnerability of communities towards climate change and also effect related developmental activities.

Keywords: greenhouse gases, Mann-Kendall test, rainfall variability, Sen's slope

Procedia PDF Downloads 200