Search results for: intrinsic rate
6357 Iterative Method for Lung Tumor Localization in 4D CT
Authors: Sarah K. Hagi, Majdi Alnowaimi
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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.Keywords: automated algorithm , computed tomography, lung tumor, tumor localization
Procedia PDF Downloads 6076356 The Relationship between Environmental Factors and Purchasing Decisions in the Residential Market in Sweden
Authors: Agnieszka Zalejska-Jonsson
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The Swedish Green Building Council (SGBC) was established in 2009. Since then, over 1000 buildings have been certified, of which approximately 600 are newly produced and 340 are residential buildings. During that time, approximately 2000 apartment buildings have been built in Sweden. This means that over a five- year period 17% of residential buildings have been certified according to the environmental building scheme. The certification of the building is not a guarantee of environmental progress but it gives us an indication of the extent of the progress. The overarching aim of this study is to investigate the factors behind the relatively slow evolution of the green residential housing market in Sweden. The intention is to examine stated willingness to pay (WTP) for green and low energy apartments, and to explore which factors have a significant effect on stated WTP among apartment owners. A green building was defined as a building certified according to the environmental scheme and a low energy building as a building designed and constructed with high energy efficiency goals. Data for this study were collected through a survey conducted among occupants of comparable apartment buildings: two green and one conventional. The total number of received responses was 429: green A (N=160), response rate 42%; green B (N=138) response rate 35%, and conventional (N=131) response rate 43%. The study applied a quasi-experimental method. Survey responses regarding factors affecting purchase of apartment, stated WTP and environmental literacy have been analysed using descriptive statistics, the Mann–Whitney (rank sum) test and logistic models. Comments received from respondents have been used for further interpretation of results. Results indicate that environmental education has a significant effect on stated WTP. Occupants who declared higher WTP showed a higher level of environmental literacy and indicated that energy efficiency was one of the important factors that affected their decision to buy an apartment. Generally, the respondents were more likely to pay more for low energy buildings than for green buildings. This is to a great extent a consequence of rational customer behaviour and difficulty in apprehending the meaning of green building certification. The analysis shows that people living in green buildings indicate higher WTP for both green and low energy buildings, the difference being statistically significant. It is concluded that growth in the green housing market in Sweden might be achieved if policymakers and developers engage in active education in the environmental labelling system. The demand for green buildings is more likely to increase when the difference between green and conventional buildings is easily understood and information is not only delivered by the estate agent, but is part of an environmental education programme.Keywords: consumer, environmental education, housing market, stated WTP, Sweden
Procedia PDF Downloads 2426355 Thermally Stable Nanocrystalline Aluminum Alloys Processed by Mechanical Alloying and High Frequency Induction Heat Sintering
Authors: Hany R. Ammar, Khalil A. Khalil, El-Sayed M. Sherif
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The as-received metal powders were used to synthesis bulk nanocrystalline Al; Al-10%Cu; and Al-10%Cu-5%Ti alloys using mechanical alloying and high frequency induction heat sintering (HFIHS). The current study investigated the influence of milling time and ball-to-powder (BPR) weight ratio on the microstructural constituents and mechanical properties of the processed materials. Powder consolidation was carried out using a high frequency induction heat sintering where the processed metal powders were sintered into a dense and strong bulk material. The sintering conditions applied in this process were as follow: heating rate of 350°C/min; sintering time of 4 minutes; sintering temperature of 400°C; applied pressure of 750 Kgf/cm2 (100 MPa); cooling rate of 400°C/min and the process was carried out under vacuum of 10-3 Torr. The powders and the bulk samples were characterized using XRD and FEGSEM techniques. The mechanical properties were evaluated at various temperatures of 25°C, 100°C, 200°C, 300°C and 400°C to study the thermal stability of the processed alloys. The bulk nanocrystalline Al; Al-10%Cu; and Al-10%Cu-5%Ti alloys displayed extremely high hardness values even at elevated temperatures. The Al-10%Cu-5%Ti alloy displayed the highest hardness values at room and elevated temperatures which are related to the presence of Ti-containing phases such as Al3Ti and AlCu2Ti, these phases are thermally stable and retain the high hardness values at elevated temperatures up to 400ºC.Keywords: nanocrystalline aluminum alloys, mechanical alloying, hardness, elevated temperatures
Procedia PDF Downloads 4576354 Deployment of Beyond 4G Wireless Communication Networks with Carrier Aggregation
Authors: Bahram Khan, Anderson Rocha Ramos, Rui R. Paulo, Fernando J. Velez
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With the growing demand for a new blend of applications, the users dependency on the internet is increasing day by day. Mobile internet users are giving more attention to their own experiences, especially in terms of communication reliability, high data rates and service stability on move. This increase in the demand is causing saturation of existing radio frequency bands. To address these challenges, researchers are investigating the best approaches, Carrier Aggregation (CA) is one of the newest innovations, which seems to fulfill the demands of the future spectrum, also CA is one the most important feature for Long Term Evolution - Advanced (LTE-Advanced). For this purpose to get the upcoming International Mobile Telecommunication Advanced (IMT-Advanced) mobile requirements (1 Gb/s peak data rate), the CA scheme is presented by 3GPP, which would sustain a high data rate using widespread frequency bandwidth up to 100 MHz. Technical issues such as aggregation structure, its implementations, deployment scenarios, control signal techniques, and challenges for CA technique in LTE-Advanced, with consideration of backward compatibility, are highlighted in this paper. Also, performance evaluation in macro-cellular scenarios through a simulation approach is presented, which shows the benefits of applying CA, low-complexity multi-band schedulers in service quality, system capacity enhancement and concluded that enhanced multi-band scheduler is less complex than the general multi-band scheduler, which performs better for a cell radius longer than 1800 m (and a PLR threshold of 2%).Keywords: component carrier, carrier aggregation, LTE-advanced, scheduling
Procedia PDF Downloads 2006353 Developing a Green Information Technology Model in Australian Higher-Educational Institutions
Authors: Mahnaz Jafari, Parisa Izadpanahi, Francesco Mancini, Muhammad Qureshi
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The advancement in Information Technology (IT) has been an intrinsic element in the developments of the 21st century bringing benefits such as increased economic productivity. However, its widespread application has also been associated with inadvertent negative impacts on society and the environment necessitating selective interventions to mitigate these impacts. This study responded to this need by developing a Green IT Rating Tool (GIRT) for higher education institutions (HEI) in Australia to evaluate the sustainability of IT-related practices from an environmental, social, and economic perspective. Each dimension must be considered equally to achieve sustainability. The development of the GIRT was informed by the views of interviewed IT professionals whose opinions formed the basis of a framework listing Green IT initiatives in order of their importance as perceived by the interviewed professionals. This framework formed the base of the GIRT, which identified Green IT initiatives (such as videoconferencing as a substitute for long-distance travel) and the associated weighting of each practice. The proposed sustainable Green IT model could be integrated into existing IT systems, leading to significant reductions in carbon emissions and e-waste and improvements in energy efficiency. The development of the GIRT and the findings of this study have the potential to inspire other organizations to adopt sustainable IT practices, positively impact the environment, and be used as a reference by IT professionals and decision-makers to evaluate IT-related sustainability practices. The GIRT could also serve as a benchmark for HEIs to compare their performance with other institutions and to track their progress over time. Additionally, the study's results suggest that virtual and cloud-based technologies could reduce e-waste and energy consumption in the higher education sector. Overall, this study highlights the importance of incorporating Green IT practices into the IT systems of HEI to contribute to a more sustainable future.Keywords: green information technology, international higher-educational institution, sustainable solutions, environmentally friendly IT systems
Procedia PDF Downloads 786352 Ammonia Adsorption Properties of Composite Ammonia Carriers Obtained by Supporting Metal Chloride on Porous Materials
Authors: Cheng Shen, LaiHong Shen
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Ammonia is an important carrier of hydrogen energy, with the characteristics of high hydrogen content density and no carbon dioxide emission. Ammonia synthesis by the Haber process is the main method for industrial ammonia synthesis, but the conversion rate of ammonia per pass is only about 12%, while the conversion rate of biomass synthesis ammonia is as high as 56%. Therefore, safe and efficient ammonia capture for ammonia synthesis from biomass is an important way to alleviate the energy crisis and solve the energy problem. Metal chloride has a chemical adsorption effect on ammonia, and can be desorbed at high temperature to obtain high-concentration ammonia after combining with ammonia, which has a good development prospect in ammonia capture and separation technology. In this paper, the ammonia adsorption properties of CuCl₂ were measured, and the composite adsorbents were prepared by using silicon and multi-walled carbon nanotubes respectively to support CuCl₂, and the ammonia adsorption properties of the composite adsorbents were studied. The study found that the ammonia adsorption capacity of the three adsorbents decreased with the increase in temperature, so metal chlorides were more suitable for the low-temperature adsorption of ammonia. Silicon and multi-walled carbon nanotubes have an enhanced effect on the ammonia adsorption of CuCl₂. The reason is that the porous material itself has a physical adsorption effect on ammonia, and silicon can play the role of skeleton support in cupric chloride particles, which enhances the pore structure of the adsorbent, thereby alleviating sintering.Keywords: ammonia, adsorption properties, metal chloride, silicon, MWCNTs
Procedia PDF Downloads 1156351 Screening the Growth Inhibition Mechanism of Sulfate-Reducing Bacteria by Chitosan/Lignosulfonate Nanocomposite in Seawater Media
Authors: K. Rasool
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Sulfate-reducing bacteria (SRBs) induced biofilm formation is a global industrial concern due to its role in the development of microbial-induced corrosion (MIC). Herein, we have developed a biodegradable chitosan/lignosulfonate nanocomposite (CS@LS) as an efficient green biocide for the inhibition of SRBs biofilms. We investigated in detail the inhibition mechanism of SRBs by CS@LS in seawater media. Stable CS@LS-1:1 with 150–200 nm average size and zeta potential of + 34.25 mV was synthesized. The biocidal performance of CS@LS was evaluated by sulfate reduction profiles coupled with analysis of extracted extracellular polymeric substances (EPS) and lactate dehydrogenase (LDH) release assays. As the nanocomposite concentration was increased from 50 to 500 µg/mL, the specific sulfate reduction rate (SSRR) decreased from 0.278 to 0.036 g-sulfate/g-VSS*day showing a relative sulfate reduction inhibition of 86.64% as compared to that of control. Similarly, the specific organic uptake rate (SOUR) decreased from 0.082 to 0.039 0.036 g-TOC/g-VSS*day giving a relative co-substrate oxidation inhibition of 52.19% as compared to that of control. The SRBs spiked with 500 µg/mL CS@LS showed a reduction in cell viability to 1.5 × 106 MPN/mL. To assess the biosafety of the nanocomposite on the marine biota, the 72-hours acute toxicity assays using the zebrafish embryo model revealed that the LC50 for the CS@LS was 103.3 µg/mL. Thus, CS@LS can be classified as environmentally friendly. The nanocomposite showed long-term stability and excellent antibacterial properties against SRBs growth and is thus potentially useful for combating the problems of biofilm growth in harsh marine and aquatic environments.Keywords: green biocides, chitosan/lignosulfonate nanocomposite, SRBs, toxicity
Procedia PDF Downloads 1246350 Development and Characterization of a Fluorinated-Ethylene-Propylene (FEP) Polymer Coating on Brass Faucets
Authors: S. Zouari, H. Ghorbel, H. Liao, R. Elleuch
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Research is increasingly moving towards the use of surface treatment processes to limit environmental effects. Electrolytic plating has traditionally been seen as a way to protect brass products, especially faucets, from mechanical and chemical damage. However, this method was not effective industrially, economically and ecologically. The aim of this work is to develop non-usual polymer coatings for brass faucets in order to improve the performance of brass and to replace electrolytic chromium coatings, thereby reducing environmental impact. Fluorinated-Ethylene-Propylene polymer (FEP) was chosen for its excellent mechanical and chemical properties and its good environmental performance. This coating was developed by spraying (painting) process onto brass substrates. The coatings obtained were characterized using a scanning electron microscope to evaluate the morphology of the deposits and their porosity rate. Grid adhesion, surface energy and corrosion tests (salt spray) were also performed to evaluate the mechanical and chemical behavior of these coatings properly. The results show that the deposits obtained have a homogeneous microstructure with a very low porosity rate. The results of the grid adhesion test prove the conformity of the test according to the NF077 standard. The coatings have a hydrophobic character following the low values of surface energy obtained and a very good resistance to corrosion. These results are interesting and may represent real technological issues in the industrial field.Keywords: FEP coatings, spraying process, brass, adhesion, surface energy, corrosion resistance
Procedia PDF Downloads 1456349 The Relationship between the Skill Mix Model and Patient Mortality: A Systematic Review
Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu
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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.Keywords: nurse staffing level, nursing assistants, mortality, skill mix
Procedia PDF Downloads 1206348 Sea-Level Rise and Shoreline Retreat in Tainan Coast
Authors: Wen-Juinn Chen, Yi-Phei Chou, Jou-Han Wang
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Tainan coast is suffering from beach erosion, wave overtopping, and lowland flooding; though most of the shoreline has been protected by seawalls, they still threatened by sea level rise. For coastal resources developing, coastal land utilization, and to draft an appropriate mitigate strategy. Firstly; we must assess the impact of beach erosion under a different scenario of climate change. Here, we have used the meteorological data since 1898 to 2012 to prove that the Tainan area did suffer the impact of climate change. The result shows the temperature has been raised to about 1.7 degrees since 1989. Also, we analyzed the tidal data near the Tainan coast (Anpin site and Junjunn site), it shows sea level rising with a rate about 4.1~4.8 mm/year, this phenomenon will have serious impacts on Tainan coastal area, especially it will worsen coastal erosion. So we have used Bruun rule to calculate the shoreline retreated rate at every two decade period since 2012. Wave data and bottom sand diameter D50 were used to calculate the closure depth that will be used in Bruun formula and the active length of the profile is computed by the beach slope and Dean's equilibrium concept. After analysis, we found that in 2020, the shoreline will be retreated about 3.0 to 12 meters. The maximum retreat is happening at Chigu coast. In 2060, average shoreline retreated distance is 22m, but at Chigu and Tsenwen, shoreline may be backward retreat about 70m and will be reached about 130m at 2100, this will cause a lot of coastal land loss to the sea, protect and mitigate project must be quickly performed.Keywords: sea level rise, shoreline, coastal erosion, climate change
Procedia PDF Downloads 4106347 Women Entrepreneurship as an Inventive Approach to Ensure a Sustainable Development in Anambre State
Authors: S. Muogbo Uju, Akpunonu Uju,
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The prevailing harsh environment factors couple with poverty rate and unemployment propels a high rate of entrepreneurial activities in developing countries of the world. Women entrepreneurs operate within gender bias among other constraint that can constitute a threat or create opportunity for women entrepreneurs. This empirical paper investigates and critically examines women entrepreneurship as an inventive approach to sustainable development in Anambra State. The study used descriptive statistics (frequencies, mean, and percentages) to answer the three research questions posed. Hypotheses testing were done with person product moment correlation and multiple regressions were employed in data analysis. SPSS [statistical package for Social Science] software was used to run the analysis. Three hundred and fifty three (353) copies of questionnaires were administered, and one hundred and forty six (146) copies were returned. Consequently, the findings of this study portrayed a significant impact between women entrepreneurship activities, job creation, wealth creation, youth empowerment, poverty reduction, employment generation, and increase in standard of livings of people. Therefore, the findings prescribe that government should ensure that managerial lessons are accompanied with the skill acquisition programs in order for them to understand the rudiment of owing and sustaining a business. The study also recommends that women entrepreneurs that have overcome the inertia of starting a business should come together to create platforms that can help those women who are yet to take a step or kick-start such venture.Keywords: women entrepreneurship, skill acquisition, sustainability, wealth creation
Procedia PDF Downloads 4426346 Numerical Optimization of Cooling System Parameters for Multilayer Lithium Ion Cell and Battery Packs
Authors: Mohammad Alipour, Ekin Esen, Riza Kizilel
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Lithium-ion batteries are a commonly used type of rechargeable batteries because of their high specific energy and specific power. With the growing popularity of electric vehicles and hybrid electric vehicles, increasing attentions have been paid to rechargeable Lithium-ion batteries. However, safety problems, high cost and poor performance in low ambient temperatures and high current rates, are big obstacles for commercial utilization of these batteries. By proper thermal management, most of the mentioned limitations could be eliminated. Temperature profile of the Li-ion cells has a significant role in the performance, safety, and cycle life of the battery. That is why little temperature gradient can lead to great loss in the performances of the battery packs. In recent years, numerous researchers are working on new techniques to imply a better thermal management on Li-ion batteries. Keeping the battery cells within an optimum range is the main objective of battery thermal management. Commercial Li-ion cells are composed of several electrochemical layers each consisting negative-current collector, negative electrode, separator, positive electrode, and positive current collector. However, many researchers have adopted a single-layer cell to save in computing time. Their hypothesis is that thermal conductivity of the layer elements is so high and heat transfer rate is so fast. Therefore, instead of several thin layers, they model the cell as one thick layer unit. In previous work, we showed that single-layer model is insufficient to simulate the thermal behavior and temperature nonuniformity of the high-capacity Li-ion cells. We also studied the effects of the number of layers on thermal behavior of the Li-ion batteries. In this work, first thermal and electrochemical behavior of the LiFePO₄ battery is modeled with 3D multilayer cell. The model is validated with the experimental measurements at different current rates and ambient temperatures. Real time heat generation rate is also studied at different discharge rates. Results showed non-uniform temperature distribution along the cell which requires thermal management system. Therefore, aluminum plates with mini-channel system were designed to control the temperature uniformity. Design parameters such as channel number and widths, inlet flow rate, and cooling fluids are optimized. As cooling fluids, water and air are compared. Pressure drop and velocity profiles inside the channels are illustrated. Both surface and internal temperature profiles of single cell and battery packs are investigated with and without cooling systems. Our results show that using optimized Mini-channel cooling plates effectively controls the temperature rise and uniformity of the single cells and battery packs. With increasing the inlet flow rate, cooling efficiency could be reached up to 60%.Keywords: lithium ion battery, 3D multilayer model, mini-channel cooling plates, thermal management
Procedia PDF Downloads 1656345 Subway Stray Current Effects on Gas Pipelines in the City of Tehran
Authors: Mohammad Derakhshani, Saeed Reza Allahkarama, Michael Isakhani-Zakaria, Masoud Samadian, Hojjat Sharifi Rasaey
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In order to investigate the effects of stray current from DC traction systems (subway) on cathodically protected gas pipelines, the subway and the gas network maps in the city of Tehran were superimposed and a comprehensive map was prepared. 213 intersections and about 100150 meters of parallel sections of gas pipelines were found with respect to the railway right of way which was specified for field measurements. The potential measurements data were logged for one hour in each test point. 24-hour potential monitoring was carried out in selected test points as well. Results showed that dynamic stray current from subway on pipeline potential appears as fluctuations in its static potential that is visible in the diagrams during night periods. These fluctuations can cause the pipeline potential to exit the safe zone and lead to corrosion or overprotection. In this study, a maximum potential shift of 100 mv in the pipe-to-soil potential was considered as a criterion for dynamic stray current effective presence. Results showed that a potential fluctuation range between 100 mV to 3 V exists in measured points on pipelines which exceeds the proposed criterion and needs to be investigated. Corrosion rates influenced by stray currents were calculated using coupons. Results showed that coupon linked to the pipeline in one of the locations at region 1 of the city of Tehran has a corrosion rate of 4.2 mpy (with cathodic protection and under influence of stray currents) which is about 1.5 times more than free corrosion rate of 2.6 mpy.Keywords: stray current, DC traction, subway, buried Pipelines, cathodic protection list
Procedia PDF Downloads 8256344 Spatial Differentiation Patterns and Influencing Mechanism of Urban Greening in China: Based on Data of 289 Cities
Authors: Fangzheng Li, Xiong Li
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Significant differences in urban greening have occurred in Chinese cities, which accompanied with China's rapid urbanization. However, few studies focused on the spatial differentiation of urban greening in China with large amounts of data. The spatial differentiation pattern, spatial correlation characteristics and the distribution shape of urban green space ratio, urban green coverage rate and public green area per capita were calculated and analyzed, using Global and Local Moran's I using data from 289 cities in 2014. We employed Spatial Lag Model and Spatial Error Model to assess the impacts of urbanization process on urban greening of China. Then we used Geographically Weighted Regression to estimate the spatial variations of the impacts. The results showed: 1. a significant spatial dependence and heterogeneity existed in urban greening values, and the differentiation patterns were featured by the administrative grade and the spatial agglomeration simultaneously; 2. it revealed that urbanization has a negative correlation with urban greening in Chinese cities. Among the indices, the the proportion of secondary industry, urbanization rate, population and the scale of urban land use has significant negative correlation with the urban greening of China. Automobile density and per capita Gross Domestic Product has no significant impact. The results of GWR modeling showed that the relationship between urbanization and urban greening was not constant in space. Further, the local parameter estimates suggested significant spatial variation in the impacts of various urbanization factors on urban greening.Keywords: China’s urbanization, geographically weighted regression, spatial differentiation pattern, urban greening
Procedia PDF Downloads 4686343 Customer Segmentation Revisited: The Case of the E-Tailing Industry in Emerging Market
Authors: Sanjeev Prasher, T. Sai Vijay, Chandan Parsad, Abhishek Banerjee, Sahakari Nikhil Krishna, Subham Chatterjee
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With rapid rise in internet retailing, the industry is set for a major implosion. Due to the little difference among competitors, companies find it difficult to segment and target the right shoppers. The objective of the study is to segment Indian online shoppers on the basis of the factors – website characteristics and shopping values. Together, these cover extrinsic and intrinsic factors that affect shoppers as they visit web retailers. Data were collected using questionnaire from 319 Indian online shoppers, and factor analysis was used to confirm the factors influencing the shoppers in their selection of web portals. Thereafter, cluster analysis was applied, and different segments of shoppers were identified. The relationship between income groups and online shoppers’ segments was tracked using correspondence analysis. Significant findings from the study include that web entertainment and informativeness together contribute more than fifty percent of the total influence on the web shoppers. Contrary to general perception that shoppers seek utilitarian leverages, the present study highlights the preference for fun, excitement, and entertainment during browsing of the website. Four segments namely Information Seekers, Utility Seekers, Value Seekers and Core Shoppers were identified and profiled. Value seekers emerged to be the most dominant segment with two-fifth of the respondents falling for hedonic as well as utilitarian shopping values. With overlap among the segments, utilitarian shopping value garnered prominence with more than fifty-eight percent of the total respondents. Moreover, a strong relation has been established between the income levels and the segments of Indian online shoppers. Web shoppers show different motives from being utility seekers to information seekers, core shoppers and finally value seekers as income levels increase. Companies can strategically use this information for target marketing and align their web portals accordingly. This study can further be used to develop models revolving around satisfaction, trust and customer loyalty.Keywords: online shopping, shopping values, effectiveness of information content, web informativeness, web entertainment, information seekers, utility seekers, value seekers, core shoppers
Procedia PDF Downloads 1966342 Development of Affordable and Reliable Diagnostic Tools to Record Vital Parameters for Improving Health Care in Low Resources Settings
Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria
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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.Keywords: e-health for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device
Procedia PDF Downloads 1976341 Chemical Fingerprinting of Complex Samples With the Aid of Parallel Outlet Flow Chromatography
Authors: Xavier A. Conlan
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Speed of analysis is a significant limitation to current high-performance liquid chromatography/mass spectrometry (HPLC/MS) and ultra-high-pressure liquid chromatography (UHPLC)/MS systems both of which are used in many forensic investigations. The flow rate limitations of MS detection require a compromise in the chromatographic flow rate, which in turn reduces throughput, and when using modern columns, a reduction in separation efficiency. Commonly, this restriction is combated through the post-column splitting of flow prior to entry into the mass spectrometer. However, this results in a loss of sensitivity and a loss in efficiency due to the post-extra column dead volume. A new chromatographic column format known as 'parallel segmented flow' involves the splitting of eluent flow within the column outlet end fitting, and in this study we present its application in order to interrogate the provenience of methamphetamine samples with mass spectrometry detection. Using parallel segmented flow, column flow rates as high as 3 mL/min were employed in the analysis of amino acids without post-column splitting to the mass spectrometer. Furthermore, when parallel segmented flow chromatography columns were employed, the sensitivity was more than twice that of conventional systems with post-column splitting when the same volume of mobile phase was passed through the detector. These finding suggest that this type of column technology will particularly enhance the capabilities of modern LC/MS enabling both high-throughput and sensitive mass spectral detection.Keywords: chromatography, mass spectrometry methamphetamine, parallel segmented outlet flow column, forensic sciences
Procedia PDF Downloads 4946340 Climate Change in Awash River Basin of Ethiopia: A Projection Study Using Global and Regional Climate Model Simulations
Authors: Mahtsente Tadese, Lalit Kumar, Richard Koech
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The aim of this study was to project and analyze climate change in the Awash River Basin (ARB) using bias-corrected Global and Regional Climate Model simulations. The analysis included a baseline period from 1986-2005 and two future scenarios (the 2050s and 2070s) under two representative concentration pathways (RCP4.5 and RCP8.5). Bias correction methods were evaluated using graphical and statistical methods. Following the evaluation of bias correction methods, the Distribution Mapping (DM) and Power Transformation (PT) were used for temperature and precipitation projection, respectively. The 2050s and 2070s RCP4 simulations showed an increase in precipitation during half of the months with 32 and 10%, respectively. Moreover, the 2050s and 2070s RCP8.5 simulation indicated a decrease in precipitation with 18 and 26%, respectively. The 2050s and 2070s RCP8.5 simulation indicated a significant decrease in precipitation in four of the months (February/March to May) with the highest decreasing rate of 34.7%. The 2050s and 2070s RCP4.5 simulation showed an increase of 0.48-2.6 °C in maximum temperature. In the case of RCP8.5, the increase rate reached 3.4 °C and 4.1 °C in the 2050s and 2070s, respectively. The changes in precipitation and temperature might worsen the water stress, flood, and drought in ARB. Moreover, the critical focus should be given to mitigation strategies and management options to reduce the negative impact. The findings of this study provide valuable information on future precipitation and temperature change in ARB, which will help in the planning and design of sustainable mitigation approaches in the basin.Keywords: variability, climate change, Awash River Basin, precipitation
Procedia PDF Downloads 1786339 In Vitro Morphogenic Response of the Alginate Encapsulated Nodal Segment and Antioxidative Enzymes Analysis during Acclimatization of Cassia Angustifolia Vahl
Authors: Iram Siddique
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Synthetic seed technology is an alternative to traditional micropropagation for production and delivery of cloned plantlets. Synthetic seeds were produced by encapsulating nodal segments of C. angustifolia in calcium alginate gel. 3% (w/v) sodium alginate and 100 mM CaCl2. 2H2O were found most suitable for encapsulation of nodal segments. Synthetic seeds cultured on half strength Murashige and Skoog (MS) medium supplemented with thidiazuron (5.0 µM) + indole -3- acetic acid (1.0 µM) produced maximum number of shoots (10.9 ± 0.78) after 8 weeks of culture exhibiting (78%) in vitro conversion response. Encapsulated nodal segments demonstrated successful regeneration after different period (1-6 weeks) of cold storage at 4 °C. The synthetic seeds stored at 4 °C for a period of 4 weeks resulted in maximum conversion frequency (93%) after 8 weeks when placed back to regeneration medium. The isolated shoots when cultured on half strength MS medium supplemented with 1.0 µM indole -3- butyric acid (IBA), produced healthy roots and plantlets with well developed shoot and roots were successfully hardened off in plastic pots containing sterile soilrite inside the growth chamber and gradually transferred to greenhouse where they grew well with 85% survival rate. Changes in the content of photosynthetic pigments, net photosynthetic rate (PN), superoxide dismutase (SOD) and catalase (CAT) activity in C. angustifolia indicated the adaptation of micropropagated plants to ex vitro conditions.Keywords: biochemical studies, nodal segments, rooting, synthetic seeds, thidiazuron
Procedia PDF Downloads 3606338 Effects of the Supplementary for Understanding and Preventing Plagiarism on EFL Students’ Writing
Authors: Surichai Butcha, Dararat Khampusaen
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As the Internet is recognized as a high potential and powerful educational tool to access sources of knowledge, plagiarism is an increasing unethical issue found in students’ writing. This paper is deriving from the 1st phase of an on-going study investigating the effects of the supplementary on citing sources on undergraduate students’ writing. The 40 participants were divided into 1 experimental group and 1 control group. Both groups were administered with a questionnaire on knowledge and an interview on attitude related to using sources in writing. Only the experimental group undertook the 4 lessons focusing on using outside sources and citing the original work (quoting, synthesizing, summarizing and paraphrasing) were delivered to them via e-learning tools throughout a semester. Participants were required to produce 4 writing tasks after each lesson. The results were concerned with types and factors on using outside sources in writing of Thai undergraduate EFL students from the survey. The interview results supported and clarified the survey result. In addition, the writing rubrics confirmed the types of plagiarism frequently occurred in students’ writing. The results revealed the types and factors on plagiarism including their perceptions on using the outside sources in their writing from the interview. The discussion shed the lights on cultural dimensions of plagiarism in student writing, roles of teachers, library, and university policy on the rate of plagiarism. Also, the findings promoted the awareness on ethics in writing and prevented the rate of potential unintentional plagiarism. Additionally, the results of this phase of study could lead to the appropriate contents to be considered for inclusion in the supplementary on using sources for writing for future research.Keywords: citing source, EFL writing, e-learning, Internet, plagiarism
Procedia PDF Downloads 1526337 The Role of Motivational Beliefs and Self-Regulated Learning Strategies in The Prediction of Mathematics Teacher Candidates' Technological Pedagogical And Content Knowledge (TPACK) Perceptions
Authors: Ahmet Erdoğan, Şahin Kesici, Mustafa Baloğlu
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Information technologies have lead to changes in the areas of communication, learning, and teaching. Besides offering many opportunities to the learners, these technologies have changed the teaching methods and beliefs of teachers. What the Technological Pedagogical Content Knowledge (TPACK) means to the teachers is considerably important to integrate technology successfully into teaching processes. It is necessary to understand how to plan and apply teacher training programs in order to balance students’ pedagogical and technological knowledge. Because of many inefficient teacher training programs, teachers have difficulties in relating technology, pedagogy and content knowledge each other. While providing an efficient training supported with technology, understanding the three main components (technology, pedagogy and content knowledge) and their relationship are very crucial. The purpose of this study is to determine whether motivational beliefs and self-regulated learning strategies are significant predictors of mathematics teacher candidates' TPACK perceptions. A hundred seventy five Turkish mathematics teachers candidates responded to the Motivated Strategies for Learning Questionnaire (MSLQ) and the Technological Pedagogical And Content Knowledge (TPACK) Scale. Of the group, 129 (73.7%) were women and 46 (26.3%) were men. Participants' ages ranged from 20 to 31 years with a mean of 23.04 years (SD = 2.001). In this study, a multiple linear regression analysis was used. In multiple linear regression analysis, the relationship between the predictor variables, mathematics teacher candidates' motivational beliefs, and self-regulated learning strategies, and the dependent variable, TPACK perceptions, were tested. It was determined that self-efficacy for learning and performance and intrinsic goal orientation are significant predictors of mathematics teacher candidates' TPACK perceptions. Additionally, mathematics teacher candidates' critical thinking, metacognitive self-regulation, organisation, time and study environment management, and help-seeking were found to be significant predictors for their TPACK perceptions.Keywords: candidate mathematics teachers, motivational beliefs, self-regulated learning strategies, technological and pedagogical knowledge, content knowledge
Procedia PDF Downloads 4856336 Formulation and Test of a Model to explain the Complexity of Road Accident Events in South Africa
Authors: Dimakatso Machetele, Kowiyou Yessoufou
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Whilst several studies indicated that road accident events might be more complex than thought, we have a limited scientific understanding of this complexity in South Africa. The present project proposes and tests a more comprehensive metamodel that integrates multiple causality relationships among variables previously linked to road accidents. This was done by fitting a structural equation model (SEM) to the data collected from various sources. The study also fitted the GARCH Model (Generalized Auto-Regressive Conditional Heteroskedasticity) to predict the future of road accidents in the country. The analysis shows that the number of road accidents has been increasing since 1935. The road fatality rate follows a polynomial shape following the equation: y = -0.0114x²+1.2378x-2.2627 (R²=0.76) with y = death rate and x = year. This trend results in an average death rate of 23.14 deaths per 100,000 people. Furthermore, the analysis shows that the number of crashes could be significantly explained by the total number of vehicles (P < 0.001), number of registered vehicles (P < 0.001), number of unregistered vehicles (P = 0.003) and the population of the country (P < 0.001). As opposed to expectation, the number of driver licenses issued and total distance traveled by vehicles do not correlate significantly with the number of crashes (P > 0.05). Furthermore, the analysis reveals that the number of casualties could be linked significantly to the number of registered vehicles (P < 0.001) and total distance traveled by vehicles (P = 0.03). As for the number of fatal crashes, the analysis reveals that the total number of vehicles (P < 0.001), number of registered (P < 0.001) and unregistered vehicles (P < 0.001), the population of the country (P < 0.001) and the total distance traveled by vehicles (P < 0.001) correlate significantly with the number of fatal crashes. However, the number of casualties and again the number of driver licenses do not seem to determine the number of fatal crashes (P > 0.05). Finally, the number of crashes is predicted to be roughly constant overtime at 617,253 accidents for the next 10 years, with the worse scenario suggesting that this number may reach 1 896 667. The number of casualties was also predicted to be roughly constant at 93 531 overtime, although this number may reach 661 531 in the worst-case scenario. However, although the number of fatal crashes may decrease over time, it is forecasted to reach 11 241 fatal crashes within the next 10 years, with the worse scenario estimated at 19 034 within the same period. Finally, the number of fatalities is also predicted to be roughly constant at 14 739 but may also reach 172 784 in the worse scenario. Overall, the present study reveals the complexity of road accidents and allows us to propose several recommendations aimed to reduce the trend of road accidents, casualties, fatal crashes, and death in South Africa.Keywords: road accidents, South Africa, statistical modelling, trends
Procedia PDF Downloads 1636335 The DAQ Debugger for iFDAQ of the COMPASS Experiment
Authors: Y. Bai, M. Bodlak, V. Frolov, S. Huber, V. Jary, I. Konorov, D. Levit, J. Novy, D. Steffen, O. Subrt, M. Virius
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In general, state-of-the-art Data Acquisition Systems (DAQ) in high energy physics experiments must satisfy high requirements in terms of reliability, efficiency and data rate capability. This paper presents the development and deployment of a debugging tool named DAQ Debugger for the intelligent, FPGA-based Data Acquisition System (iFDAQ) of the COMPASS experiment at CERN. Utilizing a hardware event builder, the iFDAQ is designed to be able to readout data at the average maximum rate of 1.5 GB/s of the experiment. In complex softwares, such as the iFDAQ, having thousands of lines of code, the debugging process is absolutely essential to reveal all software issues. Unfortunately, conventional debugging of the iFDAQ is not possible during the real data taking. The DAQ Debugger is a tool for identifying a problem, isolating the source of the problem, and then either correcting the problem or determining a way to work around it. It provides the layer for an easy integration to any process and has no impact on the process performance. Based on handling of system signals, the DAQ Debugger represents an alternative to conventional debuggers provided by most integrated development environments. Whenever problem occurs, it generates reports containing all necessary information important for a deeper investigation and analysis. The DAQ Debugger was fully incorporated to all processes in the iFDAQ during the run 2016. It helped to reveal remaining software issues and improved significantly the stability of the system in comparison with the previous run. In the paper, we present the DAQ Debugger from several insights and discuss it in a detailed way.Keywords: DAQ Debugger, data acquisition system, FPGA, system signals, Qt framework
Procedia PDF Downloads 2866334 A Review of Atomization Mechanisms Used for Spray Flash Evaporation: Their Effectiveness and Proposal of Rotary Bell Atomizer for Flashing Application
Authors: Murad A. Channa, Mehdi Khiadani. Yasir Al-Abdeli
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Considering the severity of water scarcity around the world and its widening at an alarming rate, practical improvements in desalination techniques need to be engineered at the earliest. Atomization is the major aspect of flashing phenomena, yet it has been paid less attention to until now. There is a need to test efficient ways of atomization for the flashing process. Flash evaporation together with reverse osmosis is also a commercially matured desalination technique commonly famous as Multi-stage Flash (MSF). Even though reverse osmosis is massively practical, it is not economical or sustainable compared to flash evaporation. However, flashing evaporation has its drawbacks as well such as lower efficiency of water production per higher consumption of power and time. Flash evaporation is simply the instant boiling of a subcooled liquid which is introduced as droplets in a well-maintained negative environment. This negative pressure inside the vacuum increases the temperature of the liquid droplets far above their boiling point, which results in the release of latent heat, and the liquid droplets turn into vapor which is collected to be condensed back into an impurity-free liquid in a condenser. Atomization is the main difference between pool and spray flash evaporation. Atomization is the heart of the flash evaporation process as it increases the evaporating surface area per drop atomized. Atomization can be categorized into many levels depending on its drop size, which again becomes crucial for increasing the droplet density (drop count) per given flow rate. This review comprehensively summarizes the selective results relating to the methods of atomization and their effectiveness on the evaporation rate from earlier works to date. In addition, the reviewers propose using centrifugal atomization for the flashing application, which brings several advantages viz ultra-fine droplets, uniform droplet density, and the swirling geometry of the spray with kinetically more energetic sprays during their flight. Finally, several challenges of using rotary bell atomizer (RBA) and RBA Sprays inside the chamber have been identified which will be explored in detail. A schematic of rotary bell atomizer (RBA) integration with the chamber has been designed. This powerful centrifugal atomization has the potential to increase potable water production in commercial multi-stage flash evaporators, where it would be preferably advantageous.Keywords: atomization, desalination, flash evaporation, rotary bell atomizer
Procedia PDF Downloads 866333 Autonomous Learning Motivates EFL Students to Learn English at Al Buraimi University College in the Sultanate of Oman: A Case Study
Authors: Yahia A. M. AlKhoudary
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This Study presents the outcome of an investigation to evaluate the importance of autonomous learning as a means of motivation. However, very little research done in this field. Thus, the aims of this study are to ascertain the needs of the learners and to investigate their attitudes and motivation towards the mode of learning. Various suggestions made on how to improve learners’ participation in the learning process. A survey conducted on a sample group of 60 Omani College students. Self-report questionnaires and retrospective interviews conducted to find out their material-type preferences in a self-access learning context. Achieving autonomous learning system, which learners is one of the Ministry of Education goals in the Sultanate of Oman. As a result, this study presents the outcome of an investigation to evaluate the students’ performance in English as a Foreign Language (EFL). It focuses on the effect of autonomous learning that encourages students to learn English, a research conducted at Buraimi city, the Sultanate of Oman. The procedure of this investigation based on four dimensions: (1) sixty students are selected and divided into two groups, (2) pre and posttest projects are given to them, and (3) questionnaires are administered to both students who are involved in the experiment and 50 teachers (25 males and 25 females) to collect accurate data, (4) an interview with students and teachers to find out their attitude towards autonomous learning. Analysis of participants’ responses indicated that autonomous learning motivates students to learn English independently and increase the intrinsic rather than extrinsic motivation to improve their English language as a long-life active learning. The findings of this study show that autonomous learning approach is the best remedy to empower the students’ skills and overcome all relevant difficulties. They also show that secondary school teachers can fully rely on this learning approach that encourages language learners to monitor their progress, increase both learners and teachers’ motivation and ameliorate students’ behavior in the classroom. This approach is also an ongoing process, which takes time, patience and support to be lifelong learning.Keywords: Omani, autonomous learning system, English as a Foreign Language (EFL), learning approach
Procedia PDF Downloads 4686332 Ovarian Hormones and Antioxidants Biomarkers in Dromedary Camels Synchronized with Controlled Intravaginal Drug Release/Ovsynch GPG Program during Breeding Season
Authors: Heba Hozyen, Ragab Mohamed, Amal Abd El Hameed, Amal Abo El-Maaty
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This study aimed to investigate the effect of CIDR and ovsynch (Gonadotropin-prostaglandine-gonadotropin GPG) protocols for synchronization of follicular waves of dromedary camels on ovarian hormones, oxidative stress and conception during breeding season. Twelve dark colored dromedary camels were divided into two equal groups. The first group was subjected to CIDR insertion for 7 days and blood samples were collected each other day from the day of CIDR insertion (day 0) till day 21. The other group was subjected to GPG system (Ovsynch) and blood samples were collected daily for 11 days. Progesterone (P4) and estradiol were assayed using commercial ELISA diagnostic EIA kits. Catalase (CAT), total antioxidants capacity (TAC), glutathione reduced (GHD), lipid peroxide product (malondialdehyde, MDA) and nitric oxide (NO) were measured colorimetrically using spectrophotometer. Results revealed that CIDR treated camels had significantly high P4 (P= 0.0001), estradiol (P= 0.0001), CAT (P= 0.034), NO (P= 0.016) and TAC (P= 0.04) but significantly low MDA (P= 0.001) and GHD (P= 0.003) compared to GPG treated ones. Camels inserted with CIDR had higher conception rate (66.7%) compared to those treated with GPG (33%). In conclusion, camels treated with CIDR had higher hormonal response and antioxidant capacity than those synchronized with GPG which positively reflected on their conception rate. The better response of camels to CIDR and the higher conception compared to GPG protocol recommends its use for future reproductive management in camels.Keywords: antioxidants, camel, CIDR, season, steroid hormones
Procedia PDF Downloads 2946331 Effect of Burdock Root Extract Concentration on Physiochemical Property of Coated Jasmine Rice by Using Top-Spay Fluidized Bed Coating Technique
Authors: Donludee Jaisut, Norihisa Kato, Thanutchaporn Kumrungsee, Kiyoshi Kawai, Somkiat Prachayawarakorn, Patchalee Tungtrakul
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Jasmine Rice is a principle food of Thai people. However, glycemic index of jasmine rice is in high level, risk of type II diabetes after consuming. Burdock root is a good source of non-starch polysaccharides such as inulin. Inulin acts as prebiotic and helps reduce blood-sugar level. The purpose of this research was to reduce digestion rate of jasmine rice by coating burdock root extract on rice surface, using top-spay fluidized bed coating technique. Coating experiments were performed by spraying burdock root solution onto Jasmine rice kernels (Khao Dawk Mali-105; KDML), which had an initial moisture content of 11.6% wet basis, suspended in the fluidized bed. The experimental conditions were: solution spray rates of 31.7 mL/min, atomization pressure of 1.5 bar, spray time of 10 min, time of drying after spraying of 30 s, superficial air velocity of 3.2 m/s and drying temperatures of 60°C. The coated rice quality was evaluated in terms of the moisture content, texture, whiteness and digestion rate. The results showed that initial and final moisture contents of samples were the same in concentration 8% (v/v) and 10% (v/v). The texture was insignificantly changed from that of uncoated sample. The whiteness values were varied on concentration of burdock root extract. Coated samples were slower digested.Keywords: burdock root, digestion, drying, rice
Procedia PDF Downloads 2956330 Teenage Pregnancy: The Unmet Needs of Female Adolescents in Uganda
Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan
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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.Keywords: adolescents, attitudes, teenage pregnancy, Uganda
Procedia PDF Downloads 1926329 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study
Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker
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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation
Procedia PDF Downloads 1426328 Reasons for Choosing Medicine and the Personality Traits of Pre-Clinical Medical Students
Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar
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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.Keywords: career, medical students, medicine, personality
Procedia PDF Downloads 351