Search results for: direct examination
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4850

Search results for: direct examination

4640 Role of Foreign Direct Investment in Economic Growth of Pakistan

Authors: Nayyra Zeb, Fu Qiang, Sundas Rauf

Abstract:

Foreign Direct Investment (FDI) is often seen as a significant factor of economic development in developing countries like Pakistan. The aim of this article is to investigate the effect of FDI on Pakistan’s economic growth during 1972–2012. Besides FDI, three other variables such as trade openness, political instability and terrorist attacks are also used in this study. The least square method has been applied to check the effect of these variables on GDP of Pakistan. The results show that FDI has a positive significant effect on economic growth of Pakistan.

Keywords: FDI inflows, trade openness, political instability, terrorist attacks

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4639 Improvement of Direct Torque and Flux Control of Dual Stator Induction Motor Drive Using Intelligent Techniques

Authors: Kouzi Katia

Abstract:

This paper proposes a Direct Torque Control (DTC) algorithm of dual Stator Induction Motor (DSIM) drive using two approach intelligent techniques: Artificial Neural Network (ANN) approach replaces the switching table selector block of conventional DTC and Mamdani Fuzzy Logic controller (FLC) is used for stator resistance estimation. The fuzzy estimation method is based on an online stator resistance correction through the variations of stator current estimation error and its variation. The fuzzy logic controller gives the future stator resistance increment at the output. The main advantage of suggested algorithm control is to reduce the hardware complexity of conventional selectors, to avoid the drive instability that may occur in certain situation and ensure the tracking of the actual of the stator resistance. The effectiveness of the technique and the improvement of the whole system performance are proved by results.

Keywords: artificial neural network, direct torque control, dual stator induction motor, fuzzy logic estimator, switching table

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4638 Performance Analysis of Permanent Magnet Synchronous Motor Using Direct Torque Control Based ANFIS Controller for Electric Vehicle

Authors: Marulasiddappa H. B., Pushparajesh Viswanathan

Abstract:

Day by day, the uses of internal combustion engines (ICE) are deteriorating because of pollution and less fuel availability. In the present scenario, the electric vehicle (EV) plays a major role in the place of an ICE vehicle. The performance of EVs can be improved by the proper selection of electric motors. Initially, EV preferred induction motors for traction purposes, but due to complexity in controlling induction motor, permanent magnet synchronous motor (PMSM) is replacing induction motor in EV due to its advantages. Direct torque control (DTC) is one of the known techniques for PMSM drive in EV to control the torque and speed. However, the presence of torque ripple is the main drawback of this technique. Many control strategies are followed to reduce the torque ripples in PMSM. In this paper, the adaptive neuro-fuzzy inference system (ANFIS) controller technique is proposed to reduce torque ripples and settling time. Here the performance parameters like torque, speed and settling time are compared between conventional proportional-integral (PI) controller with ANFIS controller.

Keywords: direct torque control, electric vehicle, torque ripple, PMSM

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4637 An Acerbate Psychotics Symptoms, Social Support, Stressful Life Events, Medication Use Self-Efficacy Impact on Social Dysfunction: A Cross Sectional Self-Rated Study of Persons with Schizophrenia Patient and Misusing Methamphetamines

Authors: Ek-Uma Imkome, Jintana Yunibhand, Waraporn Chaiyawat

Abstract:

Background: Persons with schizophrenia patient and misusing methamphetamines suffering from social dysfunction that impact on their quality of life. Knowledge of factors related to social dysfunction will guide the effective intervention. Objectives: To determine the direct effect, indirect effect and total effect of an acerbate Psychotics’ Symptoms, Social Support, Stressful life events, Medication use self-efficacy impact on social dysfunction in Thai schizophrenic patient and methamphetamine misuse. Methods: Data were collected from schizophrenic and methamphetamine misuse patient by self report. A linear structural relationship was used to test the hypothesized path model. Results: The hypothesized model was found to fit the empirical data and explained 54% of the variance of the psychotic symptoms (X2 = 114.35, df = 92, p-value = 0.05, X2 /df = 1.24, GFI = 0.96, AGFI = 0.92, CFI = 1.00, NFI = 0.99, NNFI = 0.99, RMSEA = 0.02). The highest total effect on social dysfunction was psychotic symptoms (0.67, p<0.05). Medication use self-efficacy had a direct effect on psychotic symptoms (-0.25, p<0.01), and social support had direct effect on medication use self efficacy (0.36, p <0.01). Conclusions: Psychotic symptoms and stressful life events were the significance factors that influenced direct on social dysfunctioning. Therefore, interventions that are designed to manage these factors are crucial in order to enhance social functioning in this population.

Keywords: psychotic symptoms, methamphetamine, schizophrenia, stressful life events, social dysfunction, social support, medication use self efficacy

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4636 Empathy and Yoga Philosophy: Both Eastern and Western Concepts

Authors: Jacqueline Jasmine Kumar

Abstract:

This paper seeks to challenge the predominate Western-centric paradigm concerning empathy by conducting an exploration of its presence within both Western and Eastern philosophical traditions. The primary focus of this inquiry is the examination of the Indian yogic tradition, encompassing the four yogas: bhakti (love/devotion), karma (action), jnāna (knowledge), and rāja (psychic control). Through this examination, it is demonstrated that empathy does not exclusively originate from Western philosophical thought. Rather than superimposing the Western conceptualization of empathy onto the tenets of Indian philosophy, this study endeavours to unearth a distinct array of ideas and concepts within the four yogas, which significantly contribute to our comprehension of empathy as a universally relevant phenomenon. To achieve this objective, an innovative approach is adopted, delving into various facets of empathy, including the propositional, affective/intuitive, perspective-taking, and actionable dimensions. This approach intentionally deviates from conventional Western frameworks, shifting the emphasis towards lived morally as opposed to engagement in abstract theoretical discourse. While it is acknowledged that the explicit term “empathy” may not be overly articulated within the yogic tradition, a scrupulous examination reveals the underlying substance and significance of this phenomenon. Throughout this comparative analysis, the paper aims to lay a robust foundation for the discourse of empathy within the contexts of the human experience. By assimilating insights gleaned from the Indian yogic tradition, it contributes to the expansion of our comprehension of empathy, enabling an exploration of its multifaceted dimensions. Ultimately, this scholarly endeavour facilitates the development of a more comprehensive and inclusive perspective on empathy, transcending cultural boundaries and enriching our collective repository of knowledge.

Keywords: Bhakti, Yogic, Jnana, Karma

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4635 Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

Abstract:

An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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4634 An Extended Eclectic Paradigm of Dunning: Impact of New International Business Processes

Authors: D. De Matías Batalla

Abstract:

This paper develops and extended eclectic paradigm to fit the firm internationalization process with the real international business world. The approach is based on Dunning´s, introducing new concepts like mode of entry, international joint venture o international mergers and acquisitions. At the same time is presented a model to describe the Spanish international mergers and acquisitions in order to determinate the most important factor that influence in this type of foreign direct investment.

Keywords: dunning, eclectic paradigm, foreign direct investment, IJV, international business, international management, multinational firms, firm internationalization process, M&A

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4633 The Evaluation of Caustic and Corrosive Poisoning in Children

Authors: Sabiha Sahin

Abstract:

Introduction: We have planned this study because of the increasing number of corrosive substance poisoning who admitted to the Pediatric Emergency Department. Method: 636 corrosive substance poisoning cases applied to the Osmangazi University PED between 1 January 2015 - 31 December 2017 were retrospectively analyzed. Results: 438 (69%) cases were male.The poisoning rate of groups 0-4 was significantly higher and occurred by accident. A total of 616 cases (96.9%) were poisoned by the oral route, and 20 cases were poisoned by inhalation.462 Patients were admitted to the hospital within an hour (72.8%). Of the 134 patients who had only erosion and redness around the mouth, 24 patients had salivation and dysphagia symptoms besides these. Of the 28 cases of 158 patients with symptoms, eusaphegeal stenosis was detected. on third day examination. Although there was no statistically significant correlation between esophageal stenosis and erosion and redness around the mouth, there was a statistically significant correlation between dysphagia and salivation between esophageal stenosis Conclusion: The increased salivation and the dysphagia are important signs of risk of devoloping esophageal stenosis at first examination corrosive poisoning in children.

Keywords: caustic, corrosive, poisoning, children

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4632 Prevalence and Characteristics of Torus Palatinus among Western Indonesian Population

Authors: Raka Aldy Nugraha, Kiwah Andanni, Aditya Indra Pratama, Aswin Guntara

Abstract:

Background: Torus palatinus is a bony protuberance in the hard palate. Sex and race are considered as influencing factors for the development of torus palatinus. Hence, the objective of this study was to determine the prevalence and characteristics of torus palatinus and its correlation with sex and ethnicity among Western Indonesian Population. Methods: We conducted a descriptive and analytical study employing cross-sectional design in 274 new students of Universitas Indonesia. Data were collected by using consecutive sampling method through questionnaire-filling and direct oral examination. Subject with racial background other than indigenous Indonesian Mongol were excluded from this study. Data were statistically analyzed using chi square test for categorical variables whereas logistic regression model was employed to assess the correlation between variables of interest with prevalence of torus palatinus. Results: Torus palatinus were found in 212 subjects (77.4%), mostly small in size (< 3 mm) and single in number, with percentage of 50.5% and 90.6%, respectively. The prevalence of torus palatinus were significantly higher in women (OR 2.88; 95% CI: 1.53-5.39; p = 0.001), dominated by medium-sized and single tori. There was no significant correlation between ethnicity and the occurrence of torus palatinus among Western Indonesian population. Conclusion: Torus palatinus was prevalent among Western Indonesian population. It showed significant positive correlation with sex, but not with ethnicity.

Keywords: characteristic, ethnicity, Indonesia, mongoloid, prevalence, sex, Torus palatinus

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4631 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

Abstract:

Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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4630 Effect of Silt Presence on Shear Strength Parameters of Unsaturated Sandy Soils

Authors: R. Ziaie Moayed, E. Khavaninzadeh, M. Ghorbani Tochaee

Abstract:

Direct shear test is widely used in soil mechanics experiment to determine the shear strength parameters of granular soils. For analysis of soil stability problems such as bearing capacity, slope stability and lateral pressure on soil retaining structures, the shear strength parameters must be known well. In the present study, shear strength parameters are determined in silty-sand mixtures. Direct shear tests are performed on 161 Firoozkooh sand with different silt content at a relative density of 70% in three vertical stress of 100, 150, and 200 kPa. Wet tamping method is used for soil sample preparation, and the results include diagrams of shear stress versus shear deformation and sample height changes against shear deformation. Accordingly, in different silt percent, the shear strength parameters of the soil such as internal friction angle and dilation angle are calculated and compared. According to the results, when the sample contains up to 10% silt, peak shear strength and internal friction angle have an upward trend. However, if the sample contains 10% to 50% of silt a downward trend is seen in peak shear strength and internal friction angle.

Keywords: shear strength parameters, direct shear test, silty sand, shear stress, shear deformation

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4629 Supergrid Modeling and Operation and Control of Multi Terminal DC Grids for the Deployment of a Meshed HVDC Grid in South Asia

Authors: Farhan Beg, Raymond Moberly

Abstract:

The Indian subcontinent is facing a massive challenge with regards to energy security in member countries, to provide reliable electricity to facilitate development across various sectors of the economy and consequently achieve the developmental targets. The instability of the current precarious situation is observable in the frequent system failures and blackouts. The deployment of interconnected electricity ‘Supergrid’ designed to carry huge quanta of power across the Indian sub-continent is proposed in this paper. Besides enabling energy security in the subcontinent, it will also provide a platform for Renewable Energy Sources (RES) integration. This paper assesses the need and conditions for a Supergrid deployment and consequently proposes a meshed topology based on Voltage Source High Voltage Direct Current (VSC-HVDC) converters for the Supergrid modeling. Various control schemes for the control of voltage and power are utilized for the regulation of the network parameters. A 3 terminal Multi Terminal Direct Current (MTDC) network is used for the simulations.

Keywords: super grid, wind and solar energy, high voltage direct current, electricity management, load flow analysis

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4628 Direct Displacement-Based Design Procedure for Performance-Based Seismic Design of Structures

Authors: Haleh Hamidpour

Abstract:

Since the seismic damageability of structures is controlled by the inelastic deformation capacities of structural elements, seismic design of structure based on force analogy methods is not appropriate. In recent year, the basic approach of design codes have been changed from force-based approach to displacement-based. In this regard, a Direct Displacement-Based Design (DDBD) and a Performance-Based Plastic Design (PBPD) method are proposed. In this study, the efficiency of these two methods on seismic performance of structures is evaluated through a sample 12-story reinforced concrete moment frame. The building is designed separately based on the DDBD and the PBPD methods. Once again the structure is designed by the traditional force analogy method according to the FEMA P695 regulation. Different design method results in different structural elements. Seismic performance of these three structures is evaluated through nonlinear static and nonlinear dynamic analysis. The results show that the displacement-based design methods accommodate the intended performance objectives better than the traditional force analogy method.

Keywords: direct performance-based design, ductility demands, inelastic seismic performance, yield mechanism

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4627 Experimental and Characterization Studies on Micro Direct Methanol Fuel Cell

Authors: S. Muthuraja Soundrapandian, C.K. Subramaniam

Abstract:

A micro Direct Methanol Fuel Cell (DMFC) of 1 cm2 active area with selective sensor materials to sense methanol for redox, has been developed. Among different Pt alloys, Pt-Sn/C was able to produce high current density and repeatability. Membrane Elecctrode Assembly (MEA) of anode catalyst Pt-Sn/C was prepared with nafion as active membrane and Pt black as cathode catalyst. The sensor’s maximum ability to detect the trace levels of methanol in ppm has been analyzed. A compact sensor set up has also been made and the characterization studies were carried out. The acceptable value of current density was derived by the cell and the results are able to fulfill the needs of DMFC technology for the practical applications.

Keywords: DMFC, sensor, MEA, Pt-Sn

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4626 Comparison between High Resolution Ultrasonography and Magnetic Resonance Imaging in Assessment of Musculoskeletal Disorders Causing Ankle Pain

Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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4625 The Effect of Metal Transfer Modes on Mechanical Properties of 3CR12 Stainless Steel

Authors: Abdullah Kaymakci, Daniel M. Madyira, Ntokozo Nkwanyana

Abstract:

The effect of metal transfer modes on mechanical properties of welded 3CR12 stainless steel were investigated. This was achieved by butt welding 10 mm thick plates of 3CR12 in different positions while varying the welding positions for different metal transfer modes. The ASME IX: 2010 (Welding and Brazing Qualifications) code was used as a basis for welding variables. The material and the thickness of the base metal were kept constant together with the filler metal, shielding gas and joint types. The effect of the metal transfer modes on the microstructure and the mechanical properties of the 3CR12 steel was then investigated as it was hypothesized that the change in welding positions will affect the transfer modes partly due to the effect of gravity. The microscopic examination revealed that the substrate was characterized by dual phase microstructure, that is, alpha phase and beta phase grain structures. Using the spectroscopic examination results and the ferritic factor calculation had shown that the microstructure was expected to be ferritic-martensitic during air cooling process. The tested tensile strength and Charpy impact energy were measured to be 498 MPa and 102 J which were in line with mechanical properties given in the material certificate. The heat input in the material was observed to be greater than 1 kJ/mm which is the limiting factor for grain growth during the welding process. Grain growths were observed in the heat affected zone of the welded materials. Ferritic-martensitic microstructure was observed in the microstructure during the microscopic examination. The grain growth altered the mechanical properties of the test material. Globular down hand had higher mechanical properties than spray down hand. Globular vertical up had better mechanical properties than globular vertical down.

Keywords: welding, metal transfer modes, stainless steel, microstructure, hardness, tensile strength

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4624 Augmented Reality in Advertising and Brand Communication: An Experimental Study

Authors: O. Mauroner, L. Le, S. Best

Abstract:

Digital technologies offer many opportunities in the design and implementation of brand communication and advertising. Augmented reality (AR) is an innovative technology in marketing communication that focuses on the fact that virtual interaction with a product ad offers additional value to consumers. AR enables consumers to obtain (almost) real product experiences by the way of virtual information even before the purchase of a certain product. Aim of AR applications in relation with advertising is in-depth examination of product characteristics to enhance product knowledge as well as brand knowledge. Interactive design of advertising provides observers with an intense examination of a specific advertising message and therefore leads to better brand knowledge. The elaboration likelihood model and the central route to persuasion strongly support this argumentation. Nevertheless, AR in brand communication is still in an initial stage and therefore scientific findings about the impact of AR on information processing and brand attitude are rare. The aim of this paper is to empirically investigate the potential of AR applications in combination with traditional print advertising. To that effect an experimental design with different levels of interactivity is built to measure the impact of interactivity of an ad on different variables o advertising effectiveness.

Keywords: advertising effectiveness, augmented reality, brand communication, brand recall

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4623 A Rare Form of Rapidly Progressive Parkinsonism Associated with Dementia

Authors: Murat Emre, Zeynep Tufekcioglu

Abstract:

Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.

Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism

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4622 A Digital Health Approach: Using Electronic Health Records to Evaluate the Cost Benefit of Early Diagnosis of Alpha-1 Antitrypsin Deficiency in the UK

Authors: Sneha Shankar, Orlando Buendia, Will Evans

Abstract:

Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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4621 A Spectral Decomposition Method for Ordinary Differential Equation Systems with Constant or Linear Right Hand Sides

Authors: R. B. Ogunrinde, C. C. Jibunoh

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In this paper, a spectral decomposition method is developed for the direct integration of stiff and nonstiff homogeneous linear (ODE) systems with linear, constant, or zero right hand sides (RHSs). The method does not require iteration but obtains solutions at any random points of t, by direct evaluation, in the interval of integration. All the numerical solutions obtained for the class of systems coincide with the exact theoretical solutions. In particular, solutions of homogeneous linear systems, i.e. with zero RHS, conform to the exact analytical solutions of the systems in terms of t.

Keywords: spectral decomposition, linear RHS, homogeneous linear systems, eigenvalues of the Jacobian

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4620 The Effects of Transcranial Direct Current Stimulation on Brain Oxygenation and Pleasure during Exercise

Authors: Alexandre H. Okano, Pedro M. D. Agrícola, Daniel G. Da S. Machado, Luiz I. Do N. Neto, Luiz F. Farias Junior, Paulo H. D. Nascimento, Rickson C. Mesquita, John F. Araujo, Eduardo B. Fontes, Hassan M. Elsangedy, Shinsuke Shimojo, Li M. Li

Abstract:

The prefrontal cortex is involved in the reward system and the insular cortex integrates the afferent inputs arriving from the body’ systems and turns into feelings. Therefore, modulating neuronal activity in these regions may change individuals’ perception in a given situation such as exercise. We tested whether transcranial direct current stimulation (tDCS) change cerebral oxygenation and pleasure during exercise. Fourteen volunteer healthy adult men were assessed into five different sessions. First, subjects underwent to a maximum incremental test on a cycle ergometer. Then, subjects were randomly assigned to a transcranial direct current stimulation (2mA for 15 min) intervention in a cross over design in four different conditions: anode and cathode electrodes on T3 and Fp2 targeting the insular cortex, and Fpz and F4 targeting prefrontal cortex, respectively; and their respective sham. These sessions were followed by 30 min of moderate intensity exercise. Brain oxygenation was measured in prefrontal cortex with a near infrared spectroscopy. Perceived exertion and pleasure were also measured during exercise. The asymmetry in prefrontal cortex oxygenation before the stimulation decreased only when it was applied over this region which did not occur after insular cortex or sham stimulation. Furthermore, pleasure was maintained during exercise only after prefrontal cortex stimulation (P > 0.7), while there was a decrease throughout exercise (P < 0.03) during the other conditions. We conclude that tDCS over the prefrontal cortex changes brain oxygenation in ventromedial prefrontal cortex and maintains perceived pleasure during exercise. Therefore, this technique might be used to enhance effective responses related to exercise.

Keywords: affect, brain stimulation, dopamine neuromodulation, pleasure, reward, transcranial direct current stimulation

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4619 Human Capital Development, Foreign Direct Investment and Industrialization in Nigeria

Authors: Ese Urhie, Bosede Olopade, Muyiwa Oladosun, Henry Okodua

Abstract:

In the past three and half decades, aside from the fact that the contribution of the industrial sector to gross domestic product in Nigeria has nose-dived, its performance has also been highly unstable. Investment funds needed to develop the industrial sector usually come from both internal and external sources. The internal sources include surplus generated within the industrial sector and surplus diverted from other sectors of the economy. It has been observed that due to the small size of the industrial sector in developing countries, very limited funds could be raised for further investment. External sources of funds which many currently industrialized and some ‘newly industrializing countries’ have benefited from including direct and indirect investment by foreign capitalists; foreign aid and loans; and investments by nationals living abroad. Foreign direct investment inflow in Nigeria has been declining since 2009 in both absolute and relative terms. High level of human capital has been identified as one of the crucial factors that explain the miraculous growth of the ‘Asian Tigers’. Its low level has also been identified as the major cause for the low level of FDI flow to Nigeria in particular and Africa in general. There has been positive, but slow improvement in human capital indicators in Nigeria in the past three decades. In spite of this, foreign direct investment inflow has not only been low; it has declined drastically in recent years. i) Why has the improvement in human capital in Nigeria failed to attract more FDI inflow? ii) To what extent does the level of human capital influence FDI inflow in Nigeria? iii) Is there a threshold of human capital stock that guarantees sustained inflow of FDI? iv) Does the quality of human capital matter? v) Does the influence of other (negative) factors outweigh the benefits of human capital? Using time series secondary data, a system of equations is employed to evaluate the effect of human capital on FDI inflow in Nigeria on one hand and the effect of FDI on the level of industrialization on the other. A weak relationship between human capital and FDI is expected, while a strong relationship between FDI and industrial growth is expected from the result.

Keywords: human capital, foreign direct investment, industrialization, gross domestic product

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4618 Assessing the Informed Consent Practices during Normal Vaginal Delivery Process and Immediate Postpartum Care in Tertiary Level Hospitals of Bangladesh

Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

Abstract:

Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

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4617 Computer-Aided Exudate Diagnosis for the Screening of Diabetic Retinopathy

Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

Abstract:

Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

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4616 Study of Chlorine Gas Leak Consequences in Direct Chlorination System Failure in Cooling Towers in the Petrochemical Industry

Authors: Mohammad H. Ruhipour, Mahdi Goharrokhi, Mahsa Ghasemi, Artadokht Ostadsarayi

Abstract:

In this paper, we are aiming to study the consequences of chlorine gas leak in direct chlorine gas injection compared to using bleach (sodium hypochlorite), studying the negative effects both on the environment and individuals. This study was performed in the cooling towers of a natural fractioning unit of Bandar-e-IMAM petrochemical plant. Considering that chlorine gas is highly toxic and based on the health regulation, its release into the surrounding environment can be very dangerous for people and even fatal for individuals. We studied performing quantitative studies in the worst cases of event incidence. In addition, studying alternative methods with a lower risk was also on the agenda to select the least likely possible option causing an accident. In this paper chlorine gas release consequences have been evaluated by using PHAST software. Reaching to 10 ppm of chlorine gas concentration was basis of hazardous area determination. The results show that the full chlorine gas line rupture scenario in Pasquill category F, were worst case, and many people could be harmed around cooling towers area because of chlorine gas inhalation.

Keywords: chlorine gas, consequence modeling, cooling towers, direct chlorination, risk assessment, system failure

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4615 Mike Hat: Coloured-Tape-in-Hat as a Head Circumference Measuring Instrument for Early Detection of Hydrocephalus in an Infant

Authors: Nyimas Annissa Mutiara Andini

Abstract:

Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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4614 Results of Operation of Online Medical Care System

Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

Abstract:

Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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4613 Experimental Investigation of Compressed Natural Gas Injector for Direct Injection System

Authors: Rafal Sochaczewski, Grzegorz Baranski, Adam Majczak

Abstract:

This paper presents the bench research results on a CNG injector at steady state. The quantities measured included voltage and current in a solenoid, pressure of gas behind an injector and injector’s flow rate. Accordingly, injector’s operation parameters were determined according to needle’s lift and injection pressure. The discrepancies between the theoretical (electric) and actual time of injection were defined to specify injector’s opening and closing lag times and the uniqueness of these values in successive cycles of gas injection. It has been demonstrated that needle’s lift has got a stronger impact on injector’s operating parameters than injection pressure. With increasing injection pressure, the force increases and closes an injection valve, which adversely affects uniqueness of injector’s operation. The paper also describes the concept of an injector dedicated to direct CNG injection into a combustion chamber in a dual-fuel engine. The injector’s design enables us to replace 80% of diesel fuel in a dual-fuel engine with a maximum power of 85 kW. Minimum injection pressure is 1,4 MPa then. Simultaneously, injector’s characteristics for varied needle’s lifts and injector’s nonlinear operating points were developed. Acknowledgement: This work has been financed by the Polish National Centre for Research and Development, under Grant Agreement No. PBS1/A6/4/2012.

Keywords: CNG injector, diesel engine, direct injection, dual fuel

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4612 New Result for Optical OFDM in Code Division Multiple Access Systems Using Direct Detection

Authors: Cherifi Abdelhamid

Abstract:

In optical communication systems, OFDM has received increased attention as a means to overcome various limitations of optical transmission systems such as modal dispersion, relative intensity noise, chromatic dispersion, polarization mode dispersion and self-phase modulation. The multipath dispersion limits the maximum transmission data rates. In this paper we investigate OFDM system where multipath induced intersymbol interference (ISI) is reduced and we increase the number of users by combining OFDM system with OCDMA system using direct detection Incorporate OOC (orthogonal optical code) for minimize a bit error rate.

Keywords: OFDM, OCDMA, OOC (orthogonal optical code), (ISI), prim codes (Pc)

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4611 Political Economy of Foreign Direct Investment: Literature Review of Domestic Interest Groups’ Preferences

Authors: Chaiwat Wuthinitikornkit

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Foreign Direct Investment (FDI) inevitably affects the landscape of the political economy of the host country. It is, therefore, significant to review and uncover how and in what way(s) FDI shapes the preferences of the interest groups within the host country, as such preferences may, in turn, influence the policies of the host country. By conducting a review of relevant literature, this paper attempts to outline the key forces behind such preferences and identify potential gaps for future studies. This paper argues that while existing theories have specified endowment and political and institutional factors as key explanations behind the preferences of domestic interest groups, other qualitative attributes of the foreign investors' side, such as their nationalities, have yet to be adequately investigated empirically and may potentially also possess explanatory power. This is particularly important in the current global economic landscape, where key global investors hail from origins from both developed and developing countries with diverse political systems and business practices. This paper aims to provide the groundwork for future studies on these potential gaps, which may provide not only contributions to the academic sphere but also practical insight into policymaking and business communities.

Keywords: foreign direct investment, interest groups, international political economy, political economy

Procedia PDF Downloads 64