Search results for: frequent adjustment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1436

Search results for: frequent adjustment

1226 TP53 Mutations in Molecular Subtypes of Breast Cancer in Young Pakistani Patients

Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi

Abstract:

Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.

Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53

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1225 Improving Short-Term Forecast of Solar Irradiance

Authors: Kwa-Sur Tam, Byung O. Kang

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By using different ranges of daily sky clearness index defined in this paper, any day can be classified as a clear sky day, a partly cloudy day or a cloudy day. This paper demonstrates how short-term forecasting of solar irradiation can be improved by taking into consideration the type of day so defined. The source of day type dependency has been identified. Forecasting methods that take into consideration of day type have been developed and their efficacy have been established. While all methods that implement some form of adjustment to the cloud cover forecast provided by the U.S. National Weather Service provide accuracy improvement, methods that incorporate day type dependency provides even further improvement in forecast accuracy.

Keywords: day types, forecast methods, National Weather Service, sky cover, solar energy

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1224 Recognising the Importance of Smoking Cessation Support in Substance Misuse Patients

Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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1223 Clinical and Molecular Characterization of Ichthyosis at King Abdulaziz Medical City, Riyadh KSA

Authors: Reema K. AlEssa, Sahar Alshomer, Abdullah Alfaleh, Sultan ALkhenaizan, Mohammed Albalwi

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Ichthyosis is a disorder of abnormal keratinization, characterized by excessive scaling, and consists of more than twenty subtypes varied in severity, mode of inheritance, and the genes involved. There is insufficient data in the literature about the epidemiology and characteristics of ichthyosis locally. Our aim is to identify the histopathological features and genetic profile of ichthyosis. Method: It is an observational retrospective case series study conducted in March 2020, included all patients who were diagnosed with Ichthyosis and confirmed by histological and molecular findings over the last 20 years in King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Molecular analysis was performed by testing genomic DNA and checking genetic variations using the AmpliSeq panel. All disease-causing variants were checked against HGMD, ClinVar, Genome Aggregation Database (gnomAD), and Exome Aggregation Consortium (ExAC) databases. Result: A total of 60 cases of Ichthyosis were identified with a mean age of 13 ± 9.2. There is an almost equal distribution between female patients 29 (48%) and males 31 (52%). The majority of them were Saudis, 94%. More than half of patients presented with general scaling 33 (55%), followed by dryness and coarse skin 19 (31.6%) and hyperlinearity 5 (8.33%). Family history and history of consanguinity were seen in 26 (43.3% ), 13 (22%), respectively. History of colloidal babies was found in 6 (10%) cases of ichthyosis. The most frequent genes were ALOX12B, ALOXE3, CERS3, CYP4F22, DOLK, FLG2, GJB2, PNPLA1, SLC27A4, SPINK5, STS, SUMF1, TGM1, TGM5, VPS33B. Most frequent variations were detected in CYP4F22 in 16 cases (26.6%) followed by ALOXE3 6 (10%) and STS 6 (10%) then TGM1 5 (8.3) and ALOX12B 5 (8.3). The analysis of molecular genetic identified 23 different genetic variations in the genes of ichthyosis, of which 13 were novel mutations. Homozygous mutations were detected in the majority of ichthyosis cases, 54 (90%), and only 1 case was heterozygous. Few cases, 4 (6.6%) had an unknown type of ichthyosis with a negative genetic result. Conclusion: 13 novel mutations were discovered. Also, about half of ichthyosis patients had a positive history of consanguinity.

Keywords: ichthyosis, genetic profile, molecular characterization, congenital ichthyosis

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1222 Neighbourhood Walkability and Quality of Life: The Mediating Role of Place Adherence and Social Interaction

Authors: Michał Jaśkiewicz

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The relation between walkability, place adherence, social relations and quality of life was explored in a Polish context. A considerable number of studies have suggested that environmental factors may influence the quality of life through indirect pathways. The list of possible psychological mediators includes social relations and identity-related variables. Based on the results of Study 1, local identity is a significant mediator in the relationship between neighbourhood walkability and quality of life. It was assumed that pedestrian-oriented neighbourhoods enable residents to interact and that these spontaneous interactions can help to strengthen a sense of local identity, thus influencing the quality of life. We, therefore, conducted further studies, testing the relationship experimentally in studies 2a and 2b. Participants were exposed to (2a) photos of walkable/non-walkable neighbourhoods or (2b) descriptions of high/low-walkable neighbourhoods. They were then asked to assess the walkability of the neighbourhoods and to evaluate their potential social relations and quality of life in these places. In both studies, social relations with neighbours turned out to be a significant mediator between walkability and quality of life. In Study 3, we implemented the measure of overlapping individual and communal identity (fusion with the neighbourhood) and willingness to collective action as mediators. Living in a walkable neighbourhood was associated with identity fusion with that neighbourhood. Participants who felt more fused expressed greater willingness to engage in collective action with other neighbours. Finally, this willingness was positively related to the quality of life in the city. In Study 4, we used commuting time (an aspect of walkability related to the time that people spend travelling to work) as the independent variable. The results showed that a shorter average daily commuting time was linked to more frequent social interactions in the neighbourhood. Individuals who assessed their social interactions as more frequent expressed a stronger city identification, which was in turn related to quality of life. To sum up, our research replicated and extended previous findings on the association between walkability and well-being measures. We introduced potential mediators of this relationship: social interactions in the neighbourhood and identity-related variables.

Keywords: walkability, quality of life, social relations, analysis of mediation

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1221 Improved Accuracy of Ratio Multiple Valuation

Authors: Julianto Agung Saputro, Jogiyanto Hartono

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Multiple valuation is widely used by investors and practitioners but its accuracy is questionable. Multiple valuation inaccuracies are due to the unreliability of information used in valuation, inaccuracies comparison group selection, and use of individual multiple values. This study investigated the accuracy of valuation to examine factors that can increase the accuracy of the valuation of multiple ratios, that are discretionary accruals, the comparison group, and the composite of multiple valuation. These results indicate that multiple value adjustment method with discretionary accruals provides better accuracy, the industry comparator group method combined with the size and growth of companies also provide better accuracy. Composite of individual multiple valuation gives the best accuracy. If all of these factors combined, the accuracy of valuation of multiple ratios will give the best results.

Keywords: multiple, valuation, composite, accuracy

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1220 Epidemiological Analysis of the Patients Supplied with Foot Orthoses in Ortho-Prosthetic Center of Kosovo

Authors: Ardiana Murtezani, Ilirijana Dallku, Teuta Osmani Vllasolli, Sabit Sllamniku

Abstract:

Background: The use of foot orthoses are always indicated when there are alterations of the optimal biomechanics' position of the foot. Orthotics are very effective and very suitable for the majority of patients with pain due to overload which can be related to biomechanical disorders. Aim: To assess the frequency of patients requiring foot orthoses, type of orthoses and analysis of their disease leading to the use of foot orthoses. Material and Methods: Our study included 128 patients with various foot pathologies, treated at the outpatient department of the Ortho-Prosthetic Center of Kosovo (OPCK) in Prishtina. Prospective-descriptive clinical method was used during this study. Functional status of patients was examined, and the following parameters are noted: range of motion measurements for the affected joints/lower extremities, manual test for muscular strength below the knee and foot of the affected extremity, perimeter measurements of the lower extremities, measurements of lower extremities, foot length measurement, foot width measurements and size. In order to complete the measurements the following instruments are used: plantogram, pedogram, meter and cork shoe lift appliances. Results: The majority of subjects in this study are male (60.2% vs. 39.8%), and the dominant age group was 0-9 (47.7%), 61 subjects respectively. Most frequent foot disorders were: congenital disease 60.1%, trauma cases 13.3%, consequences from rheumatologic disease 12.5%, neurologic dysfunctions 11.7%, and the less frequented are the infectious cases 1.6%. Congenital anomalies were the most frequent cases, and from this group majority of cases suffered from pes planovalgus (37.5%), eqinovarus (15.6%) and discrepancies between extremities (6.3%). Furthermore, traumatic amputations (2.3%) and arthritis (0.8%). As far as neurologic disease, subjects with cerebral palsy are represented with (3.1%), peroneal nerve palsy (2.3%) and hemiparesis (1.6%). Infectious disease osteomyelitis sequels are represented with (1.6%). Conclusion: Based on our study results, we have concluded that the use of foot orthoses for patients suffering from rheumatoid arthritis and nonspecific arthropaty was effective treatment choice, leading to decrease of pain, less deformities and improves the quality of life.

Keywords: orthoses, epidemiological analysis, rheumatoid arthritis, rehabilitation

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1219 Perceptual Organization within Temporal Displacement

Authors: Michele Sinico

Abstract:

The psychological present has an actual extension. When a sequence of instantaneous stimuli falls in this short interval of time, observers perceive a compresence of events in succession and the temporal order depends on the qualitative relationships between the perceptual properties of the events. Two experiments were carried out to study the influence of perceptual grouping, with and without temporal displacement, on the duration of auditory sequences. The psychophysical method of adjustment was adopted. The first experiment investigated the effect of temporal displacement of a white noise on sequence duration. The second experiment investigated the effect of temporal displacement, along the pitch dimension, on temporal shortening of sequence. The results suggest that the temporal order of sounds, in the case of temporal displacement, is organized along the pitch dimension.

Keywords: time perception, perceptual present, temporal displacement, Gestalt laws of perceptual organization

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1218 A Comparison between Five Indices of Overweight and Their Association with Myocardial Infarction and Death, 28-Year Follow-Up of 1000 Middle-Aged Swedish Employed Men

Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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1217 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

Abstract:

Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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1216 A Compact Quasi-Zero Stiffness Vibration Isolator Using Flexure-Based Spring Mechanisms Capable of Tunable Stiffness

Authors: Thanh-Phong Dao, Shyh-Chour Huang

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This study presents a quasi-zero stiffness (QZS) vibration isolator using flexure-based spring mechanisms which afford both negative and positive stiffness elements, which enable self-adjustment. The QZS property of the isolator is achieved at the equilibrium position. A nonlinear mathematical model is then developed, based on the pre-compression of the flexure-based spring mechanisms. The dynamics are further analyzed using the Harmonic Balance method. The vibration attention efficiency is illustrated using displacement transmissibility, which is then compared with the corresponding linear isolator. The effects of parameters on performance are also investigated by numerical solutions. The flexure-based spring mechanisms are subsequently designed using the concept of compliant mechanisms, with evaluation by ANSYS software, and simulations of the QZS isolator.

Keywords: vibration isolator, quasi-zero stiffness, flexure-based spring mechanisms, compliant mechanism

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1215 An Elbow Biomechanical Model and Its Coefficients Adjustment

Authors: Jie Bai, Yongsheng Gao, Shengxin Wang, Jie Zhao

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Through the establishment of the elbow biomechanical model, it can provide theoretical guide for rehabilitation therapy on the upper limb of the human body. A biomechanical model of the elbow joint can be built by the connection of muscle force model and elbow dynamics. But there are many undetermined coefficients in the model like the optimal joint angle and optimal muscle force which are usually specified as the experimental parameters of other workers. Because of the individual differences, there is a certain deviation of the final result. To this end, the RMS value of the deviation between the actual angle and calculated angle is considered. A set of coefficients which lead to the minimum RMS value will be chosen to be the optimal parameters. The direct search method and the conjugacy search method are used to get the optimal parameters, thus the model can be more accurate and mode adaptability.

Keywords: elbow biomechanical model, RMS, direct search, conjugacy search

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1214 Intelligent Human Pose Recognition Based on EMG Signal Analysis and Machine 3D Model

Authors: Si Chen, Quanhong Jiang

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In the increasingly mature posture recognition technology, human movement information is widely used in sports rehabilitation, human-computer interaction, medical health, human posture assessment, and other fields today; this project uses the most original ideas; it is proposed to use the collection equipment for the collection of myoelectric data, reflect the muscle posture change on a degree of freedom through data processing, carry out data-muscle three-dimensional model joint adjustment, and realize basic pose recognition. Based on this, bionic aids or medical rehabilitation equipment can be further developed with the help of robotic arms and cutting-edge technology, which has a bright future and unlimited development space.

Keywords: pose recognition, 3D animation, electromyography, machine learning, bionics

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1213 The Positive Impact of Wheelchair Service Provision on the Health and Overall Satisfaction of Wheelchair Users with the Devices

Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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1212 A Comparative Study of Insurance Policies Worldwide in Public Private Partnerships

Authors: Guanqun Shi, Xueqing Zhang

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The frequent occurrence of failures in PPP projects which caused great loss has raised attention from the government as well as the concessionaire. PPPs are complex arrangements for its long operation period and multiple players. Many types of risks in PPP projects may cause the project fail. The insurance is an important tool to transfer the risks. Through a comparison and analysis of international government PPP guidelines and contracts as well as the case studies worldwide, we have identified eight main insurance principles, discussed thirteen insurance types in different stages. An overall procedure would be established to improve the practices in PPP projects.

Keywords: public private partnerships, insurance, contract, risk

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1211 A Wireless Sensor Network Protocol for a Car Parking Space Monitoring System

Authors: Jung-Ho Moon, Myung-Gon Yoon, Tae Kwon Ha

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This paper presents a wireless sensor network protocol for a car parking monitoring system. A wireless sensor network for the purpose is composed of multiple sensor nodes, a sink node, a gateway, and a server. Each of the sensor nodes is equipped with a 3-axis AMR sensor and deployed in the center of a parking space. The sensor node reads its sensor values periodically and transmits the data to the sink node if the current and immediate past sensor values show a difference exceeding a threshold value. The operations of the sink and sensor nodes are described in detail along with flow diagrams. The protocol allows a low-duty cycle operation of the sensor nodes and a flexible adjustment of the threshold value used by the sensor nodes.

Keywords: car parking monitoring, sensor node, wireless sensor network, network protocol

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1210 Innovation and Analysis of Vibrating Fork Level Switch

Authors: Kuen-Ming Shu, Cheng-Yu Chen

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A vibrating-fork sensor can measure the level height of solids and liquids and operates according to the principle that vibrations created by piezoelectric ceramics are transmitted to the vibrating fork, which produces resonance. When the vibrating fork touches an object, its resonance frequency changes and produces a signal that returns to a controller for immediate adjustment, so as to effectively monitor raw material loading. The design of the vibrating fork in a vibrating-fork material sensor is crucial. In this paper, ANSYS finite element analysis software is used to perform modal analysis on the vibrations of the vibrating fork. In addition, to design and produce a superior vibrating fork, the dimensions and welding shape of the vibrating fork are compared in a simulation performed using the Taguchi method.

Keywords: vibrating fork, piezoelectric ceramics, sound wave, ANSYS, Taguchi method, modal analysis

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1209 Swedish Police Officers' Experiences of Meeting with Women Who Were Raped

Authors: Lisa Rudolfsson

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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.

Keywords: focus groups, police, raped women, restoration

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1208 Lessons from Nature: Defensive Designs for the Built Environment

Authors: Rebecca A. Deek

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There is evidence that erratic and extreme weather is becoming a common occurrence, and even predictions that this will become even more frequent and more severe. It also appears that the severity of earthquakes is intensifying. Some observers believe that human conduct has given reasons for such change; others attribute this to environmental and geological cycles. However, as some physicists, environmental scientists, politicians, and others continue to debate the connection between weather events, seismic activities, and climate change, other scientists, engineers, and urban planners are exploring how can our habitat become more responsive and resilient to such phenomena. There are a number of recent instances of nature’s destructive events that provide basis for the development of defensive measures.

Keywords: biomimicry, natural disasters, protection of human lives, resilient infrastructures

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1207 Air Quality Health Index in Windsor, Canada, and the Impact of Regional Scale Transport

Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

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In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

Procedia PDF Downloads 38
1206 DEA-Based Variable Structure Position Control of DC Servo Motor

Authors: Ladan Maijama’a, Jibril D. Jiya, Ejike C. Anene

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This paper presents Differential Evolution Algorithm (DEA) based Variable Structure Position Control (VSPC) of Laboratory DC servomotor (LDCSM). DEA is employed for the optimal tuning of Variable Structure Control (VSC) parameters for position control of a DC servomotor. The VSC combines the techniques of Sliding Mode Control (SMC) that gives the advantages of small overshoot, improved step response characteristics, faster dynamic response and adaptability to plant parameter variations, suppressed influences of disturbances and uncertainties in system behavior. The results of the simulation responses of the VSC parameters adjustment by DEA were performed in Matlab Version 2010a platform and yield better dynamic performance compared with the untuned VSC designed.

Keywords: differential evolution algorithm, laboratory DC servomotor, sliding mode control, variable structure control

Procedia PDF Downloads 392
1205 Evaluation of Batch Splitting in the Context of Load Scattering

Authors: S. Wesebaum, S. Willeke

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Production companies are faced with an increasingly turbulent business environment, which demands very high production volumes- and delivery date flexibility. If a decoupling by storage stages is not possible (e.g. at a contract manufacturing company) or undesirable from a logistical point of view, load scattering effects the production processes. ‘Load’ characterizes timing and quantity incidence of production orders (e.g. in work content hours) to workstations in the production, which results in specific capacity requirements. Insufficient coordination between load (demand capacity) and capacity supply results in heavy load scattering, which can be described by deviations and uncertainties in the input behavior of a capacity unit. In order to respond to fluctuating loads, companies try to implement consistent and realizable input behavior using the capacity supply available. For example, a uniform and high level of equipment capacity utilization keeps production costs down. In contrast, strong load scattering at workstations leads to performance loss or disproportionately fluctuating WIP, whereby the logistics objectives are affected negatively. Options for reducing load scattering are e.g. shifting the start and end dates of orders, batch splitting and outsourcing of operations or shifting to other workstations. This leads to an adjustment of load to capacity supply, and thus to a reduction of load scattering. If the adaptation of load to capacity cannot be satisfied completely, possibly flexible capacity must be used to ensure that the performance of a workstation does not decrease for a given load. Where the use of flexible capacities normally raises costs, an adjustment of load to capacity supply reduces load scattering and, in consequence, costs. In the literature you mostly find qualitative statements for describing load scattering. Quantitative evaluation methods that describe load mathematically are rare. In this article the authors discuss existing approaches for calculating load scattering and their various disadvantages such as lack of opportunity for normalization. These approaches are the basis for the development of our mathematical quantification approach for describing load scattering that compensates the disadvantages of the current quantification approaches. After presenting our mathematical quantification approach, the method of batch splitting will be described. Batch splitting allows the adaptation of load to capacity to reduce load scattering. After describing the method, it will be explicitly analyzed in the context of the logistic curve theory by Nyhuis using the stretch factor α1 in order to evaluate the impact of the method of batch splitting on load scattering and on logistic curves. The conclusion of this article will be to show how the methods and approaches presented can help companies in a turbulent environment to quantify the occurring work load scattering accurately and apply an efficient method for adjusting work load to capacity supply. In this way, the achievements of the logistical objectives are increased without causing additional costs.

Keywords: batch splitting, production logistics, production planning and control, quantification, load scattering

Procedia PDF Downloads 374
1204 The Impact of Non-Interest Banking on Economic Development in Nigeria

Authors: Oduntan Kemi Olalekan

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Nigeria as the largest economy in Africa is still in its developing stage as its economy cannot be termed developed; it is still in search of economic policy that will positively affect the life of majority of her citizenry. Several policies have been employed to take care of the situation prominent among which is Structural Adjustment Programme (SAP) of Babangida Administration but it could not rescue the economy. Non-interest Banking otherwise known as Islamic Banking has been suggested as a means of developing Nigerian economy as it will enable more Nigerian have access to working capital and contribute positively to the growth of her economy. The paper investigated the level of Nigeria economic development and gave an overview of economic policies since independence, traced the genesis of non-interest banking in Nigeria and made recommendations on the adoption of the policy as an antidote to Nigeria economic development.

Keywords: economic development, Nigerian economy, non-interest banking, working capital, Islamic banking.

Procedia PDF Downloads 349
1203 Two Steady States and Two Movement Patterns under the Balanced Budget Rule: An Economy with Divisible Labor

Authors: Fujio Takata

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When governments levy taxes on labor income on the basis of a balanced budget rule, two steady states in an economy exist, of which one can cause two movement patterns, namely, indeterminacy paths and a saddle path. However, in this paper, we assume an economy with divisible labor, in which labor adjustment is made by an intensive margin. We demonstrate that there indeed exist the two paths in the economy and that there exists a critical condition dividing them. This is proved by establishing the relationship between a finite elasticity of labor with regard to real wages and the share of capital in output. Consequently, we deduce the existence of an upper limit in the share of capital in output for indeterminacy to occur. The largest possible value of that share is less than 0.5698.

Keywords: balanced budget rule, divisible labor, labor income taxation, two movement patterns

Procedia PDF Downloads 126
1202 Arterial Line Use for Acute Type 2 Respiratory Failure

Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

Procedia PDF Downloads 397
1201 The 'Saudade' Market and the Development of Tourism in the Azores: An Analysis of Travel Preferences of Azorean Emigrants

Authors: Silvia Rocha, Flavio Tiago, Maria Teresa Tiago, Sandra Faria, Joao Couto

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The Azores have a tourist potential that has been developing, especially after an increase in promotion and the liberalization of airspace. However, there is still a gap with regard to the understanding of tourists from North America. Previous studies referred to the existence of two basic types of touristic flows: Emigrants and locals. Looking to help fill this gap, a study of travelers from North America was conducted. Using cluster analysis, it was determined the existence of three segments: nostalgic, regular and frequent. The recognition of these three segments is important to determine the necessary adjustments in tourist offerings to this market.

Keywords: tourism, diaspora, nostalgia, culture

Procedia PDF Downloads 157
1200 Applying Biculturalism in Studying Tourism Host Community Cultural Integrity and Individual Member Stress

Authors: Shawn P. Daly

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Communities heavily engaged in the tourism industry discover their values intersect, meld, and conflict with those of visitors. Maintaining cultural integrity in the face of powerful external pressures causes stress among society members. This effect represents a less studied aspect of sustainable tourism. The present paper brings a perspective unique to the tourism literature: biculturalism. The grounded theories, coherent hypotheses, and validated constructs and indicators of biculturalism represent a sound base from which to consider sociocultural issues in sustainable tourism. Five models describe the psychological state of individuals operating at cultural crossroads: assimilation (joining the new culture), acculturation (grasping the new culture but remaining of the original culture), alternation (varying behavior to cultural context), multicultural (maintaining distinct cultures), and fusion (blending cultures). These five processes divide into two units of analysis (individual and society), permitting research questions at levels important for considering sociocultural sustainability. Acculturation modelling has morphed into dual processes of acculturation (new culture adaptation) and enculturation (original culture adaptation). This dichotomy divides sustainability research questions into human impacts from assimilation (acquiring new culture, throwing away original), separation (rejecting new culture, keeping original), integration (acquiring new culture, keeping original), and marginalization (rejecting new culture, throwing away original). Biculturalism is often cast in terms of its emotional, behavioral, and cognitive dimensions. Required cultural adjustments and varying levels of cultural competence lead to physical, psychological, and emotional outcomes, including depression, lowered life satisfaction and self-esteem, headaches, and back pain—or enhanced career success, social skills, and life styles. Numerous studies provide empirical scales and research hypotheses for sustainability research into tourism’s causality and effect on local well-being. One key issue in applying biculturalism to sustainability scholarship concerns identification and specification of the alternative new culture contacting local culture. Evidence exists for tourism industry, universal tourist, and location/event-specific tourist culture. The biculturalism paradigm holds promise for researchers examining evolving cultural identity and integrity in response to mass tourism. In particular, confirmed constructs and scales simplify operationalization of tourism sustainability studies in terms of human impact and adjustment.

Keywords: biculturalism, cultural integrity, psychological and sociocultural adjustment, tourist culture

Procedia PDF Downloads 377
1199 Uni … Mihi ('to Me Only'): Patterns of Uniqueness in Statius' Thebaid and Silius' Punica

Authors: Arianna Sacerdoti

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There is a rich and frequent representation of uniqueness in Statius’ poem called Thebaid. This topos interweave with a psychoanalytical study about groups and individual but is also a literary device. This paper will analyze all the passages in the 'Thebaid' referred to uniqueness and exceptionality. Antigone, Adrastus and other characters are, in fact, often characterized as the only ones to behave in a specific way or to do something. Also, the insomniac characters are often the only ones who do not sleep. The material of such a tòpos is very rich throughout the 'Thebaid'. The methodology will be text-oriented. Conclusions will enlighten Statius’ specific use of this tòpos, as related to his models, and will be interdisciplinary. In concluding, this is a study linking philology and psychoanalysis and focused on a topic which deserves a specific analysis.

Keywords: statius, Silius Italicus, uniqueness, epic

Procedia PDF Downloads 153
1198 A Concept of Data Mining with XML Document

Authors: Akshay Agrawal, Anand K. Srivastava

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The increasing amount of XML datasets available to casual users increases the necessity of investigating techniques to extract knowledge from these data. Data mining is widely applied in the database research area in order to extract frequent correlations of values from both structured and semi-structured datasets. The increasing availability of heterogeneous XML sources has raised a number of issues concerning how to represent and manage these semi structured data. In recent years due to the importance of managing these resources and extracting knowledge from them, lots of methods have been proposed in order to represent and cluster them in different ways.

Keywords: XML, similarity measure, clustering, cluster quality, semantic clustering

Procedia PDF Downloads 345
1197 The Non-Motor Symptoms of Filipino Patients with Parkinson’s Disease

Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

Procedia PDF Downloads 417