Search results for: unknown environments
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2896

Search results for: unknown environments

286 Generation-Based Travel Decision Analysis in the Post-Pandemic Era

Authors: Hsuan Yu Lai, Hsuan Hsuan Chang

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The consumer decision process steps through problems by weighing evidence, examining alternatives, and choosing a decision path. Currently, the COVID 19 made the tourism industry encounter a huge challenge and suffer the biggest amount of economic loss. It would be very important to reexamine the decision-making process model, especially after the pandemic, and consider the differences among different generations. The tourism industry has been significantly impacted by the global outbreak of COVID-19, but as the pandemic subsides, the sector is recovering. This study addresses the scarcity of research on travel decision-making patterns among generations in Taiwan. Specifically targeting individuals who frequently traveled abroad before the pandemic, the study explores differences in decision-making at different stages post-outbreak. So this study investigates differences in travel decision-making among individuals from different generations during/after the COVID-19 pandemic and examines the moderating effects of social media usage and individuals' perception of health risks. The study hypotheses are “there are significant differences in the decision-making process including travel motivation, information searching preferences, and criteria for decision-making” and that social-media usage and health-risk perception would moderate the results of the previous study hypothesis. The X, Y, and Z generations are defined and categorized based on a literature review. The survey collected data including their social-economic background, travel behaviors, motivations, considerations for destinations, travel information searching preferences, and decision-making criteria before/after the pandemic based on the reviews of previous studies. Data from 656 online questionnaires were collected between January to May 2023 and from Taiwanese travel consumers who used to travel at least one time abroad before Covid-19. SPSS is used to analyze the data with One-Way ANOVA and Two-Way ANOVA. The analysis includes demand perception, information gathering, alternative comparison, purchase behavior, and post-travel experience sharing. Social media influence and perception of health risks are examined as moderating factors. The findings show that before the pandemic, the Y Generation preferred natural environments, while the X Generation favored historical and cultural sites compared to the Z Generation. However, after the outbreak, the Z Generation displayed a significant preference for entertainment activities. This study contributes to understanding changes in travel decision-making patterns following COVID-19 and the influence of social media and health risks. The findings have practical implications for the tourism industry.

Keywords: consumer decision-making, generation study, health risk perception, post-pandemic era, social media

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285 Psoriasis Diagnostic Test Development: Exploratory Study

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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284 The Influence of Operational Changes on Efficiency and Sustainability of Manufacturing Firms

Authors: Dimitrios Kafetzopoulos

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Nowadays, companies are more concerned with adopting their own strategies for increased efficiency and sustainability. Dynamic environments are fertile fields for developing operational changes. For this purpose, organizations need to implement an advanced management philosophy that boosts changes to companies’ operation. Changes refer to new applications of knowledge, ideas, methods, and skills that can generate unique capabilities and leverage an organization’s competitiveness. So, in order to survive and compete in the global and niche markets, companies should incorporate the adoption of operational changes into their strategy with regard to their products and their processes. Creating the appropriate culture for changes in terms of products and processes helps companies to gain a sustainable competitive advantage in the market. Thus, the purpose of this study is to investigate the role of both incremental and radical changes into operations of a company, taking into consideration not only product changes but also process changes, and continues by measuring the impact of these two types of changes on business efficiency and sustainability of Greek manufacturing companies. The above discussion leads to the following hypotheses: H1: Radical operational changes have a positive impact on firm efficiency. H2: Incremental operational changes have a positive impact on firm efficiency. H3: Radical operational changes have a positive impact on firm sustainability. H4: Incremental operational changes have a positive impact on firm sustainability. In order to achieve the objectives of the present study, a research study was carried out in Greek manufacturing firms. A total of 380 valid questionnaires were received while a seven-point Likert scale was used to measure all the questionnaire items of the constructs (radical changes, incremental changes, efficiency and sustainability). The constructs of radical and incremental operational changes, each one as one variable, has been subdivided into product and process changes. Non-response bias, common method variance, multicollinearity, multivariate normal distribution and outliers have been checked. Moreover, the unidimensionality, reliability and validity of the latent factors were assessed. Exploratory Factor Analysis and Confirmatory Factor Analysis were applied to check the factorial structure of the constructs and the factor loadings of the items. In order to test the research hypotheses, the SEM technique was applied (maximum likelihood method). The goodness of fit of the basic structural model indicates an acceptable fit of the proposed model. According to the present study findings, radical operational changes and incremental operational changes significantly influence both efficiency and sustainability of Greek manufacturing firms. However, it is in the dimension of radical operational changes, meaning those in process and product, that the most significant contributors to firm efficiency are to be found, while its influence on sustainability is low albeit statistically significant. On the contrary, incremental operational changes influence sustainability more than firms’ efficiency. From the above, it is apparent that the embodiment of the concept of the changes into the products and processes operational practices of a firm has direct and positive consequences for what it achieves from efficiency and sustainability perspective.

Keywords: incremental operational changes, radical operational changes, efficiency, sustainability

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283 Myanmar Consonants Recognition System Based on Lip Movements Using Active Contour Model

Authors: T. Thein, S. Kalyar Myo

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Human uses visual information for understanding the speech contents in noisy conditions or in situations where the audio signal is not available. The primary advantage of visual information is that it is not affected by the acoustic noise and cross talk among speakers. Using visual information from the lip movements can improve the accuracy and robustness of automatic speech recognition. However, a major challenge with most automatic lip reading system is to find a robust and efficient method for extracting the linguistically relevant speech information from a lip image sequence. This is a difficult task due to variation caused by different speakers, illumination, camera setting and the inherent low luminance and chrominance contrast between lip and non-lip region. Several researchers have been developing methods to overcome these problems; the one is lip reading. Moreover, it is well known that visual information about speech through lip reading is very useful for human speech recognition system. Lip reading is the technique of a comprehensive understanding of underlying speech by processing on the movement of lips. Therefore, lip reading system is one of the different supportive technologies for hearing impaired or elderly people, and it is an active research area. The need for lip reading system is ever increasing for every language. This research aims to develop a visual teaching method system for the hearing impaired persons in Myanmar, how to pronounce words precisely by identifying the features of lip movement. The proposed research will work a lip reading system for Myanmar Consonants, one syllable consonants (င (Nga)၊ ည (Nya)၊ မ (Ma)၊ လ (La)၊ ၀ (Wa)၊ သ (Tha)၊ ဟ (Ha)၊ အ (Ah) ) and two syllable consonants ( က(Ka Gyi)၊ ခ (Kha Gway)၊ ဂ (Ga Nge)၊ ဃ (Ga Gyi)၊ စ (Sa Lone)၊ ဆ (Sa Lain)၊ ဇ (Za Gwe) ၊ ဒ (Da Dway)၊ ဏ (Na Gyi)၊ န (Na Nge)၊ ပ (Pa Saug)၊ ဘ (Ba Gone)၊ ရ (Ya Gaug)၊ ဠ (La Gyi) ). In the proposed system, there are three subsystems, the first one is the lip localization system, which localizes the lips in the digital inputs. The next one is the feature extraction system, which extracts features of lip movement suitable for visual speech recognition. And the final one is the classification system. In the proposed research, Two Dimensional Discrete Cosine Transform (2D-DCT) and Linear Discriminant Analysis (LDA) with Active Contour Model (ACM) will be used for lip movement features extraction. Support Vector Machine (SVM) classifier is used for finding class parameter and class number in training set and testing set. Then, experiments will be carried out for the recognition accuracy of Myanmar consonants using the only visual information on lip movements which are useful for visual speech of Myanmar languages. The result will show the effectiveness of the lip movement recognition for Myanmar Consonants. This system will help the hearing impaired persons to use as the language learning application. This system can also be useful for normal hearing persons in noisy environments or conditions where they can find out what was said by other people without hearing voice.

Keywords: feature extraction, lip reading, lip localization, Active Contour Model (ACM), Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), Two Dimensional Discrete Cosine Transform (2D-DCT)

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282 Music as Source Domain: A Cross-Linguistic Exploration of Conceptual Metaphors

Authors: Eleanor Sweeney, Chunyuan Di

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The metaphors people use in everyday discourse do not arise randomly; rather, they develop from our physical experiences in our social and cultural environments. Conceptual Metaphor Theory (CMT) explains that through metaphor, we apply our embodied understanding of the physical world to non-material concepts to understand and express abstract concepts. Our most productive source domains derive from our embodied understanding and allow us to develop primary metaphors, and from primary metaphors, an elaborate, creative world of culturally constructed complex metaphors. Cognitive Linguistics researchers draw upon individual embodied experience for primary metaphors. Socioculturally embodied experience through music has long furnished linguistic expressions in diverse languages, as conceptual metaphors or everyday expressions.  Can a socially embodied experience function in the same way as an individually embodied experience in the creation of conceptual metaphors? The authors argue that since music is inherently social and embodied, musical experiences function as a richly motivated source domain. The focus of this study is socially embodied musical experience which is then reflected and expressed through metaphors. This cross-linguistic study explores music as a source domain for metaphors of social alignment in English, French, and Chinese. The authors explored two public discourse sites, Facebook and Linguée, in order to collect linguistic metaphors from three different languages. By conducting this cross-linguistic study, cross-cultural similarities and differences in metaphors for which music is the source domain can be examined. Different musical elements, such as melody, speed, rhythm and harmony, are analyzed for their possible metaphoric meanings of social alignment. Our findings suggest that the general metaphor cooperation is music is a productive metaphor with some subcases, and that correlated social behaviors can be metaphorically expressed with certain elements in music. For example, since performance is a subset of the category behavior, there is a natural mapping from performance in music to behavior in social settings: social alignment is musical performance. Musical performance entails a collective social expectation that exerts control over individual behavior.  When individual behavior does not align with the collective social expectation, music-related expressions are often used to express how the individual is violating social norms. Moreover, when individuals do align their behavior with social norms, similar musical expressions are used. Cooperation is a crucial social value in all cultures, indeed it is a key element of survival, and music provides a coherent, consistent, and rich source domain—one based upon a universal and definitive cultural practice.

Keywords: Chinese, Conceptual Metaphor Theory, cross-linguistic, culturally embodied experience, English, French, metaphor, music

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281 The Gypsy Community Facing the Sexual Orientation: An Empirical Approach to the Attitudes of the Gypsy Population of Granada Towards Homosexual Sex-Affective Relationships

Authors: Elena Arquer Cuenca

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The gypsy community has been a mistreated and rejected group since its arrival in the Iberian Peninsula in the 15th century. At present, despite being the largest ethnic minority group in Spain as well as in Europe, the different legal and social initiatives in favour of equality continue to suffer discrimination by the general society. This has fostered a strengthening of the endogroup accompanied by cultural conservatism as a form of self-protection. Despite the current trend of normalization of sexual diversity in modern societies, LGB people continue to suffer discrimination, especially in more traditional environments or communities. This rejection for reasons of sexual orientation within the family or community can hinder the free development of the person and compromise peaceful coexistence. The present work is intended as an approach to the attitudes of the gypsy population towards non-heterosexual sexual orientation. The objective is none other than ‘to know the appreciation that the gypsy population has about homosexual sex-affective relationships, in order to assess whether this has any impact on family and community coexistence’. The following specific objectives are derived from this general objective: ‘To find out whether there is a relationship between the dichotomous Roma gender system and the acceptance/rejection of homosexuality’; ‘to analyse whether sexual orientation has an impact on the coexistence of the Roman family and community’; ‘to analyse whether the historical discrimination suffered by the Roman population favours the maintenance of the patriarchal heterosexual reproductive family’; and lastly ‘to explore whether ICTs have promoted the process of normalisation and/or acceptance of homosexuality within the Roma community’. In order to achieve these objectives, a bibliographical and documentary review has been used, as well as the semi-structured interview technique, in which 4 gypsy people participated (2 women and 2 men of different ages). One of the main findings was the inappropriateness of the use of the homogenising category "Gypsy People" at present, given the great diversity among the Roma communities. Moreover, the difficulty in accepting homosexuality seems to be related to the fact that the heterosexual reproductive family has been the main survival mechanism of Roma communities over centuries. However, it will be concluded that attitudes towards homosexuality will vary depending on the socio-economic and cultural context and factors such as age or professed religion. Three main contributions of this research are: firstly, the inclusion of sexual orientation as a variable to be considered when analysing peaceful coexistence; secondly socio-historical dynamics and structures of inequality have been taken into account when analysing Roma attitudes towards homosexuality; and finally, the processual nature of socio-cultural changes has also been considered.

Keywords: gender, homosexuality, ICTs, peaceful coexistence, Roma community, sexual orientation

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280 Influence of Strain on the Corrosion Behavior of Dual Phase 590 Steel

Authors: Amit Sarkar, Jayanta K. Mahato, Tushar Bhattacharya, Amrita Kundu, P. C. Chakraborti

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With increasing the demand for safety and fuel efficiency of automobiles, automotive manufacturers are looking for light weight, high strength steel with excellent formability and corrosion resistance. Dual-phase steel is finding applications in automotive sectors, because of its high strength, good formability, and high corrosion resistance. During service automotive components suffer from environmental attack and thereby gradual degradation of the components occurs reducing the service life of the components. The objective of the present investigation is to assess the effect of deformation on corrosion behaviour of DP590 grade dual phase steel which is used in automotive industries. The material was received from TATA Steel Jamshedpur, India in the form of 1 mm thick sheet. Tensile properties of the steel at strain rate of 10-3 sec-1: 0.2 % Yield Stress is 382 MPa, Ultimate Tensile Strength is 629 MPa, Uniform Strain is 16.30% and Ductility is 29%. Rectangular strips of 100x10x1 mm were machined keeping the long axis of the strips parallel to rolling direction of the sheet. These strips were longitudinally deformed at a strain rate at 10-3 sec-1 to a different percentage of strain, e.g. 2.5, 5, 7.5,10 and 12.5%, and then slowly unloaded. Small specimens were extracted from the mid region of the unclamped portion of these deformed strips. These small specimens were metallographic polished, and corrosion behaviour has been studied by potentiodynamic polarization, electrochemical impedance spectra, and cyclic polarization and potentiostatic tests. Present results show that among three different environments, the 3.5 pct NaCl solution is most aggressive in case of DP 590 dual-phase steel. It is observed that with the increase in the amount of deformation, corrosion rate increases. With deformation, the stored energy increases and leads to enhanced corrosion rate. Cyclic polarization results revealed highly deformed specimen are more prone to pitting corrosion as compared to the condition when amount of deformation is less. It is also observed that stability of the passive layer decreases with the amount of deformation. With the increase of deformation, current density increases in a passive zone and passive zone is also decreased. From Electrochemical impedance spectroscopy study it is found that with increasing amount of deformation polarization resistance (Rp) decreases. EBSD results showed that average geometrically necessary dislocation density increases with increasing strain which in term increased galvanic corrosion as dislocation areas act as the less noble metal.

Keywords: dual phase 590 steel, prestrain, potentiodynamic polarization, cyclic polarization, electrochemical impedance spectra

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279 Federated Knowledge Distillation with Collaborative Model Compression for Privacy-Preserving Distributed Learning

Authors: Shayan Mohajer Hamidi

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Federated learning has emerged as a promising approach for distributed model training while preserving data privacy. However, the challenges of communication overhead, limited network resources, and slow convergence hinder its widespread adoption. On the other hand, knowledge distillation has shown great potential in compressing large models into smaller ones without significant loss in performance. In this paper, we propose an innovative framework that combines federated learning and knowledge distillation to address these challenges and enhance the efficiency of distributed learning. Our approach, called Federated Knowledge Distillation (FKD), enables multiple clients in a federated learning setting to collaboratively distill knowledge from a teacher model. By leveraging the collaborative nature of federated learning, FKD aims to improve model compression while maintaining privacy. The proposed framework utilizes a coded teacher model that acts as a reference for distilling knowledge to the client models. To demonstrate the effectiveness of FKD, we conduct extensive experiments on various datasets and models. We compare FKD with baseline federated learning methods and standalone knowledge distillation techniques. The results show that FKD achieves superior model compression, faster convergence, and improved performance compared to traditional federated learning approaches. Furthermore, FKD effectively preserves privacy by ensuring that sensitive data remains on the client devices and only distilled knowledge is shared during the training process. In our experiments, we explore different knowledge transfer methods within the FKD framework, including Fine-Tuning (FT), FitNet, Correlation Congruence (CC), Similarity-Preserving (SP), and Relational Knowledge Distillation (RKD). We analyze the impact of these methods on model compression and convergence speed, shedding light on the trade-offs between size reduction and performance. Moreover, we address the challenges of communication efficiency and network resource utilization in federated learning by leveraging the knowledge distillation process. FKD reduces the amount of data transmitted across the network, minimizing communication overhead and improving resource utilization. This makes FKD particularly suitable for resource-constrained environments such as edge computing and IoT devices. The proposed FKD framework opens up new avenues for collaborative and privacy-preserving distributed learning. By combining the strengths of federated learning and knowledge distillation, it offers an efficient solution for model compression and convergence speed enhancement. Future research can explore further extensions and optimizations of FKD, as well as its applications in domains such as healthcare, finance, and smart cities, where privacy and distributed learning are of paramount importance.

Keywords: federated learning, knowledge distillation, knowledge transfer, deep learning

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278 A Principal’s Role in Creating and Sustaining an Inclusive Environment

Authors: Yazmin Pineda Zapata

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Leading a complete school and culture transformation can be a daunting task for any administrator. This is especially true when change agents are advocating for inclusive reform in their schools. As leaders embark on this journey, they must ascertain that an inclusive environment is not a place, a classroom, or a resource setting; it is a place of acceptance nurtured by supportive and meaningful learning opportunities where all students can thrive. A qualitative approach, phenomenology, was used to investigate principals’ actions and behaviors that supported inclusive schooling for students with disabilities. Specifically, this study sought to answer the following research question: How do leaders develop and maintain inclusive education? Fourteen K-12 principals purposefully selected from various sources (e.g., School Wide Integrated Framework for Transformation (SWIFT), The Maryland Coalition for Inclusive Education (MCIE), The Arc of Texas Inclusion Works organization, The Association for Persons with Severe Handicaps (TASH), the CAL State Summer Institute in San Marcos, and the PEAK Parent Center and/or other recognitions were interviewed individually using a semi-structured protocol. Upon completion of data collection, all interviews were transcribed and marked using A priori coding to analyze the responses and establish a correlation among Villa and Thousand’s five organizational supports to achieve inclusive educational reform: Vision, Skills, Incentives, Resources, and Action Plan. The findings of this study reveal the insights of principals who met specific criteria and whose schools had been highlighted as exemplary inclusive schools. Results show that by implementing the five organizational supports, principals were able to develop and sustain successful inclusive environments where both teachers and students were motivated, made capable, and supported through the redefinition and restructuring of systems within the school. Various key details of the five variables for change depict essential components within these systems, which include quality professional development, coaching and modeling of co-teaching strategies, collaborative co-planning, teacher leadership, and continuous stakeholder (e.g., teachers, students, support staff, and parents) involvement. The administrators in this study proved the valuable benefits of inclusive education for students with disabilities and their typically developing peers. Together, along with their teaching and school community, school leaders became capable stakeholders that promoted the vision of inclusion, planned a structured approach, and took action to make it a reality.

Keywords: Inclusive education, leaders, principals, shared-decision making, shared leadership, special education, sustainable change

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277 The Impact of HKUST-1 Metal-Organic Framework Pretreatment on Dynamic Acetaldehyde Adsorption

Authors: M. François, L. Sigot, C. Vallières

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Volatile Organic Compounds (VOCs) are a real health issue, particularly in domestic indoor environments. Among these VOCs, acetaldehyde is frequently monitored in dwellings ‘air, especially due to smoking and spontaneous emissions from the new wall and soil coverings. It is responsible for respiratory complaints and is classified as possibly carcinogenic to humans. Adsorption processes are commonly used to remove VOCs from the air. Metal-Organic Frameworks (MOFs) are a promising type of material for high adsorption performance. These hybrid porous materials composed of metal inorganic clusters and organic ligands are interesting thanks to their high porosity and surface area. The HKUST-1 (also referred to as MOF-199) is a copper-based MOF with the formula [Cu₃(BTC)₂(H₂O)₃]n (BTC = benzene-1,3,5-tricarboxylate) and exhibits unsaturated metal sites that can be attractive sites for adsorption. The objective of this study is to investigate the impact of HKUST-1 pretreatment on acetaldehyde adsorption. Thus, dynamic adsorption experiments were conducted in 1 cm diameter glass column packed with 2 cm MOF bed height. MOF were sieved to 630 µm - 1 mm. The feed gas (Co = 460 ppmv ± 5 ppmv) was obtained by diluting a 1000 ppmv acetaldehyde gas cylinder in air. The gas flow rate was set to 0.7 L/min (to guarantee a suitable linear velocity). Acetaldehyde concentration was monitored online by gas chromatography coupled with a flame ionization detector (GC-FID). Breakthrough curves must allow to understand the interactions between the MOF and the pollutant as well as the impact of the HKUST-1 humidity in the adsorption process. Consequently, different MOF water content conditions were tested, from a dry material with 7 % water content (dark blue color) to water saturated state with approximately 35 % water content (turquoise color). The rough material – without any pretreatment – containing 30 % water serves as a reference. First, conclusions can be drawn from the comparison of the evolution of the ratio of the column outlet concentration (C) on the inlet concentration (Co) as a function of time for different HKUST-1 pretreatments. The shape of the breakthrough curves is significantly different. The saturation of the rough material is slower (20 h to reach saturation) than that of the dried material (2 h). However, the breakthrough time defined for C/Co = 10 % appears earlier in the case of the rough material (0.75 h) compared to the dried HKUST-1 (1.4 h). Another notable difference is the shape of the curve before the breakthrough at 10 %. An abrupt increase of the outlet concentration is observed for the material with the lower humidity in comparison to a smooth increase for the rough material. Thus, the water content plays a significant role on the breakthrough kinetics. This study aims to understand what can explain the shape of the breakthrough curves associated to the pretreatments of HKUST-1 and which mechanisms take place in the adsorption process between the MOF, the pollutant, and the water.

Keywords: acetaldehyde, dynamic adsorption, HKUST-1, pretreatment influence

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276 Fatigue Influence on the Residual Stress State in Shot Peened Duplex Stainless Steel

Authors: P. D. Pedrosa, J. M. A. Rebello, M. P. Cindra Fonseca

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Duplex stainless steels (DSS) exhibit a biphasic microstructure consisting of austenite and delta ferrite. Their high resistance to oxidation, and corrosion, even in H2S containing environments, allied to low cost when compared to conventional stainless steel, are some properties which make this material very attractive for several industrial applications. However, several of these industrial applications imposes cyclic loading to the equipments and in consequence fatigue damage needs to be a concern. A well-known way of improving the fatigue life of a component is by introducing compressive residual stress in its surface. Shot peening is an industrial working process which brings the material directly beneath component surface in a high mechanical compressive state, so inhibiting fatigue crack initiation. However, one must take into account the fact that the cyclic loading itself can reduce and even suppress these residual stresses, thus having undesirable consequences in the process of improving fatigue life by the introduction of compressive residual stresses. In the present work, shot peening was used to introduce residual stresses in several DSS samples. These were thereafter submitted to three different fatigue regimes: low, medium and high cycle fatigue. The evolution of the residual stress during loading were then examined on both surface and subsurface of the samples. It was used the DSS UNS S31803, with microstructure composed of 49% austenite and 51% ferrite. The treatment of shot peening was accomplished by the application of blasting in two Almen intensities of 0.25 and 0.39A. The residual stresses were measured by X-ray diffraction using the double exposure method and a portable equipment with CrK radiation and the (211) diffracting plane for the austenite phase and the (220) plane for the ferrite phase. It is known that residual stresses may arise when two regions of the same material experienced different degrees of plastic deformation. When these regions are separated in respect to each other on a scale that is large compared to the material's microstructure they are called macro stresses. In contrast, microstresses can largely vary over distances which are small comparable to the scale of the material's microstructure and must balance zero between the phases present. In the present work, special attention will be paid to the measurement of residual microstresses. Residual stress measurements were carried out in test pieces submitted to low, medium and high-cycle fatigue, in both longitudinal and transverse direction of the test pieces. It was found that after shot peening, the residual microstress is tensile in the austenite and compressive in the ferrite phases. It was hypothesized that the hardening behavior of the austenite after shot peening was probably due to its higher nitrogen content. Fatigue cycling can effectively change this stress state but this effect was found to be dependent of the shot peening intensity was well as the fatigue range.

Keywords: residual stresses, fatigue, duplex steel, shot peening

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275 Alternate Approaches to Quality Measurement: An Exploratory Study in Differentiation of “Quality” Characteristics in Services and Supports

Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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274 Differentials of Motor Fitness Components among the School Children of Rural and Urban Areas of the Jammu Region

Authors: Sukhdev Singh, Baljinder Singh Bal, Amandeep Singh, Kanchan Thappa

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A nation's future almost certainly rests on the future of its children, and a nation's wellbeing can be greatly improved by providing for the right upbringing of its children. Participating in physical education and sports programmes is crucial for reaching one's full potential. As we are all aware, sports have recently become incredibly popular on a global scale. Sports are continually becoming more and more popular, and this positive trend is probably going to last for some time to come. Motor abilities will provide more accurate information on the developmental process of children. Motor fitness is a component of physical fitness that includes strength, speed, flexibility, and agility, and is related to enhanced performance and the development of motor skills. In recent years, there has been increased interest in the differences in child growth between urban and rural environments. Differences in student growth, body dimensions, body composition, and fitness levels due to urban and rural environmental disparities have come into focus in recent years. The main aim of this study is to know the differentials of motor fitness components among the school children of rural and urban areas of the Jammu region. Material and Methods: In total, sixty male subjects (mean ± SD; age, 16.475 ± 1.0124 yrs.; height, 172.8 ± 2.0153 cm; Weight, 59.75 ± 3.628 kg) from the Jammu region took part in the study. A minimum sample size of 40 subjects was obtained and was derived from Rural (N1=20) and Urban (N2=20) school-going children. Statistical Applications: The Statistical Package for the Social Sciences (SPSS) version 14.0 was used for all analyses. The differences in the mean of each group for the selected variable were tested for the significance of difference by an independent samples t-test. For testing the hypotheses, the level of significance was set at 0.05. Results: Results revealed that there were significant differences of leg explosive strength (p=0.0040*), dynamic balance (p=0.0056*), and Agility (p=0.0176*) among the School Children of the rural and urban areas of the Jammu region. However, Results further revealed that there were not significant differences of cardio respiratory endurance (p=0.8612), speed (p=0.2231), Low Back/Hamstring Flexibility (p=0.6478), and Two Hand Coordination. (p= 0.0953) among the School Children of the rural and urban areas of the Jammu region. Conclusion: The results of study showed that there is significance difference between Rural and Urban School children of the Jammu region with regards to a variable," leg explosive strength, dynamic balance, Agility” and the there is no significance difference between Rural and Urban School children of the Jammu region with regards variable “cardio-respiratory endurance, speed, Low Back/Hamstring Flexibility, Two Hand Coordination”.

Keywords: motor fitness, rural areas, school children, urban areas

Procedia PDF Downloads 76
273 A Lightning Strike Mimic: The Abusive Use of Dog Shock Collar Presents as Encephalopathy, Respiratory Arrest, Cardiogenic Shock, Severe Hypernatremia, Rhabdomyolysis, and Multiorgan Injury

Authors: Merrick Lopez, Aashish Abraham, Melissa Egge, Marissa Hood, Jui Shah

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A 3 year old male with unknown medical history presented initially with encephalopathy, intubated for respiratory failure, and admitted to the pediatric intensive care unit (PICU) with refractory shock. During resuscitation in the emergency department, he was found to be in severe metabolic acidosis with a pH of 7.03 and escalated on vasopressor drips for hypotension. His initial sodium was 174. He was noted to have burn injuries to his scalp, forehead, right axilla, bilateral arm creases and lower legs. He had rhabdomyolysis (initial creatinine kinase 5,430 U/L with peak levels of 62,340 normal <335 U/L), cardiac injury (initial troponin 88 ng/L with peak at 145 ng/L, normal <15ng/L), hypernatremia (peak 174, normal 140), hypocalcemia, liver injury, acute kidney injury, and neuronal loss on magnetic resonance imaging (MRI). Soft restraints and a shock collar were found in the home. He was critically ill for 8 days, but was gradually weaned off drips, extubated, and started on feeds. Discussion Electrical injury, specifically lightning injury is an uncommon but devastating cause of injury in pediatric patients. This patient with suspected abusive use of a dog shock collar presented similar to a lightning strike. Common entrance points include the hands and head, similar to our patient with linear wounds on his forehead. When current enters, it passes through tissues with the least resistance. Nerves, blood vessels, and muscles, have high fluid and electrolyte content and are commonly affected. Exit points are extremities: our child who had circumferential burns around his arm creases and ankles. Linear burns preferentially follow areas of high sweat concentration, and are thought to be due to vaporization of water on the skin’s surface. The most common cause of death from a lightning strike is due to cardiopulmonary arrest. The massive depolarization of the myocardium can result in arrhythmias and myocardial necrosis. The patient presented in cardiogenic shock with evident cardiac damage. Electricity going through vessels can lead to vaporization of intravascular water. This can explain his severe hypernatremia. He also sustained other internal organ injuries (adrenal glands, pancreas, liver, and kidney). Electrical discharge also leads to direct skeletal muscle injury in addition to prolonged muscular spasm. Rhabdomyolysis, the acute damage of muscle, leads to release of potentially toxic components into the circulation which could lead to acute renal failure. The patient had severe rhabdomyolysis and renal injury. Early hypocalcemia has been consistently demonstrated in patients with rhabdomyolysis. This was present in the patient and led to increased vasopressor needs. Central nervous system injuries are also common which can include encephalopathy, hypoxic injury, and cerebral infarction. The patient had evidence of brain injury as seen on MRI. Conclusion Electrical injuries due to lightning strikes and abusive use of a dog shock collar are rare, but can both present in similar ways with respiratory failure, shock, hypernatremia, rhabdomyolysis, brain injury, and multiorgan damage. Although rare, it is essential for early identification and prompt management for acute and chronic complications in these children.

Keywords: cardiogenic shock, dog shock collar, lightning strike, rhabdomyolysis

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272 The Impact of Housing Design on the Health and Well-Being of Populations: A Case-Study of Middle-Class Families in the Metropolitan Region of Port-Au-Prince, Haiti

Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

Procedia PDF Downloads 139
271 Exploring Neural Responses to Urban Spaces in Older People Using Mobile EEG

Authors: Chris Neale, Jenny Roe, Peter Aspinall, Sara Tilley, Steve Cinderby, Panos Mavros, Richard Coyne, Neil Thin, Catharine Ward Thompson

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This research directly assesses older people’s neural activation in response to walking through a changing urban environment, as measured by electroencephalography (EEG). As the global urban population is predicted to grow, there is a need to understand the role that the urban environment may play on the health of its older inhabitants. There is a large body of evidence suggesting green space has a beneficial restorative effect, but this effect remains largely understudied in both older people and by using a neuroimaging assessment. For this study, participants aged 65 years and over were required to walk between a busy urban built environment and a green urban environment, in a counterbalanced design, wearing an Emotiv EEG headset to record real-time neural responses to place. Here we report on the outputs for these responses derived from both the proprietary Affectiv Suite software, which creates emotional parameters with a real time value assigned to them, as well as the raw EEG output focusing on alpha and beta changes, associated with changes in relaxation and attention respectively. Each walk lasted around fifteen minutes and was undertaken at the natural walking pace of the participant. The two walking environments were compared using a form of high dimensional correlated component regression (CCR) on difference data between the urban busy and urban green spaces. For the Emotiv parameters, results showed that levels of ‘engagement’ increased in the urban green space (with a subsequent decrease in the urban busy built space) whereas levels of ‘excitement’ increased in the urban busy environment (with a subsequent decrease in the urban green space). In the raw data, low beta (13 – 19 Hz) increased in the urban busy space with a subsequent decrease shown in the green space, similar to the pattern shown with the ‘excitement’ result. Alpha activity (9 – 13 Hz) shows a correlation with low beta, but not with dependent change in the regression model. This suggests that alpha is acting as a suppressor variable. These results suggest that there are neural signatures associated with the experience of urban spaces which may reflect the age of the cohort or the spatiality of the settings themselves. These are shown both in the outputs of the proprietary software as well as the raw EEG output. Built busy urban spaces appear to induce neural activity associated with vigilance and low level stress, while this effect is ameliorated in the urban green space, potentially suggesting a beneficial effect on attentional capacity in urban green space in this participant group. The interaction between low beta and alpha requires further investigation, in particular the role of alpha in this relationship.

Keywords: ageing, EEG, green space, urban space

Procedia PDF Downloads 224
270 Association between Occupational Characteristics and Well-Being: An Exploratory Study of Married Working Women in New Delhi, India

Authors: Kanchan Negi

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Background: Modern and urban occupational culture have driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and wellbeing in a sample of women living in the metropolitan hub of Delhi. Method: This study is based on the data collected from 360 currently married women between age 29 and 49 years, working in the urban capital hub of India, i.e., Delhi. The women interviewed were professionals from the education, health, banking and information and technology (IT) sector. Bivariate analysis was done to study the characteristics of the sample. Logistic regression analysis was used to estimate the physical and psychological wellbeing across occupational characteristics. Results: Most of the working women were below age 35 years; around 30% of women worked in the education sector, 23% in health, 21% in banking and 26% in the IT sector. Over 55% of women were employed in the private sector and only 36% were permanent employees. Nearly 30% of women worked for more than the standard 8 hours a day. The findings from logistic regression showed that compared to women working in the education sector, those who worked in the banking and IT sector more likely to have physical and psychological health issues (OR 2.07-4.37, CI 1.17-4.37); women who bear dual burden of responsibilities had higher odds of physical and psychological health issues than women who did not (OR 1.19-1.85 CI 0.96-2.92). Women who worked for more than 8 hours a day (OR 1.15, CI 1.01-1.30) and those who worked for more than five days a week (OR 1.25, CI 1.05-1.35) were more likely to have physical health issues than women who worked for 6-8 hours a day and five days e week, respectively. Also, not having flexible work timings and compensatory holidays increased the odds of having physical and psychological health issues among working women (OR 1.17-1.29, CI 1.01-1.47). Women who worked in the private sector, those employed temporarily and who worked in the non-conducive environments were more likely to have psychological health issues as compared to women in the public sector, permanent employees and those who worked in a conducive environment, respectively (OR 1.33-1.67, CI 1.09-2.91). Women who did not have poor work-life balance had reduced the odds of psychological health issues than women with poor work-life balance (OR 0.46, CI 0.25-0.84). Conclusion: Poor wellbeing significantly linked to strenuous and rigid work patterns, suggesting that modern and urban work culture may contribute to the poor wellbeing of working women. Noticing the recent decline in female workforce participation in Delhi, schemes like Flexi-timings, compensatory holidays, work-from-home and daycare facilities for young ones must be welcomed; these policies already exist in some private sector firms, and the public sectors companies should also adopt such changes to ease the dual burden as homemaker and career maker. This could encourage women in the urban areas to readily take up the jobs with less juggle to manage home and work.

Keywords: occupational characteristics, urban India, well-being, working women

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269 The Attitudes of Senior High School Students Toward Work Immersion Programs of Nazareth School of National University

Authors: Kim Katherine Castillo, Nelson John Datubatang, Terrence Phillip Dy, Norelie Hampac, Reichen Crismark Martinez, Nina Faith Pantinople, Jose Dante Santos II, Marchel Ann Santos, Sophia Abigail Santiago, Zyrill Xsar San Juan, Aira Mae Tagao, Crystal Kylla Viagedor

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The Work Immersion Program was implemented to help students gain abundant work-related experiences while on-site; additionally, the program aims to help students improve their competencies and interpersonal skills as they are given the option to join the workforce if they ever choose to do so after senior high school. The work immersion experience posed diverse challenges for students, spanning personal, financial, engagement, environmental, and equipment-related domains. These included the need for assistance in time management, transportation expenses, and procurement of materials. Furthermore, students faced difficulties in independent task completion and encountered suboptimal work environments. Addressing these multifaceted obstacles is crucial to optimize the educational outcomes of work immersion programs. In addition to the challenges, several other issues have been identified, including the absence of standardized work immersion programs across schools and industries, the challenges in securing appropriate work immersion placements, the necessity for enhanced monitoring and evaluation of program effectiveness, and the limited availability of field programs aligned with students' chosen courses. Furthermore, there is a lack of comprehensive information regarding the attitudes of Senior High School students toward work immersion programs within their respective schools. This study aims to investigate the attitudes of senior high school students at Nazareth School of National University towards work immersion programs, with a focus on identifying factors that influence their perception and participation, including collegiality and expectations. By exploring the students' attitudes, the research endeavors to enhance the school's work immersion programs and contribute to the overall educational experience of the students. This study addresses challenges related to work immersion programs, focusing on six subtopics: Work Immersion, Work Immersion in the Philippines, Students' Attitudes, Factors Affecting Students' Attitudes, Effectiveness of Work Immersion for Senior High School Students, and Students' Perception and Willingness to Participate. Using a descriptive research design, the study examines the attitudes of senior high school students at Nazareth School of National University in Manila. Data was collected from 100 students, representing different academic strands, through a 35-item researcher-made survey. Descriptive statistics, including measures of central tendency and variability, will be used to analyze the data using JASP, providing valuable insights into the students' attitudes toward work immersion.

Keywords: attitudes, challenges, educational outcomes, work immersion programs

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268 Narrating Atatürk Cultural Center as a Place of Memory and a Space of Politics

Authors: Birge Yildirim Okta

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This paper aims to narrate the story of Atatürk Cultural Center in Taksim Square, which was demolished in 2018 and discuss its architectonic as a social place of memory and its existence and demolishment as the space of politics. The paper uses narrative discourse analysis to research Atatürk Cultural Center (AKM) as a place of memory and space of politics from the establishment of the Turkish Republic (1923) until today. After the establishment of the Turkish Republic, one of the most important implementations in Taksim Square, reflecting the internationalist style, was the construction of the Opera Building in Prost Plan. The first design of the opera building belonged to Aguste Perret, which could not be implemented due to economic hardship during World War II. Later the project was designed by architects Feridun Kip and Rüknettin Güney in 1946 but could not be completed due to the 1960 military coup. Later the project was shifted to another architect Hayati Tabanlıoglu, with a change in its function as a cultural center. Eventually, the construction of the building was completed in 1969 in a completely different design. AKM became a symbol of republican modernism not only with its modern architectural style but also with it is function as the first opera building of the Republic, reflecting the western, modern cultural heritage by professional groups, artists, and the intelligentsia. In 2005, Istanbul’s council for the protection of cultural heritage decided to list AKM as a grade 1 cultural heritage, ending a period of controversy which saw calls for the demolition of the center as it was claimed, it ended its useful lifespan. In 2008 the building was announced to be closed for repairs and restoration. Over the following years, the building was demolished piece by piece silently while the Taksim mosque has been built just in front of Atatürk Cultural Center. Belonging to the early republican period AKM was a representation of the cultural production of modern society for the emergence and westward looking, secular public space in Turkey. Its erasure from the Taksim scene under the rule of the conservative government, Justice, and Development Party, and the construction of the Taksim mosque in front of AKM’s parcel is also representational. The question of governing the city through space has always been an important aspect for governments, those holding political power since cities are the chaotic environments that are seen as a threat for the governments, carrying the tensions of the proletariat or the contradictory groups. The story of AKM as a dispositive or a regulatory apparatus demonstrates how space itself is becoming a political medium, to transform the socio-political condition. The paper narrates the existence and demolishment of the Atatürk Cultural Center by discussing the constructed and demolished building as a place of memory and space of politics.

Keywords: space of politics, place of memory, Atatürk Cultural Center, Taksim square, collective memory

Procedia PDF Downloads 140
267 Case Report: Peripartum Cardiomyopathy, a Rare but Fatal Condition in Pregnancy and Puerperium

Authors: Sadaf Abbas, HimGauri Sabnis

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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.

Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium

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266 Open Space Use in University Campuses with User Requirements Analysis: The Case of Eskişehir Osmangazi University Meşelik Campus

Authors: Aysen Celen Ozturk, Hatice Dulger

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University may be defined as a teaching institution consisting of faculties, institutes, colleges, and units that have undergraduate and graduate education, scientific research and publications. It has scientific autonomy and public legal personality. Today, universities are not only the institutions in which students and lecturers experience education, training and scientific work. They also offer social, cultural and artistic activities that strengthen the link with the city. This also incorporates all city users into the campus borders. Thus, universities contribute to social and individual development of the country by providing science, art, socio-cultural development, communication and socialization with people of different cultural and social backgrounds. Moreover, universities provide an active social life, where the young population is the majority. This enables the sense of belonging to the users to develop, to increase the interaction between academicians and students, and to increase the learning / producing community by continuing academic sharing environments outside the classrooms. For this reason, besides academic spaces in university campuses, the users also need closed and open spaces where they can socialize, spend time together and relax. Public open spaces are the most important social spaces that individuals meet, express themselves and share. Individuals belonging to different socio-cultural structures and ethnic groups maintain their social experiences with the physical environment they are in, the outdoors, and their actions and sharing in these spaces. While university campuses are being designed for their individual and social development roles, user needs must be determined correctly and design should be realized in this direction. While considering that requirements may change over time, user satisfaction should be questioned at certain periods and new arrangements should be made in existing applications in the direction of current demands. This study aims to determine the user requirements through the case of Eskişehir Osmangazi University, Meşelik Campus / Turkey. Post Occupancy Evaluation (POE) questionnaire, cognitive mapping and deep interview methods are used in the research process. All these methods show that the students, academicians and other officials in the Meşelik Campus of Eskişehir Osmangazi University find way finding elements insufficient and are in need of efficient landscape design and social spaces. This study is important in terms of determining the needs of the users as a design input. This will help improving the quality of common space in Eskişehir Osmangazi University and in other similar universities.

Keywords: university campuses, public open space, user requirement, post occupancy evaluation

Procedia PDF Downloads 243
265 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles

Authors: Shiau-Fang Chao, Yu-Chih Chen

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Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

Procedia PDF Downloads 197
264 Requirement Engineering for Intrusion Detection Systems in Wireless Sensor Networks

Authors: Afnan Al-Romi, Iman Al-Momani

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The urge of applying the Software Engineering (SE) processes is both of vital importance and a key feature in critical, complex large-scale systems, for example, safety systems, security service systems, and network systems. Inevitably, associated with this are risks, such as system vulnerabilities and security threats. The probability of those risks increases in unsecured environments, such as wireless networks in general and in Wireless Sensor Networks (WSNs) in particular. WSN is a self-organizing network of sensor nodes connected by wireless links. WSNs consist of hundreds to thousands of low-power, low-cost, multi-function sensor nodes that are small in size and communicate over short-ranges. The distribution of sensor nodes in an open environment that could be unattended in addition to the resource constraints in terms of processing, storage and power, make such networks in stringent limitations such as lifetime (i.e. period of operation) and security. The importance of WSN applications that could be found in many militaries and civilian aspects has drawn the attention of many researchers to consider its security. To address this important issue and overcome one of the main challenges of WSNs, security solution systems have been developed by researchers. Those solutions are software-based network Intrusion Detection Systems (IDSs). However, it has been witnessed, that those developed IDSs are neither secure enough nor accurate to detect all malicious behaviours of attacks. Thus, the problem is the lack of coverage of all malicious behaviours in proposed IDSs, leading to unpleasant results, such as delays in the detection process, low detection accuracy, or even worse, leading to detection failure, as illustrated in the previous studies. Also, another problem is energy consumption in WSNs caused by IDS. So, in other words, not all requirements are implemented then traced. Moreover, neither all requirements are identified nor satisfied, as for some requirements have been compromised. The drawbacks in the current IDS are due to not following structured software development processes by researches and developers when developing IDS. Consequently, they resulted in inadequate requirement management, process, validation, and verification of requirements quality. Unfortunately, WSN and SE research communities have been mostly impermeable to each other. Integrating SE and WSNs is a real subject that will be expanded as technology evolves and spreads in industrial applications. Therefore, this paper will study the importance of Requirement Engineering when developing IDSs. Also, it will study a set of existed IDSs and illustrate the absence of Requirement Engineering and its effect. Then conclusions are drawn in regard of applying requirement engineering to systems to deliver the required functionalities, with respect to operational constraints, within an acceptable level of performance, accuracy and reliability.

Keywords: software engineering, requirement engineering, Intrusion Detection System, IDS, Wireless Sensor Networks, WSN

Procedia PDF Downloads 322
263 Evolutionary Advantages of Loneliness with an Agent-Based Model

Authors: David Gottlieb, Jason Yoder

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The feeling of loneliness is not uncommon in modern society, and yet, there is a fundamental lack of understanding in its origins and purpose in nature. One interpretation of loneliness is that it is a subjective experience that punishes a lack of social behavior, and thus its emergence in human evolution is seemingly tied to the survival of early human tribes. Still, a common counterintuitive response to loneliness is a state of hypervigilance, resulting in social withdrawal, which may appear maladaptive to modern society. So far, no computational model of loneliness’ effect during evolution yet exists; however, agent-based models (ABM) can be used to investigate social behavior, and applying evolution to agents’ behaviors can demonstrate selective advantages for particular behaviors. We propose an ABM where each agent contains four social behaviors, and one goal-seeking behavior, letting evolution select the best behavioral patterns for resource allocation. In our paper, we use an algorithm similar to the boid model to guide the behavior of agents, but expand the set of rules that govern their behavior. While we use cohesion, separation, and alignment for simple social movement, our expanded model adds goal-oriented behavior, which is inspired by particle swarm optimization, such that agents move relative to their personal best position. Since agents are given the ability to form connections by interacting with each other, our final behavior guides agent movement toward its social connections. Finally, we introduce a mechanism to represent a state of loneliness, which engages when an agent's perceived social involvement does not meet its expected social involvement. This enables us to investigate a minimal model of loneliness, and using evolution we attempt to elucidate its value in human survival. Agents are placed in an environment in which they must acquire resources, as their fitness is based on the total resource collected. With these rules in place, we are able to run evolution under various conditions, including resource-rich environments, and when disease is present. Our simulations indicate that there is strong selection pressure for social behavior under circumstances where there is a clear discrepancy between initial resource locations, and against social behavior when disease is present, mirroring hypervigilance. This not only provides an explanation for the emergence of loneliness, but also reflects the diversity of response to loneliness in the real world. In addition, there is evidence of a richness of social behavior when loneliness was present. By introducing just two resource locations, we observed a divergence in social motivation after agents became lonely, where one agent learned to move to the other, who was in a better resource position. The results and ongoing work from this project show that it is possible to glean insight into the evolutionary advantages of even simple mechanisms of loneliness. The model we developed has produced unexpected results and has led to more questions, such as the impact loneliness would have at a larger scale, or the effect of creating a set of rules governing interaction beyond adjacency.

Keywords: agent-based, behavior, evolution, loneliness, social

Procedia PDF Downloads 96
262 Environmental Threats and Great Barrier Reef: A Vulnerability Assessment of World’s Best Tropical Marine Ecosystems

Authors: Ravi Kant Anand, Nikkey Keshri

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The Great Barrier Reef of Australia is known for its beautiful landscapes and seascapes with ecological importance. This site was selected as a World Heritage site in 1981 and popularized internationally for tourism, recreational activities and fishing. But the major environmental hazards such as climate change, pollution, overfishing and shipping are making worst the site of marine ecosystem. Climate change is directly hitting on Great Barrier Reef through increasing level of sea, acidification of ocean, increasing in temperature, uneven precipitation, changes in the El Nino and increasing level of cyclones and storms. Apart from that pollution is second biggest factor which vanishing the coral reef ecosystem. Pollution including over increasement of pesticides and chemicals, eutrophication, pollution through mining, sediment runoff, loss of coastal wetland and oil spills. Coral bleaching is the biggest problem because of the environmental threatening agents. Acidification of ocean water reduced the formation of calcium carbonate skeleton. The floral ecosystem (including sea grasses and mangroves) of ocean water is the key source of food for fishes and other faunal organisms but the powerful waves, extreme temperature, destructive storms and river run- off causing the threat for them. If one natural system is under threat, it means the whole marine food web is affected from algae to whale. Poisoning of marine water through different polluting agents have been affecting the production of corals, breeding of fishes, weakening of marine health and increased in death of fishes and corals. In lieu of World Heritage site, tourism sector is directly affected and causing increasement in unemployment. Fishing sector also affected. Fluctuation in the temperature of ocean water affects the production of corals because it needs desolate place, proper sunlight and temperature up to 21 degree centigrade. But storms, El Nino, rise in temperature and sea level are induced for continuous reduction of the coral production. If we do not restrict the environmental problems of Great Barrier Reef than the best known ecological beauty with coral reefs, pelagic environments, algal meadows, coasts and estuaries, mangroves forests and sea grasses, fish species, coral gardens and the one of the best tourist spots will lost in upcoming years. My research will focus on the different environmental threats, its socio-economic impacts and different conservative measures.

Keywords: climate change, overfishing, acidification, eutrophication

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261 Ozonation as an Effective Method to Remove Pharmaceuticals from Biologically Treated Wastewater of Different Origin

Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke

Abstract:

Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.

Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants

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260 An Ecological Approach to Understanding Student Absenteeism in a Suburban, Kansas School

Authors: Andrew Kipp

Abstract:

Student absenteeism is harmful to both the school and the absentee student. One approach to improving student absenteeism is targeting contextual factors within the students’ learning environment. However, contemporary literature has not taken an ecological agency approach to understanding student absenteeism. Ecological agency is a theoretical framework that magnifies the interplay between the environment and the actions of people within the environment. To elaborate, the person’s personal history and aspirations and the environmental conditions provide potential outlets or restrictions to their intended action. The framework provides the unique perspective of understanding absentee students’ decision-making through the affordances and constraints found in their learning environment. To that effect, the study was guided by the question, “Why do absentee students decide to engage in absenteeism in a suburban Kansas school?” A case study methodology was used to answer the research question. Four suburban, Kansas high school absentee students in the 2020-2021 school year were selected for the study. The fall 2020 semester was in a remote learning setting, and the spring 2021 semester was in an in-person learning setting. The study captured their decision-making with respect to school attendance throughsemi-structured interviews, prolonged observations, drawings, and concept maps. The data was analyzed through thematic analysis. The findings revealed that peer socialization opportunities, methods of instruction, shifts in cultural beliefs due to COVID-19, manifestations of anxiety and lack of space to escape their anxiety, social media bullying, and the inability to receive academic tutoring motivated the participants’ daily decision to either attend or miss school. The findings provided a basis to improve several institutional and classroom practices. These practices included more student-led instruction and less teacher-led instruction in both in-person and remote learning environments, promoting socialization through classroom collaboration and clubs based on emerging student interests, reducing instances of bullying through prosocial education, safe spaces for students to escape the classroom to manage their anxiety, and more opportunities for one-on-one tutoring to improve grades. The study provides an example of using the ecological agency approach to better understand the personal and environmental factors that lead to absenteeism. The study also informs educational policies and classroom practices to better promote student attendance. Further research should investigate other school contexts using the ecological agency theoretical framework to better understand the influence of the school environment on student absenteeism.

Keywords: student absenteeism, ecological agency, classroom practices, educational policy, student decision-making

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259 Acrylate-Based Photopolymer Resin Combined with Acrylated Epoxidized Soybean Oil for 3D-Printing

Authors: Raphael Palucci Rosa, Giuseppe Rosace

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Stereolithography (SLA) is one of the 3D-printing technologies that has been steadily growing in popularity for both industrial and personal applications due to its versatility, high accuracy, and low cost. Its printing process consists of using a light emitter to solidify photosensitive liquid resins layer-by-layer to produce solid objects. However, the majority of the resins used in SLA are derived from petroleum and characterized by toxicity, stability, and recalcitrance to degradation in natural environments. Aiming to develop an eco-friendly resin, in this work, different combinations of a standard commercial SLA resin (Peopoly UV professional) with a vegetable-based resin were investigated. To reach this goal, different mass concentrations (varying from 10 to 50 wt%) of acrylated epoxidized soybean oil (AESO), a vegetable resin produced from soyabean oil, were mixed with a commercial acrylate-based resin. 1.0 wt% of Diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) was used as photo-initiator, and the samples were printed using a Peopoly moai 130. The machine was set to operate at standard configurations when printing commercial resins. After the print was finished, the excess resin was drained off, and the samples were washed in isopropanol and water to remove any non-reacted resin. Finally, the samples were post-cured for 30 min in a UV chamber. FT-IR analysis was used to confirm the UV polymerization of the formulated resin with different AESO/Peopoly ratios. The signals from 1643.7 to 1616, which corresponds to the C=C stretching of the AESO acrylic acids and Peopoly acrylic groups, significantly decreases after the reaction. The signal decrease indicates the consumption of the double bonds during the radical polymerization. Furthermore, the slight change of the C-O-C signal from 1186.1 to 1159.9 decrease of the signals at 809.5 and 983.1, which corresponds to unsaturated double bonds, are both proofs of the successful polymerization. Mechanical analyses showed a decrease of 50.44% on tensile strength when adding 10 wt% of AESO, but it was still in the same range as other commercial resins. The elongation of break increased by 24% with 10 wt% of AESO and swelling analysis showed that samples with a higher concentration of AESO mixed absorbed less water than their counterparts. Furthermore, high-resolution prototypes were printed using both resins, and visual analysis did not show any significant difference between both products. In conclusion, the AESO resin was successful incorporated into a commercial resin without affecting its printability. The bio-based resin showed lower tensile strength than the Peopoly resin due to network loosening, but it was still in the range of other commercial resins. The hybrid resin also showed better flexibility and water resistance than Peopoly resin without affecting its resolution. Finally, the development of new types of SLA resins is essential to provide new sustainable alternatives to the commercial petroleum-based ones.

Keywords: 3D-printing, bio-based, resin, soybean, stereolithography

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258 Information Seeking and Evaluation Tasks to Enhance Multiliteracies in Health Education

Authors: Tuula Nygard

Abstract:

This study contributes to the pedagogical discussion on how to promote adolescents’ multiliteracies with the emphasis on information seeking and evaluation skills in contemporary media environments. The study is conducted in the school environment utilizing perspectives of educational sciences and information studies to health communication and teaching. The research focus is on the teacher role as a trusted person, who guides students to choose and use credible information sources. Evaluating the credibility of information may often be challenging. Specifically, children and adolescents may find it difficult to know what to believe and who to trust, for instance, in health and well-being communication. Thus, advanced multiliteracy skills are needed. In the school environment, trust is based on the teacher’s subject content knowledge, but also the teacher’s character and caring. Teacher’s benevolence and approachability generate trustworthiness, which lays the foundation for good interaction with students and further, for the teacher’s pedagogical authority. The study explores teachers’ perceptions of their pedagogical authority and the role of a trustee. In addition, the study examines what kind of multiliteracy practices teachers utilize in their teaching. The data will be collected by interviewing secondary school health education teachers during Spring 2019. The analysis method is a nexus analysis, which is an ethnographic research orientation. Classroom interaction as the interviewed teachers see it is scrutinized through a nexus analysis lens in order to expound a social action, where people, places, discourses, and objects are intertwined. The crucial social actions in this study are information seeking and evaluation situations, where the teacher and the students together assess the credibility of the information sources. The study is based on the hypothesis that a trustee’s opinions of credible sources and guidance in information seeking and evaluation affect students’, that is, trustors’ choices. In the school context, the teacher’s own experiences and perceptions of health-related issues cannot be brushed aside. Furthermore, adolescents are used to utilize digital technology for day-to-day information seeking, but the chosen information sources are often not very high quality. In the school, teachers are inclined to recommend familiar sources, such as health education textbook and web pages of well-known health authorities. Students, in turn, rely on the teacher’s guidance of credible information sources without using their own judgment. In terms of students’ multiliteracy competences, information seeking and evaluation tasks in health education are excellent opportunities to practice and enhance these skills. To distinguish the right information from a wrong one is particularly important in health communication because experts by experience are easy to find and their opinions are convincing. This can be addressed by employing the ideas of multiliteracy in the school subject health education and in teacher education and training.

Keywords: multiliteracies, nexus analysis, pedagogical authority, trust

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257 A Prospective Neurosurgical Registry Evaluating the Clinical Care of Traumatic Brain Injury Patients Presenting to Mulago National Referral Hospital in Uganda

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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