Search results for: generalized Riemann– Liouville and Erdélyi–Kober fractional integral operators

Authors: Dmitry Yu. Korulkin, Raissa A. Muzychkina

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Bioactive substances of plant origin can be one of the advanced means of solution to the issue of combined therapy to inflammation. The main advantages of medical plants are softness and width of their therapeutic effect on an organism, the absence of side effects and complications even if the used continuously, high tolerability by patients. Moreover, medial plants are often the only and (or) cost-effective sources of natural biologically active substances and medicines. Along with other biologically active groups of chemical compounds, essential oils with wide range of pharmacological effects became very ingrained in medical practice. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Polygonum L. plants using Clevenger apparatus. Qualitative composition of essential oils was analyzed by chromatography-mass-spectrometry method using Agilent 6890N apparatus. The qualitative analysis is based on the comparison of retention time and full mass-spectra with respective data on components of reference oils and pure compounds, if there were any, and with the data of libraries of mass-spectra Wiley 7th edition and NIST 02. The main components of essential oil are for: Polygonum amphibium L. - γ-terpinene, borneol, piperitol, 1,8-cyneole, α-pinene, linalool, terpinolene and sabinene; Polygonum minus Huds. Fl. Angl. – linalool, terpinolene, camphene, borneol, 1,8-cyneole, α-pinene, 4-terpineol and 1-octen-3-ol; Polygonum alpinum All. – camphene, sabinene, 1-octen-3-ol, 4-carene, p- and o-cymol, γ-terpinene, borneol, -terpineol; Polygonum persicaria L. - α-pinene, sabinene, -terpinene, 4-carene, 1,8-cyneole, borneol, 4-terpineol. Antibacterial activity was researched relating to strains of gram-positive bacteria Staphylococcus aureus, Bacillus subtilis, Streptococcus agalacticae, relating to gram-negative strain Escherichia coli and to yeast fungus Сandida albicans using agar diffusion method. The medicines of comparison were gentamicin for bacteria and nystatin for yeast fungus Сandida albicans. It has been shown that Polygonum L. essential oils has moderate antibacterial effect to gram-positive microorganisms and weak antifungal activity to Candida albicans yeast fungus. At the second stage of our researches wound healing properties of ointment form of 3% essential oil was researched on the model of flat dermal wounds. To assess the influence of essential oil on healing processes the model of flat dermal wound. The speed of wound healing on rats of different groups was judged based on assessment the area of a wound from time to time. During research of wound healing properties disturbance of integral in neither group: general condition and behavior of animals, food intake, and excretion. Wound healing action of 3% ointment on base of Polygonum L. essential oil and polyethyleneglycol is comparable with the action of reference substances. As more favorable healing dynamics was observed in the experimental group than in control group, the tested ointment can be deemed more promising for further detailed study as wound healing means.

Keywords: antibacterial, antifungal, bioactive substances, essential oils, isolation, Polygonum L.

Procedia PDF Downloads 513

Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

Procedia PDF Downloads 166

Authors: Sylvie Michel, François Cocula

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Digital agriculture is an approach that exploits information and communication technologies. These encompass data acquisition tools like mobile applications, satellites, sensors, connected devices, and smartphones. Additionally, it involves transfer and storage technologies such as 3G/4G coverage, low-bandwidth terrestrial or satellite networks, and cloud-based systems. Furthermore, embedded or remote processing technologies, including drones and robots for process automation, along with high-speed communication networks accessible through supercomputers, are integral components of this approach. While farm-level adoption studies regarding digital agricultural technologies have emerged in recent years, they remain relatively limited in comparison to other agricultural practices. To bridge this gap, this study delves into understanding farmers' intention to adopt digital tools, employing the technology, organization, environment framework. A qualitative research design encompassed semi-structured interviews, totaling fifteen in number, conducted with key stakeholders both prior to and following the 2020-2021 COVID-19 lockdowns in France. Subsequently, the interview transcripts underwent thorough thematic content analysis, and the data and verbatim were triangulated for validation. A coding process aimed to systematically organize the data, ensuring an orderly and structured classification. Our research extends its contribution by delineating sub-dimensions within each primary dimension. A total of nine sub-dimensions were identified, categorized as follows: perceived usefulness for communication, perceived usefulness for productivity, and perceived ease of use constitute the first dimension; technological resources, financial resources, and human capabilities constitute the second dimension, while market pressure, institutional pressure, and the COVID-19 situation constitute the third dimension. Furthermore, this analysis enriches the TOE framework by incorporating entrepreneurial orientation as a moderating variable. Managerial orientation emerges as a pivotal factor influencing adoption intention, with producers acknowledging the significance of utilizing digital sales support tools to combat "greenwashing" and elevate their overall brand image. Specifically, it illustrates that producers recognize the potential of digital tools in time-saving and streamlining sales processes, leading to heightened productivity. Moreover, it highlights that the intent to adopt digital sales support tools is influenced by a market mimicry effect. Additionally, it demonstrates a negative association between the intent to adopt these tools and the pressure exerted by institutional partners. Finally, this research establishes a positive link between the intent to adopt digital sales support tools and economic fluctuations, notably during the COVID-19 pandemic. The adoption of sales support tools in agriculture is a multifaceted challenge encompassing three dimensions and nine sub-dimensions. The research delves into the adoption of digital farming technologies at the farm level through the TOE framework. This analysis provides significant insights beneficial for policymakers, stakeholders, and farmers. These insights are instrumental in making informed decisions to facilitate a successful digital transition in agriculture, effectively addressing sector-specific challenges.

Keywords: adoption, digital agriculture, e-commerce, TOE framework

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Authors: Jose L. Diego, Antonio Berlanga, Gregorio López, Diana López

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The Rayuela method is a success story, as it is part of a project selected by the European Commission to face the challenge launched by itself for achieving a better understanding of human factors, as well as social and organisational aspects that are able to solve issues in fighting against crime. Rayuela's method specifically focuses on the drivers of cyber criminality, including approaches to prevent, investigate, and mitigate cybercriminal behavior. As the internet has become an integral part of young people’s lives, they are the key target of the Rayuela method because they (as a victim or as a perpetrator) are the most vulnerable link of the chain. Considering the increased time spent online and the control of their internet usage and the low level of awareness of cyber threats and their potential impact, it is understandable the proliferation of incidents due to human mistakes. 51% of Europeans feel not well informed about cyber threats, and 86% believe that the risk of becoming a victim of cybercrime is rapidly increasing. On the other hand, Law enforcement has noted that more and more young people are increasingly committing cybercrimes. This is an international problem that has considerable cost implications; it is estimated that crimes in cyberspace will cost the global economy $445B annually. Understanding all these phenomena drives to the necessity of a shift in focus from sanctions to deterrence and prevention. As a research project, Rayuela aims to bring together law enforcement agencies (LEAs), sociologists, psychologists, anthropologists, legal experts, computer scientists, and engineers, to develop novel methodologies that allow better understanding the factors affecting online behavior related to new ways of cyber criminality, as well as promoting the potential of these young talents for cybersecurity and technologies. Rayuela’s main goal is to better understand the drivers and human factors affecting certain relevant ways of cyber criminality, as well as empower and educate young people in the benefits, risks, and threats intrinsically linked to the use of the Internet by playing, thus preventing and mitigating cybercriminal behavior. In order to reach that goal it´s necessary an interdisciplinary consortium (formed by 17 international partners) carries out researches and actions like Profiling and case studies of cybercriminals and victims, risk assessments, studies on Internet of Things and its vulnerabilities, development of a serious gaming environment, training activities, data analysis and interpretation using Artificial intelligence, testing and piloting, etc. For facilitating the real implementation of the Rayuela method, as a community policing strategy, is crucial to count on a Police Force with a solid background in trust-building and community policing in order to do the piloting, specifically with young people. In this sense, Valencia Local Police is a pioneer Police Force working with young people in conflict solving, through providing police mediation and peer mediation services and advice. As an example, it is an official mediation institution, so agreements signed by their police mediators have once signed by the parties, the value of a judicial decision.

Keywords: fight against crime and insecurity, avert and prepare young people against aggression, ICT, serious gaming and artificial intelligence against cybercrime, conflict solving and mediation with young people

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Authors: Teodora Vukovic, Christoph Hottiger, Noah Bubenhofer

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The development of VIAN-DH aims at bridging two linguistic approaches: conversation analysis/interactional linguistics (IL), so far a dominantly qualitative field, and computational/corpus linguistics and its quantitative and automated methods. Contemporary IL investigates the systematic organization of conversations and interactions composed of speech, gaze, gestures, and body positioning, among others. These highly integrated multimodal behaviour is analysed based on video data aimed at uncovering so called “multimodal gestalts”, patterns of linguistic and embodied conduct that reoccur in specific sequential positions employed for specific purposes. Multimodal analyses (and other disciplines using videos) are so far dependent on time and resource intensive processes of manual transcription of each component from video materials. Automating these tasks requires advanced programming skills, which is often not in the scope of IL. Moreover, the use of different tools makes the integration and analysis of different formats challenging. Consequently, IL research often deals with relatively small samples of annotated data which are suitable for qualitative analysis but not enough for making generalized empirical claims derived quantitatively. VIAN-DH aims to create a workspace where many annotation layers required for the multimodal analysis of videos can be created, processed, and correlated in one platform. VIAN-DH will provide a graphical interface that operates state-of-the-art tools for automating parts of the data processing. The integration of tools that already exist in computational linguistics and computer vision, facilitates data processing for researchers lacking programming skills, speeds up the overall research process, and enables the processing of large amounts of data. The main features to be introduced are automatic speech recognition for the transcription of language, automatic image recognition for extraction of gestures and other visual cues, as well as grammatical annotation for adding morphological and syntactic information to the verbal content. In the ongoing instance of VIAN-DH, we focus on gesture extraction (pointing gestures, in particular), making use of existing models created for sign language and adapting them for this specific purpose. In order to view and search the data, VIAN-DH will provide a unified format and enable the import of the main existing formats of annotated video data and the export to other formats used in the field, while integrating different data source formats in a way that they can be combined in research. VIAN-DH will adapt querying methods from corpus linguistics to enable parallel search of many annotation levels, combining token-level and chronological search for various types of data. VIAN-DH strives to bring crucial and potentially revolutionary innovation to the field of IL, (that can also extend to other fields using video materials). It will allow the processing of large amounts of data automatically and, the implementation of quantitative analyses, combining it with the qualitative approach. It will facilitate the investigation of correlations between linguistic patterns (lexical or grammatical) with conversational aspects (turn-taking or gestures). Users will be able to automatically transcribe and annotate visual, spoken and grammatical information from videos, and to correlate those different levels and perform queries and analyses.

Keywords: multimodal analysis, corpus linguistics, computational linguistics, image recognition, speech recognition

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Authors: Sebastian Kehne, Alexander Epple, Werner Herfs

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A new method for optimal selection of components for multi-axes forward-feed drive systems is proposed in which the choice of motors, gear boxes and ball screw drives is optimized. Essential is here the synchronization of electrical and mechanical frequency behavior of all axes because even advanced controls (like H∞-controls) can only control a small part of the mechanical modes – namely only those of observable and controllable states whose value can be derived from the positions of extern linear length measurement systems and/or rotary encoders on the motor or gear box shafts. Further problems are the unknown processing forces like cutting forces in machine tools during normal operation which make the estimation and control via an observer even more difficult. To start with, the open source Modelica Feed Drive Library which was developed at the Laboratory for Machine Tools, and Production Engineering (WZL) is extended from one axis design to the multi axes design. It is capable to simulate the mechanical, electrical and thermal behavior of permanent magnet synchronous machines with inverters, different gear boxes and ball screw drives in a mechanical system. To keep the calculation time down analytical equations are used for field and torque producing equivalent circuit, heat dissipation and mechanical torque at the shaft. As a first step, a small machine tool with a working area of 635 x 315 x 420 mm is taken apart, and the mechanical transfer behavior is measured with an impulse hammer and acceleration sensors. With the frequency transfer functions, a mechanical finite element model is built up which is reduced with substructure coupling to a mass-damper system which models the most important modes of the axes. The model is modelled with Modelica Feed Drive Library and validated by further relative measurements between machine table and spindle holder with a piezo actor and acceleration sensors. In a next step, the choice of possible components in motor catalogues is limited by derived analytical formulas which are based on well-known metrics to gain effective power and torque of the components. The simulation in Modelica is run with different permanent magnet synchronous motors, gear boxes and ball screw drives from different suppliers. To speed up the optimization different black-box optimization methods (Surrogate-based, gradient-based and evolutionary) are tested on the case. The objective that was chosen is to minimize the integral of the deviations if a step is given on the position controls of the different axes. Small values are good measures for a high dynamic axes. In each iteration (evaluation of one set of components) the control variables are adjusted automatically to have an overshoot less than 1%. It is obtained that the order of the components in optimization problem has a deep impact on the speed of the black-box optimization. An approach to do efficient black-box optimization for multi-axes design is presented in the last part. The authors would like to thank the German Research Foundation DFG for financial support of the project “Optimierung des mechatronischen Entwurfs von mehrachsigen Antriebssystemen (HE 5386/14-1 | 6954/4-1)” (English: Optimization of the Mechatronic Design of Multi-Axes Drive Systems).

Keywords: ball screw drive design, discrete optimization, forward feed drives, gear box design, linear drives, machine tools, motor design, multi-axes design

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Authors: Andreas Rudisch, Ralf Lampert, Andreas Kolbitsch

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It is a well-known fact among the engineering community that earthquakes with comparatively low magnitudes can cause serious damage to nonstructural components (NSCs) of buildings, even when the supporting structure performs relatively well. Past research works focused mainly on NSCs of nuclear power plants and industrial plants. Particular attention should also be given to architectural façade elements of old masonry buildings (e.g. ornamental figures, balustrades, vases), which are very vulnerable under seismic excitation. Large numbers of these historical nonstructural components (HiNSCs) can be found in highly frequented historical city centers and in the event of failure, they pose a significant danger to persons. In order to estimate the vulnerability of acceleration sensitive HiNSCs, the peak horizontal floor acceleration (PHFA) is used. The PHFA depends on the dynamic characteristics of the building, the ground excitation, and induced nonlinearities. Consequently, the PHFA can not be generalized as a simple function of height. In the present research work, an extensive case study was conducted to investigate the influence of induced nonlinearity on the PHFA for old masonry buildings. Probabilistic nonlinear FE time-history analyses considering three different hazard levels were performed. A set of eighteen synthetically generated ground motions was used as input to the structure models. An elastoplastic macro-model (multiPlas) for nonlinear homogenized continuum FE-calculation was calibrated to multiple scales and applied, taking specific failure mechanisms of masonry into account. The macro-model was calibrated according to the results of specific laboratory and cyclic in situ shear tests. The nonlinear macro-model is based on the concept of multi-surface rate-independent plasticity. Material damage or crack formation are detected by reducing the initial strength after failure due to shear or tensile stress. As a result, shear forces can only be transmitted to a limited extent by friction when the cracking begins. The tensile strength is reduced to zero. The first goal of the calibration was the consistency of the load-displacement curves between experiment and simulation. The calibrated macro-model matches well with regard to the initial stiffness and the maximum horizontal load. Another goal was the correct reproduction of the observed crack image and the plastic strain activities. Again the macro-model proved to work well in this case and shows very good correlation. The results of the case study show that there is significant scatter in the absolute distribution of the PHFA between the applied ground excitations. An absolute distribution along the normalized building height was determined in the framework of probability theory. It can be observed that the extent of nonlinear behavior varies for the three hazard levels. Due to the detailed scope of the present research work, a robust comparison with code-recommendations and simplified PHFA distributions are possible. The chosen methodology offers a chance to determine the distribution of PHFA along the building height of old masonry structures. This permits a proper hazard assessment of HiNSCs under seismic loads.

Keywords: nonlinear macro-model, nonstructural components, time-history analysis, unreinforced masonry

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Authors: Martina Maria Keitsch, Sangeeta Singh

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There has been a growing recognition that sustainable development needs to consider economic, social and environmental aspects including gender. In Nepal, the majority of the population lives in rural areas, and many households do not have access to electricity. In rural areas, the difficulty of accessing energy is becoming one of the greatest constraints for improving living conditions. This is particularly true for women and children, who spent much time for collecting firewood and cooking and thus are often deprived of time for education, political- and business activities. The poster introduces an education and research project financed by the Norwegian Government. The project runs from 2015-2020 and is a collaboration between the Norwegian University of Science (NTNU) and Technology Institute of Engineering (IOE), Tribhuvan University. It has the title Master program and Research in Energy for Sustainable Social Development Energy for Sustainable Social Development (MSESSD). The project addresses engineering and architecture students and comprises several integral activities towards gender mainstreaming. The following activities are conducted; 1. Creating academic opportunities, 2. Updating administrative personnel on strategies to effectively include gender issues, 3. Integrating female and male stakeholders in the design process, 4. Sensitizing female and male students for gender issues in energy systems. The project aims to enable students to design end-user-friendly solutions which can, for example, save time that can be used to generate and enhance income. Relating to gender mainstreaming, design concepts focus on smaller-scale technologies, which female stakeholders can take control of and manage themselves. Creating academic opportunities, we have a 30% female students’ rate in each master student batch in the program with the goal to educate qualified female personnel for academia and policy-making/government. This is a very ambitious target in a Nepalese context. The rate of female students, who completed the MSc program at IOE between 1998 and January 2015 is 10% out of 180 students in total. For recruiting, female students were contacted personally and encouraged to apply for the program. Further, we have established a Master course in gender mainstreaming and energy. On an administrative level, NTNU has hosted a training program for IOE on gender-mainstreaming information and -strategies for academic education. Integrating female and male stakeholders, local women groups such as, e.g., mothers group are actively included in research and education for example in planning, decision-making, and management to establish clean energy solutions. The project meets women’s needs not just practically by providing better technology, but also strategically by providing solutions that enhance their social and economic decision-making authority. Sensitizing the students for gender issues in energy systems, the project makes it mandatory to discuss gender mainstreaming based on the case studies in the Master thesis. All activities will be discussed in detail comprising an overview of MSESSD, the gender mainstreaming master course contents’, and case studies where energy solutions were co-designed with men and women as lead-users and/or entrepreneurs. The goal is to motivate educators to develop similar forms of transnational gender collaboration.

Keywords: knowledge generation on gender mainstreaming, sensitizing students, stakeholder inclusion, education strategies for design and architecture in gender mainstreaming, facilitation for cooperation

Procedia PDF Downloads 101

Authors: P. Ramesh, Aby Joseph, Arya G. Lal, U. S. Aji

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Integration of distributed green renewable energy sources in addition with battery energy storage is an inevitable requirement in a smart grid environment. To achieve this, an Intelligent Green Energy Management System (i-GEMS) needs to be incorporated to ensure coordinated operation between supply and load demand based on the hierarchy of Renewable Energy Sources (RES), battery energy storage and distribution grid. A bi-directional energy harvester is an integral component facilitating Intelligent Green Energy Management System (i-GEMS) and it is required to meet the technical challenges mentioned as follows: (1) capability for bi-directional mode of operation (buck/boost) (2) reduction of circuit parasitic to suppress voltage spikes (3) converter startup problem (4) high frequency magnetics (5) higher power density (6) mode transition issues during battery charging and discharging. This paper is focused to address the above mentioned issues and targeted to design, develop and implement a bi-directional energy harvester with galvanic isolation. In this work, the hardware architecture for bi-directional energy harvester rated 3.5 kW is developed with Isolated Full Bridge Boost Converter (IFBBC) as well as Dual Active Bridge (DAB) Converter configuration using modular power electronics hardware which is identical for both solar PV array and battery energy storage. In IFBBC converter, the current fed full bridge circuit is enabled and voltage fed full bridge circuit is disabled through Pulse Width Modulation (PWM) pulses for boost mode of operation and vice-versa for buck mode of operation. In DAB converter, all the switches are in active state so as to adjust the phase shift angle between primary full bridge and secondary full bridge which in turn decides the power flow directions depending on modes (boost/buck) of operation. Here, the control algorithm is developed to ensure the regulation of the common DC link voltage and maximum power extraction from the renewable energy sources depending on the selected mode (buck/boost) of operation. The circuit analysis and simulation study are conducted using PSIM 9.0 in three scenarios which are - 1.IFBBC with passive clamp, 2. IFBBC with active clamp, 3. DAB converter. In this work, a common hardware prototype for bi-directional energy harvester with 3.5 kW rating is built for IFBBC and DAB converter configurations. The power circuit is equipped with right choice of MOSFETs, gate drivers with galvanic isolation, high frequency transformer, filter capacitors, and filter boost inductor. The experiment was conducted for IFBBC converter with passive clamp under boost mode and the prototype confirmed the simulation results showing the measured efficiency as 88% at 2.5 kW output power. The digital controller hardware platform is developed using floating point microcontroller TMS320F2806x from Texas Instruments. The firmware governing the operation of the bi-directional energy harvester is written in C language and developed using code composer studio. The comprehensive analyses of the power circuit design, control strategy for battery charging/discharging under buck/boost modes and comparative performance evaluation using simulation and experimental results will be presented.

Keywords: bi-directional energy harvester, dual active bridge, isolated full bridge boost converter, intelligent green energy management system, maximum power point tracking, renewable energy sources

Procedia PDF Downloads 107

Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

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Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

Procedia PDF Downloads 92

Authors: Marcela Davalos Lopez

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The history of the circulation of hygienic knowledge and the consolidation of public health in Latin American cities towards the end of the 19th century is well known. Among them, Mexico City was inserted in international politics, strengthened institutions, medical knowledge, applied parameters of modernity and built sanitary engineering works. Despite the power that this hygienist system achieved, its scope was relative: it cannot be generalized to all cities. From a comparative and contextual analysis, it will be shown that conclusions derived from modern urban historiography present, from our contemporary observations, fractures. Between 1890 and 1930, the small cities and areas surrounding the Mexican capital adapted in their own way the international and federal public health regulations. This will be shown for neighborhoods located around Mexico City and in a medium city, close to the Mexican capital (about 80 km), called Cuernavaca. While the inhabitants of the neighborhoods kept awaiting the evolutionary process and the forms that public hygiene policies were taking (because they were witnesses and affected in their territories), in Cuernavaca, the dictates came as an echo. While the capital was drained, large roads were opened, roundabouts were erected, residents were expelled, and drains, sewers, drinking water pipes, etc., were built; Cuernavaca was sheltered in other times and practices. What was this due to? Undoubtedly, the time and energy that it took politicians and the group of "scientists" to carry out these enormous works in the Mexican capital took them away from addressing the issue in remote villages. It was not until the 20th century that the federal hygiene policy began to be strengthened. Despite this, there are other factors that emphasize the particularities of each site. I would like to draw attention here to the different receptions that each town prepared on public hygiene. We will see that Cuernavaca responded to its own semi-rural culture, history, orography and functions, prolonging for much longer, for example, the use of its deep ravines as sewers. For their part, the neighborhoods surrounding the capital, although affected and excluded from hygienist policies, chose to move away from them and solve the deficiencies with their own resources (they resorted to the waste that was left from the dried lake of Mexico to continue their lake practices). All of this points to a paradox that shapes our contemporary concerns: on the one hand, the benefits derived from medical knowledge and its technological applications (in this work referring particularly to the urban health system) and, on the other, the alteration it caused in environmental settings. Places like Cuernavaca (classified by the nineteenth-century and hygienists of the first decades of the twentieth century as backward), as well as landscapes such as neighborhoods, affected by advances in sanitary engineering, keep in their memory buried practices that we observe today as possible ways to reestablish environmental balances: alternative uses of water; recycling of organic materials; local uses of fauna; various systems for breaking down excreta, and so on. In sum, what the nineteenth and first half of the twentieth centuries graduated as levels of backwardness or progress, turn out to be key information to rethink the routes of environmental conservation. When we return to the observations of the scientists, politicians and lawyers of that period, we find historically rejected cultural alterity. Populations such as Cuernavaca that, due to their history, orography and/or insufficiency of federal policies, kept different relationships with the environment, today give us clues to reorient basic elements of cities: alternative uses of water, waste of raw materials, organic or consumption of local products, among others. It is, therefore, a matter of unearthing the rejected that cries out to emerge to the surface.

Keywords: sanitary hygiene, Mexico city, cultural alterity, environmental conservation, environmental history

Procedia PDF Downloads 145

Authors: Lolwa Alansari, Hanen Mrabet, Kholoud Khaled, Abdelhamid Azhaghdani, Sufia Athar, Aska Kaima, Zaineb Mhamdia, Zubaria Altaf, Almunzer Zakaria, Tamara Alshadafat

Abstract:

Introduction: The Obstetrics and Gynecology Emergency Department at Alwakra Hospital has faced significant challenges, which have been further worsened by the impact of the COVID-19 pandemic. These challenges involve issues such as overcrowding, extended wait times, and a notable surge in demand for emergency care services. Moreover, prolonged waiting times have emerged as a primary factor contributing to situations where patients leave without receiving attention, known as left without being seen (LWBS), and unexpectedly abscond. Addressing the issue of insufficient patient mobility in the obstetrics and gynecology emergency department has brought about substantial improvements in patient care, healthcare administration, and overall departmental efficiency. These changes have not only alleviated overcrowding but have also elevated the quality of emergency care, resulting in higher patient satisfaction, better outcomes, and operational rewards. Methodology: The COVID-19 pandemic has served as a catalyst for substantial transformations in the obstetrics and gynecology emergency, aligning seamlessly with the strategic direction of Hamad Medical Corporation (HMC). The fundamental aim of this initiative is to revolutionize the operational efficiency of the OB-GYN ED. To accomplish this mission, a range of transformations has been initiated, focusing on essential areas such as digitizing systems, optimizing resource allocation, enhancing budget efficiency, and reducing overall costs. The project utilized the Plan-Do-Study-Act (PDSA) model, involving a diverse team collecting baseline data and introducing throughput improvements. Post-implementation data and feedback were analysed, leading to the integration of effective interventions into standard procedures. These interventions included optimized space utilization, real-time communication, bedside registration, technology integration, pre-triage screening, enhanced communication and patient education, consultant presence, and a culture of continuous improvement. These strategies significantly reduced waiting times, enhancing both patient care and operational efficiency. Results: Results demonstrated a substantial reduction in overall average waiting time, dropping from 35 to approximately 14 minutes by August 2023. The wait times for priority 1 cases have been reduced from 22 to 0 minutes, and for priority 2 cases, the wait times have been reduced from 32 to approximately 13.6 minutes. The proportion of patients spending less than 8 hours in the OB ED observation beds rose from 74% in January 2022 to over 98% in 2023. Notably, there was a remarkable decrease in LWBS and absconded patient rates from 2020 to 2023. Conclusion: The project initiated a profound change in the department's operational environment. Efficiency became deeply embedded in the unit's culture, promoting teamwork among staff that went beyond the project's original focus and had a positive influence on operations in other departments. This effectiveness not only made processes more efficient but also resulted in significant cost reductions for the hospital. These cost savings were achieved by reducing wait times, which in turn led to fewer prolonged patient stays and reduced the need for additional treatments. These continuous improvement initiatives have now become an integral part of the Obstetrics and Gynecology Division's standard operating procedures, ensuring that the positive changes brought about by the project persist and evolve over time.

Keywords: overcrowding, waiting time, person centered care, quality initiatives

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Authors: David J. Foran, Nhan Do, Samuel Ajjarapu, Wenjin Chen, Tahsin Kurc, Joel H. Saltz

Abstract:

The large-scale data and computational requirements of investigators throughout the clinical and research communities demand an informatics infrastructure that supports both existing and new investigative and translational projects in a robust, secure environment. In some subspecialties of medicine and research, the capacity to generate data has outpaced the methods and technology used to aggregate, organize, access, and reliably retrieve this information. Leading health care centers now recognize the utility of establishing an enterprise-wide, clinical data warehouse. The primary benefits that can be realized through such efforts include cost savings, efficient tracking of outcomes, advanced clinical decision support, improved prognostic accuracy, and more reliable clinical trials matching. The overarching objective of the work presented here is the development and implementation of a flexible Intelligent Retrieval and Interrogation System (IRIS) that exploits the combined use of computational imaging, genomics, and data-mining capabilities to facilitate clinical assessments and translational research in oncology. The proposed System includes a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide insight into the underlying tumor characteristics that are not be apparent by human inspection alone. A key distinguishing feature of the System is a configurable Extract, Transform and Load (ETL) interface that enables it to adapt to different clinical and research data environments. This project is motivated by the growing emphasis on establishing Learning Health Systems in which cyclical hypothesis generation and evidence evaluation become integral to improving the quality of patient care. To facilitate iterative prototyping and optimization of the algorithms and workflows for the System, the team has already implemented a fully functional Warehouse that can reliably aggregate information originating from multiple data sources including EHR’s, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology PAC systems, Digital Pathology archives, Unstructured Clinical Documents, and Next Generation Sequencing services. The System enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information about patient tumors individually or as part of large cohorts to identify patterns that may influence treatment decisions and outcomes. The CRDW core system has facilitated peer-reviewed publications and funded projects, including an NIH-sponsored collaboration to enhance the cancer registries in Georgia, Kentucky, New Jersey, and New York, with machine-learning based classifications and quantitative pathomics, feature sets. The CRDW has also resulted in a collaboration with the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) at the U.S. Department of Veterans Affairs to develop algorithms and workflows to automate the analysis of lung adenocarcinoma. Those studies showed that combining computational nuclear signatures with traditional WHO criteria through the use of deep convolutional neural networks (CNNs) led to improved discrimination among tumor growth patterns. The team has also leveraged the Warehouse to support studies to investigate the potential of utilizing a combination of genomic and computational imaging signatures to characterize prostate cancer. The results of those studies show that integrating image biomarkers with genomic pathway scores is more strongly correlated with disease recurrence than using standard clinical markers.

Keywords: clinical data warehouse, decision support, data-mining, intelligent databases, machine-learning.

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Authors: Mina Naeini, Thomas A. Adams II

Abstract:

Solid Oxide Fuel Cells (SOFCs) feature high electrical efficiency and generate substantial amounts of waste heat that make them suitable for integrated community energy systems (ICEs). By harvesting and distributing the waste heat through hot water pipelines, SOFCs can meet thermal demand of the communities. Therefore, they can replace traditional gas boilers and reduce greenhouse gas (GHG) emissions. Despite these advantages of SOFCs over competing power generation units, this technology has not been successfully commercialized in large-scale to replace traditional generators in ICEs. One reason is that SOFC performance deteriorates over long-term operation, which makes it difficult to find the proper sizing of the cells for a particular ICE system. In order to find the optimal sizing and operating conditions of SOFCs in a community, a proper knowledge of degradation mechanisms and effects of operating conditions on SOFCs long-time performance is required. The simplified SOFC models that exist in the current literature usually do not provide realistic results since they usually underestimate rate of performance drop by making too many assumptions or generalizations. In addition, some of these models have been obtained from experimental data by curve-fitting methods. Although these models are valid for the range of operating conditions in which experiments were conducted, they cannot be generalized to other conditions and so have limited use for most ICEs. In the present study, a general, detailed degradation-based model is proposed that predicts the performance of conventional SOFCs over a long period of time at different operating conditions. Conventional SOFCs are composed of Yttria Stabilized Zirconia (YSZ) as electrolyte, Ni-cermet anodes, and LaSr₁₋ₓMnₓO₃ (LSM) cathodes. The following degradation processes are considered in this model: oxidation and coarsening of nickel particles in the Ni-cermet anodes, changes in the pore radius in anode, electrolyte, and anode electrical conductivity degradation, and sulfur poisoning of the anode compartment. This model helps decision makers discover the optimal sizing and operation of the cells for a stable, efficient performance with the fewest assumptions. It is suitable for a wide variety of applications. Sulfur contamination of the anode compartment is an important cause of performance drop in cells supplied with hydrocarbon-based fuel sources. H₂S, which is often added to hydrocarbon fuels as an odorant, can diminish catalytic behavior of Ni-based anodes by lowering their electrochemical activity and hydrocarbon conversion properties. Therefore, the existing models in the literature for H₂-supplied SOFCs cannot be applied to hydrocarbon-fueled SOFCs as they only account for the electrochemical activity reduction. A regression model is developed in the current work for sulfur contamination of the SOFCs fed with hydrocarbon fuel sources. The model is developed as a function of current density and H₂S concentration in the fuel. To the best of authors' knowledge, it is the first model that accounts for impact of current density on sulfur poisoning of cells supplied with hydrocarbon-based fuels. Proposed model has wide validity over a range of parameters and is consistent across multiple studies by different independent groups. Simulations using the degradation-based model illustrated that SOFCs voltage drops significantly in the first 1500 hours of operation. After that, cells exhibit a slower degradation rate. The present analysis allowed us to discover the reason for various degradation rate values reported in literature for conventional SOFCs. In fact, the reason why literature reports very different degradation rates, is that literature is inconsistent in definition of how degradation rate is calculated. In the literature, the degradation rate has been calculated as the slope of voltage versus time plot with the unit of voltage drop percentage per 1000 hours operation. Due to the nonlinear profile of voltage over time, degradation rate magnitude depends on the magnitude of time steps selected to calculate the curve's slope. To avoid this issue, instantaneous rate of performance drop is used in the present work. According to a sensitivity analysis, the current density has the highest impact on degradation rate compared to other operating factors, while temperature and hydrogen partial pressure affect SOFCs performance less. The findings demonstrated that a cell running at lower current density performs better in long-term in terms of total average energy delivered per year, even though initially it generates less power than if it had a higher current density. This is because of the dominant and devastating impact of large current densities on the long-term performance of SOFCs, as explained by the model.

Keywords: degradation rate, long-term performance, optimal operation, solid oxide fuel cells, SOFCs

Procedia PDF Downloads 110