Search results for: outcome evaluation

Authors: Thelma Maria Melo Pinheiro, Guilherme Raposo Diniz Vieira, Sidney Matos da Silva, Leonardo Mendonça de Oliveira Queiroz, Mateus Sousa Pinheiro, Danyllo Wenceslau de Oliveira Lopes

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The present article has the objective to describe the regulatory impact analysis (RIA) of the contracting efficiency of the Brazilian transmission system usage. This contracting is made by users connected to the main transmission network and is used to guide necessary investments to supply the electrical energy demand. Therefore, an inefficient contracting of this energy amount distorts the real need for grid capacity, affecting the sector planning accuracy and resources optimization. In order to provide this efficiency, the Brazilian Electricity Regulatory Agency (ANEEL) homologated the Normative Resolution (NR) No. 666, from July 23th of 2015, which consolidated the procedures for the contracting of transmission system usage and the contracting efficiency verification. Aiming for a more efficient and rational transmission system contracting, the resolution established economic incentives denominated as Inefficiency installment for excess (IIE) and inefficiency installment for over-contracting (IIOC). The first one, IIE, is verified when the contracted demand exceeds the established regulatory limit; it is applied to consumer units, generators, and distribution companies. The second one, IIOC, is verified when the distributors over-contract their demand. Thus, the establishment of the inefficiency installments IIE and IIOC intends to avoid the agent contract less energy than necessary or more than it is needed. Knowing that RIA evaluates a regulatory intervention to verify if its goals were achieved, the results from the application of the above-mentioned normative resolution to the Brazilian transmission sector were analyzed through indicators that were created for this RIA to evaluate the contracting efficiency transmission system usage, using real data from before and after the homologation of the normative resolution in 2015. For this, indicators were used as the efficiency contracting indicator (ECI), excess of demand indicator (EDI), and over-contracting of demand indicator (ODI). The results demonstrated, through the ECI analysis, a decrease of the contracting efficiency, a behaviour that was happening even before the normative resolution of 2015. On the other side, the EDI showed a considerable decrease in the amount of excess for the distributors and a small reduction for the generators; moreover, the ODI notable decreased, which optimizes the usage of the transmission installations. Hence, with the complete evaluation from the data and indicators, it was possible to conclude that IIE is a relevant incentive for a more efficient contracting, indicating to the agents that their contracting values are not adequate to keep their service provisions for their users. The IIOC also has its relevance, to the point that it shows to the distributors that their contracting values are overestimated.

Keywords: contracting, electricity regulation, evaluation, regulatory impact analysis, transmission power system

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Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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Authors: Sumeet Dwivedi, Shweta Shriwas, Raghvendra Dubey

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The number of products based on new drug delivery systems has significantly increased in the past few years, and this growth is expected to continue in the near future. These biopharmaceuticals present challenges to drug delivery scientists because of their unique nature and difficulty in delivery through conventional routes. Therefore, future research will focus on the delivery of these complex molecules through different routes, including oral, nasal, pulmonary, vaginal, rectal, etc. The aim of present study was to formulate and evaluate ethosomes of Plumeria indica flowers which may deliver the drug to targeted site more efficiently than marketed preparation and also overcome the problems related with oral administration of drug. The formulations were prepared with ethanol, lecithin, propylene glycol and were evaluated.

Keywords: ethosomes, herbal extract, plumeria alba, lecithin

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Authors: Audrey Smith, M. Saifur Rahaman

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The waste crisis has become a global issue, forcing many industries to reconsider their disposal methods and environmental practices. Sludge is a form of waste created in many fields, which include water and wastewater, pulp and paper, as well as from breweries. The composition of this sludge differs between sources and can, therefore, have varying disposal methods or future applications. When looking at the brewery industry, it produces a significant amount of sludge with a high water content. In order to avoid landfilling, this waste can further be processed into a valuable material. Specifically, the sludge must undergo dewatering, a process which typically involves the addition of coagulants like aluminum sulfate or ferric chloride. These chemicals, however, limit the potential uses of the sludge since it will contain traces of metals. In this case, the desired outcome of the brewery sludge would be to produce animal feed; however, these conventional coagulants would add a toxic component to the sludge. The use of biopolymers like chitosan, which act as a coagulant, can be used to dewater brewery sludge while allowing it to be safe for animal consumption. Chitosan is also a by-product created by the shellfish processing industry and therefore reduces the environmental imprint since it involves using the waste from one industry to treat the waste from another. In order to prove the effectiveness of this biopolymer, experiments using jar-tests will be utilised to determine the optimal dosages and conditions, while variances of contaminants like ammonium will also be observed. The efficiency of chitosan can also be compared to other polysaccharides to determine which is best suited for this waste. Overall a significant separation has been achieved between the solid and liquid content of the waste during the coagulation-flocculation process when applying chitosan. This biopolymer can, therefore, be used to dewater brewery sludge such that it can be repurposed as animal feed. The use of biopolymers can also be applied to treat sludge from other industries, which can reduce the amount of waste produced and allow for more diverse options for reuse.

Keywords: animal feed, biopolymer, brewery sludge, chitosan

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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Authors: Ioannis Kavouras, Eftychios Protopapadakis, Emmanuel Sardis, Anastasios Doulamis

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In this paper, we investigate the appropriateness and usability of three different free and open-source rendering tools for urban planning visualizations. The process involves the selection of a map area, the 3D rendering transformation, the addition of nature-based solution placement, and the evaluation and assessment of the suggested applied interventions. The manuscript uses a case study involved at Dilaveri Coast, Piraeus region, Greece. Research outcomes indicate that a Blender-OSM implementation is an appropriate tool capable of supporting high-fidelity urban planning, with quick and accurate visibility of related results for end users and involved in NBS transformations.

Keywords: urban planning, nature based solution, 3D gaming tools, game engine, free and open source

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Authors: L. Horňák

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The aim of the paper is to analyze a longstanding problem in Slovakia – the effective education of Roma students coming from socially disadvantaged backgrounds. Although it is a relatively small country, there are over 630 communities in the Slovak Republic. The efficiency of the projects was verified by interviews with participants; questionnaires; and direct observations. Evaluation reports which summarized and evaluated the outcomes of the projects only confirmed their success. Slovakia realizes that appropriate social inclusion of marginalized citizens coming from the Roma ethnic group can only be achieved through education based on equality of all students and acceptance of diversity.

Keywords: inclusive education, marginalized communities, Roma pupil, equity in education, socially disadvantaged backgrounds, social inclusion

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Authors: Najah Majouri, Mohamed El Mankibi, Jalila Sghaier

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This study examined the geotechnical, mineralogical, thermal and physical characterization of clays in south-west Tunisia. Its aims are to elaborate an insulator material based on the clay used in the field of building materials. The geotechnical study showed that the clay studied is characterized by a high degree of plasticity of 30.83%. High mineralogical findings showed that the sample consisted mainly of kaonolite and other clay minerals. The thermal and physical properties of the different samples are obtained by mixing clays, which indicates a promising future for the use of this type of clays in the production of insulating building materials.

Keywords: clay, energy-saving, insulator material, and South-West Tunisia.

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Prachi Chavda

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The world, as of today, is smaller than it was for those who lived few decades ago. Internet, media and telecommunications have impacted the world like never before. Culture is the pillar upon which a society mushrooms. A culture develops with human creativity over the years and also by the exchange and intermixing of ideas and way of life across different civilizations and we can say that one of the influencing medium of exchange and intermixing of these ideas is cinema. Cinema has been the wonderful as well as important medium of communication since it has been emerged. Change is the thumb rule of life and so have been Indian cinema. As society has evolved from time to time so has the stories of Indian Cinema and its characters, hence it directly effects to the Indian culture as cinema has been very strong mediator for information exchange. The paper tries to discuss deeply how Indian cinema (reel life) and Indian culture (real life) has been influencing each other that results into a constant modification in both. Moreover, the research tries to deal with the issue with some examples that as a outcome how movies impact the Indian culture positively and negatively on culture. Therefore, it spreads the wave of change in cultural settings of society. The paper also tries to light the psychology of youth of India. Today, children and youth greatly admire the ostentatious materialistic display of outfits and style of the actors in the movies. Also, the movies bearing romanticism and showcasing disputatious issues like pre-marital sex, live-in relationship, homo-sexuality etc. though without highlighting them extensively have indeed inspired the commoners. Pros and cons always exist. Such revelation of issues certainly give a spark in the minds of those who are in their formative years and the effect of which is seen with the passage of time Thus, we can say that emergence of cinema as a strong tool of social change as well as culture as a triggering factor for transformation in cinema. As, a finding we can say that culture and cinema of India are influencing factors for each other. Cinema and culture are two sides of a coin, where both are responsible for evolution of each other.

Keywords: cinema, culture, influence, transformation

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Authors: Natsumi Murakami, Jae-Ho Kim, Susumu Yonezawa

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The calcium fluorosilicate (CaSiF₆) was prepared from calcium silicate (CaSiO₃) with fluorine gas at 25 ~ 200 ℃ and 760 Torr for 1~24 h. Especially, the pure CaSiF₆ could be prepared at 25 ℃ for 24 h with F₂ gas from the results of X-ray diffraction. Increasing temperature to higher than 100 ℃, the prepared CaSiF₆ was decomposed into CaF₂ and SiF₄. The release of SiF₄ gas was confirmed by the results of gas-phase infrared spectroscopy. In this study, we tried to modify the surface of polycarbonate (PC) resin using the SiF₄ gas released from CaSiF₆ particles. By using the prepared CaSiF₆, the surface roughness of fluorinated PC samples was approximately four times larger than that (1.4 nm) of the untreated sample. The results of X-ray photoelectron spectroscopy indicated the formation of fluorinated bonds (e.g., -CFx) on the surface of PC after surface fluorination. Consequently, the CaSiF₆ particles can be useful for a new fluorinating agent.

Keywords: calcium fluorosilicate, fluorinating agent, polycarbonate, surface fluorination

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Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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Authors: Neha Bhattacharyya, Soumendra Singh, Amrita Banerjee, Ria Ghosh, Oindrila Sinha, Nairit Das, Rajkumar Gayen, Somya Subhra Pal, Sahely Ganguly, Tanmoy Dasgupta, Tanusree Dasgupta, Pulak Mondal, Aniruddha Adhikari, Sharmila Sarkar, Debasish Bhattacharyya, Asim Kumar Mallick, Om Prakash Singh, Samir Kumar Pal

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Background: We aim to develop an integrated device comprised of single-probe EEG and CCD-based motion sensors for a more objective measure of Attention-deficit Hyperactivity Disorder (ADHD). While the integrated device (MAHD) relies on the EEG signal (spectral density of beta wave) for the assessment of attention during a given structured task (painting three segments of a circle using three different colors, namely red, green and blue), the CCD sensor depicts movement pattern of the subjects engaged in a continuous performance task (CPT). A statistical analysis of the attention and movement patterns was performed, and the accuracy of the completed tasks was analysed using indigenously developed software. The device with the embedded software, called MAHD, is intended to improve certainty with criterion E (i.e. whether symptoms are better explained by another condition). Methods: We have used the EEG signal from a single-channel dry sensor placed on the frontal lobe of the head of the subjects (3-5 years old pre-schoolers). During the painting of three segments of a circle using three distinct colors (red, green, and blue), absolute power for delta and beta EEG waves from the subjects are found to be correlated with relaxation and attention/cognitive load conditions. While the relaxation condition of the subject hints at hyperactivity, a more direct CCD-based motion sensor is used to track the physical movement of the subject engaged in a continuous performance task (CPT) i.e., separation of the various colored balls from one table to another. We have used our indigenously developed software for the statistical analysis to derive a scale for the objective assessment of ADHD. We have also compared our scale with clinical ADHD evaluation. Results: In a limited clinical trial with preliminary statistical analysis, we have found a significant correlation between the objective assessment of the ADHD subjects with that of the clinician’s conventional evaluation. Conclusion: MAHD, the integrated device, is supposed to be an auxiliary tool to improve the accuracy of ADHD diagnosis by supporting greater criterion E certainty.

Keywords: ADHD, CPT, EEG signal, motion sensor, psychometric test

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Authors: Nagia Ali, R. S. R. El-Mohamedy

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The purpose of this paper is to irradiate the dyes biologically through the use of Moreinga oleifera. The study confirms the potential use of Moringa oleifera in decolourization of dyes and thus opens up a scope for future analysis pertaining to its performance in treatment of textile effluent. In this paper, the ability of natural products in removing dyes was tested using two reactive dyes and one acid dye. After a preliminary screening for dye removal capacity, a vegetal protein extract derived from Moeringa oleifera seed was fully studied. The influences of several parameters such as pH, temperature or initial dye concentration were tested and the behavior of coagulants was compared. It was found that dye removal decreased as pH increased. Temperature did not seem to have a considerable effect, while initial dye concentration appeared to be a very important variable.

Keywords: Moreinga oleifera, decolourization, waste water, reactive dyes, acid dyes

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp

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The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.

Keywords: equation, Graves’disease, prediction, 24-hour uptake

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Authors: Ramin Mirzada, Takuya Maruyama

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Kabul is the heart of political, commercial, cultural, educational and social life in Afghanistan and the fifth fastest growing city in the world. Minimum income inclined most of Kabul residents to use public transport, especially buses, although there is no proper bus system, beside that there is no proper fare exist in Kabul city Due to wars. From 1992 to 2001 during civil wars, Kabul suffered damage and destruction of its transportation facilities including pavements, sidewalks, traffic circles, drainage systems, traffic signs and signals, trolleybuses and almost all of the public transport system (e.g. Millie bus). This research is mainly focused on Kabul city’s transportation system. In this research, the data used have been gathered by Japan International Cooperation Agency (JICA) in 2008 and this data will be used to find demand and fare structure, additionally a survey was done in 2016 to find satisfaction level of Kabul residents for fare structure. Aim of this research is to observe the demand for Large Buses, compare to the actual supply from the government, analyze the current fare structure and compare it with the proposed fare (distance based fare) structure which has already been analyzed. Outcome of this research shows that the demand of Kabul city residents for the public transport (Large Buses) exceeds from the current supply, so that current public transportation (Large Buses) is not sufficient to serve public transport in Kabul city, worth to be mentioned, that in order to overcome this problem, there is no need to build new roads or exclusive way for buses. This research proposes government to change the fare from fixed fare to distance based fare, invest on public transportation and increase the number of large buses so that the current demand for public transport is met.

Keywords: transportation, planning, public transport, large buses, Kabul, Afghanistan

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Authors: Chungkuk Jin, Moo-Hyun Kim, HeonYong Kang

Abstract:

A surface riding (SR) wave energy converter (WEC) is designed and its feasibility and performance are numerically simulated by the author-developed floater-mooring-magnet-electromagnetics fully-coupled dynamic analysis computer program. The biggest advantage of the SR-WEC is that the performance is equally effective even in low sea states and its structural robustness is greatly improved by simply riding along the wave surface compared to other existing WECs. By the numerical simulations and actuator testing, it is clearly demonstrated that the concept works and through the optimization process, its efficiency can be improved.

Keywords: computer simulation, electromagnetics fully-coupled dynamics, floater-mooring-magnet, optimization, performance evaluation, surface riding, WEC

Procedia PDF Downloads 145

Authors: Yeganeh Mousavi Jahromi, Sahar Dehghan

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In Direct Tax Act, penalties and incentives are two strategies for realization of the expected tax revenues. In this study, the interaction between individual businesses' taxpayers' behaviors and National Tax Administration is investigated by using prospect theory which is based on behavioral economics approach. For this purpose, the structure of the tax compliance of the mentioned taxpayers is evaluated via the changes in penalty and incentive rates. In this way, a special questionnaire regarding the items of individual businesses sector of Direct Tax Act was designed for tax compliance evaluation, and the results were obtained using Bayesian Hierarchical method. The results indicate that the investigated individual business taxpayers, at all income levels, were more sensitive toward incentive rates so that this result can be useful for tax policymakers.

Keywords: behavioral economics, prospect theory, tax compliance, penalties, incentives

Procedia PDF Downloads 68

Authors: Azza M. Atya, Mahmoud M. Nasser

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Background/ /Significance: Peripheral neuropathy is one of the long term serious complications of diabetes, which may attribute to postural instability and alteration of planter pressure. Whole body vibration (WBV) is a somatosensory stimulation type of exercise that has been emerged in sport training and rehabilitation of neuromuscular disorders. Purpose: The aim of this study was to investigate the effect of whole Body Vibration on antroposterior (AP), mediolateral (ML) posture stability and planter foot pressure in patients with diabetic neuropathy. Subjects: forty diabetic patients with moderate peripheral neuropathy aged from 35 to 50 years, were randomly assigned to WBV group (n=20) and control group (n=20). Methods and Materials: the WBV intervention consisted of three session weekly for 8 weeks (frequency 20 Hz, peak-to peak displacement 4mm, acceleration 3.5 g). Biodex balance system was used for postural stability assessment and the foot scan plate was used to measure the mean peak pressure under the first and lesser metatarsals. The main Outcome measures were antroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI),and mean peak foot pressure. Analyses: Statistical analysis was performed using the SPSS software package (SPSS for Windows Release 18.0). T-test was used to compare between the pre- and post-treatment values between and within groups. Results: For the 40 study participants (18male and 22 females) there were no between-group differences at baseline. At the end of 8 weeks, Subjects in WBV group experienced significant increase in postural stability with a reduction of mean peak of planter foot pressure (P<0.05) compared with the control group. Conclusion: The result suggests that WBV is an effective therapeutic modality for increasing postural stability and reducing planter pressure in patients with diabetic neuropathy.

Keywords: whole body vibration, diabetic neuropathy, posture stability, foot pressure

Procedia PDF Downloads 383

Authors: R. A. Mandour

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The physical, chemical, and microbiological analyses of fifty Quaternary water samples representing the different types of drinking water (surface and wells) in the governorate were carried-out. This paper aims to evaluate the drinking water in Dakahlia governorate in comparison with the national and international standards as a step to handle water pollutants affecting human health in this governorate. All investigated water samples were chemically considered suitable for drinking except two samples for iron, two samples for lead and one water sample for manganese having values higher than the permissible limit of EMH and WHO. Also microbiologically there were five water samples having a high total count of bacteria and three samples having high coli form than the permissible limit of EMH. Obviously, groundwater samples from Mit-Ghamr, El-Sinbillawin and Aga districts of Dakahlia governorate should have special attention for treatment.

Keywords: major ions, minor elements, microbiology, EMH, WHO

Procedia PDF Downloads 378

Authors: Huseyin Altundag, Emel Bina, Esra Altıntıg

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The aim of this study is determining amount of Al, Cu, Fe, Mn, Ni, Pb and Zn in the samples of honey which are gathered from Sakarya and Istanbul regions. In this study the evaluation of the trace elements in honeys samples are gathered from Sakarya and Istanbul, Turkey. The sample preparation phase is performed via wet decomposition method and microwave digestion system. The accuracy of the method was corrected by the standard reference material, Tea Leaves (INCY-TL-1) and NIST SRM 1515 Apple leaves. The comparison between gathered data and literature values has made and possible resources of the contamination to the samples of honey have handled. The obtained results will be presented in ICCIS 2015: XIII International Conference on Chemical Industry and Science.

Keywords: Wet decomposition, Microwave digestion, Trace element, Honey, ICP-OES

Procedia PDF Downloads 462

Authors: Megan Burfoot, Ali GhaffarianHoseini, Nicola Naismith, Amirhosein GhaffarianHoseini

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Intelligent Acoustic Technology (IAT) is a novel architectural device used in buildings to automatically vary the acoustic conditions of space. IAT is realized by integrating two components: Variable Acoustic Technology (VAT) and an intelligent system. The VAT passively alters the RT by changing the total sound absorption in a room. In doing so, the Reverberation Time (RT) is changed and thus, the sound strength and clarity are altered. The intelligent system detects sound waves in real-time to identify the aural situation, and the RT is adjusted accordingly based on pre-programmed algorithms. IAT - the synthesis of these two components - can dramatically improve acoustic comfort, as the acoustic condition is automatically optimized for any detected aural situation. This paper presents an evaluation of the improvements of acoustic comfort in an existing tertiary classroom located at Auckland University of Technology in New Zealand. This is a pilot case study, the first of its’ kind attempting to quantify the benefits of IAT. Naturally, the potential acoustic improvements from IAT can be actualized by only installing the VAT component of IAT and by manually adjusting it rather than utilizing an intelligent system. Such a simplified methodology is adopted for this case study to understand the potential significance of IAT without adopting a time and cost-intensive strategy. For this study, the VAT is built by overlaying reflective, rotating louvers over sound absorption panels. RT's are measured according to international standards before and after installing VAT in the classroom. The louvers are manually rotated in increments by the experimenter and further RT measurements are recorded. The results are compared with recommended guidelines and reference values from national standards for spaces intended for speech and communication. The results obtained from the measurements are used to quantify the potential improvements in classroom acoustic comfort, where IAT to be used. This evaluation reveals the current existence of poor acoustic conditions in the classroom caused by high RT's. The poor acoustics are also largely attributed to the classrooms’ inability to vary acoustic parameters for changing aural situations. The classroom experiences one static acoustic state, neglecting to recognize the nature of classrooms as flexible, dynamic spaces. Evidently, when using VAT the classroom is prescribed with a wide range of RTs it can achieve. Namely, acoustic requirements for varying teaching approaches are satisfied, and acoustic comfort is improved. By quantifying the benefits of using VAT, it can confidently suggest these same benefits are achieved with IAT. Nevertheless, it is encouraged that future studies continue this line of research toward the eventual development of IAT and its’ acceptance into mainstream architecture.

Keywords: acoustic comfort, classroom acoustics, intelligent acoustics, variable acoustics

Procedia PDF Downloads 189

Authors: Mohammad Hadi Jalali, Behrooz Shahriari, Mostafa Ghayour, Saeed Ziaei-Rad, Shahram Yousefi

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Most flexible rotors can be considered as beam-like structures. In many cases, rotors are modeled as one-dimensional bodies, made basically of beam-like shafts with rigid bodies attached to them. This approach is typical of rotor dynamics, both analytical and numerical, and several rotor dynamic codes, based on the finite element method, follow this trend. In this paper, a finite element model based on Timoshenko beam elements is utilized to analyze the lateral dynamic behavior of a certain rotor-bearing system in operating conditions.

Keywords: finite element method, Timoshenko beam elements, operational deflection shape, unbalance response

Procedia PDF Downloads 428

Authors: Henry Schwartz, Bogdan Iancu, Magnus Gustafsson, Johan Lilius

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The shipping sector generates significant amounts of carbon emissions on annual basis. The excess amount of carbon dioxide is harmful for both the environment and the society, and partly for that reason, there is acute interest to decrease the volume of anthropogenic carbon dioxide emissions in shipping. The usage of the existing cargo carrying capacity can be maximized, and the share of time used in actual transportation operations could be increased if the whole transportation and logistics chain was optimized with the aid of information sharing done through a centralized marketplace and an information-sharing platform. The outcome of this change would be decreased carbon dioxide emission volumes produced per each metric ton of cargo transported by a vessel. Cargo coordination is a platform under development that matches the need for waterborne transportation services with the ships that operate at a given moment in time. In this research, the transition towards adopting cargo coordination is modelled with system dynamics. The model encompasses the complex supply-demand relationships of ship operators and cargo owners. The built scenarios predict the pace at which different stakeholders start using the digitalized platform and by doing so reduce the amount of annual CO2 emissions generated. To improve the reliability of the results, various sensitivity analyses considering the pace of transition as well as the overall impact on the environment (carbon dioxide emissions per amount of cargo transported) are conducted. The results of the study can be used to support investors and politicians in decision making towards more environmentally sustainable solutions. In addition, the model provides concepts and ideas for a wider discussion considering the paths towards carbon neutral transportation.

Keywords: carbon dioxide emissions, energy efficiency, sustainable transportation, system dynamics

Procedia PDF Downloads 147

Authors: Che Hsiu Chen, Kuo Wei Tseng, Zih Jian Huang, Hon Wen Cheng

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A typical warm-up contains both stretching exercises and jogging. The static stretching prior to training or competition may cause detrimental effects to athletic performance. However, it is unclear whether different types of dynamic stretching exercises had different acute effects on knee flexors stiffness, flexibility, and strength. The purpose of this study was to analyze the knee flexors stiffness, flexibility, and strength gains after dynamic straight leg raise (DSLR) and dynamic modified toe-touch (MTT) stretching. Sixteen healthy university active men (height 176.27 ± 4.03 cm; weight 72.27 ± 8.90 kg; age 22.09 ± 2.31 years). After 5 minutes (8km/h) of running subjects performed 2 randomly ordered stretching protocols: DSLR and MTT stretching protocols. There were a total of six, 30 seconds bouts of dynamic stretching (15 repetitions) with 30seconds rest between bouts. The outcome measures were maximal voluntary isokinetic concentric hamstring strength (60°/s), muscle flexibility test by passive straight leg raise (PSLR), active straight leg raise (ASLR), and muscle stiffness using ultrasound Acoustic Radiation Forced Impulse (ARFI) elastography before and immediately after stretching. The muscle stiffness and concentric strength decreased significantly (p < .05), the flexibility no significant change after DSLR protocol (p > .05). The concentric strength decreased significantly (p < .05), the flexibility and muscle stiffness no significant change after MTT protocol (p > .05), whereas no significant differences were found for the DSLR and MTT. Our findings suggest that dynamic stretching (30s x 6 bouts) resulted in change in muscle stiffness or may be induced slack in the musculotendinous unit thereby, reducing force production. Therefore, 30s x 6 bouts of dynamic stretching adversely affects efforts of hamstring muscle maximal concentric strength.

Keywords: sport injury, ultrasound, eccentric exercise, performance

Procedia PDF Downloads 285

Authors: Hanifeh Imanian, Morteza Kolahdoozan

Abstract:

The purpose of this study is to present a mathematical phrase for calculating the dispersion rate of spilled oil in water column under non-breaking waves. In this regard, a multiphase numerical model is applied for which waves and oil phase were computed concurrently, and accuracy of its hydraulic calculations have been proven. More than 200 various scenarios of oil spilling in wave waters were simulated using the multiphase numerical model and its outcome were collected in a database. The recorded results were investigated to identify the major parameters affected vertical oil dispersion and finally 6 parameters were identified as main independent factors. Furthermore, some statistical tests were conducted to identify any relationship between the dependent variable (dispersed oil mass in the water column) and independent variables (water wave specifications containing height, length and wave period and spilled oil characteristics including density, viscosity and spilled oil mass). Finally, a mathematical-statistical relationship is proposed to predict dispersed oil in marine waters. To verify the proposed relationship, a laboratory example available in the literature was selected. Oil mass rate penetrated in water body computed by statistical regression was in accordance with experimental data was predicted. On this occasion, it was necessary to verify the proposed mathematical phrase. In a selected laboratory case available in the literature, mass oil rate penetrated in water body computed by suggested regression. Results showed good agreement with experimental data. The validated mathematical-statistical phrase is a useful tool for oil dispersion prediction in oil spill events in marine areas.

Keywords: dispersion, marine environment, mathematical-statistical relationship, oil spill

Procedia PDF Downloads 233